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1. With regards to the Meaning of Professionalism. Which of the following is true.

A. A profession is a collegial discipline that regulates itself by means of mandatory,

systematic training. It has a base in a body of technical and specialized knowledge
that it both teaches and advances; it sets and enforces its own standards.

B. A profession has a profit rather than a service orientation, and its standards of
practice are enshrined in a code of ethics.

C. A profession has cognitive, collegial, and moral attributes based on informal

apprenticeship.

D. The nature of the unhealing relationship is itself the foundation of the special
obligations of Surgeons as surgeons.

E. The Oath of Hippocrates, declares, “I will practice my art with purity and holiness
and for the benefit of the healthy.”

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2. Choose the false statement among the following. In surgery the four aspects
of professionalism include:

A. A competent surgeon is more than a competent technician

B. Professionalism incorporates surgeons’ relationships with patients and society

C. Professionals should not be held accountable

D. Professional organizations are responsible for fostering professionalism in their

membership.

E. Surgical professionalism includes the following cardinal themes: public

professionalism (roles within society), interpersonal professionalism (roles between
doctor and patient and between/among colleagues), and intrapersonal
professionalism (relationship to self

3. Regarding communication skills. Choose the false statement.

A. A consultation is a meeting of two experts: you as the clinician and the patient as
an expert on his own body and mind.

B. Excellent communication skills allow you to identify a patient’s problem rapidly and
accurately and improve patient satisfaction.

C. Poor communication skills are associated with decreased medicolegal vulnerability

and clinician burnout.

D. Communication skills tend to develop with experience but can always be improved.

E. Working in teams does not change your personal accountability for your conduct
and the care you provide.

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4. Regarding professional attitude, choose the incorrect answer.

A. Dress and demeanour: The way you dress is not important in establishing a
successful patient–doctor relationship.

B. Your dress style and demeanour should never make your patient or colleagues
uncomfortable or distract them.

C. Smart, sensitive and modest dress is appropriate; expressing your personality is

not.

D. Exposing your chest, midriff and legs may not only create offence but impede
communication.

E. Have short or three-quarter-length sleeves or roll long sleeves up, away from your
wrists, before examining patients or carrying out procedures.

Clear selection

5. The reasons why people come to the hospital and why they must be taken
seriously include the following except?

A. They have not reached their limits of tolerance

B. They have reached their limits of anxiety

C. They have problems of daily living presenting with symptoms

D. For prevention

E. For administrative reasons

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6. Acute abdominal pain and abdominal masses are two clinical entities that are
intimately interconnected. The following are true except?

A. In many cases, abdominal pain and abdominal mass clinically present together.

B. The diagnostic process for evaluating abdominal pain and abdominal masses is
largely different and has been preserved since ancient times.

C. The varied differential diagnosis of such pathology was discussed in the Ebers
Papyrus (ca. 1500 BC).

D. The state of the hypochondrium is best when it is free from pain, soft, and of equal
size on the right side and the left.

E. If the hypochondrium is inflamed, or painful, or distended; or when the right and left
sides are of disproportionate sizes; all of these appearances are to be dreaded.

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7. The primary goals in the clerkship of patients with abdominal pain and/or an
abdominal mass are:

A. To establish a differential diagnosis through obtaining a clinical history,

B. To refine that differential diagnosis with a physical examination and appropriate

investigations

C. To determine the role of operative intervention in the treatment or refinement of the

working diagnosis.

D. To assign stage to malignant diseases

E. To grade and prognosticate benign neoplasms for example BPE

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8. Secondary hemorhhage is usually due to:

A. Trauma

B. Slipped ligature

C. Infection

D. All of the above

E. None of the above

Clear selection

9. As regard Bockdalek hernia all are correct except:

A. lt always presents in neonatal life.

B. Presents with neonatal distress with scaphoid abdomen.

C. X-ray shows gas shadow with mediastinal shift.

D. Main line of treatment is conservative with respiratory support.

E. Surgery is main line of treatment

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10. The commonest diaphragmatic hernia in adults is:

A. Bockdalek hernia.

B. Morgogni hernia.

C. Rolling hernia.

D. Sliding hiatus hernia.

E. Diaphragmatic everntration

Clear selection

11. The commonest diaphragmatic hernia in infants is:

A. Bockdalek hernia.

B. Morgagni hernia.

C. Rolling hernia.

D. Sliding hiatus hernia.

E. Petersen hernia

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12. Helicobacter pylori:

A. Is a gram negative bacilli spiral in shape (spirochetes)

B. Is the most common chronic infection worldwide?

C. Is a common cause of chronic peptic ulcer?

D. Urease test can easily diagnose infection.

E. All of the above.

Clear selection

The most common site of peptic ulcer is:

A. Fundus of stomach.

B. Distal end of esophagus.

C. 1st part of the duodenum.

D. Lesser curvature.

E. Greater curvature

Clear selection

14. The main line of treatment of gastric erosion is?

A. Conservative treatment.

B. Surgical ligation of feeding vessel.

C. Gastrectomy.

D. None of the above.

E. All the above

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15. Common Signs and Symptoms of Stomach Pathology

A. Haemorrhage

B. Nausea and vomiting

C. Dyspepsia

D. Abdominal pain

E. All the above.

16. Which of the following is true about hematemesis?

A. It is vomiting of unaltered blood

B. GI bleeding below the duodenum rarely enters the stomach

C. Colour of vomited blood depends on concentration of hydrochloric acid regardless

of the duration of contact with acid

D. Short duration leads to coffee colour

E. Long duration bright red colour.

17. The aims of understanding surgical emergencies thoroughly are

A. Recognize different surgical emergencies

B. Decrease delayed diagnosis

C. Prevent secondary damage

D. To institute damage control surgery promptly

E. All the above

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18. The stigmata for life threatening head injury include: which one is true?

A. Intracranial haemorrhage of any size and site

B. Epidural hematoma with normal cerebral perfusion pressure

C. Subdural hematoma with decreased delta pressure

D. Intracerebral hematoma with lateralising signs

E. All the above

Clear selection

19. The following are true about flail chest except?

A. When three or more ribs are fractured, each in more than one place, producing a
free floating section of the chest wall with or without separation of the costochondral
junction it is called a flail chest.

B. The flail segment interferes with the ventilatory function by ineffective chest wall
motion (paradoxical movement)

C. Movement inward with expiration and outward with inspiration, producing pain and
splinting and thereby a fall in tidal volume, hypoxia and hypercarbia

D. All the above are correct

E. None of the above

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20. An overzealous political carder of the ruling party was attacked with sticks,
stones and metal bars. He presented with difficulty in breathing. The radiograph
shown below was obtained. What is your diagnosis?

A. Cardiac tamponade

B. Mediastinal hemorrhage Tension pneumothorax on the right.

C. Haemothorax

D. Flail chest

E. diaphragmatic rupture

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21. The following photograph was obtained of a child who suffered open flame
burns. Give the classification of this burn injury and the approximate burn
surface area include your method of estimating the BSA.

A. This a deep partial thickness burn (third degree) involving 15% BSA by the Wallace
rule of 7 in children and nines adults.

B. This a split partial thickness burn(second degree) involving 15% BSA by the
Wallace rule of 9 in children and 7 adults

C. This a deep partial thickness burn(second degree) involving 18% BSA by the
Wallace rule of 7 in children and nines adults

D. This a partial thickness burn(third degree) involving 15% BSA by Lund and Broader
Charts

E. None of the above is correct.

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22. Common non-operable diseases that cause acute abdomen include all the
following except?

A. Acute gastroenteritis

B. TB mesenteric adenitis

C. Acute gastritis

D. Sickle cell disease in VOC

E. Perforated peptic ulcer

Clear selection

Sphincter of Oddi consists of:

A. 2 sphincters

B. 3 sphincters

C. 4 sphincters

D. 5 sphincter

E. 1

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Bleeding adjacent to the “Triangle of Calot” should be controlled by:

A. Pressing the artery manually

B. Blind clipping

C. Kocher’s artery forceps

D. Stitching

E. Any of the above can do.

Clear selection

25. “Limey bile” is:

A. Present in the CBD

B. Thin and clear

C. Like toothpaste emulsion in the gall bladder

D. Bacteria rich

E. Has high bilirubin

Clear selection

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Pain at the tip of shoulder is due to all except:

A. Peptic ulcer

B. Pancreatitis

C. Cholecystitis

D. Appendicitis

E. All the above

Clear selection

27. A middle aged patient presents with the complaint of right hypochondrial
pain. On X-ray, elevated right hemidiaphragm was seen. All of the following are
the possible diagnoses except:

A. Subphrenic abscess

B. Acute cholecystitis

C. Pyogenic liver abscess

D. Amoebic liver abscess in right lobe

E. All the above

Clear selection

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28. Evolution of renal functions before IVU is best done by measuring:

A. Urine specific gravity.

B. Urea level.

C. Creatinine level.

D. None of the above.

E. All the above

Clear selection

The following is incorrect regarding urinary investigations:

A. With IVP the kidney may not be visualized if congenitally absent, surgically
removed.

B. The best advantage in performing CT in urinary tumors is to assess exact extent

and invasion.

C. U/S is indicated for any renal cyst.

D. IVP is not indicated after any abdominal trauma.

E. isotope imaging show fractional renal function.

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Benign cyst by U/S all are correct except:

A. Is smooth containing clear fluid.

B. Leaves residual mass after aspiration.

C. No rapid recollection.

D. All are true.

Clear selection

Urinary system investigations:

A. IVP is safe in renal impairment.

B. Cystogram is the most diagnostic method of urinary bladder carcinoma.

C. Vesicoureteric reflux is diagnosed by MCU.

D. Cystoscope of bladder carcinoma shows pseudotubercle, sandy patches and

ulceration.

Clear selection

32. Inflammatory bowel diseases are :

A. Very common in Zambia

B. Rare but have been diagnosed in Zambia

C. Need biopsy for diagnosis

D. Can resolve completely without treatment

E. Are commoner in black people

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33. The following conditions may lead to shock except:

A. Penicillin injection.

B. Myocardial infarction.

C. Quinsy.

D. Loss of 87mL blood volume.

E. None of the Above.

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34. . A 26-year-old man from Sesheke was brought to the emergency room after
being picked up by well-wishers from the road side. He complained of an intense
headache, nausea, and was found to have memory troubles. It was later
discovered he was a university student fond of bola betting gambling games. His
vital signs were normal range and a GCS of 14/15. On neurological examination,
he was agitated and confused with post-traumatic amnesia. He had no apparent
motor or sensory deficit except for right sided pupillary dilation. A thorough
examination was done to exclude associated injuries and a non-contrast CT
study of the head was done, which revealed the image seen

What is your diagnosis?

A. Subdural hematoma with obvious midline shift, ventricular compression, sulci

obliteration and perilesional oedema.

B Epidural hematoma with obvious midline shift ventricular compression sulci

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B. Epidural hematoma with obvious midline shift, ventricular compression, sulci
obliteration and perilesional oedema

C. Subarachnoid hemorrhage with some ventricular hemorrhage

D. Image shows missed picture of epi/subdural lesion with ventricular compression.

E. This is a cerebral hematoma with significant midline shift and ventricular

compression

Clear selection

Take a close look at the image below.

What is your diagnosis?

A. Combined Cerebral and subdural hematomas with severe compression of

ventricles and peri-lesional oedema

B. Subdural hematoma and extra dural extension with compression of ventricles

C. Extradural hematoma and subarachnoid hemorrhage

D. Pontine hemorrhage with diffuse axonal injury

E. Ventricular hemorrhage

Clear selection

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36. Best treatment for testicular torsion is:

A. Resuscitation.

B. Early operation to untwist and pexy the affected testis.

C. Orchiopexy for other testis.

D. All of the above in sequence.

E. A and B are correct.

Clear selection

37. In epididymo-orchitis, which of the following is false?

A. The causes are chlamydia and gonococci as sexually transmitted infections.

B. The initial symptoms are those of urinary tract infection (UTI).

C. In mumps 18 per cent of men may develop the condition.

D. It is a common postoperative complication after prostatectomy.

E. Treatment is doxycycline for chlamydia or a broad-spectrum antibiotic.

Clear selection

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38. History: A male aged 69 presents with blood in urine, lower backache
radiating to the lower limbs. On further probing he reveals that he has been
coughing and the cough does not respond to the usual antibiotics. He had
features of anemia too.On examination: he was cachexic, tachypnoeic, generally
weak, pale but not jaundiced and not cyanosed. Digital rectal exam: normal sized
prostate, nodular surface, rock hard consistence, normal overlying mucosa and
median sulcus appreciable. What is your working diagnosis and next course of
action?

A. Most likely cancer of the prostate and needs work up for baseline bloods and
imaging to rule in metastases through abdominal CT, spine CT/X-rays, chest CT and a
prostate biopsy.

B. Likely prostate carcinoma. He needs pelvic ultrasound, PSA, if these are suggestive
of BPH, treat for BPH.

C. In this age group this is likely to be benign prostatic hyperplasia

D. Working diagnosis is BPE to R/O Ca Prostate and course of action is to transfuse

the patient to treat the anemia.

E. Working diagnosis is BPE to R/O Ca Prostate and course of action is to treat

medically.

Clear selection

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You are given a urethrographic image as shown below. Which of the options
below is true?

A. The image shows a long urethral stricture most likely caused by chlamydial
infection

B. The image shows a long urethral stricture most likely caused by gonococcal
infection

C. The location of the stricture is in the membranous urethra

D. This image shows a narrowing consistent with prostate enlargement

E. None of the above

Option 6

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Look at the image below. Which statement is false about this investigation?

A. This is a special X-ray of the renal system using urografin

B. This is an intravenous urogram

C. It shows both excretory function and patency of the conducting systems

D. It is the best investigation for urethral strictures

E. It may show some constrictions which are normal anatomically

Clear selection

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The investigation displayed in the image below is for a middle aged male adult.
The following statements about this patient and the displayed investigation are
true except?

A. This image shows left sided kidney stones

B. The revealed stone size is significantly large to warrant surgical removal

C. The diameter of the ureters is 6-8mm

D. There are three narrowings of the ureter where stones may impact

E. This is a KUB X-ray.

Clear selection

41. Which one is true about Hydroceles ?

A. Are always trans-illuminable

B. May be communicating if the tunica vaginalis is obliterated

C. Is tender to touch

D. The examiner can get above it if it’s purely vaginal

E. None of the above.

Clear selection

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42. Investigation of skin ulcers. Which one is true?

A. Incisional biopsy is gold standard for suspected malignancies

B. Venous ulcers are investigated using arteriograms with digital subtraction

C. Arterial ulcers cannot be diagnosed with the aid of CT-angiography

D. Infectious ulcers always require culture of the causative bacteria for treatment

E. An ainhum is easy to investigate

Clear selection

43. The following are true about an ainhum except?

A. Ainhum (dactylolysis spontanea) is a condition of idiopathic etiology involving a

bandlike constriction of the soft tissue of a digit.

B. Generally, the constriction presents bilaterally, with involvement of the fifth digit
most commonly.

C. Pseudoainhum is a similar condition that occurs as a secondary event resulting

from certain hereditary and nonhereditary diseases that lead to annular constriction
of digits

D. It is common in the tropics

E. All of the above.

Clear selection

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44. Circumduction is possible only for:

A. Wrist joint

B. Elbow joint

C. Hip joint

D. Ankle joint

E. Knee joint

Option 6

Clear selection

45. Genu Varus means:

A. The part distal to the ankle joint is displaced medially the median plan

B. The part distal to the ankle joint is displaced laterally the median plane

C. The part distal to the knee joint is displaced medially the median plane

D. The part distal to the knee joint is displaced laterally the median plane

E. The part distal to the elbow joint is displaced laterally the median plane

Clear selection

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46. Muscles power of Grade 1 is:

A. Only a flicker of movement

B. Movement against gravity

C. No movement

D. Movement against resistant

E. Movement with gravity eliminated

Clear selection

47. All are causes of bone deformity except:

A. Pseudoarthrosis

B. Rickets

C. Volkmann’s contracture

D. Growth plate injuries

E. Fracture malunion

Clear selection

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48. For bone imaging, the ideal isotope is:

A. Technetium-99

B. Technetium-99m

C. Technetium-98

D. Technetium-97

E. Technetium-97m

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49. Which cell is responsible for bone formation?

A. Basophil

B. Osteoblast

C. Platelet

D. Osteoclast

E. Chondrocyte

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50. All are major trauma by mechanism except:

A. Road traffic accident: net speed < 30 km/h

B. A fall > 3 meters

C. Thrown from a vehicle

D. Injury from low velocity weapon

E. Pedestrian hit by a car

Clear selection

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