1.

In the treatment of sigmoid volvulus:

a. Diagnosis cannot be made without Ba enema
b. The majority are treated by flatus tube through a sigmoidoscope
c. The treatment of choice in gangrenous bowel is primary resection and anastomosis
d. Impotence is a possible complication in resection and anastomosis of the colon
e. Antibiotics and fluid therapy are alternative treatment to deflation
2. Regarding bladder cancer generally:
a. Transitional cell carcinoma is the most frequent carcinoma
b. Also in Zimbabwe , the more frequent carcinoma is the transitional cell carcinoma
c. A T4 tumor has only infiltrated the superficial muscle layer
d. A squamous cell carcinoma predominates in areas where bilharzia is endemic
3. Bladder rupture
a. May be intraperitoneal
b. May be extra peritoneal
c. Is best diagnosed with cystogram
d. Is best diagnosed with an urethrocytoscopy
e. Has a high mortality rate when surgically deal with after 24 hours
4. Unilateral optic atrophy with contralateral papiloedema would suggest
a. Multiple sclerosis
b. Olfactory groove meningioma
c. Occipital lobe glioma
d. Carvenous sinus thrombosis
e. Pinealoma
5. Pituitary ablation is a reasonable consideration in the treatment of:
a. Severe diabetic retinopathy
b. Metastatic carcinoma of the breast
c. Enlarging pituitary adenoma
d. Metastatic carcinoma of the prostrate
e. Inappropriate secretion of antidiuretic hormone
6. A patient has an epidural hematoma with frequently have:
a. A lucid interval from the time of injury to the time of neurologic deterioration
b. Loss of consciousness
c. Dilation of the pupil on the side of the injury
d. Rotatory nystagmus
e. Hemiparesis
7. Which of the signs are typical of the fracture of the malar complex of the face:
a. Periorbital hematoma
b. Infraorbital anesthesia
c. Partial nerve palsy
d. Trismus
e. Diplopia
8. A 65 year old male who has smoked a pipe for over 40 years notes small white patched on the
anterolateral edge of the tongue. This is not painful at first but becomes so as it ulcerates. The
most likely diagnosis
a. Benign, non-specific ulceration
b. Benign leukoplasia
c. Epulis
d. Carcinoma of the tongue
e. Syphilis
9. A unilateral cleft-lip should be repaired when the child is in good health and is
a. 6 weeks old
b. 6 months old
c. 1 year old
d. 18 months old
e. 5 years old
10. Which of the following situations requires urgent repair using vascularized skin flap, in contrast
to a free skin graft
a. An exposed joint
b. An exposed tendon or nerve
c. Exposed cornea due to destruction of eyelids
d. Exposed periosteum
e. Exposed muscle
11. A patient presents with a hand newly crushed in a roller press. The hand lookd slightly swollen,
but otherwise intact. Which of the following would you take
a. immediately call out the micro vascular surgery team
b. Reprimand the patient for wasting everyone’s time coming to the hospital
c. Give analgesia, if required, admit the patient and X-ray the hand
d. Test the urine qualitatively and quantitavely over the next few days
e. Elevate the hand immediately inform the surgeon on call
12. You find an area of consolidation in the right lung field on x-ray of the chest. There is no other
abnormality visible in the lung fields or pleura. This is the middle lobe if:
a. The right margin of the heart is clear
b. The lateral view there is an opaque triangle lying anterior to the mediastinum with its
base and anterior and apex posterior
c. In the lateral view there is an opaque triangular lying anterior to the mediastinum with
it’s a*ex anterior and the base posteriorly
d. There is dullness to percussion over the right mid-zone of the chest posterior
e. There are bronchial breath sounds immediately below the right clavicle
13. A barium swallow radiograph in a patient complaining of difficulty in swallowing shows normal
shaped esophagus with a tyering clean-out edge in its distal third. Thus suggests which one of
the following
a. Cardio spasm (Achalasia of the esophagus)
b. Carcinoma of the esophagus
 c. Benign stricture
d. A dilated (L) atrium
e. Plummet-vinson syndrome
14. A 50 year old man presents with a cavitating shadow in his lung. Which one of the following is
the likely diagnosis:
a. Pulmonary infarct
b. Tuberculosis
c. Metastatic deposit
d. Bronchial carcinoma
15. Silver nitrate dressings on burs wounds may cause systemic depletion if all of the following
a. NA+
b. K+
c. Mg++
d. Ca++
e. Cl-
16. The following are features of acute appendicitis
a. Leukocytosis of over 10 000 cells per cu
b. Pyrexia over 40 degrees Celsius
c. Frequency of micturition
d. Flexion of hip joint
e. Distended abdomen
17. The following investigations are essential in mechanical intestinal obstruction in adults:
a. Plain abdominal x-ray
b. Four quadrant tap
c. Serum electrolytes
d. Barium meal
e. Barium enema
18. In a jaundiced person with a palpable gall bladder
a. Gall stones in the gallbladder are the most likely cause
b. Gall stones in the common bile duct are the most likely cause
c. Carcinoma of the head of pancreas is the most likely cause
d. Duodenal diverticulum is a likely cause
e. Duodenal ulcer is a likely cause
19. Varicose in the lower limb is associated with
a. Incompetent communicating (perforating) veins
b. Incompetent valves
c. Aterio-venous fistulae
d. Wucheria Eencrofti infestion
e. Deep vein thrombosis
20. The following are complications of hemorrhoids:
a. Portal pyaemia
b. Amoebic liver abscess
 c. Pilondial sinus
d. Massive hemorrhage
e. Anal stenosis
21. In bleeding esophageal varices
a. Balloon tamponade is definitive treatment
b. Sclerotherapy in the treatment of choice today
c. Porto-caval shunting is complicated by rebleeding
d. Gastric transection is a palliative procedure
e. Coagulants form part of the treatment
22. In treatment of sigmoid volvulus
a. Diagnosis cannot be made without barium enema
b. The majority are treated by flatus tube through sigmoidoscope
c. The treatment of choice in gangrenous bowel is primary resection and anastomosis
d. Impotence is a possible complication in resection and anastomosis of the colon
e. The treatment of choice in gangrenous bowel is primary resection and colostomy
23. The following are complications of surgical treatment of carcinoma of stomach
a. Anastomic ulcer
b. Pyloric stenosis
c. Post-gastrectomy syndrome
d. Megaloblastic anemia
e. Pernicious anemia
24. Which of the following situations requires urgent repair using a vascularized skin flap, in
contrast to free skin graft:
a. An exposed joint
b. An exposed tendon or nerve
c. Exposed cornea due to destruction of eyelids
d. Exposed periosteum
e. Exposed muscle
25. After abdominal surgery, NGT suction is continued until
a. X-ray studies show free passage of food
b. Blood volume has returned to normal
c. BP and pulse rate have stabilized
d. Patient is passing flatus, has intrabdominal sounds and small volume nasogastric
aspirate
e. Patient develops a sore throat
26. Hypertrophic pyloric stenosis
a. Rarely cause of vomiting in the first week of life
b. Caused by obstruction of the distal part of the ampulla
c. More common in females
d. Associated with dehydration and hypochloromic ankylosis
e. Vary successful intervention with an operation
27. In the examination of hernia in the groin
 a. Femoral hernia is lateral to the pubic tuberosis
b. The deep inguinal point is at the mid inguinal point
c. Indirect inguinal hernia comes out through the hasselback’s triangle
d. Direct inguinal hernia is lateral to the inferior epigastric vessels
28. The following statements are true of burns
a. Superficial burns require skin grafting to prevent contractures
b. Exposure (open) method is good for the face and the neck
c. Burns involving joints require full thickness skin grafts
d. Topical antimicrobial agents e.g., Silver sulphur diazim (SSD)are contraindicated
e. To prevent contracture early physiotherapy is an advantage
29. Gall stone formation (Cholelithiasis) is associated
a. High protein intake
b. Multiparity
c. Saint’s triad
d. High carbohydrate intake
e. High fat intake
30. The following are characteristic of thyrotoxicosis
a. Increased appetite
b. Increased weight
c. Preference for cold
d. Casual pulse rate is normal
e. Increased perspiration
31. True statements regarding adenocarcinoma of the pancreas include
a. Occurs most frequently in the body of the gland
b. Carries a 1-2% 5 year survival rate
c. Is non-resectable if it presents as painless jaundice
d. Is associated with diabetes mellitus
e. Is related to bile-duct pathology
32. A 26 year old man sustains a gunshot wound to the left thigh. Exploration reveals that a 2 cm
portion of the superficial femoral artery is destroyed. Appropriate management may include:
a. Debridement and end to end anastomosis
b. Debridement and repair with Dacron graft
c. Debridement and repair with vein graft
d. Ligation and observation
e. Reverse saphenous vein bypass graft
33. Treatment of clostridial myconecrosis (gas gangrene) includes which of the following procedures
a. Administration of penicillin
b. Administration of hyperbaric of oxygen
c. Wide debridement
d. Administration of antitoxin
e. Administration of IV barbiturates
34. A rectal carcinoma found at 5 cm from the denatae line can best treated by
 a. Abdominal-perineal resection
b. Intensive-radiotherapy
c. Sigmoid pull –through after rectal resection
d. Abdominal rectal resection with anosigmoid stapling
e. Palliative fulguration since prognosis is so poor
35. Anorectal malformations in female children
a. Most often are associated with a recto-vaginal fistula
b. Are often associated with a recto-urethral or recto-vesical fistula
c. May be associated with renal abnormalities
d. Usually do not need an emergency colostomy immediately after birth
e. Are usually repaired with operineal operation
36. Correct statements regarding groin hernias are
a. Direct hernias protrude medial to the inferior epigastric vessels
b. Femoral hernias are the most common hernia in women
c. Indirect hernias rarely cause serious problems
d. Hernias in infants are usually a combined direct and indirect type
e. Femoral hernias are more likely to strangulate than inguinal hernias
37. A 32 year old woman has an appendicectomy done for acute appendicitis. The pathology report
indicated that a 1 cm carcinoid tumor is located at the tip. Corrected statements include the
following:
a. The patient should be advised to undergo ileo-colectomy
b. The most common location for carcinoids in the appendix
c. Carcinoid syndrome occurs in more than 50% of patients with carcinoid tumors
d. The tumor is an apudoma
e. The prognosis of the patient is favorable
38. Non cardiac factor that can increase central venous pressure (CVP) include
a. Hypervolemia
b. Positive pressure ventilation
c. Pneumothorax
d. Flail chest
e. Primary shock
39. Tissue protruding from the anus after defecation in a 2 year old child
a. May be due to rectal prolapse
b. Can be safely reduced back into the rectum by parents
c. May be due to the prolapse of a polyp of the rectum,
d. Is likely due to malignant adenomatous polyp
e. If due to a polyp, the poly is most likely a juvenile or inflammatory one which is not
malignant
40. A palpable abdominal mass filling the left upper and mid abdomen in a 2 year old child
a. Is a Wilm’s tumour (nephroblastoma) until ruled otherwise
b. Should be observed for six weeks before investigations are ordered
c. May be a hydronephrotic kidney or an enlarged spleen
 d. Should be invested by USS
e. Should be investigated by IVP
41. A 25 year old woman with a sero-sanguinous nipple discharge is found to have no palpable
breast mass. Likely diagnosis would include
a. Cysto sarcoma phylloides
b. Fibroadenoma
c. Chronic cystic mastitis
d. Carcinoma
e. Intra ductal papilloma
42. Fatigue and/ or hoarseness of the voice after thyroidectomy may indicate damage to which
nerves:
a. Hypoglossal nerve
b. External branch of superior laryngeal nerve
c. Internal branch of superior laryngeal nerve
d. Hypoglossal nerve
e. Recurrent laryngeal nerve
43. A 65 year old male has smoked a pipe over 30 years, notes a small white pathc on antero-lateral
edge of the tongue. This is not pain at first but becomes so as it ulceraties. The most likely
diagnosis is
a. Benign, non-specific ulceration
b. Benign leukoplakia
c. Epulis
d. Carcinoma of the tongue
e. Syphillis
44. Late mortality in burns is caused most commonly by
a. Acute renal failure
b. Electrolyte imbalance
c. Haematemesis
d. Septicemia
e. Decubitus ulcers
45. Fractures :
a. Premature closure of the epiphysis is commonly seen after a Salter II fracture
b. Intra-articular fractures of the calcaneum often lead to post traumatic subtalar
osteoarthritis
c. Avascular necrosis of the Talus is a frequent complication of the complete dislocation of
the body of talus
d. Displaced intra-articular fractures are best treated by open reduction
e. A fracture fragment is insufficient size for attachment of rigid fixation is a relative
contra-indication to open reduction and internal fixation
46. Dislocations:
a. The direction of dislocated patella is usually lateral
b. Neurovascular injuries are uncommon in the knee dislocations
 c. In a fracture- dislocation of the hip the integrity of the acetabula femoral head are
crucial prognostic factors
d. In an isolated displaced proximal ulnar fracture there is usually a dislocation of the
radius at wrist level
47. Bone tumors
a. The commonest malignant tumor of bone is osteogenic sarcoma
b. The prognosis osteosarcoma following paget’s disease is good
c. The osteochondroma is the commonest benign tumor affecting long bones
d. The osteosarcoma seen in the teenage group may mimic acute osteomyelitis
e. Histologically it may be difficult to differentiate an ewing’s sarcoma from
reticulosarcoma
48. Intussusception in children
a. Is usually associated with the blood per rectum
b. If seen early after onset, can be diagnosed by palpating a tubular mass in the abdomen
c. Is more common in children older than 5 years
d. Need prompt operative repair because it rapidly becomes the irreducible and produce
gangrene of the bowel
e. Most of the associated with no identifiable lesion causing the intussusception
(idiopathic)
49. Fracture treatment
a. In a reduction of a fracture the undamaged soft tissues are brought into normal
relationship so that the bone fragments will return to their normal position
b. In a volar angulated fracture the volar perioteum can be used as a soft tissue hinge to
reduce the fracture
c. In fracture if short bones the displacement is the limited by the extent to which the
fibrous tissues in the vicinity have been torn and in the majority of cases no further
displacement will occur if the fracture is not splintered
d. In the reduction of an extension – supracondylar elbow fracture lateral displacement of
the distal fragment is corrected when the elbow is brought into flexed position
e. After reduction a Colles fracture is immobilized in flexion and radial deviation
50. Tibia and ankle fractures
a. Segmental tibia fractures are best treated by open reduction
b. A calcaneal pin is best inserted 2 inches above and in front of the profile of the heel
c. In the conservative treatment of the tibia fracture no shortening more than 1 cm is
considered acceptable
d. The key factor in the reduction of the unstable fracture – dislocation of ankle is a
position of talus relation to the tibia
e. In the reduction of an unstable abduction fracture with talar shift “side to side”
compression at the same level over each malleolus will reduce the fracture