Хірургія 4 курс стоматологічний факультет.
1.
What complications of peptic ulcer disease: 1 Penetration, 2 Perforation, 3 Stenosis, 4
Bleeding, 5 Malignancy
A.
1,3.
B.
1,3,4.
C.
2,3,4.
D.
1,2,3,4.
E.
1,2,3,4,5
ANSWER: E
2.
Which disease is characterized by disappearance of pain in the epigastrium?
A.
Pancreatitis.
B.
Cholecystitis.
C.
Piloroduodenal stenosis.
D.
Perforation of ulcer.
E.
Bleeding from an ulcer.
ANSWER: E
3.
Which disease is characterized by melena?
A.
Penetration.
B.
Malignancy .
C.
Stenosis.
D.
Perforation .
E.
Bleeding from an ulcer.
ANSWER: E
4.
What is used for diagnostics of perforative ulcers:
A.
X-Ray
B.
Endoscopy
C.
Laparocentesis
D.
Sonography
E.
Laparoscopy
ANSWER: E
5.
For successful surgical treatment of duodenal ulcer is necessarily:
A.
Sonography
B.
Angiography
C.
Examination of liver
D.
Colonoscopy
E.
Estimation of the state of pylorus
ANSWER: E
6.
At which disease will be tension of muscles of anterior abdominal wall?
A.
At pylorostenosis
B.
At hernia
C.
At appendicitis
D.
At chronic gastritis
E.
Right answer not present
ANSWER: E
7.
What is pain localization at ulcer of small curvature of stomach?
A.
In back
B.
In left inguinal region
C.
Near a umbilicus
D.
In right inguinal region
E.
In epigastrium
ANSWER: E
8.
Which symptoms is absent at perforative gastric ulcer:
A.
Severe state of patient
B.
Disappearance of hepatic sound.
C.
"Knife-like" pain
D.
Wooden belly.
E.
Frequent vomiting.
ANSWER: E
9.
What is most frequent vagotomy is used:
A.
Posterior trunk.
B.
Anterior trunk
C.
Selective
D.
Trunk
E.
SPV
ANSWER: E
10.
What indicated at a gastric ulcer, which diagnosed during X-Ray examination of stomach:
A.
Immediate operation - resection of stomach.
B.
Protracted conservative treatment,
C.
Periodically X-Ray control
D.
Operative treatment
E.
Gastroscopy with biopsy and treatment depending on its result
ANSWER: E
11.
What is treatment of peptic ulcer disease with cicatrices and deformation of duodenum
A.
Conservative treatment
B.
Antibiotic.
C.
Antispastic
D.
H-2 blockers
E.
Operative treatment.
ANSWER: E
12.
At a large gastric ulcer the best method of treatment is:
A.
Selective proximal vagotomy.
B.
Gastrectomy.
C.
Selective vagotomy and pyloroplasty by Finney.
D.
Trunk vagotomy with excision of ulcer.
E.
Resection of stomach.
ANSWER: E
13.
What is not complication of ulcerous disease of duodenum:
A.
Pyloroduodenal stenosis.
B.
Gastro-duodenal bleeding.
C.
Perforation of ulcer.
D.
Penetration of ulcer.
E.
Malignancy of ulcer.
ANSWER: E
14.
Clinical sign of perforative ulcer of duodenum in the first 6 hours of disease is not
characterized by:
A.
By absence of vomiting.
B.
By disappearance of hepatic sound.
C.
By a "knife-like" abdominal pain.
D.
Wooden belly.
E.
Diarrhea.
ANSWER: E
15.
The clinic of decompensated pyloroduodenal stenosis is characterized:
A.
By a "splash sound" on an empty stomach.
B.
By the hypovolemia.
C.
Delay of barium in a stomach to 24 hours.
D.
By the decrease of mass of body.
E.
All of answers are correct.
ANSWER: E
16.
What operation is performed for patient, 43 years, with bleeding ulcer of antrum part of
stomach:
A.
Gastrectomy.
B.
Conservative treatment.
C.
Proximal vagotomy.
D.
Excision of ulcer with trunk vagotomy.
E.
Resection of stomach.
ANSWER: E
17.
Why could be disappearance of hepatic sound at a perforative gastric ulcer?
A.
A presence of liquid in abdominal cavity.
B.
Swelling of intestine.
C.
Interposition of intestinal loops between a liver and diaphragm.
D.
High location of diaphragm.
E.
A presence of free gas in an abdominal cavity.
ANSWER: E
18.
A patient, 32 years, 4 hours ago has "knife-like" abdominal pain. Diagnosis?
A.
Acute appendicitis.
B.
Acute ileus.
C.
Acute pancreatitis.
D.
Gangrenous cholecystitis.
E.
All of answers are incorrect.
ANSWER: E
19.
What is the best method of treatment of patient, 28 years, with a duodenal ulcer,
complicated by subcompensated piloro-duodenal stenosis:
A.
Posterior gastroenteroanastomosis.
B.
Trunk vagotomy.
C.
Subtotal resection of stomach.
D.
Selective proximal vagotomy.
E.
Selective proximal vagotomy in combination with a draining operation.
ANSWER: E
20.
What treatment of ulcer, complicated by non-stopped gastro-duodenal bleeding?
A.
Introduction of probe of Blekmora.
B.
Embolization of gastric and gastro-duodenal arteries.
C.
Operation at the relapse of bleeding.
D.
Conservative treatment.
E.
Urgent operation.
ANSWER: E
21.
Which drug is prescribed at the gastro-duodenal bleeding:
A.
Vicalinum.
B.
Baralgin
C.
Paracetamol
D.
Aspirin
22.
E.
Dicinon.
ANSWER: E
Among the symptoms of perforative ulcer one is indicated wrong:
A.
Positive symptom of Schetkin-Blumberg.
B.
Disappearance of hepatic sound.
C.
There is a knife-like pain.
D.
Tension of muscles of anterior abdominal wall.
E.
Vomiting is not facilitate.
ANSWER: E
23.
What is criteria of adequate preoperative preparation at patient with decompensated
ulcerous stenosis of pylorus: 1. Level of diuresis. 2. Indexes of volume of circulatory blood.
3. Level of hematocrit. 4. Indexes of electrolytes of blood. Choose correct combination of
answers:
A.
All of answers are wrong.
B.
3 and 4.
C.
2,3,4.
D.
2,4.
E.
All of answers are correct.
ANSWER: E
24.
What operation is performed in patient with the ulcer of duodenum, penetrated to the
pancreas:
A.
Pyloroplasty by Finney
B.
Selective proximal vagotomy.
C.
Vagotomy and draining operation.
D.
Distal subtotal resection of stomach.
E.
Resection 2/3 stomach
ANSWER: E
25.
What is the reasons of formation of peptic ulcers after resection of stomach:
A.
Acute ileus
B.
Pancreatitis
C.
Syndrome of Zollinger - Ellison
D.
Economy resection of stomach
E.
Is not resected antrum part of stomach
ANSWER: E
26.
Name the most informative method of examination at dumping-syndrome:
A.
Colonoscopy
B.
Examination of volume of circulatory blood
C.
Endoscopy
D.
CT
E.
X-Ray with barium
ANSWER: E
27.
Specify the most informative method of examination at a peptic ulcer:
A.
Colonoscopy
B.
CT
C.
Determine the gastric secretion
D.
Sonography
E.
Endoscopy
ANSWER: E
28.
Which clinical sign is not characteristic for dumping-syndrome:
A.
A diarrhoea after eating
B.
Pain in an epigastrium after food intake
C.
Weakness, dizziness, hard beet filling after the food intake
D.
A loss of weight, general weakness
E.
Vomiting by the eaten food
ANSWER: E
29.
When conservative treatment could be performed at perforative ulcer?
A.
Bleeding ulcer
B.
If a atypical perforation
C.
At the clinical picture of general peritonitis
D.
In patients with tuberculosis
E.
If patient does not want operation
ANSWER: E
30.
What operation is performed at decompensated stenosis of pylorus in old patients?
A.
Subtotal resection of stomach
B.
Resection of stomach
C.
Pyloroplasty with vagotomy
D.
Antrumectomy with vagotomy
E.
Gastroenteroanastomosis
ANSWER: E
31.
The typical ways of metastasis of tumor of antrum part on large curvature of stomach is:
A.
Lymphatic nodes of pancreas
B.
Mesenteri
C.
Spleen
D.
Paraesophageal lymphatic nodes
E.
Liver
ANSWER: E
32.
The characteristic clinical signs of cancer of cardiac part of stomach is:
A.
Pain in epigastrium
B.
Belch
C.
Weakness
D.
Sense of weight in epigastrium
E.
Dysphagia
ANSWER: E
33.
The characteristic of X-Ray signs of malignancy of stomach is:
A.
Rigidity of wall of stomach
B.
Strengthening of peristalsis
C.
Defect of filling
D.
"Niche"
E.
Convergence of folds of mucous membrane of stomach
ANSWER: E
34.
Rare complication of ulcer of duodenum is:
A.
Cicatrical deformation of bowel
B.
Penetration
C.
Bleeding
D.
Perforation
E.
Malignancy
ANSWER: E
35.
For perforative gastro-duodenal ulcer is characteristic:
A.
General weakness
B.
Vomiting
C.
Spastic pain
D.
Gradual growth of pain syndrome
E.
Acute pain in epigastrium
ANSWER: E
36.
Belching by bright red blood which increased at a cough is characteristic for:
A.
Syndrome of Randyu – Osler
B.
Bleeding gastric ulcer
C.
Syndrome of Mellori - Weiss
D.
Tumor of cardiac part
E.
Pulmonary bleeding
ANSWER: E
37.
The reliable X-Ray sign of perforation of gastro-duodenal ulcer is:
A.
Absent of gas in the stomach
B.
Kloyber’s "cup"
C.
Gas in the intestine
D.
High location of diaphragm
E.
Presence of free gas in abdominal region
ANSWER: E
38.
The most frequent complication of ulcer of anterior wall of duodenum is:
A.
Stenosis
B.
Malignancy
C.
Penetration in the head of pancreas
D.
Bleeding
E.
Perforation
ANSWER: E
39.
Endoscopic examination does not diagnose:
A.
Stenosis of pylorus
B.
Type of gastritis
C.
Cancer of stomach
D.
Syndrome of Mellori - Weiss
E.
Syndrome of Zollinger - Ellison
ANSWER: E
40.
At suspicion of duodenal ulcer is performed:
A.
Examination of gastric secretion
B.
X-Ray of organs of abdominal cavity
C.
Cholecystography
D.
Determination of level of gastrin in blood
E.
Esophagogastroduodenoscopy
ANSWER: E
41.
The best method of diagnostics of perforative ulcers is:
A.
X-Ray
B.
Endoscopy
C.
Laparocentesis
D.
Sonography
E.
Laparoscopy
ANSWER: E
42.
At determination of indications to the operation of ulcerous disease there it is not important:
A.
Duodeno-gastric reflux
B.
Gastric secretion
C.
Pathogenesis of disease
D.
E.
Complications of ulcerous disease
Predisposition to dumping-syndrome
ANSWER: E
43.
Relative indications to surgical treatment of ulcerous disease:
A.
Atypical perforation of ulcer
B.
Malignant regeneration of ulcer
C.
Stenosis of pylorus
D.
Relapse of the ulcerous bleeding after endoscopic hemostasis
E.
Low bulb ulcers
ANSWER: E
44.
An absolute indication to the operation at ulcerous disease are:
A.
Persistent duodeno-gastric reflux with gastritis and ulcer
B.
Presence of genetic predisposition to ulcerous disease
C.
Combination of gigant gastric and duodenal ulcers
D.
Large ulcer of pylorus with possible development of stenos
E.
Penetrative ulcer with formation of pathological fistula
ANSWER: E
45.
Operation of choice at ulcerous disease with violation of duodenal passage is:
A.
SPV without the special correction of the duodenal passage
B.
SPV with duodeno-jejuno anastomosis
C.
Resection of stomach (antrumectomy) with vagotomy by Gofmeyster–Finsterer
D.
Resection of stomach (antrumectomy) with vagotomy by Bilroth-1
E.
Resection of stomach (antrumectomy) with vagotomy by Ru
ANSWER: E
46.
The II phase of the clinical course of acute intestinal obstruction is:
A.
False improvement
B.
Initial manifestations
C.
"Ileus scream"
D.
Terminal
E.
Intoxications
ANSWER: E
47.
The I phase of the clinical course of acute intestinal obstruction is:
A.
False improvement
B.
Initial manifestations
C.
Terminal
D.
Intoxications
E.
"Ileus scream"
ANSWER: E
48.
Name a radical operation in the volvulus of sygmoid colon:
A.
Detorsion of volvulus
B.
Mesosygmopexia
C.
Gartman's operation
D.
Mesosygmoplication
E.
A resection of sygmoid colon in any modifications
ANSWER: E
49.
Name the most frequent form of colon volvulus:
A.
Volvulus of descending colon
B.
Volvulus of appendix
C.
Volvulus of ascending colon
D.
Volvulus of cecum
50.
E.
Volvulus of sygmoid colon
ANSWER: E
The nodulus involves in the process:
A.
Parietal peritoneum
B.
All parts of intestine
C.
One or more parts of intestine
D.
One part of intestine
E.
Not less than two parts of intestine
ANSWER: E
51.
What is the drawback of Gartman's operation?
A.
Death of patient
B.
A long term of patient stay in the hospital
C.
Development of early adhesive intestinal obstruction
D.
Volvulus of mesentery
E.
Formation of stoma
ANSWER: E
52.
Name the most frequent causes of obturation intestinal obstruction:
A.
Tumours
B.
Helmints
C.
Foreign bodies
D.
Scar and inflammatory stricture
E.
All mentioned
ANSWER: E
53.
When is the intubation zond removed from intestine after the operation for acute intestinal
obstruction?
A.
On desire of the patient
B.
On the 3th day
C.
On the 4th day
D.
On the 5th day
E.
On the next day after appearance of peristalsis, but not later than on 7th day
ANSWER: E
54.
Name the methods of intestinal intubation:
A.
Nasogasral
B.
Through the rectum
C.
Through ceco- or appendicostoma
D.
Through gastrostoma
E.
All types are acceptable, depending on a clinical situation
ANSWER: E
55.
In paralytic intestinal obstruction the stimulation of peristalsis of intestine is performed:
A.
Not indicated
B.
Depending on a clinical situation
C.
Contra-indicated
D.
Depending on age
E.
Only after infusion therapy and correction of hypovolemia
ANSWER: E
56.
Name the causes of intestinal obstruction:
A.
Adhesions of abdominal cavity
B.
None of mentioned
C.
Tumours of the abdominal cavity and retroperitoneal space
D.
Long mesentery of small or large intestine which results in the mobility of their loops
E.
All mentioned causes
ANSWER: E
57.
What is the definition of intestinal obstruction?
A.
Disturbances of defecation
B.
Absence of stool
C.
Constipation
D.
Syndrome of acute vomiting
E.
Complete or partial disturbance of passage through intestinal tract
ANSWER: E
58.
What does acute intestinal obstruction, caused by a tumour obturation, require?
A.
Only symptomatic treatment
B.
Surgery only after chemotherapy
C.
Liquidations of the tumour by radiotherapy
D.
Liquidations of the tumour by chemotherapy
E.
Operative intervation
ANSWER: E
59.
What is the character of peristalsis at the beginning of acute intestinal obstruction:
A.
Heard only in the region higher to obstruction
B.
Variable
C.
Absent
D.
Normal peristalsis
E.
Hyperperistalsis
ANSWER: E
60.
Name the leading signs of acute intestinal obstruction:
A.
Nausea, loss of appetite, metallic taste in the mouth
B.
Wave-like pain, anaemia
C.
„Knife-like” pain, wooden abdomen, vomiting
D.
„Knife-like” pain, wooden abdomen, proper anamnesis
E.
Wave-like pain, vomiting, delay of gases and stool
ANSWER: E
61.
What is the aim of conservative therapy in decompensated acute intestinal obstruction?
A.
None of mentioned
B.
All mentioned
C.
Detoxication
D.
Treating
E.
Preoperative preparation
ANSWER: E
62.
What is the aim of conservative therapy in compensated acute intestinal obstruction?
A.
None of mentioned
B.
All mentioned
C.
Detoxication
D.
Preoperative preparation
E.
Treating
ANSWER: E
63.
What type of vomit is characteristic for acute intestinal obstruction?
A.
Double
B.
Not characteristically
C.
With relief
D.
Single, with relief
E.
Frequent, without relief
ANSWER: E
64.
What pathology the Mayo-Robson's sign is characteristic for?
A.
Peritonitis
B.
Volvulus
C.
Spastic acute intestinal obstruction
D.
Perforative gastric ulcer
E.
Acute pancreatitis
ANSWER: E
65.
Is a fecal vomit is characteristic sign for acute intestinal obstruction?
A.
In obturation acute intestinal obstruction
B.
Always
C.
Never
D.
Yes, in I phase
E.
Yes, in III phase
ANSWER: E
66.
The percussion in acute intestinal obstruction reveals:
A.
Dullness in lower sites
B.
Tympanic sound in the region of liver
C.
Dull sound
D.
No changes
E.
Tympanic sound
ANSWER: E
67.
Renders the first medical aid:
A.
Hospital attendant on a battle-field
B.
Suffer man to itself
C.
Medical assistant during transporting
D.
Doctor of the specially equipped permanent establishment
E.
A and B
ANSWER: E
68.
Renders the specialized medicare:
A.
Traumatologist
B.
Neuro-surgeon
C.
Medical assistant during transporting
D.
Doctor with general preparation
E.
A and B
ANSWER: E
69.
Classification of paraproctitis depending on etiologic sign
A.
Intersphincteric, transsphincteric, extrasphincteric
B.
front, lateral, back
C.
perianal, submucos, ischiorectal, pelviorectal, retrorectal
D.
acute, chronic
E.
banal, specific, posttraumatic
ANSWER: E
70.
What layers of the bowel are damaged at Crohn disease
A.
muscle
B.
submucous
71.
72.
C.
submucous and muscle
D.
mucus
E.
all of layers
ANSWER: E
F.
At Crohn disease is damaged
A.
only sigmoid bowel
B.
only rectum
C.
only colon
D.
only small intestine
E.
all parts of gastrointestinal truct
ANSWER: E
A method of choice at surgical treatment of unspecific ulcerative colitis
A.
application of colostomy.
B.
colectomy
C.
resection of colon
D.
hemicolectomy
E.
proctocolectomy
ANSWER: E
73.
Classification of haemorrhoids by the degrees
A.
all are false
B.
I, II stage
C.
complicated, non-complicated
D.
external, internal
E.
I, II, III of the stage
ANSWER: E
74.
Classification of haemorrhoids by the degrees
A.
all are false
B.
I, II stage
C.
complicated, non-complicated
D.
external, internal
E.
I, II, III of the stage
ANSWER: E
75.
Classification of haemorrhoids by the localizations
A.
all are false
B.
I, II stage
C.
complicated, non-complicated
D.
I, II,III of the stage
E.
external, internal
ANSWER: E
76.
Classification of haemorrhoids by the localizations
A.
all are false
B.
I, II stage
C.
complicated, non-complicated
D.
I, II,III of the stage
E.
external, internal
ANSWER: E
77.
Classification of haemorrhoids by the degrees
A.
all are false
B.
I, II stage
C.
complicated, non-complicated
D.
external, internal
E.
I, II, III of the stage
ANSWER: E
78.
Classification of haemorrhoids by the localizations
A.
all are false
B.
I, II stage
C.
complicated, non-complicated
D.
I, II,III of the stage
E.
external, internal
ANSWER: E
79.
What is the operation of choice at a unspecific ulcerative colitis:
A.
Resection of sygmoid bowel
B.
Right-side hemicolectomy
C.
Left-side hemicolectomy
D.
Resection of rectum
E.
Proctocolectomy
ANSWER: E
80.
In the perianal area patient has the slight swelling, red skins, soft infiltrate. What is the
diagnosis?
A.
Proctopolypus
B.
Cancer of rectum
C.
Haemorrhoids
D.
Anal fissure
E.
Acute paraproctitis
ANSWER: E
81.
Hyperbaric oxygenation in a postoperative period is used at:
A.
Cancer of rectum
B.
Haemorrhoids
C.
Epithelial coccygeal
D.
To the anal fissure
E.
Anaerobic paraproctitis
ANSWER: E
82.
Which preparation is used for treatment of unspecific ulcerative colitis
A.
ketanov
B.
analgin
C.
cerucal
D.
fenolftaleine
E.
sulfasalasine
ANSWER: E
83.
At what disease could be histologically unspecific hranuloma
A.
diverticulosis
B.
poliposis
C.
cancer of rectum
D.
unspecific ulcerative colitis
E.
Crohn disease
ANSWER: E
84.
What part of colon is damaged by cancer most often:
A.
Rectum
B.
Descending part
C.
Ascending part
D.
Caecum
E.
Sigmoid colon
ANSWER: E
85.
During rectoscopy is found the endoscopic symptom of “roadway”. What disease?
A.
Syndrome of irritation of colon
B.
Salmonellosis
C.
Dysentery
D.
Unspecific ulcerative colitis
E.
Crohn disease of rectum
ANSWER: E
86.
What method of examination is used to confirm the diagnosis of Crohn disease?
A.
Rectoscoopy
B.
Sonography
C.
Sciagraphy
D.
CT
E.
A biopsy is with histological examination
ANSWER: E
87.
What volume of blood lost at a unspecific ulcerative colitis does consider complications?
A.
200-300 ml
B.
150-200 ml
C.
50-100 ml
D.
To 50 ml
E.
300 ml and more
ANSWER: E
88.
What operation is performed at a acute shoe-shaped paraproctitis ?
A.
Conservative treatment
B.
Cutting of abscess with shifting of mucus to distal part of rectum
C.
Cutting of abscess (by Gabrial)
D.
Opening of abscess with suturing
E.
Opening of abscess with the ligature conduction
ANSWER: E
89.
What is location of fistula chanal at intersphincteric paraproctitis?
A.
All are false
B.
All are true
C.
Located after sphincter
D.
Passes through sphincter
E.
Between mucus and sphincter
ANSWER: E
90.
Where are anal papilla usually located?
A.
In perianal region
B.
In any area of rectum
C.
In sygmoid colon
D.
In any area of anal channel
E.
Only above and lower from dentata line
ANSWER: E
91.
Small amount of blood in stool could has patients with:
A.
Appendicitis
B.
Peptic ulcer disease
C.
Pancreatitis
D.
Colitis
E.
Poliposis
ANSWER: E
92.
What patients with poliposis of colon could has in stool:
A.
Melena
B.
Presence of part of polypuses
C.
Undigested meal
D.
Nothing
E.
Small amount of blood
ANSWER: E
93.
For the parietal peritoneum of anterior and back abdominal wall is characteristic:
A.
resorbtion
B.
proliferation
C.
salivation
D.
imbibition
E.
exudation
ANSWER: E
94.
For the parietal peritoneum of lateral wall of the abdomen is characteristic:
A.
proliferation
B.
exudation
C.
salivation
D.
imbibition
E.
resorbtion
ANSWER: E
95.
For the parietal peritoneum of diaphragm is characteristic:
A.
salivation
B.
exudation
C.
proliferation
D.
imbibition
E.
resorbtion
ANSWER: E
96.
During one daythe inflamed peritoneum can absorbe a volume of fluid to:
A.
10 litres
B.
50 litres
C.
40 litres
D.
20 litres
E.
70 litres
ANSWER: E
97.
The cavity between organs and abdominal wall is called:
A.
interintestinal
B.
retroperitoneal space
C.
pelvic
D.
abdominal
E.
peritoneal
ANSWER: E
98.
Mesoteliocyts of peritoneum are located in such layer:
A.
nervous
B.
vascular
C.
middle
D.
deep
E.
superficial
ANSWER: E
99.
What is the volume of fluid contained in peritoneal cavity?
A.
50 ml.
B.
40 ml.
C.
30 ml.
D.
100 ml.
E.
10 ml.
ANSWER: E
100.
The vascular layer of peritoneum is located under:
A.
nervous
B.
fibrous
C.
deep
D.
serous
E.
superficial
ANSWER: E