3) Which of following statement is correct with c) is more common in Asians than in Jews.

regard to gastric bypass for obesity? d) is caused by Mycobacterium paratuberculosis.

a) Anastomotic leak after gastric bypass is often e) tends to occur in families.
heralded by bradycardia
b) Rapid weight loss following successfull gastric 7. A 55 years old man presents with left lower
bypass for obesity is associated with an increased risk quadrant (LLQ) abdominal pain of 2 day
of developing cholelithiazis duraiton,associated with constipation.On physical
c) Vit B12 deficiency is complication of gastric examination, he has tenderness localized to the
bypass due to gastric mucosal atrophy LLQ with fullness in that area leukocyte count is
d) Marjinal ulcer develops in %25 of gastric bypass 22,000 and temperature is 101.5F.Which would be
patient the best diagnostic study to evaluate this man ?
e) Non of these are correct a) Colonoscopy
b) Diagnostic laparoscopy
4) Ten years after diagnosis of total proctocolitis c) Barium enemia
this patient undergoes colonoscopy and biopsy d) Plain abdominal roentgenogram
reveals high-grade dysplasia in 2-10 specimens. e) Computed tomography(CT) of the
What should the physician recommend? abdomenly/pelvis with orally(PO) and intravenous(IV)
A) resection of the involved segment contrast.
B) early repeat colonoscopy and biopsy area again
C) Total proctocolectomy 8. Excision rather than bypass is preferred for
D) increase steroid dosage surgical treatment of small intestinal Chrons
e) repeat colonoscopy in 1 year because:
a) Excision is safer
5) 25-year old woman with known ulcerative colitis b) Bypass does not relave symptoms
presents to the emergency room with a 24 hour c) Excision cures the patient of Chrons disease but
history of abdominal pain, distention, and bypass doesnt
obstipation. Physical examination reveals a d) Fever early complication appear with excision
temperature of 38.6’C, abdominal distention and e) The risk of small intestine cancer is reduced
diffuse abdominal tenderness. Abdominal X-rays
show marked colonic dilatation, most pronounced 9) Complications of diverticulitis include:
in the transverse colon. Laboratory examination a) Carcinoma of colon
reveals a White blood count of 19,000/mm3. Over b) Extrainstestinal manifestation such as arthritis,
the first 24 hours of hospitalization, symptoms are iritis and skin rash
progressive in spite of intravenous fluid c) Fistulization to adjacent organ such as bladder with
resusciation, nasogastric suctioning, and insuring colovesical fistula
intravenous antibiotics. The most appropriate d) Arteriovenous fistula of intestine
management for this patient would include which e) Sclerozing cholangitis
of the following?
a) proctocolectomy with formation of end ileostomy 10-A patient's CT scan shows diverticulitis
b) cecostomy confined to the sigmoid colon. There is no
c) total abdominal colectomy with formation of associated pericolic abscess. What is the best
Hartmann pouch and end ileostomy course of treatment?
d) decompressive colonoscopy a) Bowel rest, nasogastric suction, IV fluids, and
e) continue to the medical treatment broad spectrum antibiotics.
b) Urgent surgical resection
c) Steroids
d)Diverting colostomy
6) Crohn's disease e)Ileostomy
a)is less frequent in temperate climates than in
tropical ones.
b)is improved by smoking.
11-An elderly nursing home patient is brought to E)Total body weight is %50 in woman and %60 in
the hospital with recent onset of colicky abdominal men
pain, distension and obstipation on examination,
15) What is the purpose of performing the Apnea
the abdomen is markedly distended and
test?
tympanitic. There is no marked tenderness. Plain A)to evaluate the effects of increased pco2 on
abdominal x-ray shows a markedly distended loop heart rate
located mainly in the right upper quadrant. The B) to evaluate the effects of PO2 reduction on
likely diagnosis is: blood pressure
a)-Small-bowel obstruction C) to evaluate the effects of PO2 reduction on the
b) Large-bowel obstruction respiratory effort
D) to evaluate the effects of increased pco2 on the
c)Gallstone ileus
respiratory effort
d)Mesenteric vascular occlusion E) to evaluate the effects of increased pco2 on
e)Sigmoid volvulus blood pressure

12. A 28 years old man decides to donate a kidney

to his brother, who is in chronic renal failure, after 16) Which expertise branch is not included in the
HLA typing suggests that he would be a suitable delegation to inform decision on the determination
of brain death in Turkey?
donor. He is admitted to the hospital, and his right a) Neurology
kidney is removed and transplanted into his b)General surgery
brother. Which of the following indices would be c) Neurosurgery
expected to be decreased in the donor after full d) Anestesiology and reamination
recovery from the operation? e) It all takes place
a) Creatinine clearence
17) Which is not typical for a patient with brain
b) Creatinine production
death?
c) Daily excretion of sodium a) No response to painfull warning
d) Plasma creatinine concentration b) Dilated pupils without pupil response to light
e) Renal excretion of creatinine c) Absence of respiratory movements
d) Vestibulocochlear reflex
13. A 25 years old man presents to a e) Having a hypothermia
rheumatologist with complaints of joint pain
involving the large joints of the legs. On
18)Which of the following does not correlate with
questioning, the patient indicates that disease activity from extracellular findings of
exacerbations in the joint pain are frequently ulcerative colitis
accompanied by diarrhea.Which of the following is a)Sclerozan colangitis
the most likely diagnosis? b)Uveitis
a) Amebic colitis c)Ankilozan spondilitis
b) Chronic appendicitis d)Pyoderma gangrenozum
e)Thrombosis
c) Diverticulosis
d) Pseudomembranous colitis 19) In which case is there no indications for
e) Ulcerative colitis surgical treatment of diverticular disease of the
colon?
a) Lower intestinal hemorrhage related to
14)Which of the following is wrong about total diverticular disease for first time in a 70-year-old
body water? woman
A)In humans, about %60 of body weight made up b) 50-year- old male patient with vesico-colic
water fistula due to diverticulitis
B)The difference between individuals are largely c) Recurrence of acute diverticulitis in a 60-year-
due to changes in fat tissue ratio old male patient who had previously been
C)Total body fluid increases with advanced age treated with medical treatment
D)It consists of two parts intracellular and d) 60-year-old woman with diverticulitis-
extracellular fluid associated colo-colonic fistula
 e) A 50-year-old male patient without arterial
blood pressure stabilization despite 4 units of blood
transfusion
24)A 46 year old woman receives a non-
20)Which one of the following is wrong for lymphocyte-depleted ,allogeneic bone marrow
inflammatory bowel disease? transplant from a matched, unrelated donor.
a)In Crohn's disease, all layers of the intestine Immunosuppresive therapy with cyclosporine is
are effected. started.one month later, she has fever. Cytolytic
b)Lesions are seen countinously in the affected destruction of skin, gastrointestinal tract and liver
part of the ulcerative colitis canal. is seen, with associated
c)Mucosal pseudopolips are seen in Crohn's dermatitis ,enteritis ,hepatitis. Which of the
disease. following best explains these finding ?
d)The annual risk of cancer occurence is 2% a)c3b depositon
after a period of 10 years in ulcerative colitis. b)cytomegalovirus infection
e)Barium examination reveals stove pipe image c)graft-versus-host disease
in Crohn's disease. d)tolerance induction
e)type1 (immediate)hypersensitivity
21)Which of the following does not appear in the
course of toxic megacolon? 25)a 26 year old man is brought to emergency
a)Radiologic transverse colon diameter greater department by ambulance 30 min. After being shot
than 6 cm. in leg. He is unconscious and appears markedly
b)Bradycardia pale. His pulse is 120/min , respiratons rate 16/min
c)Body temperature of 38C and blood pressure is 80/60 mmHg. Compared
d)Abdominal distention with healthy adult , which of following finings is
e)Mental changes most likely in this patient?
CVP PVR CO
22) Which one of the following is responsible for vO2
acute cellular rejection? a)decreased Decreased Decreased
a) B lymphocytes Decreased
b) T helper cells b)decreased decreased increased
c) Antigen presenting cells increased
d) Cytotoxic T cells c)decreased Increased Increased
e) Memory cells Decreased
d)decreased Increased Decreased
23) Which variable doesn’t determine transplant Decreased
outcome? e)increased increased Decreased
a) Donor-host antigenic disparity decreased
b) Strength of host anti donor response
c) Immunosuppressive regimen
26.A 55-year-old man is brought to the emergency
d) Gender of the host
department because of shortness of breath and
e) Primary disease of the host
confusion for 4 hours.He has hypertension and
chronic kidney disease requiring
hemodialysis.Physical examination is most likely to
show which of the following findings?
Blood Pressure(mm Hg) Pulse(/min)
Venous Pressure Pulsus Paradoxus
a. 85/60 120
increased increased
b. 85/60 120-
increased normal
c.85/60 120
normal normal 29. Which of the following is not from the
d.120/80 80 symptoms of sepsis?
a)Body temperature higher than 38⁰C,
increased increased
lower than 36⁰C.
e.120/80- 80 b)The heart rate is higher than 90 per
normal increased minute.
c)Respiratory rate is 10-20 per minute.
d)PaCO2 is less than 32 mmHg.
27.A 59-year-old man is brought to the emergency e)The white blood cell count is either
department because of a 4-day history of nausea, greater than 12000/mm³ or less than
vomiting, and diarrhea.He also has been confused 4000/mm³.
and agitated during this period.He has a history of
mild hypertension.His current medication is a 30. Which substrate is consumed first during
diuretic.His temperature is 37, pulse is 108/min, starvation?
respirations are 26/min, and blood pressure is a) Proteins
70/47 mm Hg.Physical examination shows delayed b) Keton bodies
c) Glucose
capillary refill of the lips and nail beds and cool d) Lipids
extremies.His oxyhemoglobin saturation in a e) Depends on cause
central vein is 60%(N=70-75).These findings are
most consistent with which of the following types 31. In order to be able to synthesize protein in the
of shock? body, how many calories per gram of nitrogen
a.Cardiogenic should be taken ?
a) 150 cal
b.Distributive
b) Less than 100 cal
c.Hypovolemic c) 300 cal
d.Obstructive d) 400 cal
e.Septic e) Depends on the illness
28. A 42-year-old man comes to the physician
32) HOW MANY KCAL PER KG İS NEEDED
because of malaise, muscle and joint pain, and
FOR AN ADULT PERSON AT REST?
temperatures to 38.4 ⁰C for 3 days. Three months
a)20
ago, he underwent cadaveric renal transplantation
b)30
resulting in immediate kidney function. At the time
c)50
of discharge, his serum creatinine concentration
d)70
was 0.8 mg/dL. He is receiving cyclosporine and
e)100
corticosteroids. Examination shows no
abnormalities. His leukocyte count is 2700/mm³, 33) WHİCH TEST ARE NOT USED TO ASSESS
and serum creatinine consentration is 1.6 mg/dL; MALNUTRİTİON ?
serum cyclosporine concentration is in the a)TOTAL LYMPHOCYTE COUNT
therapeutic range. A biopsy of the transplanted b)PREALBUMİN
kidney shows intracellular inclusion bodies. c)ALBUMİN
Which of the following is the most appropriate d)CHOLESTEROL
next step in the management? e)DELAYED TYPE HYPERSENSİTİVİTY
TEST
a)Increase the dosage of corticosteroid
b)Increase the dosage of cyclosporine 34-) In which of the following situations does the
c)Begin the amphotericin therapy daily caloric requirement not increase?
d)Begin ganciclovir therapy a. Starvation
e)Begin heparin therapy b. Acute pancreatitis
c. Burns
d. Head trauma
e. None of them
35-) Which is the test that can be done to detect
malnutrition in the earliest phase? 42) Which statement does not defined massive
a. Prealbumine hemorrhage?
b. Albumine a) If the blood transfuse within 24 hr equal the
c. Retinol binding protein total blood volume( >10 u full blood)
d. Transferin b) Within 24 hr more than 20 units of erythrocyte
e. Low density lipoprotein suspension
c) Transfusion up to total blood volume in less
36) Which of the following factor does not affect than 3 hr
total energy consumption? d) Blood loss more than 150mL/min
a) Basal metabolism e) All define it
b) Activity factor
c) Ilness factor 43) Which criteria is not used to defined metabolic
d) Heat factor syndrome?
e) All affect a) Hypertension
b) Waist measurement
37) What is the contraendication of enteral nutrion? c) HDL
a) Severe depression d) VLDL
b) Peritonitis e) Trigliceride
c) Anorexia nervosa
d) Short bowel syndrome 44.Which is not the complication of obesity?
e) Preoperative malnutrion a. Arthritis
b.Sleep apnea
38)At what speed should enteral feeding be c.Cataract
started ? d.Breast cancer
a)20 ml/h e.Gallstone
b)40 ml/h
c)50 ml/h 45.Which surgical procedure causes gallstones
d)60 ml/h mostly?
e)80 ml/h a.Adjustable gastric band
b.Transit bipartition
39)Which one is not among the compensator
c.Sleeve gastrectomy
mechanism in
d.Gastric bypass
a)increasing of dopamin and cortisol secretion
e.Biliopancreatic diversion
b)vasoconstriction in the splancnic organs
c)increasing in cardiac output
d)inhition of the antidiuretic hormone secretion 46)in case of chrons dx,which surgical procedure is
e)increasing peripheral vascular resistance used for surgical tx for morbid obesity?
a)transit bipartition
40. What is the pathognomotic finding in class II b)sleeve gastrectomy
(decompensate) shock? c)gastic bypass
a) Postural hypotension* d)biliopancreatic diversion
b) Mental changes e)surgical precedure is contraindicated for
c) Feeling of thirst morbid obesity in chrons dx
d) Urine output less than 10ml/h
e) GI bleeding
16) Which expertise branch is not included in the
41. Which test is least likely to be used in delegation to inform decision on the determination
monitoring shock? of brain death in Turkey?
a) Core temperature* A. General surgery
b) Lactate level
c) Urine output 17) Which is not typical for a patient with brain
d) Central venous pressure death?
e) Hemoglobin level Having a hypotherm
1. True about strangulation of intestine is: C. Vit D application
(MHPGMCET 2001) D. Intravenous potassium phosphate
a. Arterial blood flow affected first E. Observation
b. Usually venous blood flow affected first
c. Blood flow normal 8. 62-year old female refers to the hospital for
d. No gangrene health check-up. There is nothing specific in
the physical examination of the patient with
2. Most common cause of hyponatremia in stable vital findings. Calcium is 11.2 mg/dL in
surgical practice: the performed blood test. What should be the
a. Small intestinal obstruction (MHPGMCET 2008) next step in the approach?
b. Duodenal fistula (intestinal fistula)
c. Pancreatic fistula A. Checking the PTH level
d. Intussusception B. Repetition of the calcium level
C. Checking the level of PTH related peptide
3. Best investigation for acute intestinal D. Checking the ACE level
obstruction is: E. Lung x-ray
a. Barium studies
b. X -ray 9. Which of the following causes primary
c. USG hyperparathyroidism most frequently?
d. ERCP
A) Parathyroid adenoma (80%)
4. Early sign of intestinal strangulation: (PGI SS B) Parathyroid hyperplasia (15-20%)
June 2001) C) Parathyroid carcinoma (1-5%)
a. Continuous pain D) Ectopic parathormone release (rarly)
b. Abdominal rigidity and shock E) Metastatic bone tumours (2ry
c. Abdominal fluid hyperparathyroidism)
d. Dilated bowel loops on USG
1) What is your diagnosis according to the graphy ?
5. The most common cause of small intestinal a)Perforation
obstruction is: (All India 96, PGI 97) b)Ileus*
a. Intussusception c)Normal abdominal graphy
b. Iatrogenic adhesions d)Pneumothorax
c. Trauma
e)Pneumonia
d. Carcinoma

2) How do you define a patient who has a painful

6. Which finding will not improve after
burn characterized with blisters in the entire right
parathyroidectomy in a 65-year old female patient
with primary hyperparathyroidism? arm according to the rule of nines ?
a)First degree 9%
a. Fatigue b)Second degree 18%
b. Bone cyst c)Third degree 27%
c. Peptic ulcer d)Second degree 9%*
d. Polyuria, polydipsia e)First degree 18%
e. Hypertension-

7. Parathyroidectomy is performed after 3) Which one of the following shows the function of
diagnosis of parathyroid adenoma to a 45-year the liver?
old female patient with kidney stone a)AST
complaints twice in the last 12 months. 2 days b)ALT
postop, the patient describes numbness and c)ALP
twitching around the mouth with cramps in the d)GGT
muscles. What is the next suitable step in the e)PT*
management of this patient? (hypo-
parathyroidism)
A. Intravenous calcium gluconate 4) Which one of the following is not an ethiological
B. Neck exploration factor of hepatoma?
a) hemochromatosis d)Fat necrosis
b) alcholic sirosis e)Intraductal papilloma*
c) gallbladder Stones*
d) alpha1 antitrypsin deficiency 9)A 56-year-old male patient develops an accentric
e) thyrosinemia hard breast lump over the past few months and a
biopsy proves this to be breast carcinoma.Of all
breast cancers,the rate of occurrence in males is
5) Which one is not an expected complication for
which of the following?
femoral vein catheterization?
a) <1%*
a) infection
b) 4%
b) thrombosis
c) 7%
c) air embolism
d) 10%
d) arterial puncture
e) >10%
e) pneumothroax*

10) Which color wristband is used in patient with

history of any allergic disease?
a) White
b) Blue
c) Red*
6) An 18 years old presents with a well-
d) Yellow
circumscribed 2 cm mass in her right breast.The
e) None
mass is painless and has a rubbery consistency and
discrete borders.It appears to move freely through
the breast tissue.There is a liquid component in it 11) Which of the following is the best choice to
with ultrasound .What is the likeliest diagnosis ? replace isotonic (serum) fluid loss?
a) Carcinoma A) D5 1/4 NS with 20 mEq KCl/liter
b) Cyst* B) D5 1/2 NS with 20 mEq KCl/liter
c) Fibroadenoma C) 3% saline solution
d) Cystosarcoma phylloides D) Lactated Ringer's*
e) intramammary lymph node E) Mannitol

7) A patient presents 1 month after a bening right

breast biopsy with a lateral subcutaneous cord felt 12) A 56 year old male patient with severe vomiting
just under the skin and causing pain.The etiology has an obstructing mass in distal stomach, which
of this condition is ? are the followings are TRUE?
a) Fat necrosis* 1- Hipokalemia
b) Infection 2- Alcholosis
c) Superficial thrombophlebitis 3- Loss of HCO3-
d) Suture granulomas 4- Loss of H+
e) Misdiagnosed breast cancer 5-Hipomagnesemia
a) 1-2-3
8) A 36-year-old woman complains of a 3-month b) 1-2-4
history of bloody discharge from the nipple.At the c) 1-2-3-4-5*
examination ,a small nodule is found,deep to the d) 3-4-5
areola. Careful palpation of the nipple- areolar e) 2-4-5
complex results in blood arrearing at the 3 O’clock
position.Mammogram findings are normal.What is 13) Which of the following locations of gastric
the likeliest diagnosis? ulcers to associated with increased acid production?
a)Breast cyst a) Cardia
b)Intraductal carcinoma b) Fundus
c)Carcinoma in situ c) Angularis incisura
 d) Pylorus*
e) Abdominal esophagus

14) Which of the following is one of Ranson’s

criteria determined during the initial assessment of
a patient wiht pancreatitis?
a)Serum calcium 8 mg/ dL 19) Which of the following is the most effective
b)Serum LDH >350 IU/ dL* dosing of antibiotics in a patient undergoing
c)Blood glucose >120 mg/ dL elective colon resection?
d)Serum AST > 150 U/ dL a)A single dose given within 30 min. prior to
e)Serum ALT >150 U / dL skin incision*
15) A 20-year old young man presents with a left b)Asingle dose given at the time of skin incision
anterior 8th intercostal space stab wound.His c)A single preoperative dose +24 hours of
vitals are 62 heart beat/minute, his chest x-ray is postoperative antibiotics
normal.A diagnostic peritoneal lavage is d)A single preoperative dose +48 hours of
performed and has a RBC count of 8.000 /ul and a postoperative antibiotics
WBC count of 300/ul.Which of the following is the e) None
BEST treatment fort his patient?
a)observation only 20) Which of the following is required for platelet
b)CT scan adherence to exposed areas of an injured vessel ?
c)Laparoscopy* a) Prothrombin
d)Exploratory Laparotomy b) von Willebrand factor*
e)Ultrasonography c) Glycoprotein IX
d) Prostoglandin G12
16) Appendectomy is a/an ..........Biopsy e) Aspirin
a)Excisional*
b)Incisional 21) A patient with hemophilia has a factor level or
c)Fine needle 3%.This is considered to be ...
d)Punch a) Mild hemophilia
e)None b) Moderately severe hemophilia*
c) Severe hemophilia
17) The most common cause of small bowel d) Extremly severe hemophilia
obstruction is e) Not severe hemophilia
a)Adhesion*
b)Hernia 22) A 45 years old obese white man comes to his
c)Malignancy physician for a rutin visit , he complain of burning
d)Crohn’s disease chest pain for the past month that occurs with
e)Congenital meals and sometimes awakens him from sleep. He
smokes one pack of cigarette and 2 beers daily .
18) Which of the following is a positive Rovsing His temperature is 36.5 , heart rate is 65 , blood
sign? pressure is 137/78 mmHg and respiratory rate is
a)Pain with percussion of the right lower 9/min . Which of the following would be the most
quadrant appropriate initial treatment is his symptom ?
b)Pain in the right lower quadrant with a)avoiding spicy food
compression of the left lower quadrant* b) histamine-2 receptor blockers
c)Cutaneous hyperesthesia in the T10-T12 c)life style modification including weight
distribution loss ,cessation of smoking, avoiding alcohol*
d)Suprapubic pain on rectal examination d)Nissen fundoplication
e)Epigastric pain and vomiting e)proton-pump inhibitors
23) A patient presents to her primary care 27) A 42-year-old female presents to the emergency
physician with vogue complaint of epigastric pain. department with severe right upper
X-ray of the abdomen is suggestive of a quadrant(RUQ) abdominal pain.She says she has
type1( sliding ) hiatal hernia and this is later had episodes like this before, but has never sought
confirmed on barium swallow. The patient is medical attention, and this episode is more severe
recommended to undergo surgical repair. The goal than usual.She also has nausea and vomiting.On
of surgery is to prevent which complication? physical examination she is febrile to 38,2 celcius ,
a)GERD and subsequent barrett’s esophagus* obese, and has tenderness to palpation in the
b)gastric cancer RUQ.An ultrasound reveals stones in her
c)gastric ulcer gallbladder.Laboratory tests result are: WBC
d)gastric volvulus/incarceration count 13,000/mm3 , total bilirubin 3,8 mg/dL ,
e)motility disorder Aspartate aminotransferase: 130 U/L , Alanine
aminotransferase: 150 U/L, Alkaline
24) Which of the following is the best treatment for phosphatase:300 U/L , Amylase: < 30 U/L. Whic of
chronic anal fissures? the following is most likely responsible for her
a) excision and primary closure symptoms and laboratory values ?
b) lateral internal sphincterotomy* a) A stone obstructing her common hepatic duct*
c) botilinum injection b) A stone obstructing her cystic duct
d) laxatives ,sitting bath c) A stone obstructing her common bile duct
e) fasciocutan flap d) A stone obstructing her hepatoduodenal
ampulla(of Vater)
25) Which of the following is the classification for e) Stone in her gallbladder
anorectal fistula?
a)bismuth 28) Which of the following is NOT part of
b) Park* Reynolds’ pentad?
c)strasberg a)Jaundice
d)goodsall b)Mental status changes
e)allonso-lej-todani c)Fever
d)Hypovolemic shock*
26) A 40-year-old Asian women present to the e)Pain
emergencydepartment complaining of intermittent
epigastric pain.The pain is severe, lasts for a few 29) A 46-year-old African-American mother of
hours, and is sometimes accompanied by nausea three presents to the emergency department
and vomiting.Her bowel movements have been complaining of colicky abdominal pain, vomiting,
normal.Her temperature is 38,3,pulse is 100/min, fevers, and chills. She has noted her stools over the
blood pressure is 150/80 mmHg and respiratort past 2 days to be lighter-colored than usual. She
rate is 22/min.Physical examination reveals has had similar pain before, but it resolved with
moderate obesity and mildly icteric sclerae.Bowel time and was never this bad. Her temperature
sounds are normal, with an abrupt halt of is 39.6⁰C (103.3⁰F), pulse is 115/min, blood
inspiration upon palpation of the RUQ, and pressure is 95/60 mmHg, and respiratory rate is
guarding is noted.Labaratory values reveal a WBC 22/min. On examination she is in obvious distress
count of 13.000/mm3 , total bilirubin of 3,3mg/dL, and sclerae are icteric. Bowel sounds are normal
and normal liver enzzymes and alkaline and the abdomen is tender to palpation in the right
phosphatase levels.Whic of the following is the first upper quadrant without rebound. Laboratory
diagnostic imaging study that should be performed? studies show a WBC count of 15.000/mm³, total
a) Computed Tomography bilirubin of 4.0 mg/dL, and elevated levels of
b) Flat and upright plain x-rays of the abdomen alanine aminotransferase, aspartate aminotransferase,
c) Hepatobiliary iminodiacetic acid scan and alkaline phosphatase. Ultrasound reveals dilated
d) Magnetic Resonance Imaging intrahepatic bile ducts with a few stones in the
e) Ultrasound of the Right Upper Quadrant* gallbladder. Which of the following is the most
likely diagnosis?
 a)Acute cholangitis* b) Type III and VII
b)Acute cholecystitis c) Type II and X
c)Complete small bowel obstruction d) Type VI and XII
d)Hepatitis e) Type IX and XV
e)Pancreatic cancer
36) Which of the following is not an alarm
30) Which of the following is NOT true? symptom that indicate the need for upper
gastrointestinal endoscopy?
a) Charcot's triad - Acute cholangitis
a) Weight loss
b) Alonso Lej Todani Classification - b) Dysphagia
Choledochal cyst c) Anemia
c) Strasberg Classification - Gall bladder injury* d) Obesity*
d) Bismuth Classification - Cholangiocarcinoma e) Recurrent vomiting
(Klatskin tm)
e) Sphincter of Oddi - Boyden Sphincter 37) A 30 year old man presents to his physician for
routine physical. On questioning he comments that
his father was diagnosed with colon cancer at 45
31) Which of the following is a tension free hernia years of age. The patient has never had polyps and
repair? does not suffer diarhhea, constipation, or bloody
a) Mc Vay stools. The patient is nervous about screening and
b) Shouldice wants to delay as long as possible. According to
c) Bassini current recommendations, when should he have
d) Lichtenstein* his first colonoscopy?
a) 30 years old
e) Marcy
b) 35 years old*
c) 40 years old
d) 45 years old
32) Which of the following is one of the border of e) 50 years old
hasselbach’s triangle
a) Superior epigastric artery 38) What is the incidence of diabetic foot ulcer in
b) Edge of the transversalis muscle diabetic patients?
c) Internal inguinal ring a)%10* b)%15 c)%20 d)%25 e)%30
d) Femoral artery
e) İnguinal ligament* 39)The word ethics is derived from Greek word
ethos which means ?
33)Which of the following is known effect of tumor a)Rule of procedure b)Humanity
necrosis facor alfa (TNF alfa )? c)Character*
a) Decrease catabolic response d)Law e)Education
b) Promotes insulin entry into cell
c) Delays activation of the coagulation pathway 40) Surgical ethics standards are below, except one
d) Enhances the expression of eicosanoids * a)Autonomy
e) None of above b)Nonmaleficence*
c)Beneficence
34) The first cells to migrate into a wound are... d)Justice
a) Macrophages e)Good results
b) T lymphocytes
c) Neutrophils (PMNs)* 41) Sir Joseph Lister was a….
d) Fibroblasts a) Pathologist
e) Collagens b)Pharmasist
c)Surgeon*
35) Which types of collagens are most important in d)Internal medicine doctor
wound healing? e)Anatomist
a) Type I and III*
42) Which of the following statement is the right d)Adrenal insufficiency
description for wirchow triad? e)Imbalance of salt and water balance
a) hypercoagulability +venous stasis
+leucocytosis
b) endothelial damage +homan’s sign positivity 46) Which of the following statements is not an
+atrial fibrillarion indication for splenectomy?
a)No response to 6 week steroid tx
c) hypercoagulability+Venous stasis+Endothelial
b)If the dx recurs when the steroid tx is reduced
damage*
c)If there is a response to medical tx but the side
d) venous stasis +immobilization +tachypnea
effects are severe
e) venous stasis +chest pain+dyspnea
d)Intracranial or GIS bleeding (severe)
e)Young age*
43) A 42 year old male presents to your clinic for
annual physical examination .he is in good health 47) Which of the following structures does not lie
and has no complaints at this time.His vitals are in at least in the retroperitoneum?
within normal limits.On physical examination ,you a) adrenal gland
palpate A firm 2 cm nodule just inferior the his b) duodenum*
adam’s apple on the left side.He denies any c) kidney
pain ,as well as any symptoms consistent with d) pancreas
hyper or hypothyroidisim.TSH is ordered and is e) spleen
normal .Which of the following is the best next
step is the management of this patient? 48) The usual presentation of uncomplicated
a)excisional biopsy diverticulosis is:
b)computerized tomography of the neck a) Asymptomatic*
c)thyroid scintigraphy b) Dull aching right iliac fossa pain
d)thyroid and neck ultrasonography * c) Fever and throbbing pain
e) follow up in 6 months d) Bleeding per rectum
e) Vomiting and abdominal distantion
44) A 25-year-old woman presents to your clinic
concerned about a mass she felt over her right 49) The most common side of colon cancer is:
breast.She does not know how long it has been a)Caecum
there.She has no pain and no nipple discharge.Her b)Ascending colon
medical history is only significant for Type 1 c)Transverse colon
Diabetes Mellitus.Her family history is significant d)Descending colon
for breast cancer in her aunt age 43. Physical exam e)Sigmoid and rectum*
is significant for a 3 cm
50) A 28 year old man decides to donate a kidney
mobile,rubbery,smooth,painless mass in the upper
to his brother, who is in chronic renal failure, after
outer quadrant of the right breast.No axillary HLA typing suggests that he would be a suitable
palpabl lymph node is present.Which of the donor. He is admitted to the hospital, and his right
following is the best next step in the management kidney is removed and transplanted into his
of this patient? brother. Which of the following indices would be
a)Breast Ultrasonography* expected to be decreased in the donor after full
recovery from the operation?
b)Mammography
a) Creatinine production
c)Fine needle aspiration biopsy of mass b) Daily excretion of sodium
d)core needle biopsy of the mass c) Plasma creatinine clearence
e)excision of the mass d) Creatinine clearance*
e) Renal excretion of creatinine
45) What is a likely cause of Cushing’s syndrome?
a)Prolonged exposure to aldosterone 1)What is the most common location of colon
cancer?
b)Hyposecretion of cortisol
A)Transverse colon
c)Cortisol secreting adrenal adenoma* B)Rectosigmoid area
C)Ileocecalarea E)Polyester
D)Descending colon
E)Ascending colon 8) Hydatid disease of the liver is caused by which
of the following?
2)If a 65 years old malepatient had painless A) Entamoeba Histolytica
jaundice and a palpable mass in the right B) Echinococcus granulosus
hypochondrium, what is the diagnosis? C) Ascaris lumbricoides
A)Acutpancreatitis D) HİV
B)Kolelithiasis E) Hepatitis
C)Chronic hepatitis
D)Pancreatic head tumor
E)Budd-Chiari syndrome

3)What is the most common complication of

meckel diverticulum in adults?
A)Perforation
B)Obstruction 9) Which is wrong for Meckel’s diverticulum?
C)GIS bleeding A) Prevalance 2%
D)Neoplasm B) 2 times more often in males
E)Diverticulitis C) 2 feets proximal to the ileocecal valve
D) 50% of the asymptomatic patients are below 2
4)Which of the following passes through years of age
hepatoduodenal ligament? E) İt is a false diverticulum
I.Portal Vein
II.Hepatic Artery 10) Which is not a complain in colorectal cancer of
III.Hepatic Vein the left colon?
IV.Choledoch A) Changes in stool habit
V.Cystic Duct B) Apparent blood in stool
A)I-II-III-IV C) Constipation or diarrhea
B)I-II-IV-V D) İncreasing number of defecation
C)III-IV-V E)Anemia
D)I-II-IV
E)I-IV-V 11) Which of the following is the most common
cause of massive lower gastrointestinal bleeding?
5)Which of the following is not “Proliferative A) Ulcerative colitis
without atypia” type of benign breast lesions? B) Diverticular disease
A)Radial Scar C) Colorectal cancer
B)Intraductal Papillomas D) Hemorrhoidal disease
C)Sclerosing Adenosis E) Ischemic colitis
D)Papillary Apocrine Change
E)Fibroadenomas 12) Which of the following is the most reliable
laboratory test for the diagnosis of
6)Which one is wrong? pheochromocytoma?
A)Caustic injurywash with isotonic for 30 minutes A) Plasma aldosterone level
if asidic B) Plasma renin level
B)Caustic injurywash with isotonic for 2 hours if C) Metanephrine level in 24 urine
alcaly D) Plasma metanephrine level
C)Nicolsky sign is positive in Steven-Johnson E) Cortisol level in 24 hours urine
Sendrom
D)HPV-1,2,4 have high potential for malignancy 13)Which one is not an enteral nutrition indication?
E)Eritema, edema, alopecia, hiperpigmentation seen A)Neurological and psychiatric disorders
in radiation injury. B)Esophageal diseases
C)Short bowel syndrome
7)Which of the following is an absorbable suture? D)Head trauma and coma
A)Silk E)Peritonitis
B)Polypropylene
C)Polydioxanon 14)Which one is refractory shock cause?
D)Steel A)Hypoventilation
B)Hypothermia A) I,II
C)Cardiac tamponade B) I,II,III
D)MI C) II
E)All of theabove D) II,III,IV
E) II,IV

15)Which one is priority to maintain homeostasis?

A)Cardiac output 21) Which of the following is not directly affected
B)Blood pressure by the abdominal compartment syndrome?
C)Tissue perfusion A)Renal blood flow
D)Metabolic rate B)Intracranial pressure
E)All of them C)Blood pressure
D)Central venous pressurre
16)What is the optimal calorie ratio per gram of E)Pulmonary functional capacity
nitrogen in parenteral nutrition?
A)0,1 kcal/g nitrogen 22)Which of the following is not expected for
B)1 kcal/g nitrogen abdominal compartment syndrome?
C)10 kcal/g nitrogen A)Septic patients under going massive infusion /
D)150 kcal/g nitrogen transfusion.
E)1000 kcal/g nitrogen B)Patients with intraperitoneal/retroperitoneal
bleeding
17)In a patient's thyroid scintigraphy, increased C)Patients with sudden fluid/ascites accumulation in
isotope intake suggesting a warm nodule is the peritoneal cavity.
detected. D) Long-term mechanical ventilation
Which of the following diseases is most compatible? E)Patients with intestinal edema/distention due to
A)Graves disease intestinal obstruction
B)Hyperfunctional adenom
C)Lateral aberan tiroid 23)What is the most common place of intestinal
D)Papiller tiroid carcinom obstruction due to gallstone?
E)Medullar tiroid carcinom A)Duodenum
B)Jejenum
18) A 51-year-old premenopausal female patient C)Terminal ileum
under went a needle biopsy from her breast due to D)Sigmoid colon
microcalcification. Pathological examination shows E)Transverse colon
microcalcified sclerosing adenosis and diffuse
lobular carcinoma in situ. 24)Which factor is unwanted for the spontanous
What is the most appropriate approach in this closure of enterocutaneous fistules?
patient?
A)No other surgery is required A) fistule tract longer than 2cm
B)Wide local excision B) no epithelisation in the fistule tract
C)Wide local excision and adjuvan therapy
D)Simple mastectomy. C) low flow rate fistule tract
E)Modified radical mastectomy D) distal fistüle

19) What is the common location of duedonal E) radiation

peptic ulcer?
A) Anterior of bulbusduodeni
B) Posterior of bulbusduodeni 25)Which one is wrong for hepatoma ?
C)Anterior of papillaminor of duodenum A)Aphlatoxin is a risk factor for hepatoma which
D) Posterior of papillaminor of duodenum
E) Anterior of ampulla of vater causes p53 mutation.
B) there must always be ongoing cirrhosis for
20) Which of the followings are most frequently
seen locations of internal hemorroids? hepatitis b to cause hepatoma
I. Leftposterior C) Afp is used for both diagnosis and follow-up.
II.Leftlateral
III. Right posterior D) the most common complaint is abdominal pain in
IV. Right anterior hepatoma
E) Usg is the first line imaging method for suspected C) fournier gangrene
hepatoma patients D)hpv infection
E)toxic epidermal necrolysis
26)Which one is not an indication for nasogastric
decompression? 30) Which of the following is the most common
A ) esophageal varice bleeding reason of intestinal obstruction?
B) paralytic ileus A) Invagination
C) nutrition B) Hernia
D)corrosive substance abuse C) Tumor
E) poisoning D) Adhesion
E) Volvulus
27)Which one is the most common reason for
lower gis bleeding under age of 2 ? 31)Which of the following is the most common
A) angiodysplasia reason of mechanical colonic obstruction?
B)meckel diverticulitis A) Hernia
C) peptic ulcer B) Diverticulitis
D)coagulopathies C) Hernia
E)infllammatory bowel diseases D) Volvulus
E) Carcinoma
28)Which one is wrong for the benign diseases of
liver? 32)Which of the following is a contraindication for
A) the most common benign tumor of liver is breast-conserving surgery?
hemangiomas A) Patientswhoareyoungerthan 35
B) women with hepatocellular adenoma diognosis B) Lokalizedmicrocalcifications in
should stop oral contraceptives mammography
C) we should do percutaneous biopsy when we C) First trimester
suspect from hemangiomas D) Tumorbiggerthan 3 cm
D)hepatocellular adenoma can transform into E) Axillapositivi
hepatocellular carcinoma
E)hemangiomas are generally asymmptomatic
33)60 years old female patient comes to the
29) 43 years old woman came to clinic with fever hospital complaining of a mass she recognized in
(38.7 C°) . She has painful,deep erythematous and her left breast. It is determined that the mass is
odorous lesions on her genital region. She didnt rigid and immobile during the physical
take any medicine recently. examination. The lymphnodes are not palpable.
What is the most likely diagnosis ? What should be the first approach?
A) hidroadenitis suppurativa A) Corebiopsy
B) pyoderma gangrenosum B) Excisionalbiopsy
C) FineNeedleAspirationBiopsy
D) Bone Scintigraphy E)Eritema, edema, alopecia, hiperpigmentation seen
in radiation injury.
E) Mammography
7)Which of the following is an absorbable suture?
A)Silk
1)What is the most common location of colon cancer? B)Polypropylene
A)Transverse colon C)Polydioxanone
B)Rectosigmoid area D)Steel
C)Ileocecal area E)Polyester
D)Descending colon
E)Ascending colon

2)If a 65 years old male patient had painless 8) Hydatid disease of the liver is caused by which
jaundice and a palpable mass in the right of the following?
hypochondrium, what is the diagnosis? A) Entamoeba Histolytica
A)Acut pancreatitis B) Echinococcus granulosus
B)Kolelithiasis C) Ascaris lumbricoides
C)Chronic hepatitis D) HİV
D)Pancreatic head tumor E) Hepatitis
E)Budd-Chiari syndrome
9) Which is wrong for Meckel’s diverticulum?
3)What is the most common complication of A) Prevalance 2%
meckel diverticulum in adults? B) 2 times more often in males
A)Perforation C) 2 feets proximal to the ileocecal valve
B)Obstruction D) 50% of the asymptomatic patients are below 2
C)GIS bleeding years of age
D)Neoplasm
E) İt is a false diverticulum
E)Diverticulitis
10) Which is not a complain in colorectal cancer of
4)Which of the following passes through the left colon?
hepatoduodenal ligament? A) Changes ın stool habit
I.Portal Vein B) Apparent blood in stool
II.Hepatic Artery C) Constipation or diarrhea
III.Hepatic Vein D) İncreasing number of defecation
IV.Choledoch
E) Anemia
V.Cystic Duct
11) Which of the following is the most common
A)I-II-III-IV
cause of massive lower gastrointestinal bleeding?
B)I-II-IV-V A) Ulcerative colitis
C)III-IV-V
B) Diverticular disease
D)I-II-IV C) Colorectal cancer
E)I-IV-V D) Hemorrhoidal disease
E) Ischemic colitis
5)Which of the following is not “Proliferative
without atypia” type of benign breast lesions? 12) Which of the following is the most reliable
A)Radial Scar
laboratory test for the diagnosis of
B)Intraductal Papillomas
pheochromocytoma?
C)Sclerosing Adenosis A) Plasma aldosterone level
D)Papillary Apocrine Change B) Plasma renin level
E)Fibroadenomas C) Metanephrine level in 24 urine
D) Plasma metanephrine level
6)Which one is wrong? E) Cortisol level in 24 hours urine
A)Caustic injury  wash with isotonic for 30 minutes
if asidic 13)Which one is not an enteral nutrition indication?
B)Caustic injury  wash with isotonic for 2 hours if A)Neurological and psychiatric disorders
alcaly B)Esophageal diseases
C)Nicolsky sign is positive in Steven-Johnson C)Short bowel syndrome
Sendrom D)Head trauma and coma
D)HPV-1,2,4 have high potential for malignancy E)Peritonitis
 IV. Right anterior
14)Which one is refractory shock cause? F) I,II
A)Hypoventilation G) I,II,III
B)Hypothermia H) II
C)Cardiac tamponade
İ) II,III,IV
D)MI
E)All of the above J) II,IV

15)Which one is priority to maintain homeostasis?

A)Cardiac output  Question 1
2 out of 2 points
B)Blood pressure
C)Tissue perfusion What is a likely cause of Cushing's syndrome?
D)Metabolic rate Answers: a) Prolonged exposure to
E)All of them aldosterone

16) What is the optimal calorie ratio per gram of b) Hyposecretion of cortisol
nitrogen in parenteral nutrition?
A)0,1 kcal/g nitrogen c) Cortisol secreting
B)1 kcal/g nitrogen adrenal adenoma
C)10 kcal/g nitrogen
D)150 kcal/g nitrogen d) Adrenal insufficiency
E)1000 kcal/g nitrogen e) Imbalance of salt and
water balance
17) In a patient's thyroid scintigraphy, increased
isotope intake suggesting a warm nodule is  Question 2
2 out of 2 points
detected.
Which of the following diseases is most compatible? A 49 year old man is found to have a solitary
A)Graves disease neck nodule on physical examination.
B)Hyperfunctional adenom Laboratory studies reveal an elevated
C)Lateral aberan tiroid calcitonin level and fine needle aspiration
D)Papiller tiroid carcinom confirms a diagnosis of medullary carcinoma
E)Medullar tiroid carcinom of the thyroid. Which of the following disease
processes might the physician be concerned
18) A 51-year-old premenopausal female patient to look for in this patient?
underwent a needle biopsy from her breast due to Answers:
microcalcification. Pathological examination shows a) Hyperparathyroidism
microcalcified sclerosing adenosis and diffuse
lobular carcinoma in situ.What is the most b) Papillary thyroid carcinoma
appropriate approach in this patient? c) Pituitary adenoma
A)No other surgery is required
B)Wide local excision d) Subacute thyroiditis
C)Wide local excision and adjuvan therapy e) Zollinger-Ellison syndrome
D)Simple mastectomy.
E) Modified radical mastectomy  Question 3
2 out of 2 points

19) what is the common location of duedonal You were called to the emergency department
peptic ulcer? to review a thirty year old male patient who
A) Anterior of bulbus duodeni was in a major car accident. His vital signs
B) Posterior of bulbus duodeni revealed heart rate of 140 beet/min and blood
C) Anterior of papilla minor of duodenum pressure of 60/40 mm-Hg. Physical
D) Posterior of papilla minor of duodenum examination and imaging revealed splenic
E) Anterior of ampulla of vater trauma. There was no other major injury
identified. The diagnosis of this patient is:
20) Which of the followings are most frequently Answers: a) Septic shock
seen locations of internal hemorroids?
I. Left posterior
II.Left lateral b) Hypovolemic shock
III. Right posterior c) Neurogenic shock
 d) Cardiogenic shock d) Close follow-up
e) Spinal shock e) Chemotherapy +
Question 4 Hormonotherapy
2 out of 2 points  Question 8
Hypomagnesemia clinically resembles which of the 0 out of 2 points
following ? A 76-year-old man is scheduled to undergo
repair of an abdominal hernia that is easily
Answers: reduced by pushing the abdominal contents
a) Hyperparathyroidism back through the external ring. During repair,
b) Papillary thyroid carcinoma the surgeon sees that the hernial sac
protrudes from the abdominal wall superior to
c) Pituitary adenoma the inguinal ligament and medial to the inferior
d) Subacute thyroiditis epigastric vessels. Which of the following
types of hernia does this patient have?
e) Zollinger-Ellison syndrome
Answers: a) Diaphragmatic hernia
Question 5
2 out of 2 points
b) Direct inguinal hernia
Which types of collagens are most important
in wound healing? c) Femoral hernia
Answers: d) Hiatal hernia
a) Type I and III
b) Type III and VIII e) Indirect inguinal hernia
Question 9
c) Type II and X 2 out of 2 points
d) Type VI and XII A 40-year-old woman presents to the
e) Type IX and XV emergency department complaining of
intermittent epigastric pain. The pain is severe,
Question 6 lasts for a few hours, and is sometimes
2 out of 2 points
accompanied by nausea and vomiting. Her
Which of the following is the MOST common bowel movements have been normal. Her
cause of painful rectal bleeding? temperature is 38.3°C , pulse is 100/min,
Answers: a) Internal hemorrhoids blood pressure is 150/80 mm Hg, and
respiratory rate is 22/min. Physical
b) External hemorrhoids examination reveals moderate obesity and
mildly icteric sclerae. Bowel sounds are
c) Diverticulitis
normal, with an abrupt halt of inspiration upon
palpation of the RUQ, and guarding is noted.
d) Anal fissure Laboratory values reveal a WBC count of
13,000/mm³, total bilirubin of 3.3 mg/dL, and
e) Rectal foreign body
normal liver enzymes and alkaline
Question 7 phosphatase levels. Which of the following is
0 out of 2 points the first diagnostic imaging study that should
The indispensable (sine qua non) component be performed?
following breast conserving surgery for Answers: a) Computed Tomography
invasive ductal carcinoma includes which of
the following components? b) Flat and upright plain x-
rays of the abdomen
c) Hepatobiliary
Answers: a) Mirror-image biopsy iminodiacetic acid scan
of the opposite breast d) Magnetic Rezonans
b) Mastectomy and Imaging
regional node dissection
e) Ultrasound of the Right
c) Radiotherapy Upper Quadrant
Question 10
0 out of 2 points
e) Breast infection
All of the following statements are true
 Question 14
regarding Achalasia, EXCEPT: 2 out of 2 points
Answers:
Which color wristband is used in patient with
a) Progressive dysphagia history of any allergic disease?
b) Bird’s beac deformity Answers: a) White
c) A dilated esophagus with air-fluid b) Blue
level
d) Paradoxical dysphagia c) Red
e) Regurgitation d) Yellow
Question 11 e) None
2 out of 2 points
 Question 15
A 36-year-old woman complains of a 3-month 2 out of 2 points
history of bloody discharge from the nipple. At
examination, a small nodule is found, deep to The most common cause of hypothyroidism in
the areola. Careful palpation of the nipple- adults is:
areolar complex results in blood appearing at Answers: a) Graves' disease
the 3 o’clock position. Mammogram findings
are normal. What is the likeliest diagnosis? b) Riedel's thyroiditis
Answers: a) Breast cyst
c) Hashimoto's disease
b) Ductal carcinoma in situ
d) de Quervain's thyroiditis
c) Fibroadenoma
e) Multinodular goiter

d) Intradutal papilloma  Question 16

2 out of 2 points
e) Fat necrosis The peak number of macrophages in a healing
Question 12 wound occurs
0 out of 2 points Answers:
Patients undergoing elective splenectomy a) 2 or 3 days after injury
should receive vaccinations against
Streptococcus pneumoniae, H. influenzae type b) The first day after injury
B, and meningococcus c) 7 or 8 days after injury
Answers:
d) 15 or 20 days after
a) 2-4 weeks before injury
surgery
e) 50 or 60 days after
b) The day of surgery injury
c) 1 week after surgery  Question 17
2 out of 2 points
d) 1 month after surgery
 Question 18
e) 1 day after surgery 2 out of 2 points

Question 13 What is the term for blue discoloration around

0 out of 2 points the umbilicus?
. Wich of the following statements is NOT a Answers:
sign of breast cancer? a) Cullen's sign
Answers: a) Breast pain b) Murphy's sign
b) Nipple discharge c) Rovsing's sign
c) Breast lump d) Turner sign
d) Axillary lump
 e) Trousseau sign
d) Hypovolemic shock
Question 19
2 out of 2 points e) Pain
The origin of the superior thyroid artery is  Question 24
Answers: a) Internal carotid artery 2 out of 2 points
How do you define a patient who has a painful
burn characterized with blisters in the entire
b) External carotid artery
right arm according to the rule of nines?
c) Thyrocervical trunk Answers: a) First degree, 9%
d) Innominate artery
b) Second degree, 18%
e) Subclavian artery
c) Third degree, 27%

Question 21
0 out of 2 points d) Second degree, 9%
Which is the most common malignancy seen in e) First degree, 18%
spleen?  Question 25
2 out of 2 points
Answers: a) Angiosarcoma
A 40-year-old man presents to the emergency
b) Haemangioendothelioma room complaining of severe abdominal pain
that radiates to his back accompanied by
c) Malignant fibrous several episodes of vomiting. He drinks
histiocytoma alcohol daily. On physical examination, the
patient is found on the stretcher lying in the
d) Lymphoma fetal position. He is febrile and appears ill. The
skin of his abdomen has an area of bluish
e) Metastatic tumors periumbilical discoloration. There is no flank
Question 22 discoloration. Abdominal examination reveals
2 out of 2 points decreased bowel sounds. The patient has
Which of the following statement is the right severe midepigastric tenderness on palpation
description for Virchow triad? and complains of exquisite pain when your
hands are abruptly withdrawn from his
Answers: a) Hypercoagulability + abdomen. Rectal examination is normal.
Venous stasis + Leucocytosis Which of the following is the most likely
b) Endothelial damage + diagnosis?
Homan’s sign positivity + Atrial Answers: a) Acute cholecystitis
fibrilation
b) Pyelonephritis
c) Hypercoagulability +
Venous stasis + Endothelial damage c) Acute necrotizing pancreatitis
d) Venous stasis + d) Acute gastroenteritis
Immobilization + Tachypnea e) Appendicitis
e) Venous stasis + Chest  Question 26
pain + Dyspnea 0 out of 2 points
Question 23 A 35-year-old premenopausal woman whose
2 out of 2 points mother had breast cancer comes into your
Which of the following is NOT part of office and has been told that she has
Reynolds’ pentad? fibrocystic breasts. On examination she has
multiple areas of thickening but no discrete
Answers: a) Jaundice mass. Of the following diagnostic tests, which
b) Mental status changes should be performed?
Answers: a) Computed tomography of the
c) Fever
chest
 c) The RET proto-oncogene
b) Bilateral breast ultrasound
d) The p53 tumor suppressor gene
c) Re-examination in 6 months
e) The APC gene
d) Mammography
 Question 30
e) Bilateral breast magnetic 2 out of 2 points
resonance imaging The most precise diagnostic screening
Question 27 procedure for differentiating benign thyroid
2 out of 2 points nodules from malignant ones is:
A 60-year-old man with a previous history of Answers:
appendectomy 30 years ago presents to the a) Fine-needle-aspiration biopsy
emergency room complaining of abdominal
b) Thyroid ultrasonography
pain. He describes the pain as colicky and
crampy and feels it builds up, then improves c) Thyroid scintigraphy
on its own. He has vomited at least 10 times
since the pain started this morning. He states d) Thyroid hormone levels
that he has not had a bowel movement for 2 e) Positron emission tomography
days and cannot recall the last time he passed
 Question 31
flatus. The abdomen is slightly distended. 2 out of 2 points
Abdominal auscultation reveals high-pitched
bowel sounds and peristaltic rushes. Which of the following is a correct match
Percussion reveals a tympanic abdomen. The between a tumor marker and a cancer with
patient is diffusely tender with palpation but which it is usually associated?
has no rebound tenderness. Rectal Answers: a) CA 125 and thyroid cancer
examination reveals the absence of stool.
Which of the following is the most likely b) CEA and melanoma
diagnosis? c) AFP and brain tumors
Answers: a) Cholecystitis
b) Diverticulitis d) CA 19-9 and pancreatic cancer

c) Pancreatitis e) CA 125 and lung cancer

 Question 32
d) Gastroenteritis 0 out of 2 points
e) Intestinal obstruction 60 years old patient with 2 weeks history of
Question 28 jaundice, dark urine and pruritus on
2 out of 2 points examination icteric, febrile and tenderness in
the right upper quadrant of the abdomen.
Which one of the following is not a critaria for
Complete blood count shows leukocytosis.
Child-Pugh classification?
The most likely diagnosis is:
Answers: a) Ascites Answers: a) Acute cholecystitis

b) Blood amonium level b) Acute hepatitis

c) Serum bilirubin level c) Cancer on head of pancreas

d) Serum albumin level

d) Acute cholangitis
e) Encepholopathy
e) Perforated peptic ulcer
Question 29
2 out of 2 points  Question 33
2 out of 2 points
MEN 2A and MEN 2B syndromes are
The right adrenal vein drains into the
associated with germline mutations in:
Answers: a) Right renal vein
Answers: a) The N-myc gene
b) Left renal vein
b) The H-ras gene
c) Right gonadal veins
 b) Invasive lobular carcinoma
d) Vena cava inferior
e) Vena porta c) Invasive ductal carcinoma
Question 34 d) Paget's disease
2 out of 2 points
A 35-year-old man has known ulcerative e) Mucinous carcinoma of the
colitis. Which of the following is an indication breast
for total proctocolectomy?  Question 38
2 out of 2 points
Answers: a) Sclerosing cholangitis
Which of the following statements is false
b) Iron deficiency anemia concerning primary hyperaldosteronism:
Answers:
c) Toxic megacolon a) Plasma aldosterone
concentration–plasma renin activity
d) Occasional bouts of
ratio should be greater than 20:1.
colic and diarrhea
b) May be diagnosed in
e) Arthritis
hypertensive patients by
Question 35 demonstration of an adrenal mass
2 out of 2 points on computed tomography alone.
When progressive enlargement of a
c) Is best treated surgically if it is
multinodular goiter causes symptomatic
due to aldosteronoma
tracheal compression, the preferred
management in otherwise good-risk patients d) Plasma Aldosterone level is >22
is: ng/dL, plasma K level < 3.6 mEq/L,
Answers: plasma renin level is low
a) Iodine treatment
e) Produces a syndrome of
b) Surgical resection of the thyroid diastolic hypertension, hypokalemia,
and edema.
c) Radioactive iodine treatment
 Question 39
d) Thyroid hormone treatment 2 out of 2 points
Secreted parathormone has a half-life of
e) Follow-up
Answers:
Question 36
0 out of 2 points a) 2-4 minutes
Which of the following is the selected method b) 45-60 minutes
for the prevention of venous thromboembolism
c) 3 hours
in a 63-year-old male undergoing a colectomy
for colon cancer? d) 8 hours
Answers: a) Early ambulation e) 24 hours
b) Elastic stockings 
 Question 40
c) Intermittent pneumatic 2 out of 2 points
compression
Which one of the following is the main aim of
d) Low-molecular weight heparin escharatomy in severe burn patients?
Answers:
e) Elastic stockings + low- a) To decrease the pressure in the
molecular weight heparin vessels caused by the scar tissue
Question 37 b) To remove the dead tissue from
2 out of 2 points skin
What is the most common type of breast
c) To remove the tissue until
cancer?
reaching the fat layer
Answers: a) Ductal carcinoma in situ
 d) To reduce the pain caused by the
burn d) Lichtenstein
e) To see the depth of the burn e) Marcy
Question 41  Question 45
2 out of 2 points 2 out of 2 points
The first cells to migrate into a wound are Which one is not an expected complication for
Answers:
femoral vein catheterization?
a) Macrophages
Answers: a) Infection
b) T lymphocytes
b) Thrombosis
c) Neutrophils (PMNs) c) Air embolism
d) Fibroblasts d) Arterial puncture
e) Collagens
e)Pneumothorax
Question 42
2 out of 2 points  Question 46
2 out of 2 points
Which one of the following is an unexpected
complication of hydatic cyst disease? A 35-year-old Caucasian woman who was
Answers:
breastfeeding her eight-month-old twins
a) Anaphylactic reaction by presented to our facility with a three-day
the rupture of the cyst history of severe bilateral breast pain. Physical
b) Intrabiliary rupture examination revealed an exquisitely tender
bilateral breast that was erythematous.
c) Secondary bacterial Multiple lumps are palpated in both breasts.
infection Mammogram revealed dense bilateral breast
d) Jaundice tissue. Which of the following is the most likely
diagnosis in this patient?
e) Malignancy Selected Answer:
b) Mastitis
Question 43
2 out of 2 points Answers: a) Fibroadenoma
Which of the following is required for platelet
adherence to exposed areas of an injured b) Mastitis
vessel?
c) Paget’s disease
Answers: a) Prothrombin
d) Fibrocystic disease
b) von Willebrand factor e) Mammary duct ectasia
c) Glycoprotein IX  Question 47
2 out of 2 points
d) Prostaglandin GI2 The most common cause of small bowel
e) Aspirin obstruction is
Selected Answer:
a) Adhesions
Answers:
Question 44 a) Adhesions
2 out of 2 points
Which of the following is a tension free hernia b) Hernia
repair? c) Malignancy
Answers: a) Mc Vay d) Crohn’s disease
b) Shouldice e) Congenital
c) Bassini  Question 48
2 out of 2 points
Which of the following İS NOT an alarm Which of the following is false regarding the vascular
symptom that indicate the need for upper structure of the adrenal glands?
gastrointestinal endoscopy?
Selected
Answer: • Question 29
b) Obesity
2 out of 2 points
Answers: a) Weight loss
Which of the following statements about umbilical
b) Obesity hernia is false?

c) Anemia
d) Dysphagia • Question 30
2 out of 2 points
e) Recurrent
vomiting A 65-year-old female patient who applied with
complaints of pain in the left lower quadrant of the
abdomen, fever and leukocytosis is admitted to the
hospital. There is no improvement in the patient's
condition after 48 hours, for whom antibiotics are
started. Which of the following is the most
appropriate diagnostic procedure in this patient?
Question 49
2 out of 2 points
Which of the following is one of Ranson’s
criteria determined during the initial • Question 36
assessment of a patient with pancreatitis? 2 out of 2 points
Answers: a) Serum calcium 8 mg/dL Which of the following statements regarding the
development of an incisional hernia in the anterior
b) Serum LDH >350 IU/dL abdominal wall is false?
c) Blood glucose >120 mg/dL
d) Serum AST >150 U/dL • Question 42
2 out of 2 points
e) Serum ALT>150 U/dL
Question 50 Which test can best distinguish between benign and
2 out of 2 points malignant thyroid nodules?
Which of the following is the best choice to
replace isotonic (serum) fluid loss?
Answers: • Question 43
a) D5 ¼ NS with 20 mEq KCl/liter
2 out of 2 points
b) D5 ½ NS with 20 mEq KCl/liter
Which of the following is not seen in MEN-2A
c) 3% saline solution
syndrome?

d) Lactated Ringer’s
• Question 46
e) Mannitol
2 out of 2 points

At least how much bleeding must be in the GIS for

• Question 5 melena to occur?
2 out of 2 points

Which breast cancer is multicentric and bilateral? • Question 49

2 out of 2 points
• Question 9
2 out of 2 points Which of the following lesions is most likely to have
an underlying systemic disease
• Question 50 • Metastatic cancer formation from adenocarcinoma
2 out of 2 points → p53 mutation
5) Which of the following is Stage 3 colon cancer?
Which of the following gastric ulcer localizations is A. T1N0M0
associated with increased acid production? B. T2NOM0
C. TxN1aM0
1) Which of the following is not seen in MEN2A D. T4N1M1a
Syndrome? E. T1NxM1b
A. Multifocal, bilateral medullary thyroid carcinoma Explanation:
B. Pheochromocytoma • T1N0M0 - T2N0M0 Stage 1
C. Primary hyperparathyroidism • T3N0M0 - T4N0M0 Stage 2
D. Pituitary tumor
• TxNxM0 Stage 3
E. Germ line mutation in the RET protooncogene
Explanation: • TxNxM1 Stage 4
MEN1: Hyperparathyroidism, pancreatic islet tumor, 6) Abdominal USG and CT taken in a 45-year-old
pituitary tumor male patient
MEN2A: Medullary thyroid cancer, a mass in the liver with high suspicion for malignancy
pheochromocytoma, parathyroid hyperplasia is detected. AFP levels are normal and there is no
MEN2B: Medullary thyroid cancer, history of chronic disease. A
pheochromocytoma, mucosal neuroma, What should be done in the next step?
marphonoid body structure A. Biopsy
2) How many mmHg should the intra-abdominal B. Surgical excision
pressure be in laparoscopic surgery? C. Colonoscopy and gastroscopy for metastasis
A. <7 mmHg screening
B. 12-14 mmHg D. PET-CT
C. 20-22 mmHg E.ERCP
D. 24-27 mmHg Description: Mass compatible with HCC and
E. 30-35 mmHg AFP>500 ng/dL on CT or MR
3) After the colon in the GIS of a patient with familial diagnostic;
adenomatous polyposis If there is a lesion compatible with HCC but non-
Which localization is the most common adenoma? diagnostic AFP, percutaneous
A. Duodenum needle biopsy is done.
B. jejunum ✤ 95% HCC if AFP>400 ng/dL
C. stomach one
D. ileum 7) The most common cause of hypothyroidism?
E. Esophagus A. Graves' disease
4) Which of the following gene mutations is a B. Hashimoto's disease
multistep process? C. De Quervain's thyroiditis
early development of colorectal carcinoma from D. Riedel's thyroiditis
colorectal adenoma E. Plummer's disease
seen in stages? Description: Hashimoto's thyroiditis:
A. P53 tumor suppressor gene mutation Autoimmune lymphocytic thyroid. Antibodies are
B. APC gene mutation formed against thyroid antigens.
C. SMAD4 gene mutation 10 times more common in women
D. K-ras oncogene mutation Plummer's disease; toxic adenoma. There is a nodule
E. DCC gene mutation that causes hyperthyroidism.
Explanation: De Quervain's thyroiditis; subacute painful thyroiditis.
• Small adenomatous polyp formation from 8) Which of the following is true?
A. The hepatic artery is responsible for all hepatic
hyperproliferation → 5q
oxygenation
APC mutation
B. Normal portal vein pressure is between 15-20
• Precancerous polyp formation from large mmHg
adenomatous polyp → K-RAS C. Liver adenomas can enlarge with the effect of
oncogene mutation hormones and
• Adenocancer formation from precancerous polyp → If detected, OCD use should be discontinued.
18q DCC (Chic didn't look quite right, but it has to be like this,
deletiong others are wrong)
D. According to the segmented anatomy of the liver,
the right and left lobes are falciform
ligament separates E. Invasive ductal carcinoma
E. The main host in hydatid cyst is human 13) A 26-year-old patient who applied to the
Explanation: outpatient clinic with the complaint of a mass in his
• Liver 25-35% from the hepatic artery, 65-75% from right breast.
the portal vein On physical examination of the patient, approximately
fed. 2 in the upper outer quadrant of the right breast.
• Portal vein pressure normally above 5-7 mmHg → A mobile, smooth-sided, painless, firm mass of cm in
portal size was palpated.
hypertension. Esophageal varices are seen above 12 A palpable mass on examination of the left breast and
mmHg. both axillae
• The middle hepatic artery separates the right and not detected. What is your probable diagnosis in this
left lobes in the liver. patient?
A. Fibrocyst
• Dogs are the main hosts in hydatid cysts.
B. Fibroadenoma
9) Which is not one of the criteria in Child-Pugh
C. Lipoma
classification?
2nd
A. Bilirubin
D. Paget's disease
B. Albumin
E. Invasive lobular carcinoma
C. Prothrombin
Description: The most common breast tumor in
D. ALT
adolescent and young women.
E. Encephalopathy
Most common benign tumor of the breast
Description: Criteria in Child-Pugh classification;
A clearer diagnosis can be made with USG.
Acid, Bilirubin, Albumin, Prothrombin,
characteristic of mammography
Encephalopathy
no image.
10) Which of the following is one of the 4 main
If it is less than 3 cm after diagnosis, follow-up
causes of intestinal obstruction?
not a symptom?
14) With complaints of pain in the left lower quadrant
A. Abdominal pain
of the abdomen, leukocytosis, fever 65
B.fever
year-old female patient is admitted to the hospital.
C. Inability to pass gas-stool
antibiotics were started
D. Abdominal distention
The patient's condition does not improve within 48
E. Vomiting
hours. Best suited for this patient
Description: 4 cardinal manifestations of intestinal
Which of the following is a diagnostic procedure?
obstruction; stomach ache,
A. Standing and lying abdominal X-ray
nausea and vomiting, abdominal distention,
B. Sigmoidoscopy
obstipation
C. Colonoscopy
11) For two weeks, ongoing jaundice, dark urine
D. BT
A 60-year-old patient with swelling and itching was
E. Barium column chart
admitted to the general surgery outpatient clinic.
Description: Abdominal left lower quadrant pain,
is applying. On physical examination, icterus, fever,
fever, leukocytosis, anorexia, diarrhea..
and abdomen are in the right upper quadrant.
diverticulitis symptoms. Especially over the age of 50,
A tender mass is detected on palpation. Leukocytosis
almost the population
in complete blood count
It is seen in 50% of the cases. Medical treatment is
available. Most likely diagnosis?
started. Response within 48-72 hours
A. Acute cholecystitis
surgery is not planned. Diverticulum is best visualized
B. Acute hepatitis
with CT.
C. Tumor of the head of the pancreas
15) Which of the following does not pose a significant
D. Acute cholangitis
risk of liver cancer?
E. Acute pancreatitis
A. Hepatitis B infection
Explanation: Choledochal cyst caused acute
B. Chronic alcohol use
cholangitis because it was overlooked.
C. Liver hemangioma
He is the cause of the palpable mass.
D. Aflatoxin
12) Breast cancer with multisenteric and bilateral
E. Tyrosinemia
involvement
16) What is the most common cause of upper GI
which one?
bleeding?
A. Tubular adenoma
A. Stomach cancer
B. Comedo carcinoma
B. Esophageal cancer
C. Invasive lobular carcinoma
C. Esophageal varices
D. Fibroadenoma
D. Stomach ulcer • Thrombosis is most commonly seen in femoral vein
E. Duodenal ulcer catheterization. internal
Explanation: Peptic ulcer accounts for half of all GI in 1% of the jugular vein.
bleeding. • Special training is required for CVC placement.
Bleeding due to duodenal ulcer is 4 times more than • CVC Indications;
due to gastric ulcer. Upload my role
is seen more. emergency venous route
Reason; Routine blood sampling (in major burns and drug
• Close neighborhood of the duodenum to the addicts)
gastroduodenal artery, hemodialysis
• Peptic ulcers are more common in the duodenum pulmonary artery catheter
than in the stomach. 20) Which of the following preperitoneal hernia repair
17) Which of the following is not an indication for Isn't that one of the methods?
thyroidectomy? A. Kugel
A. Press findings B. Lichtenstein
B. Diagnosis of malignancy C. TEP
C. Suspicion of malignancy D. Read-Rives
D. Nodule size over 2 cm E. TAPP
E. Toxic changes Description: TEP: Total extraperitoneal approach
Description: Detection of nodules in the thyroid gland TAPP: Transabdominal peritoneal approach
is a surgical indication 21) Which of the following is false?
does not mean! A. Visceral peritoneum surrounds the intra-abdominal
18) It manifests itself with erythema and eczematous walls
lesion on the nipple and areola. B. Parietal peritoneum surrounds the abdominal wall
Which of the following is breast disease? C. Omentum consists of 4 layers of peritoneum
A. Radial scar D. The omentum is supplied by the superior
B. Paget's disease mesenteric artery
C. Angiosarcoma E. In the gastroduodenal ligament, the common bile
D. Phyloid tumor duct, hepatic artery and
E. Ductal carcinoma in situ portal vein is located
Description: Chronic eczema or psoriatic dermatitis Description: Common hepatic artery, portal vein,
on the nipple hepatoduodenal ligament
It has a view. Usually centrally located DCIS or is located in.
invasive ductal 22) What is the most common cause of small bowel
is associated with carcinoma. obstruction (mechanical)?
Modified radical mastectomy is performed if invasive A. Adhesions / adhesions
carcinoma is present. B. Hernia
19) Which of the following is related to central C. Malignant
venous catheterization? D. Crohn's disease
is it true? E. Congenital
A. Pneumothorax after femoral vein catheterization is 23) A 9-year-old male patient, weighing 21 kilograms,
an expected fell from a height.
is a complication are being interneted for follow-up purposes. No oral
B. Thrombosis is common after internal jugular vein food intake allowed
catheterization. Tick the correct one for the patient's maintenance
C. Central venous catheter placement requires fluid therapy.
specialized training. A. Maintenance fluid amount 1520 mL/24 hours
can be done by the general practitioner without the B. Maintenance fluid amount 2440 mL/24 hours
need for C. Maintenance fluid amount 2100 mL/24 hours
D. Most commonly in femoral vein catheterization, D. Maintenance fluid amount 1050 mL/24 hours
infection is the most important cause of central E. Maintenance fluid amount 1660 mL/24 hours
venous catheterization. Explanation: 100 cc/kg for the first 10 kg, the next 10
is a complication. kg, depending on the person's weight
E. The central venous line is not used for routine 50 cc/kg and 20 cc/kg for each subsequent kg.
blood sampling 24) Which of the following is Callot's triangle or
Explanation: hepatocystic triangle?
• Thrombosis and infection are seen in femoral vein It is not one of the anatomical structures that make up
catheterization. A. Cystic artery
B. Choledoch applicable
C. Main hepatic duct D. Lobectomy on the side of the tumor is sufficient in
D. K.C. the treatment
E. Ductus cysticus Diagnosis of
Explanation: E. Nodule by thyroid FNAB and elevated calcitonin
• Callot's triangle: It consists of the cystic duct, the level
common bile duct, and the cystic artery. is put
• Hepatocystic triangle: liver margin, common bile Explanation:
duct, cystic duct. • 7% of thyroid malignancies
25) The most effective antibiotic in a patient • It develops from parafollicular C cells.
undergoing elective colon resection • IUD is not applied because it does not cause iodine
Which of the following is the dose? uptake.
A. A single dose given 30 minutes before skin • Total thyroidectomy and lymph node dissection are
incision performed in the treatment.
B. Single dose given at skin incision 30) Brought to the emergency department of our
C. Single dose preoperatively + continued for 24 hospital by the 112 emergency service team.
hours after surgery In the examination of a 20-year-old male patient, he
antibiotic therapy was conscious, cooperatively oriented, Glasgow coma
D. Single dose preoperative + 48 hours post operative scale: 14, basic locomotor system.
antibiotic therapy normal examination, blood pressure arterial 130/75
E. None mmHg, heart rate:
Description: Prophylactic ab; in the 30-45 minute 69/min. The patient's left anterior axillary line is at the
phase before the operation level of the 8th intercostal space.
should be given. Often combined with the preferred There is a stab wound. Breath sounds are bilaterally
induction of anesthesia natural and
is to be given. Both hemithorax participate equally in breathing.
There is no defense in the abdominal examination,
26) Which of the following statements about hydatid no rebonds. The patient has no nausea or vomiting.
cyst is false? Whole blood tests
A. The most common causative agent is echinococcus count, white blood cell count is 13000/mm3,
granulosus hemoglobin is 15gr/dl,
B. Free rupture of hepatic hydatid cyst may cause hematocrit 45% and platelet 156000/mm3, amylase
anaphylaxis 40U/L, urea: 6mg/
C. The most common finding is hepatomegaly. dl, creatinine: 0.85mg/dl, AST: 11 U/L, ALT: 76 U/L,
D. The main host is sheep complete urine
E. Primary treatment is surgery no erythrocytes in the urine, no leukocytes in the
27) Which of the following gastric ulcer localizations examination, direct abdomen in the pulled foot
increases acidity? pneumothorax on x-ray (x-ray) and chest x-ray (x-ray),
associated with production? hemothorax, intraabdominal-subdiaphragmatic free
A. Cardia air detection
B. Fundus was not done. In terms of general surgery, the best
C. incisura angularis approach for this patient
D. Pylorus which of the following?
E. Abdominal esophagus A. Hospitalization and close observation only
28) Which of the following is not a symptom of acute B. CT and scanning of the entire abdominal and
appendicitis? thoracic cavity
A. Fever > 38.1 degrees C. Performing diagnostic laparoscopy on the patient
B. Loss of appetite in the operating room
C. Vomiting D. Diagnostic laparotomy in the operating room
D. Reduction of abdominal pain with sitting and E. Bedside FAST in the emergency department
leaning forward Description: Haemodynamically stable patients with
E. Right lower quadrant pain penetrating injuries.
29) Which of the following is true about medullary We look for peritoneal penetration in patients.
thyroid cancer? Peritoneum
A. It constitutes 25-30% of thyroid malignancies. Penetration sign presents with somatic pain.
B. Originates from the follicular cells of the thyroid Peritoneum
C. In addition to surgery, TSH suppression and IUD Non-penetrating injuries do not require investigation. ?
are also included in the treatment.
31) Which is not a factor that negatively affects fistula • Insoluble: Silk ,Nylon ,Prolene
healing? • Sharp point needles triangle mark, round tip needles
A. Long fistula tract circle mark
B. Epithelialization of fistula tract is defined with.
C. Presence of granulomatous bowel disease • Monofilament causes less tissue reaction, bacteria
D. Abscess, presence of foreign name less likely to settle.
E. Obstruction from the distal bowel segment
• Tissue reaction and microbial colonization in
32) The following regarding the development of
multifilaments
incisional hernia in the anterior abdominal wall
probability is higher.
Which of the statements is incorrect?
A. More common in patients who have had multiple • Seam safety of multifilaments is better than
abdominal surgeries monofilaments.
B. The risk of developing an incisional hernia is They are flexible, soft, pliable and strong.
higher in obese 37) The reason for the orange peel appearance seen in
C. There is a high risk of recurrence after incisional breast cancer?
hernia repair. A. Coagulation necrosis
D. Develops in less than 5% of patients undergoing B. Embolism
abdominal surgery C. Arterial invasion
E. It develops more frequently in patients with D. Duct involvement
impaired wound healing E. Lymphatic permeation
5 38) Appendectomy is a type of ________biopsy. You
33) The test that can best differentiate benign- filled in the blank.
malignant in thyroid rewards A. Excisional
which one? B. Incisional
A. FNAB C. Fine needle
B. Thyroid USG D. FNAB again three months later
C. Thyroid Scintigraphy E. TSH suppression
D. Thyroid hormone suppression 39) At least how much bleeding must be in the GIS
E. Neck computed tomography for melena to occur?
34) What color armband should a patient with a A. 10 mL
history of allergy have? B. 50 mL
A. Pink C. 500 mL
B. White D. 1000 mL
C. Blue E. 1500 mL
D. Yellow 40) A patient diagnosed as follicular neoplasia on
E. Red thyroid fine needle biopsy.
Explanation: What would your approach be to the patient?
A. Total thyroidectomy
• Normal patient white
B.
• Allergic patient red Lobectomy
• Patients with the same name in the same service, C.
dark blue Follicular neoplasia Lobectomy
• Patients at risk of infectious diseases are yellow. Lobectomy +
35) Which of the following is the best isotonic
fluid for fluid replacement?
A. D5 ¼ NS with 20 mEq KCl/lt
B. D5 1/2 NS with 20 mEq KCl/lt
Complete
C. 3% saline solution Follow up
thyroidectomy Follow up
D. Ringer lactate
E. Mannitol
36) Which is wrong about suture materials? isthmusectomy
A. Round-tipped needles are less traumatic 6
B. Sharp-pointed needles are identified by the D. FNAB again three months later
triangular sign E. TSH suppression
C. Monofilament sutures cause less tissue reaction Explanation:
D. Polyfilament stitches have better knot security
E. Silk is a soluble monofilament suture material
Explanation:
• Fusibles:PDS , vicryl , monovicryl
41) A 75-year-old male patient was admitted to the until it is expected. It is then repaired with primer or
emergency room due to abdominal pain. In her history, mesh repair.
it was concentrated in the epigastric region and had
two oars. describes a pain felt between the bones. In 44) Which of the following lesions is present in the
the examinations white blood cell count 20.000 mm3, patient?
glucose 210 mg/dL, LDH: 350 U/L,hematocrit 42% least likely to have systemic disease?
and 37% in the two-day follow-up, lipase: 260 A. Perianal fistula recurrence
U/L,base deficit 6 mEq/L, calcium: 7.9 mg/dL, AST: B. Acute lateral anal fissure
350 U/L, PO2 (blood gas): 75 mmHg, BUN: 8 mg/dL, C. Acute anterior anal fissure
and 9 mg/dL two days later, minimal in the D. Multiple perianal fistulas
gallbladder lodge on upper abdominal sonography E. Perianal fistula with multiple ducts
Pericholecystic fluid is present, the largest in the Description: Chron in multiple and/or fissures on the
gallbladder is 3 mm lateral wall,
There are multiple millimetric calculi. Gallbladder Being an underlying disease such as colitis ulcerosa,
wall thickness 9 AIDS, tuberculosis, syphilis
mm, intrahepatic ducts are normal, common bile duct high probability.
age is normal, and pancreatic It is usually seen in the posterior midline and
could not be visualized. For the patient whose clinical sometimes in the anterior midline.
features are described above 45) Which of the following reduces the risk of venous
Which of the following is true? thromboembolism?
A. 15% chance of mortality not one of the factors?
B. 40% chance of mortality A. General anesthesia
C. The probability of mortality is 100% B. Low molecular weight heparin
D. Mortality probability is 5% C. Short operative time
E. 2% probability of mortality D. Compression stockings
Explanation: E. Early mobilization
0-2 → 2% 46) Which of the following is the most common type
3-4 → 15% of choledochal cysts?
5-6 → 40% A. Type 1
B. Type 2
7-8 →100%
C. Type 3
42) Which of the following is true about acalculous
D. Type 4a
cholecystitis?
E. Type 4b
A. Most often seen in out-of-hospital settings and in
47) Which of the following is related to the vascular
the elderly
structure of the adrenal glands?
B. The main pathophysiology is gallbladder stasis
is it wrong?
C. HIDA scintigraphy usually gives normal results
48) A 24-year-old male patient admitted to the
D. Gallbladder is usually normal on USG
emergency room 10 hours ago.
E. The patient should be followed on an outpatient
comes with a complaint of pain. The patient has pain
basis
in the right lower quadrant and
Explanation:
He says his intensity hasn't changed at all. physical
• Systemic pain is usually a problem in a patient examination deep
hospitalized in the intensive care unit. Rebound is detected on palpation. What is the most
is associated with the disease. likely diagnosis in this patient?
• Wall thickening is observed in USG. acute appendicitis
• If the treatment is cholecystectomy or the general 49) In which quadrant is breast cancer most common?
condition is not good
cholecystostomy is performed.
43) Which is wrong about umbilical hernia?
A. It is present in 10% of neonates
B. Develops more frequently in premature babies
C. It can be congenital or acquired
D. Most congenital hernias close spontaneously
within 5 years
E. Prosthetic patch is not used in patients smaller than
5 cm.
Description: Closes on its own by 2 years of age. 4
years old if not closed
In the right upper quadrant (45%)
50) Which of the following is a positive Rovsing sign?
• Rovsing sign → possible gas in the patient's left
lower quadrant
when brought to the lower right quadrant by stroking
the pile of
pain in the quadrant!
1) A 25 years old male develops diarrhea and
colicky abdominal pain.Ulcerativecolitis is
diagnosed on colonoscopy.Which of the following
findings is consistent with the diagnosis?
a) The rectum is not involved
b) The disease is confluent,there are no skip areas in
the colon and the rectum is involved.
c) The full thickness of the bowel wall is involved.
d) Microscopic examination of the mucosa reveals
normal cells without evidence of dysplasia.
e) The incidence of colorectal cancer is equal to that ıf
the general population.

2) A 35 years old man has known ulcerative

colitis.Which of the following is an indication for
total proctocolectomy?
a) Sclerosing cholangitis
b) Iron deficiency anemia
c) Toxic megacolon
d) Occasional bouts of colic and diarrhea
e) Arthritis