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1- Which of the following condition is associated with an increased risk of duodenal adencarcinoma?

a) Gardner's Syndrome.

b) Nodular hyperplasia of Brunner's Glands.

c) Adenoma of Brunner's Glands.

d) Heterotopic Pancreas.

e) Chronic peptic ulcer

2- A55 – year – old man presents to the emergency room with hematemesis and systolic blood pressure of 80. After initial fluid resuscitation, his blood pressure is 110/80, and his pulse rate is 95. What is the next step in the management of this patient?

a) Placement of a sengstaken – Blakemore tube.

b) Blood transfusion.

c) Administration of Vasopressin.

d) Administration of Octeriotid.

e) Upper gastrointestinal endoscopic examiniation.

3-Which of the following combination represents the classical clinical triad associated with choledochal cysts?

a)    Right upper quadrant pain, jaundice and fever.

b)   Right upper quadrant pain, tenderness and jaundice

c)    Right upper quadrant pain,  jaundice and an abdominal mass

d)   Right upper quadrant pain, jaundice and vomiting

e)    Right upper quadrant pain, tenderness and an abdominal mass

4- Which type of choledochal cyst represent caroli's disease?

a)    Type II

b)   Type III

c)    Type IVa

d)   Type IVb

e)    Type V

5- Which of the following is characteristic of the clinical syndrome associated with glucagon – producing islet Cell Tumours?

a)    Hypoglycemia, skin rash and seizure.

b)   Seizures, skin rash and diabetes.

c)    Polycythemia. Diabetes and hypoglycemia.

d)   Necrolytic migrating erythema, anemia and diabetes.

e)    Diabetes, skin rash and polycythemia.

6- 45 years old women complaining of right hypochondrial pain since 1 year and early satiety, ultrasound abdomen showed no gallstone, upper GIT endoscopy was normal, CT scan demonstrate liver mass 13 cm. in size in segment II, III with which is initially hypodense with peripheral-to-central enhancement by contrast material. MRI shows a dense T2 – weighted phase. Which of the following is the appropriate management?

a)    Observation.

b)   Radiation therapy.

c)    Percutaneous Needle Biopsy.

d)   Arteriography and embolism.

e)    Resection.


7- When platelet transfusion should be given for patient with ITP booked for splenctomy?

a)    One day before operation.

b)   One hour before the operation.

c)    Immediate before skin incision.

d)   After removal of spleen.

e)    Immediate postoperative.

8- 60 years old man presents with upper GI bleeding after chronic sclerotherapy for esophageal varices. Endosopic examination demonstrates that the mucosa of the gastric fundus and body is granular, with multiple red spots. Which of the following is the appropriate initial treatment of this patient?

a)    Endoscopic sclerotherapy.

b)   Placement of a sengtaken-Blakemore tube.

c)    Administration of octeriotid.

d)   TIPS.

e)    Surgical portal systemic shunt.

9- 65 years old jaundiced, otherwise healthy patient has a 2cm. mass in the head of the pancreas with few enlarged lymph nodes near the head of pancreas in CT scan. Which of the following is the most appropriate next step?

a)    ERCP and placement of a biliary wall stent.

b)   Percutaneous fine-needle aspiration of the pancreatic mass.

c)    Endoscopic ultrasound and FNA of enlarged lymph nodes.

d)   MRI abdomen.

e)    Operative exploration for resection.


10- Which of the following is the commonest concer of gallbladder?

a)    Squamous cell carcinoma

b)   Adenocarcinoma.

c)    Adenosquamous cancer.

d)   Carcionid.

e)    Oat cell cancer

11- The commonest site of cholangiocarcinoma in biliary tree is:

a)    Left hepatic duct.

b)   Right hepatic duct.

c)    Hepatic duct bifurcation.

d)   Common hepatic duct.

e)    Common bile duct.

12- The length of common bile duct is depend on:

a)    Supraduodenal segment.

b)   Retroduodnal segment.

c)    Intrapancreatic segment.

d)   Its junction with pancreatie duct.

e)    Its junction with cystic duct.

13-Which one of the following condition of hypergastrinemia is associated with increased acid secretion?

a)    Pernicious Anemia.

b)   Chronic gastritis.

c)    Gastric cancer.

d)   Postvagotomy state.

e)    Renal failure.


14- Which one of following condition of hypergastrinemia is not associated with increased acid secretion?

a)    Chronic gastritis.

b)   Renal Failure.

c)    Short bowel syndrome.

d)   Retained antrum.

e)    G-Cell hyperplasia.

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