Zhejiang University 20_____ - 20_____, ______ Term
Subject: Surgery
Examination Paper: Paper B Examination Pattern: ✓closed book
Examination Date: 2011-6-9, Examination Time: ________
Student Name: _____________________Student ID: ________________
Multiple choice questions
Each question is followed by some choices marked A), B), C), D) and E). You should decide on the best
choice and mark the corresponding letter on Answer Sheet
1. The urinary tract consists of following parts EXCEPT
A. pelvis
C. bladder
E.prostate.
2.
.
B. ureter
D. urethral
Which is the criterion of positive urine cultures?
A. >103cfu/mL
B. >104cfu/mL
C. >105cfu/mL
D. >106cfu/mL
E. >107cfu/mL
3. Urinary obstructions caused by congenital reasons are usually seen in
A. women
B. children
C. men
population.
D. old men
E. old women.
4. The most common reason for urinary obstruction occurred in old men is
A.Stone
B. bladder cancer
C. urethral stricture
D. prostate cancer
E. benign prostatic hyperplasia.
.
5.
Most of the prostatic nodules responsible for the bladder outlet obstructive symptoms associated with BPH arise
in the
.
A.peripheral zone
B.central zone
C.periurethral transition zone
D. bladder neck zone
E. preprostatic sphincteric zone
6.
Which is not the outcome of urinary tract calculi?
A. Direct injuries
B. Obstruction
C. Infection
D. Lumbar pain
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E. Malignance
7. The typical CT image of the acute subdural hematoma is _____________
A.Biconvex lens-shaped hematoma
B. Crescentic hematoma
C.Round-shaped hematoma
D. "salt and pepper" appearance
8. What is the first line therapy for BPH treatment?
A. Medicine
C. Watchful waiting
E. Open surgery
9.
B. TURP
D. Minimally invasive surgical treatment
Which option is the most important measure for management of sepsis from urinary tract infection?
A. Administration of broad-spectrum antimicrobial agents
B. Control body temperature
C. Administration of corticosteroids
D. Supportive care
E. Drainage or elimination of infection
10. Which is NOT a Factor predisposing to pyelonephritis:
A. Urinary Tract Obstruction
B. Vesicoureteral Reflux
C. Instrumentation of the Urinary Tract
D.Heart failure
E.Diabetes Mellitus
11. Which is NOT the classical sign of cystitis?
A. Dysuria (burning or discomfort on urination)
B. Frequency
C. Nocturia
D. Flank pain
E. Suprapubic discomfort
12. The most important determinant of uric acid stone formation is
.
A. High urinary pH
B. Low urinary pH
C. Supersaturation
D. PTH
E. None of the above
13. Which of the following is NOT a method to control increased ICP? _____________
A. The head of the bed is elevated to 30 degrees
B.External ventricular drain, or ventriculostomy
C. Mannitol
D.Hypoventilation
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14. Which is the most common in urinary tract calculi composition?
A. Struvite
B. Hydroxyapatite
C. Calcium oxalate
D. Uric acid
E. Cystine
15. Which one of the followings is the first-line imaging modality when renal colic is suspected in pregnancy?
A. KUB
B. IVU
C. CT
D. Sonography
E. None of the above
16. Most of bladder calculi should be treated by
.
A. Endoscopy
B. ESWL
C. Laparoscopy
D.Open surgery
E. None of the above
17.
is the best indicator of traumatic injury to the urinary system.
A. Lumbar pain
B. Hematuria
C. Abdominal pain
D. Dysuria
E. Urgency
18.
approach is recommended for surgical exploration of the renal injury.
A. Transabdominal
B. Translumbar
C. Laparoscopic
D. All of above
E. None of above
19. Which of the following exposures contributes strongly to the development of bladder cancer
A. Smoking
B. alcohol drinking
C. Coffee drinking
D. Tea drinking
?
E. Artificial sweeteners
20. Complications of posterior urethral injury are including
.
A. Urethral stenosis.
B. Impotence.
C. Incontinence.
D. All of above
E. None of above
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21. Which of the followings is the traditional imaging modality to diagnosis bladder rupture?
A. CT
B. Ultrasonography
C. Excretory urography.
D. Retrograde cystography
E. None of above
22. The classical triad of kidney cancer includes hematuria, flank pain and _______.
A. Fever
B. Bone pain
C. Cough
D. Palpable mass
E. Frequent urination.
23. Grading a patient's muscle strength, a 2 is:
A. No evidence of contractility.
B. Complete range of motion against gravity with some resistance.
C. Complete range of motion with gravity.
D. Complete range of motion with gravity eliminated.
E. Complete range of motion against gravity with full resistance.
24. The most common histopathological patterns in bladder cancer is_______?
A. Transitional Cell Carcinoma
B. Adenocarcinoma
C. Squamous cell carcinoma
D. Undifferentiated carcinomas
E. Sarcoma
25. _______ is the screening test for prostate cancer?
A. PSA
B. HCG
C. CEA
D. AFP
E. None of the above
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26. _________ is NOT appropriate for localized prostate cancer?
A. Watchful waiting
B. Radical prostatectomy
C. Chemotherapy
D. Radiotherapy
E. None of the above.
27. Which of the following is NOT a function of the spine?
A. The column provides support for the head and internal organs.
B. Provides a stable base for the attachment of ligaments, bones and muscles.
C. Protects the spinal cord.
D. The spine is a rigid structure for protection.
28. How many bones make up the spine?
A. 36
B. 46
C. 33
D. 34
E. 40
29. Which of the following is NOT a region of the spine?
A. Occiput
B. Cervical
C. Thoracic
D. Lumbar
E. Coccygeal
30. How many vertebrae are in the cervical spine?
A. 5
B. 6
C. 7
D. 8
E 12
31. The typical vertebra has which of the following?
A. Two spinous processes and one transverse process.
B. A vertebral body and the vertebral arch.
C. Three articulating facets and four processes.
D. One laminae and a spinous process.
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32. How many vertebrae are in the lumbar spine?
A. 5
B. 6
C. 7
D. 8
E 12
33. The areas of Sensation on the skin supplied by a single spinal segment are called?
A. Myotomes
B. Reflexes
C. Lower Motor Neuron
D. Dermatomes
E. Upper Motor Neuron
34. Myotomes are associated with:
A. Sensation
B. Muscles
C. Reflexes
D. Upper Motor Neuron
E. Lower Motor Neuron
35. Dermatomes are associated with:
A. Sensation
B. Muscles
C. Reflexes
D. Upper Motor Neuron
E. Lower Motor Neuron
36. Grading a patient's muscle strength, a 5 is:
A. Complete range of motion against gravity with full resistance.
B. Complete range of motion with gravity eliminated.
C. Complete range of motion with gravity.
D. Complete range of motion against gravity with some resistance.
E. Evidence of slight contractility. No joint motion.
37. Which of the following is NOT part of the shoulder complex?
A. Ribs
C. Clavicle
B. Scapula
D. Humerus
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38. A 12 years old male, found heart murmur at birth, no obvious symptoms, physical examination: no cyanosis, a
level IV /VI rough systolic murmur at the left sternal edge of the second intercostal conducts to left neck,
weakened P2 , right ventricular and pulmonary artery systolic pressure gradient 80mmHg, X-ray showed
prominent pulmonary artery segment, which is the most likely diagnosis?
A, Ventricular septal defect
B, Atrial septal defect
C, Pulmonary stenosis
D, Patent ductus artery
E, Fallot's Tetralogy
39. Which is NOT a joint in the shoulder complex?
A. Sterno-clavicular joint
B. Acromioclavicular joint
C. Glenohumeral joint
D. Scapulothoractic joint
E. Humeralcrickoid joint
40. Which of the following structures are relatively solid connective tissues that provide an articulating surface
between bones?
A. Ligaments
B. Muscles
C. Tendons
D. Cartilage
E. Bones
41. Which of the following structures is a pocket of synovial membrane that is between adjacent tendons and muscles
which provides lubrication to the joints muscle tendon region for smooth functioning?
A. Ligaments
B. Muscles
C. Tendons
D. Bursae
E. Bones
42. Which of the following muscles is NOT a knee flexor?
A. Rectus Femoris
B. Semitendinosus
C. Semimembranosus
D. Biceps Femoris
43. Which of the following muscles is a knee extensor?
A. Rectus Femoris
B. Semitendinosus
C. Semimembranosus
D. Biceps Femoris
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44. The incidence of complications and poor outcomes is high in fractures with vascular injury. Treatment for
fractures with vascular injury should begin with which of the following?
A) Fracture alignment and stability
B) Early (within 6 hours of injury) restoration of blood flow
C) Wound management
D) Early mobilization
E) Recognition of compartment syndrome
45. Which of the following factors is least likely to influence the infection rate associated with open fractures?
A. patient comorbidities
B. administration of antibiotics
C. thorough debridement
D. type of wound closure
E. severity of injury as assessed with the Gustilo- Anderson classification
46. The pathogenesis of toxic shock syndrome is:
A. bacterial production of endotoxin
B. acute traumatic injury
C. coagulopathy
D. soft-tissue necrosis
E. renal dysfunction
47. Which of the following are the most common symptoms of mitral stenosis?
A、Mitral Facies
B、Dyspnea and palpitation
C、Hemoptysis
D、Hepatomegaly
E、Edema in lower extremities
48. Which is the best method to diagnose pulmonary valve stenosis？
A、ECG
C、Right heart catheterization
B、Chest X-ray
D、Cardiac auscultation
E、Left heart catheterization
49. Which is not the clinical manifestation of chronic constrictive pericarditis？
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A、Jugular vein engorgement
B、Hepatomegaly, ascites and lower extremity edema
C、Weakening or disappearance of heart beat
D、Normal heart rhythm，weak and speed pulse and odd pulse
E、Increased heart shadow
50. Male, 18 year-old worker, was stabbed on left chest, feeling flustered shortness of breath. Examination: pale face,
jugular vein engorgement, blood pressure 60/45mmHg, heart rate 120 per minute, heart sound weak, for the
diagnosis, which of the following measures are the best?
A、Blood transfusions, oxygen therapy, anti-shock
B、Pericardiocentesis
C、Oxygen and keep airway patency
D、drugs to raise blood pressure
E、Emergency chest x-ray and electrocardiogram
51. Female patient, 30 years old, palpitations, fatigue, abdominal distension and lower extremity edema for more than
a year. PE: jugular vein engorgement, odd pulse, enhanced heart beat, ascites. ECG showed low voltage QRS
wave, elbow venous pressure 250mmH2O, which is the clinical diagnosis?
A. liver cirrhosis, portal hypertension
B. rheumatic heart disease
C. heart failure
D. constrictive pericarditis
E. cardiomyopathy
52. Which of the following is the indication for patients with traumatic brain injury to have ICP monitors
placed________?
A. GCS 8 or less
B. GCS 10 or less
C.GCS 6 or less
D. GCS 12 or less
53. A 22 year-old female patient, exertional dyspnea for three years. PE: mild cyanosis on cheeks and lips,
arrhythmias, diastolic rumbling murmur on apical , enhanced first heart sound, which of the following
examination is best?
A, Chest X-ray
B, Echocardiography
C, Electrocardiogram
D, Phonocardiogram
E, Immune therapy
54. The most typical murmur of rheumatic mitral stenosis is
?
A, Loud systolic murmur at the left sternal edge of the third and fourth intercostal
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B, Soft hair-like murmur at left sternal edge of the second intercostal
C, Continuous machinery-like murmur at the left sternal edge of the second intercostal
D, Apical mid-diastolic rumbling like Murmur
E, Apical whole-systolic murmur
55. The relation between CBF、CPP and CVR is:
A. CBF=CPP/CVR
C. CBF= CVR/CPP
B. CBF=CPP-CVR
D. CBF= CVR-CPP
56. What is the most common reason that renders a patient vocal hoarseness immediately after receiving a radical
operation for esophageal cancer with esophageal-stomach anastamosis in the neck?
A. tracheal intubation injury
B. recurrent laryngeal nerve injury
C. phrenic nerve injury
D. cancer cell metastasis in the neck lymph nodes
57. When a patient was referred to the emergency for caustic esophageal injury by accident, what is the most possible
chemical agent?
A. strong acid
B. strong alkali
C. alcohol
D.liquid soap
3. According to normal anatomy, where does esophageal originate at and where does it end in?
A. C6---T11
B. C7—T11
C. C7---T12
D. C6—T10
58. Which esophageal diverticulum presents at the most superior position?
A. zenker’s diverticulum
B. parabronchial diverticulum
C. epiphrenic diverticulum
D. traction/true diverticulum
59. The most common fungal infection of the urinary tract occurs in following patients except
.
A. With indwelling Foley catheters
B. Receiving broad-spectrum antibacterial therapy
C. Diabetes mellitus
D. On corticosteroids
E. Endourological procedures
60. Regarding a pneumothorax, what is the most critical situation that need immediate rescuer?
A. close pneumothorax
B. open pneumothorax
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C. tension pneumothorax
D. open pneumothorax with subcutaneous emphysema
61. Which symptom is not involved in the paraneoplasmatic syndrome of lung cancer?
A.arthralgia
B. myasthenia
C. club finger
D. headache
62. The normal value of adult ICP is:
A.30～80mmH2O
C.70～150mmH2O
B.50～100mmH2O
D.70～200mmH2O
63. Which one is not the main Clinical manifestation of intracranial hypertension?
A. headache
C. papilloedema
B. hemiplegy
D. vomit
64. Which of the following is NOT the sign of anterior skull base fracture_______?
A. Bilateral periorbital ecchymoses
B.CSF otorrhea
C. CSF rhinorrhea
D. Anosmia.
65. The relation between CPP、ICP and MAP is:
A.CPP =MAP-ICP
C. CPP = ICP-MAP
B.CPP =MAP/ICP
D. CPP = ICP/MAP
66. Which one will not influence intracranial hypertension in the following factors?
A. age
C. lesions expansion rate
B. gender
D. degree of cerebral edema
67. The main clinical signs to diagnose intracranial hypertension is:
A. severe headache
C. papilloedema
B. consciousness, fuzzy glance
D. pulse eddy, elevated blood pressure
68. The most reliable assistant diagnosis method for intracranial lesions is:
A. craniocerebral ultrasonic
C. cerebral angiogram
B. EEG
D.electronic computer X-ray tomography
69. Which one will not cause intracranial mass effect?
A. cerebral abscess
C. intracranial aneurysms
B. chronic subdural hematoma
D. intracranial arachnoid cyst
70. Which one correct about the treatment of cerebral edema with mannitol？
A. slow drip
C. a dose should be finished within drops in 30min
D. a dose should be finished within the 2h drops
B. quickly push
71. The main difference between Foramen magnum herniation and transtentorial herniation is:
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A. severe headache
C. fidgety
B. frequent vomiting
D. breathing stop happens early
72. The formation mechanism of cerebral hernia is:
A. volume of intracranial content increase
B. intracranial blood volume increases
C. intracranial cerebrospinal fluid volume increase
D. cavity pressure unevenly distributed
73. What is the incorrect description of the injury of chest wall that involved in multiple ribs at multiple sites?
A. malacia of the chest wall
B. paradoxical respiration
C. flail chest
D. mediastinal emphysema
74. The most common intracranial benign tumor is:
A. hemangioma
C. metastatic carcinoma
B. gliomas
C. meningioma
75. The most common intracranial malignant tumor is:
A. gliomas
C. meningioma
B. metastatic carcinoma
D. hemangioma
76. The first choice of treatment of intracranial lesions is:
A. surgical resection
C. chemical treatment
B. radiotherapy
D. adrenal cortical hormone therapy
77. The most common reason for spontaneous subarachnoid hemorrhage is _____________
A. intracranial aneurysms
B. arteriovenous malformation
C. hypertension
D. amyloid degeneration
78. Which of the following examination is NOT useful in the diagnosis of intracranial aneurysms? __________
A. CT angiography.
B. type B ultrasonic
C. DSA.
D. MR angiography
79. The most common scenario of acute epidural hematoma is _____________
A. Frontal region
B. C. Parietal region
B. Temporal region
D. Occipital region
80. Which of the following medications is NOT recommended in most of the treatment of spontaneous subarachnoid
hemorrhage? ___________
A. anti-vasospasm
B. haemostatic
C. mannitol (for dehydration)
D. dopamine (for blood pressure control)
81. Which of the following is NOT the purpose of the surgical treatment for ruptured aneurysms? ________
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A. avoiding re-rupture and re-bleeding,
B. keep the aneurysm-bearing arteries open
C. clear all the blood clot
D. controlling vasospasm
82. The intracranial lesions which most easily cause foramen magnum hernia is:
A. temporal tumor
C. pituitary adenoma
B. occipital tumor
D. fourth ventricle tumor
83. Which of the following aneurysm is most suitable for endovascular treatment? _________
A. cerebral anterior artery aneurysm located in the A 3 segment in front of the corpus callosum
B. anterior communicating artery aneurysm between the two anterior arteries
C. posterior communicating artery aneurysm located in the angle formed by cerebral anterior artery and posterior
communicating artery
D. basilar artery aneurysm between posterior cerebral artery and anterior inferior cerebellar artery
84. Which of the following is NOT the common symptom of AVM? ___________
A. paralysis
B. headache
C. seizures
D. stiff neck
85. The most common cause of ischemic stroke is ________
A. hypercoagulabale state
C. ‘steal phenomenon’ by large AVM
B. vasospasm
D. carotid atherosclerotic thrombosis
86. ONYX glue is most often used in the embolization of ____________.
A. AVM
B. aneurysm
C. cavernous hemangioma
D. telangiectasis
87. Which of the followings is the complication of renal trauma?
A. Urinoma
B. Perinephric infection
C. Delayed renal bleeding
D. All of above
E. None of above
88. Which of the following is NOT the proper treatment for intracranial aneurysms__________?
A. surgery
B. endovascular therapy
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C. stereotaxic radial therapy
D. observing
89. Which of the following is NOT the proper treatment for cavernous hemangioma_______?
A. surgery
B. endovascular therapy
C. stereotaxic radial therapy
D. observing
90. It often takes ______________for the closure of the AVM after radial therapy.
A. 2-3 days
B. 2-3 weeks
C. 2-3 months
D. 2-3 years
91. The goal of treatment of increased ICP is to try to keep the ICP less than _____________mm Hg and to maintain
cerebral perfusion pressure at or above _____________ mm Hg
A.20; 80
B.30; 70
C.20; 70
D.30; 60
92. Which of the following is NOT included in the primary traumatic brain injury? _____________
A. Contusion
B. Traumatic subarachnoid hemorrhage
C. Diffuse axonal injury
D.Traumatic brain edema
93. Which of the following score is categorized as severe traumatic brain injury________?
A. GCS 14-15
B. GCS 9-13
C. GCS 3-8
D.GCS 3-5
94. The purpose of thrombolysis for acute brain infarction is to save_____________
A. the infarct brain tissue
B. penumbra
C. the un-infarct brain tissue
D. the whole brain
95. Which of the following is NOT the sign of middle skull base fracture________?
A. Ecchymosis over the mastoids
B.Bilateral periorbital ecchymoses
C. CSF otorrhea
D. CSF rhinorrhea
96. A patient with Drowsiness, confusion, and mild focal deficit, is graded as Hunt Hess____________
A. I
B. II
C. III
D.IV
97. Which of the following is NOT correct for traumatic CSF leaks? _____________
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A.Most traumatic CSF leaks resolve spontaneously within the first week.
B.CSF leaks refractory to spinal fluid drainage require surgical closure.
C.Prophylactic antibiotics are used on a prolonged basis.
D.If the CSF leak persists beyond 5 to 7 days, lumbar taps or spinal drainage can be performed.
98. A 65-year- old man was admitted because of increasing headache for 1 week. He had 2 months history of mild
head trauma. CT scan suggested isodense fluid collection with crescentic shape over the fronto-temporo-parietal
regions. What is the most probable diagnosis? __________
A. Chronic subdural hematoma
B. Acute subdural hematoma
C. Acute epidural hematoma
D.Intraparenchymal hematoma
99. For traumatic brain injury patients, contusions and hematomas can increase in size, particularly during the
first_____________
A.1 to 2 weeks
B.12 to 24 hours
C.24 to 48 hours
D.48 to 72 hours
100. Which of the following examinations is most reliable to establish a diagnosis of bladder cancer
?
A. Ultrasonography
B. CT
C. MRI
D. Cystoscopy and biopsy
E. Urinary cytology
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Zhejiang University 20_____ - 20_____, ______ Term Subject: Surgery
Examination Paper: Paper B Examination Pattern: ✓closed book
Examination Date: 2011-6-9, Examination Time: ________
Student Name: _____________________Student ID: ________________
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