Ahmed Selim

Riham Farouk
Colorectal cancer

Midterm 2007
(Q32) There is an increased risk of development of intestinal malignancy in the following
lesion except:
a. Peutz-jegher`s syndrome
b. Familial polyposis coli
c. Ulcerative colitis
d. Diverticular disease
(Q35) All of the following statements about colorectal cancer are true except:
a. Most tumors occur in the right side of colon
b. Cecal tumors usually present by anemia and mass
c. Left sided tumors are more likely to obstruct than right sided tumors
d. Villous adenomas have a greater malignant potential than tubular adenomas
Midterm 2008
(Q43) In comparison with left sided colon carcinoma, patients with right sided cancer colon
are more likely to present with:
a. Intestinal obstruction
b. Bright red blood in stools
c. Microcytic anemia
d. Progressive constipation
(Q46) Carcinoma in the upper third of the rectum is treated by:
a. Anterior resection
b. Abdominoperineal resection
c. Radiotherapy alone
d. Chemotherapy and radiotherapy
Midterm 2009
(Q15) In carcinoma of the rectum 12cm from the anal verge, the treatment of choice is:
a. Anterior resection
b. Abdominoperineal resection
c. Hartmann`s operation
d. None of the above
(Q34) Which of the following colonic polyps may become malignant?
a. Adenoma
b. Hamartoma
c. Juvenile polyps
d. Metaplastic polyps

Ahmed Selim

Riham Farouk

Midterm 2011
(Q26) With regard to colorectal cancer:
a. Most tumors occur in the right side of the colon
b. Right sided tumors are more likely to obstruct than left sided tumors
c. Colorectal cancer has been associated with a diet high in fiber and low in saturated fat
d. Villous adenoma had a greater malignant potential than tubular adenomas
(Q29) Carcinoma of the upper third of the rectum is treated by:
a. Anterior resection
b. Abdominoperineal resection
c. Radiotherapy alone
d. Chemotherapy and radiotherapy
Midterm 2012-2
(Q22) A patient has a tumor 10 cm from the anal verge. Staging investigations show localized
disease only, which operation is ideal for him?
a. Subtotal colectomy
b. Left colectomy
c. Abdominoperineal excision of the colon and rectum
d. Anterior resection
Midterm 2013
(Q14) Which of the following is not a syndrome associated with increased risk of colonic
adenocarcinoma?
a. Familial adenomatous polyposis
b. Hereditary non-polyposis colon cancer
c. Multiple endocrine neoplasm syndrome type-2
d. Gardner`s syndrome
(Q15) Which of the following is the most common site for colonic carcinoma?
a. Rectum
b. Transverse colon
c. Descending colon
d. Caecum and ascending colon
Midterm 2014-2
(Q11) The risk of colon cancer is highest in:
a. Tubular adenoma
b. Villous adenoma
c. Tubulovillous adenomas
d. Hamartomatous adenomas

Ahmed Selim

Riham Farouk

Final 2008-1
(Q5) Which of the following colonic pathology have no malignant potential?
a. Ulcerative colitis
b. Villous adenoma
c. Familial polyposis
d. Peutz-Jeghers syndrome
(Q108) About surgical procedures on the colon and rectum:
a. Successful healing of colonic anastomosis depends on the adequacy of blood supply
b. In excising part of the colon containing cancer, the lymphatic should be avoided by dividing
the mesentery close to the wall of colon
c. When the colostomy is created, it cannot be reversed
d. Colostomy should be avoided with colonic perforation or obstruction
(Q116) About surgical procedures on the colon and rectum:
a. Successful healing of colonic anastomosis depends on the adequacy of blood supply
b. In excising part of the colon containing cancer, the lymphatic should be avoided by dividing
the mesentery close to the wall of colon
c. When the colostomy is created, it cannot be reversed
d. Colostomy should be avoided with colonic perforation or obstruction
Final 2009-1
(Q39) Carcinoma of the upper third of the rectum is treated by:
a. Anterior resection
b. Abdominoperineal resection
c. Radiotherapy alone
d. Chemotherapy and radiotherapy
(Q93) Regarding colorectal carcinoma, all are true except:
a. Left sided tumor often presents with intestinal obstruction
b. Right sided tumor often presents with anemia and mass
c. About 5% of patients have synchronous tumors
d. A Duke`s B tumors has nodal metastasis
Final 2009-2
(Q24) In the gastro-intestinal tract all of the following are pre-cancerous conditions except:
a. Barrett`s esophagus
b. Colonic villous adenoma
c. Angiodysplasia of the colon
d. Tubular adenoma of the rectum

Ahmed Selim

Riham Farouk

(Q39) Most frequent site of metastasis of colonic tumors is to:

a. Liver
b. Ovaries
c. Lung
d. Bones
(Q43) Regarding Dukes classification of rectal carcinoma, all are true except:
a. Dukes was a pathologist
b. He described three stages A, B and C
c. Stage D was not described by dukes and described later to signify wide spread metastasis
usually hepatic
d. C1 indicates affection of central lymph nodes
(Q44) Carcinoma of the upper third of the rectum is treated by:
a. Anterior resection
b. Abdominoperineal resection
c. Radiotherapy alone
d. Chemotherapy and radiotherapy
(Q91) Patients with right sided colon cancer are more likely than patients with left sided
cancer to:
a. Have obstructive signs
b. Show bright red blood in stools
c. Presents with anemia
d. Have lower abdominal pain
Final 2011
(Q16) The following diseases carry an increased risk for developing cancer colon except:
a. Intestinal TB
b. Ulcerative colitis
c. Familial polyposis coli
d. Villous adenoma
Final 2012
(Q3) Which of the following types of colonic polyps is associated with the highest incidence of
malignant change?
a. Tubular adenoma
b. Tubulovillous adenoma
c. Villous adenoma
d. Hamartomatous polyp

Ahmed Selim

Riham Farouk

(Q30) A 73-year- old lady is investigated for anemia. At colonoscopy she is found to have a
flat board based lesion in the caecum. This is biopsied and histology report states that these
have diagnostic features of an adenoma with high grade dysplasia:
a. Snare polypectomy
b. Right hemicolectomy
c. Repeat endoscopy at 3 years
d. Repeat endoscopy at 1 year
(Q38) A patient has a tumor 11cm from the anal verge. Staging investigations show localized
disease only. Which of the following procedures would be the most suitable surgical option?
a. Subtotal colectomy
b. Left hemicolectomy
c. Abdominoperineal excision of the colon and rectum
d. Anterior resection
Final 2013
(Q10) One of the following is a common presentation of ascending colon carcinoma:
a. Constipation
b. Dysentery
c. Anemia
d. Intestinal obstruction
(Q33) The risk of colon cancer is highest in:
a. Tubular adenoma
b. Villous adenoma
c. Tubulovillous adenomas
d. Hamartomatous adenomas
(Q89) All are predisposing factors of colon carcinoma except:
a. Crohn`s disease
b. Adenoma
c. Ulcerative colitis
d. Irritable bowel syndrome
(Q94) After abdominoperineal procedure for low rectal carcinoma, the result stoma is:
a. Permanent colostomy
b. Double bowel colostomy
c. Covering ileostomy
d. Loop colostomy

Ahmed Selim

Riham Farouk

Final 2014
(Q103) Which of the following is the most important prognostic determinant of survival after
treatment of colorectal cancer?
a. LN involvement
b. Transmural extension
c. Tumor size
d. Histologic differentiation
e. DNA content
(Q119) a 70-year- old man presents with pallor and breathlessness. On examination he does
not complain of abdominal pain. He has microcytic hypochromic anemia, what is the most
probable cause?
a. Diverticulosis of the colon
b. PU disease
c. Crohn`s disease
d. Ulcerative colitis
e. Carcinoma of the colon

Intestinal obstruction
Midterm 2008
(Q13) All of the following is true as regard to bowel obstruction, except:
a. Abdominal distension is usually noted on examination
b. High pitched tinkling bowel sounds are heard on examination
c. Can be treated by bowel stimulants
d. If not promptly resolved it usually require operation
Midterm 2012-2
(Q18) A 56-year- old lady is admitted with colicky abdominal pain. A plain x ray was
performed. Which of the following should not show fluid levels on a plain and film?
a. Stomach
b. Jejunum
c. Caecum
d. Descending colon
Midterm 2013
(Q20) From the list of options below, which one is most unlikely cause of mechanical
intestinal obstruction?
a. Fecal impaction
b. Cecal volvulus
c. Paralytic ileus
d. Congenital intestinal atresia

Ahmed Selim

Riham Farouk

Final 2008-1
(Q12) In simple intestinal obstruction, a low blood pressure is a result of:
a. Failure of the heart to pump blood to tissues
b. Reduction of the circulatory volume
c. Mechanical obstruction of the cardiac filling
d. Vasodilatation of low systemic vascular
Final 2008-2
(Q38) Dynamic intestinal obstruction can occur d.t all the following EXCEPT:
a. Hernia
b. Volvulus
c. Peritonitis
d. Inspissated feces
(Q83) Dynamic intestinal obstruction can occur due to all the following except:
a. Hernia
b. Volvulus
c. Peritonitis
d. Inspissated feces
Final 2009-1
(Q8) Bowel strangulation is an example of:
a. Dry gangrene
b. Moist gangrene
c. Mixture of the above
d. None of the above
Final 2013
(Q100) The rule that constipation is present in intestinal obstruction does not apply in:
a. Strangulated inguinal hernia
b. Adhesive intestinal obstruction
c. Cancer colon causing obstruction
d. Mesenteric vascular occlusion
(Q101) The presence of a malignant stricture obstructing the right colon with a competent
ileocecal valve is on type of:
a. Simple mechanical obstruction
b. Closed loop obstruction
c. Adynamic obstruction
d. Pseudo-obstruction

Ahmed Selim

Riham Farouk

(Q102) Minimal distension with profuse vomiting implies:

a. High small bowel obstruction
b. Low small bowel obstruction
c. Large bowel obstruction
d. Paralytic ileus
Final 2014
(Q108) Which of the following is true regarding the initial treatment of patients with acute
complete small bowel obstruction?
a. Immediate surgery is warranted as soon as the diagnosis is made
b. Nasogastric decompression for 24 h allows spontaneous resolution of complete bowel
obstruction in most patients
c. The presence of fever, tachycardia, localized pain or leukocytosis suggests strangulation and
warrants prompt surgery
d. All patients with complete small bowel obstruction require blood and plasma for
resuscitation
e. If a small bowel resection must be performed a stoma and mucous fistula one necessary
because an anastomosis is subject to non-healing in the face of obstruction

Intussusceptions
Midterm 2008
(Q20) Classical feature of intussusception include all of the following except:
a. Red currant jelly stool
b. Sausage shaped mass per abdomen
c. Palpable mass in PR examination
d. Fullness of right iliac fossa
Midterm 2011
(Q117) Classical feature of intussusception include all of the following except:
a. Red currant jelly stool
b. Sausage shaped mass per abdomen
c. Palpable mass in PR examination
d. Fullness of Rt iliac fossa
Final 2008-2
(Q71) Regarding classical features of intussusceptions:
a. Passage of black tarry stool
b. Empty right iliac fossa
c. Sausage shape mass at abdominal examination
d. Despite the illness the child is typically calm

Ahmed Selim

Riham Farouk

Final 2009-1
(Q108) Classical feature of intussusceptions include all of the following except:
a. Red currant jelly stool
b. Sausage shaped mass per abdomen
c. Empty right iliac fossa
d. Absolute constipation
Final 2009-2
(Q109) Regarding classical features of intussusceptions:
a. Passage of black tarry stool
b. Empty right iliac fossa
c. Sausage shape mass at abdominal examination
d. Despite the illness the child is typically calm

Sigmoid volvulus
Midterm 2013
(Q10) An 85-year-old male patient with a history of chronic constipation presents with acute
severe colicky abdominal pain and absolute constipation, plain abdominal film shows a
grossly dilated large bowel arising from the left lower quadrant. A diagnosis of sigmoid
volvulus is made, the next step in management is:
a. Sigmoidoscopy with tube insertion
b. Laparotomy
c. Barium swallow
d. Computed tomography
Final 2011
(Q53) The standard initial therapy for acute sigmoid volvulus is:
a. Rigid sigmoidoscopy
b. Laparotomy to reduce the volvulus and replace the sigmoid colon to its normal position
c. IV neostigmine
d. Colonoscopy
Final 2013
(Q103) What is the treatment of uncomplicated sigmoid volvulus?
a. Immediate exploration
b. Trail of colonoscopic manipulation
c. Reduction with barium enema
d. Repeated rectal enema

Ahmed Selim

Riham Farouk
Paralytic ileus

Midterm 2007
(Q55) In adynamic intestinal obstruction, all those symptoms occur except:
a. Distension
b. Vomiting
c. Abdominal colic
d. Constipation
Midterm2011
(Q94) On the 3rd post-operative day following an appendectomy operation, your patient still
didn`t pass flatus. He started to complain of abdominal distension or tenderness. Intestinal
sounds are absent. Supine abdominal x ray show dilated small and large intestinal loops. His
serum potassium was low. His clinical presentation is compatible with:
a. Post-operative adhesive intestinal obstruction
b. Post-operative paralytic ileus
c. Peritonitis with electrolyte imbalance
d. Electrolyte imbalance with an opened bowel
Final 2008-1
(Q97) Paralytic ileus:
a. Is associated with electrolyte imbalance
b. Is associated with severe bouts of abdominal colics
c. Requires treatment with nasogastric suction and IV fluids
d. Might be secondary to a retroperitoneal hematoma
Final 2009-1
(Q95) Treatment of paralytic ileus includes all of the following except:
a. IV fluids
b. Nasogastric suction
c. Correction of electrolyte imbalance
d. Bowel stimulants e.g. neostigmine
Final 2009-2
(Q94) The management of ileus is all except:
a. Nasogastric suction
b. IV fluids
c. Small dose of morphine
d. Bowel stimulants

Ahmed Selim

Riham Farouk

Final 2011
(Q29) On the 3rd post-operative day following an abdominal operation, your patient started
to complain of mild abdominal distension with no passage of gas. If you suspect paralytic
ileus, you expect your patient to have:
a. No abdominal pain with absent intestinal sounds
b. Abdominal pain with exaggerated intestinal sounds
c. Abdominal pain with normal intestinal sounds
d. Abdominal pain with absent intestinal sounds

Mesenteric ischemia
Midterm 2009
(Q7) Following secretion of 2 meters of the small bowel due to mesenteric vascular occlusion,
patient progressively lost weight due to protein and energy malnutrition. The best nutritional
support should be given through:
a. Nasogastric tube feeding
b. Gastrostomy tube
c. Jejunostomy tube
d. IV line
Final 2011
(Q22) Patient with chronic intestinal ischemia may experience:
a. Food fear
b. Pain out of proportion to physical finding
c. Bloody diarrhea
d. Fever
Final 2013
(Q24) Patients with chronic mesenteric ischemia may experience:
a. Pain out of proportion to physical findings
b. Bloody diarrhea
c. Fever
d. Food fear

Meconium ileus
Midterm 2008
(Q12) All of the following describes meconium ileus except:
a. Common cause of neonatal intestinal obstruction
b. Associated with cystic fibrosis
c. Inherited as an autosomal dominant trait
d. Can be relived with gastrografin enema

Ahmed Selim

Riham Farouk

Midterm 2011
(Q118) All of the following describes meconium ileus except:
a. Common cause of neonatal intestinal obstruction
b. Associated with cystic fibrosis
c. Inherited as an autosomal dominant trait
d. Can be relived with gastrografin enema
Final 2008-2
(Q50) All of the following refers to meconium ileus except:
a. Common cause of neonatal intestinal obstruction
b. 80% cases are associated with cystic fibrosis
c. Inherited as an autosomal dominant trait
d. X ray may show ground glass appearance
Final 2009-2
(Q93) Uncomplicated meconium ileus is best treated by:
a. Laparotomy and evacuation
b. Transverse colostomy
c. N-acetyl cysteine barium enema
d. Wait and watch
Final 2011
(Q69) The initial treatment for an infant with complete bowel obstruction from
uncomplicated meconium ileus is:
a. Contrast enema
b. NG decompression
c. Laparotomy and irrigation of the bowel lumen e N-acetyl cysteine
d. Laparotomy with resection of the distended distal ileum and creation of an ileostomy
Final 2013
(Q51) The initial treatment of an infant with complete bowel obstruction from
uncomplicated meconium ileus is:
a. NG decompression
b. Contrast enemas
c. Laparotomy and irrigation of the bowel lumen e N-acetyl cysteine (purse string enterostomy)
d. Laparotomy with resection of the distended distal ileum and creation of an ileostomy

Ahmed Selim

Riham Farouk
Acute appendicitis

Midterm 2007
(Q34) With regard to acute appendicitis, all of the following statements are false, except:
a. The presence of an appendix mass necessitates immediate surgical intervention
b. A normal white cell count excludes appendicitis
c. Loss of appetite is a common feature of acute appendicitis
d. Rovsing's sign is an increase in pain in left iliac fossa when the right iliac fossa is palpated
Midterm 2008
(Q15) All of the following are true as regard to appendicitis except:
a. More common in the second and third decade of life
b. Usually presents with vomiting followed by abdominal pain
c. May cause diarrhea
d. If an appendix mass develops, it should be treated conservatively
Midterm 2011
(Q20) With regard to appendicitis:
a. The presence of an appendix mass necessitate immediate surgical intervention
b. A normal white cell count excludes appendicitis
c. Loss of appetite is a common feature of acute appendicitis
d. Rovsing`s sign is an increased in pain in the left lilac fossa when the right iliac fossa is
palpated
Midterm 2012-2
(Q32) With regard to appendicitis:
a. The presence of an appendix mass necessitate immediate surgical intervention
b. A normal white cell count excludes appendicitis
c. Loss of appetite is a common feature of acute appendicitis
d. Rovsing`s sign is occurrence of pain in the left lilac fossa when the right iliac fossa is palpated
Midterm 2013
(Q12) Which of the following is not a sign associated with acute appendicitis:
a. Murphy`s sign
b. Psoas sign
c. Rovsing`s sign
d. Pain on rectal examination
Midterm 2014-2
(Q21) Which one of the following is not a sign associated with acute appendicitis:
a. Murphy`s sign
b. Cope sign
c. Rovsing's sign
d. Pain on rectal examination

Ahmed Selim

Riham Farouk

Final 2008-1
(Q65) Regarding Ochsner Sherren regimen for appendicular mass, it should be terminated in
presence of:
a. Rising pulse rate
b. Copious constant gastric aspirate
c. Spreading abdominal pain
d. Increase in size of the mass
(Q99) With regard to appendicitis:
a. The presence of an appendix mass necessitate immediate surgical intervention
b. A normal white cell count excludes appendicitis
c. Loss of appetite is a common feature of acute appendicitis
d. Rovsing`s sign is an increased in pain in the left lilac fossa when the right iliac fossa is
palpated
Final 2009-2
(Q33) In acute appendicitis, all are true, except:
a. Causes pain in the umbilical area which shifts to the right iliac fossa
b. Can be excluded if the white cell count and temperature are normal
c. Can be mistaken for ovarian cyst rupture
d. Can be treated by laparoscopic appendicectomy
Final 2012
(Q42) Regarding acute appendicitis, which of the following is true?
a. The presence of an appendix mass necessitates immediate surgical intervention
b. A normal white cell count excludes appendicitis
c. Loss of appetite is not a common feature of acute appendicitis
d. Rovsing`s sign occurrence of pain in the right iliac fossa when the left iliac fossa is palpated
Final 2013
(Q84) Acute appendicitis with frequency of micturition and diarrhea and complete absence of
abdominal rigidity, rectal examination reveals tenderness in the rectovesical pouch especially
on the right side muscles is present:
a. Subhepatic type
b. Retrocecal type
c. Postileal type
d. Pelvic type

Ahmed Selim

Riham Farouk
Meckel`s diverticulum

Midterm 2007
(Q25) All of the following statements about embryology of Meckel`s diverticulum are true
except:
a. Meckel`s diverticulum usually arises from the ileum within 2 feet of the ileocecal valve
b. Meckel`s diverticulum results from failure of the vitelline duct to obliterate
c. The incidence of Meckel`s diverticulum in the general population is 5%
d. Gastric mucosa is the most common ectopic tissue found en a Meckel's diverticulum
Midterm 2009
(Q32) Regarding meckel`s diverticulum, all are true except:
a. It is usually situated at the junction between the jejunum and ileum
b. It may be attached to the umbilicus
c. It may contain gastric mucosa
d. Inflammation causes pain in the right iliac fossa
Midterm 2013
(Q16) Which of the following is not a complication of meckel`s diverticulum:
a. Volvulus
b. Peptic ulceration
c. Intussusception
d. Pancreatitis
Final 2008-1
(Q48) A 30-year-old woman is accidently found to have a wide mouthed meckel`s
diverticulum during laparotomy, best method of treatment:
a. Diverticulectomy
b. Leave it alone
c. Resection of diverticulum with a short segment of ileum and anastomosis
d. Resection of diverticulum and stump is invaginated
Final 2008-2
(Q58) Meckel`s diverticulum may present with which of the following signs and symptoms:
a. Hemorrhage
b. Intussusception
c. Volvulus
d. Patent omphalomesenteric duct

Ahmed Selim

Riham Farouk

Final 2009-1
(Q38) False regarding meckel`s diverticulum is:
a. Located 60cm from the duodenojejunal junction valve
b. Arise from the antimesenteric border
c. A cause of intussusceptions
d. May contain gastric and pancreatic tissue
Final 2009-2
(Q92) Most complications of meckel`s diverticulum is:
a. Intussusception
b. Obstruction
c. Bleeding
d. Diverticulum
Final 2011
(Q72) All of the following statements about the embryology of meckel`s diverticulum are true
except:
a. Meckel`s diverticulum is a false diverticulum
b. Meckel`s diverticulum usually arise from the ileum within 90cm of the ileocecal valve
c. Meckel`s diverticulum results from failure of the vitelline duct to obliterate
d. The incidence of meckel`s diverticulum in the general population is 2%

APC
Final 2008-2
(Q110) Regarding colonic polyps:
a. Juvenile rectal polyps are pre-malignant
b. The risk of malignancy is higher in tubular than villous adenoma
c. Villous adenoma occasionally cause hyperkalemia
d. All patients with untreated familial adenomatous polyposis will eventually develop colorectal
carcinoma
Final 2009-1
(Q94) Regarding familial adenomatous polyposis coli:
a. Is inherited as an autosomal recessive condition
b. Is characterized by polyp formation in late adulthood
c. Is associated with osteomas and epidermoid cysts in Gardner`s syndrome
d. Is associated by limited colectomy of the affected segment

Ahmed Selim

Riham Farouk

Final 2009-2
(Q45) False regarding familial adenomatous polyposis:
a. Total colectomy early in childhood is the treatment of choice
b. Equal incidence in males and females
c. Adenomatous polyps occur in colon
d.100% chances of malignancy over a period of time
Final 2013
(Q9) The risk of colorectal cancer in patients with untreated familial adenomatous polyposis
is:
a.100%
b.90%
C.80%
d.70%
(Q88) Method of screening of familial adenomatous polyposis includes:
a. Barium enema
b. Barium meal follow-through
c. Upper GIT endoscopy
d. DNA study for the (APC) gene

Peutz-jegher`s syndrome
Midterm 2009
(Q17) Peutz-jegher`s syndrome is characterized by all except:
a. Melanosis of lips and oral mucosa
b. Polyposis is in jejunum
c. High malignancy potential
d. Familial tendency
Final 2009-2
(Q90) Peutz-jegher`s syndrome is characterized by all except:
a. Melanosis of lips and oral mucosa
b. Polyposis is in jejunum
c. High malignancy potential
d. Familial tendency
Final 2011
(Q19) Which of the following condition is characterized by generalized intestinal polyposis
with pigmentation of face and oral mucosa?
a. Neurofibromatosis
b. Peutz jegher`s syndrome
c. Familial polyposis
d. Gardner syndrome

Ahmed Selim

Riham Farouk

Final 2014
(Q24) Which of the following condition is characterized by generalized intestinal polyposis
with pigmentation of face and oral mucosa?
a. Peutz-jegher`s syndrome
b. Familial polyposis
c. Gardner syndrome
d. Neurofibromatosis

Diverticular disease
Midterm 2009
(Q33) Which of the following is true regarding diverticular disease of the colon?
a. Is caused by high fiber diet
b. Is associated with atrophy of colonic muscle wall
c. Is most commonly situated in the sigmoid colon
d. Is associated with increased risk of developing colonic carcinoma
Midterm 2011
(Q89) The most common 2 causes of severe colonic bleeding are:
a. Inflammatory bowel disease and angiodysplasia
b. Carcinoma and angiodysplasia
c. Angiodysplasia and diverticular disease
d. Inflammatory bowel disease and carcinoma
Midterm 2013
(Q22) You suspect a 75-year-old man to have a diverticular abscess. Which one of the
following is the most appropriate to confirm the diagnosis?
a. Barium enema study
b. Colonoscopy
c. Plain x-ray film
d. CT scan abdomen
Final 2009-1
(Q72) Regarding diverticular disease of the colon, all of the following are true except:
a. Is more common in the tropics
b. Increase in incidence with advancing age
c. Is associated with hypertrophied muscle in sigmoid colon
d. Does not affect the rectum

Ahmed Selim

Riham Farouk

Final 2013
(Q67) A complication of diverticular disease includes:
a. Carcinoma of the colon
b. Extraintestinal manifestations such as arthritis, iritis and skin rashes
c. Fistulisation to adjacent organs such as the bladder with insueing colovesical fistula
d. Arteriovenous fistula of the intestine

Massive bleeding per rectum

Midterm 2007
(Q46) Regarding massive lower gastrointestinal bleeding, all of the following statements are
true except:
a. Should be investigated by emergency colonoscopy
b. Is usually a result of carcinoma in elderly
c. It is caused by angiodysplasia on the right colon and diverticulosis on the left side
d. Settle spontaneously in the majority of patients
Midterm 2012-2
(Q40) A 75-year-old male presented with massive bleeding per rectum, most likely diagnosis
is:
a. Chronic ischemic colitis
b. Hemorrhoids
c. Diverticulosis
d. Colon carcinoma
Final 2008-1
(Q60) Regarding massive lower gastrointestinal bleeding:
a. Should be investigated by emergency colonoscopy
b. Is usually a result of carcinoma in elderly
c. It is caused by angiodysplasia on the right colon and diverticulosis on the left side
d. Settle spontaneously in the majority of patients
Final 2008-2
(Q97) Massive lower intestinal bleeding:
a. Should be investigated by emergency colonoscopy
b. Is usually a result of carcinoma in elderly
c. It is caused by angiodysplasia on the right colon and diverticulosis on the left side
d. Settle spontaneously in the majority of patients

Ahmed Selim

Riham Farouk

Final 2009-1
(Q6) Which of the following is not a cause of major lower gastrointestinal hemorrhage?
a. Diverticulitis
b. Angiodysplasia
c. Aorto-enteric fistula
d. None of the above
Final 2009-2
(Q22) A 70-year-old man brought to the emergency department because of massive bleeding
from the rectum, the most likely cause is:
a. Carcinoma of the colon
b. Ulcerative colitis
c. Colonic polyp
d. Diverticular disease of the colon
Final 2011
(Q74) Comparing angiography and endoscopy in the management of acute GIT bleeding, all of
the following are true, except:
a. Upper endoscopy id preferred than angiography for upper GIT bleeding
b. In case of lower GIT bleeding, angiography can localize the site of bleeding better than
endoscopy
c. Angiography is only diagnostic, unlike endoscopy which is both diagnostic and therapeutic
d. Angiography diagnoses the site of bleeding while endoscopy can diagnose the pathology as
well
(Q76) The most common 2 causes of severe colonic bleeding are:
a. Inflammatory bowel disease and angiodysplasia
b. Carcinoma and angiodysplasia
c. Angiodysplasia and diverticular disease
d. Inflammatory bowel disease and carcinoma
Final 2014
(Q39) A 75-year-old male presented with massive bleeding/rectum, most likely diagnosis is:
a. Rectal polyposis
b. Hemorrhoid
c. Diverticulosis
d. Colon carcinoma

Ahmed Selim

Riham Farouk
Crohn`s disease

Midterm 2007
(Q26) All of the following statements about histologic features of crohn`s disease are true
except:
a. The presence of granuloma involving the bowel wall mesenteric LNs
b. Transmural inflammation (affecting all layers of intestine)
c. Internal fistulae are rare compared to ulcerative colitis
d. Healing phase is marked by fibrosis e late stricture formation
Midterm 2008
(Q41) Crohn`s disease should be suspected in presence of all the following except:
a. Perianal fistulas
b. Frank bleeding per rectum
c. Recurrent intestinal obstruction
d. Frequent right iliac fossa pain
Midterm 2009
(Q27) Crohn`s disease should be suspected in presence of all the following except:
a. Perianal fistulas
b. Recurrent intestinal obstruction
c. Frequent right iliac fossa pain
d. Massive rectal bleeding
Midterm 2013
(Q18) Which of the following histopathological features not characteristic of crohn`s disease:
a. Cobble stone
b. Skip lesions
c. Lead piping
d. Serosal involvement
Midterm 2014-2
(Q9) Which of the following is the most common indication of surgery in a patient with
crohn`s disease:
a. Intestinal obstruction
b. Intestinal perforation
c. Gastrointestinal hemorrhage
d. Growth retardation

Ahmed Selim

Riham Farouk

Final 2008-1
(Q6)The most frequent indication of surgery in crohn`s disease of small intestine is:
a. Perianal fistula
b. Intra-abdominal abscess
c. Partial obstruction
d. Abdominal mass
Final 2008-2
(Q42) All of the following statements are true about histologic features of crohn`s disease are
true except:
a. The presence of granulomas involving the bowel wall and mesenteric LNs
b. Transmural affection (affecting all layers of intestine)
c. Internal fistulas are rare comparing e ulcerative colitis
d. Healing phase is marked by fibrosis and late stricture formation
Final 2009-1
(Q34) Crohn`s disease should be suspected in presence of:
a. Perianal fistula
b. Recurrent intestinal obstruction
c. Recurrent right iliac fossa pain
d. All of the above
Final 2011
(Q26) Which of the following is the most common indication of surgery in a patient with
crohn`s disease:
a. Growth retardation
b. Intestinal obstruction
c. Intestinal perforation
d. Gastrointestinal fistula
Final 2012
(Q92) The treatment of crohn`s disease may be any of the following except:
a. Medical treatment
b. Segmental resection of the affected segment
c. Total proctocolectomy with ileal pouch anastomosis
d. Strictureplasty for small bowel stricture

Ahmed Selim

Riham Farouk

Final 2013
(Q30) Which of the following is the most common indication of surgery in patient with
crohn`s disease:
a. Intestinal obstruction
b. Intestinal perforation
c. Gastrointestinal hemorrhage
d. Growth retardation
Final 2014
(Q31) Which of the following statement regarding crohn`s disease are true:
a. It is transmural disease affecting all layers of the intestine
b. Internal fistulae are rare compared with ulcerative colitis
c. Usually manifested by frank B/R
d. Skip lesions may occur
(Q96) Which of the following is the most common indication of surgery in a patient with
crohn`s disease:
a. Intestinal obstruction
b. Intestinal perforation
c. Gastrointestinal hemorrhage
d. Growth retardation
(Q102) During an operation for presumed appendicitis, appendix is found to be normal. The
terminal ileum ,however is markedly thickened and feel rubbery to firm. It`s serosa is
erythematous and inflamed and several loops of apparently normal small intestine are
adherent to it. The terminal ileum mesentery is thickened with fat growing about the bowel
circumference, which of the following is the most likely diagnosis?
a. Crohn`s disease of the terminal ileum
b. Perforated meckel`s diverticulum
c. Ulcerative colitis
d. Ileocecal TB
e. Acute ileitis
(Q112) A patient suspected of having appendicitis underwent exploration, crohn`s disease
was found. Which of the following is true?
a. The normal appendix should always be removed
b. All grossly involved bowel including the appendix should be resected
c. An inflamed appendix, cecum and terminal ileum should be resected
d. Perforated bowel and advanced crohn`s disease e obstruction should be resected
e. Only the tip of the appendix should be resected if the base is found to be involved

Ahmed Selim

Riham Farouk
Ulcerative colitis

Midterm 2007
(Q44) Regarding pathological feature of ulcerative colitis, all of the following statements are
true except:
a. Inflammation is limited to mucosa
b. Continuous lesion
c. Crypt abscess and atrophy
d. Perianal lesions are common findings
Midterm 2008
(Q10) The characteristic pathological features of ulcerative colitis include all of the following
except:
a. Inflammation is limited to mucosa
b. Skip lesions
c. Mucosal crypt abscess and atrophy
d. Mucosal pseudo polyps
Midterm 2009
(Q47) Regarding pathological features of ulcerative colitis, all are true except:
a. Inflammation is limited to mucosa
b. Continuous lesions
c. Crypt abscess and atrophy
d. Intestinal fistula more common than in crohn`s disease
Midterm 2011
(Q38) Features favoring ulcerative colitis over crohn`s disease include of the following except:
a. Transmural inflammation
b. Crypt abscess
c. Rectum almost always involved
d. Toxic megacolon
Midterm 2013
(Q11) Which of the following does not occur as a systemic manifestation of inflammatory
bowel disease?
a. Amyloidosis
b. Scleritis
c. Osteoporosis
d. Sclerosing cholangitis

Ahmed Selim

Riham Farouk

(Q19) A 28-year-old man with a 10-year-history of ulcerative colitis presents to the

emergency department with an acute severe episode of abdominal pain, nausea and
vomiting and blood stained watery diarrhea. O/E you notice that the patient has fever, is
tachycardic and the abdomen is markedly distended. An abdominal plain film radiograph
shows that the transverse colon is dilated at approximately 6.5cm.What is the most likely
diagnosis?
a. Large bowel obstruction
b. Toxic megacolon
c. Perforated diverticulitis
d. Crohn`s colitis
Midterm 2014-2
(Q19) Which of the following does not occur as a systemic manifestation of inflammatory
bowel disease?
a. Scleritis
b. Pyoderma gangrenosum
c. Sclerosing cholangitis
d. Osteoporosis
Final 2008-1
(Q93) The pathology of ulcerative colitis:
a. Show full thickness infiltration
b. The rectum is almost always involved
c. Enterocutaneous or intestinal fistulae are common
d. The serosa is usually normal
Final 2008-2
(Q37) What is true in pseudo polyps in ulcerative colitis?
a. Ulceration surrounded by normal mucosa
b. Edematous mucosa surrounded by ulcers
c. Polypoid projections from colon
(Q99) The pathology of ulcerative colitis:
a. Show full thickness infiltration
b. The rectum is almost always involved
c. Enterocutaneous or intestinal fistulae are common
d. The serosa is usually normal

Ahmed Selim

Riham Farouk

Final 2009-1
(Q23) Complications of ulcerative colitis:
a. Colon cancer
b. Toxic megacolon
c. Severe bleeding
d. All of the above
(Q91) Pathological features of ulcerative colitis include all are true except:
a. Inflammation is limited to mucosa
b. Skip lesions
c. Crypt abscess and atrophy
d. The rectum is usually affected
(Q92) Regarding carcinoma that arises following ulcerative colitis, all are true except:
a. It is more malignant than the carcinoma that occur in otherwise normal individuals
b. The incidence of carcinoma increases with the duration of active ulcerative colitis
c. The carcinoma occur only in the rectum
d. The carcinoma is usually multicentric
Final 2009-2
(Q88) The characteristic pathological features of ulcerative colitis include all of the following
except:
a. Affect all layers of the colon
b. Continuous lesions
c. Crypt abscess and atrophy
d. Affects the upper half of anal canal
(Q89) Regarding intestinal carcinoma that arises following ulcerative colitis include all are
true except:
a. It is more malignant than carcinoma that occurs in otherwise normal adults
b. The incidence of carcinoma increases e duration of an active ulcerative colitis
c. The carcinoma occurs only in the rectum
d. The carcinoma is frequently multicentric
Final 2011
(Q18) Surgical alternatives for treatment of long standing active ulcerative colitis with
dysplasia include all of the following, except:
a. Subtotal colectomy with rectal preservation for follow up
b. Total proctocolectomy with ileal J pouch anal anastomosis
c. Left colectomy e colorectal anastomosis
d. Proctocolectomy with ileostomy

Ahmed Selim

Riham Farouk

Final 2012
(Q91) Regarding ulcerative colitis, all statements are false except:
a. It is a disease that can affect any part of the gastrointestinal tract
b. It affects only the mucosal layer of the colon
c. It has an autosomal dominant mode of transmission
d. It affects only elderly individuals
Final 2013
(Q66) A 25-year-old man develops diarrhea and colicky abdominal pain, ulcerative colitis is
diagnosed on colonoscopy, which of the following finding 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
Final 2014
(Q118) A 35-year-old man has known ulcerative colitis, which of the following is an indication
for total proctocolectomy:
a. Occasional bouts of colic and diarrhea
b. Sclerosing cholangitis
c. Toxic megacolon
d. Arthritides
e. Iron deficiency anemia

Carcinoid
Midterm 2008
(Q44) All of the following are true as regard carcinoid tumors of the appendix except:
a. It is the most common tumor of the appendix
b. It commonly gives metastasis to the liver
c. The majority are less than 1cm in diameter
d. Tumors more than 2cm need hemicolectomy
Midterm 2009
(Q16) Regarding carcinoid tumor of the appendix, all are true except:
a. Most common tumor of the appendix
b. The majority occur at the base
c. The majority are less than 1cm in diameter
d. Appendectomy is adequate if the tumor is less than 1cm

Ahmed Selim

Riham Farouk

Midterm 2012-2
(Q15) A patient has an appendicectomy and 0.5cm carcinoid tumor is identified in the tip of
the appendix. What is the most appropriate management?
a. No further treatment
b. Right hemicolectomy
c. Limited ileocecal resection
d. Radioisotope scan
Midterm 2013
(Q17) Carcinoid tumors occur most commonly in which side:
a. Duodenum
b. Appendix
c. Stomach
d. Lung
Midterm 2014-2
(Q22) Carcinoid tumor occurs most commonly in:
a. Large bowel
b. Duodenum
c. Lung
d. Appendix
Final 2008-1
(Q61) Regarding carcinoid tumor of the gastrointestinal tract:
a. Are most commonly located in the appendix
b. Are usually malignant
c. Arises in the submucosa
d. Is frequently the cause of gastrointestinal hemorrhage
Final 2008-2
(Q27) Regarding carcinoid tumors of the appendix, all are true except:
a. Most common tumor of the appendix
b. The majority occur at the base
c. The majority are less than 1cm in diameter
d. Appendectomy is adequate if the tumor is less than 1cm
Final 2009-1
(Q71) Carcinoid tumor of the gastrointestinal tract characterized by all of the following
except:
a. Are most commonly located in the appendix
b. Are usually malignant
c. Develops from enterochromaffin cell
d. Associated with increase in 5 hydroxyindoleacetic acid (5HIAA) in urine

Ahmed Selim

Riham Farouk

Final 2009-2
(Q113) Regarding carcinoid tumor of the appendix, all are true except:
a. Most common tumor of the appendix
b. The majority occur at the base
c. The majority are less than 1cm in diameter
d. Appendectomy is adequate if the tumor is less than 1cm
Final 2011
(Q21) Most common site for carcinoid tumor is:
a. Appendix
b. Duodenum
c. Jejunum
d. Ileum

DD of RIF mass
Midterm 2013
(Q13) All of the following may cause the right iliac fossa mass except:
a. Ulcerative colitis
b. Tuberculosis
c. Appendicitis
d. Ovarian cancer

Peritonitis
Midterm 2007
(Q10) The following statement about peritonitis except:
a. Peritonitis can be septic or aseptic
b. Most surgical peritonitis is secondary to bacterial contamination from the gastrointestinal
tract
c. Primary peritonitis is more common in adults than in children and in men than women
d. Tuberculous peritonitis can be present with or without ascites
Midterm 2011
(Q17) With regard to acute abdomen:
a. Mesenteric adenitis is a common cause of abdominal pain in children
b. The absence of free air on an erect chest x ray exclude an intra-abdominal perforation
c. Free air under the right hemi-diaphragm can be mistaken for gas within the stomach
d. Raised serum amylase is diagnostic of acute pancreatitis

Ahmed Selim

Riham Farouk

(Q102) In spontaneous bacterial peritonitis, all are true except:

a. Fever and abdominal pain are common
b. Is an indicator of advanced liver disease
c. Infection is monomicrobial
d. Surgery is the best treatment
Final 2008-1
(Q111) About peritonitis:
a. Pain due to peritonitis causes the patient to move restlessly
b. Most secondary peritonitis can be treated non-surgically
c. Primary peritonitis is commonly due to a perforated viscous
d. Tuberculous peritonitis can present with or without ascites
(Q119) About peritonitis:
a. Pain due to peritonitis causes the patient to move restlessly
b. Most secondary peritonitis can be treated non-surgically
c. Primary peritonitis is commonly due to a perforated viscous
d. Tuberculous peritonitis can present with or without ascites
Final 2012
(Q96) Plain x ray abdomen erect show air under diaphragm is associated with all of the
following except:
a. Perforated duodenal ulcer
b. Perforated diverticulitis
c. Ruptured appendix
d. Ruptured spleen
Final 2013
(Q65) A 63-year- old woman is admitted to the hospital with severe abdominal pain of 3h
duration, abdominal examination reveals board-like rigidity, guarding and rebound
tenderness, blood pressure is 90/50 mmHg, pulse 110 bpm , respiratory rate 30 breaths/min.
After thorough history and physical and initiation of fluid resuscitation, what diagnostic study
should be performed?
a. Upright chest x ray
b. Gastrografin swallow
c. Computerized axial tomography scan of the abdomen
d. Abdominal sonogram

Ahmed Selim

Riham Farouk

Final 2014
(Q99) Regarding patients with a rigid abdomen and free air on plain film, which of the
following statements is true?
a. No further radiologic work up is required
b. CT with contrast enhancement is required to confirm the diagnosis
c. Bedside sonographic imaging is preferred over CT imaging to confirm the diagnosis of free air
d. Narcotics are contraindicated in patients with acute abdomen
e. Pre-operative prophylactic steroids are indicated in patients with free air
(Q109) A 75-year-old man taking NSAIDs for arthritis has an acute abdomen &
hemoperitoneum. His symptoms are 6 hours old & his vital signs are stable after infusion of
1L of normal saline solution. What should be the next step in the management of this
patient?
a. Computed tomography of the abdomen
b. Esophagogastroduodenoscopy (EGD)
c. Antisecretory drugs, broad spectrum antibiotics & surgery if he fails to improve in 6 hours
d. Antisecretory drugs, antibiotics for H.pylori & surgery if he fails to improve in 6 hours
e. Surgery

Mesenteric adenitis
Midterm 2011
(Q17) With regard to acute abdomen:
a. Mesenteric adenitis is a common cause of abdominal pain in children
b. The absence of free air on an erect chest x ray excludes an intra-abdominal perforation
c. Free air under the right hemi-diaphragm can be mistaken for gas within the stomach
d. Raised serum amylase is diagnostic of acute pancreatitis