Which of the following types of hernia does this patient have?

Q 71 A 76-year-old man is scheduled to undergo repair of an abdominal hernia that is easily reduced by pushing the abdominal contents back through the external ring. During repair, the surgeon sees that the hernial sac protrudes from the abdominal wall superior to the inguinal ligament and medial to the inferior epigastric vessels.

Which of the following types of hernia does this patient have?

(A) Diaphragmatic hernia
(B) Direct inguinal hernia
© Femoral hernia
(D) Hiatal hernia

Q 72 30-year-old patient comes to the physician to explore the possibility of an endocrine disorder. Physical examination reveals a solitary thyroid nodule. Laboratory studies show an increased serum calcitonin level and a pentagastrin-induced rise in the secretion of calcitonin. A biopsy confirms the presence of a carcinoma. The patient is scheduled for a total thyroidectomy.

Which of the following is a potential complication of this treatment?

(A) Acromegaly
(B) Cretinism
© Hypertension
(D) Hypoparathyroidism

Q 73 Which of the following hernias follows the path of the spermatic cord within the cremaster muscle?

a. Femoral
b. Direct inguinal
c. Indirect inguinal
d. Spigelian

Q 74 The incidence of breast cancer ?

a. Increases with increasing age
b. Has declined since the 1940s
c. Is related to dietary fat intake
d. Is related to coffee intake

Q 75 70-year-old man complains of a sensation of food sticking in his lower chest area. This happens when he eats either liquids or solids. He also has a slight weight loss.

The most likely diagnosis is ?

A ) Achalasia

B ) Esophageal spasm

C ) Hypertensive LES

D ) Hiatal hernia with GERD

Q 76 Which of the following statements about schwannomas is true?

a. They represent central nerve tumors
b. Treatment is via excision
c. They arise most frequently in motor nerves
d. They often degenerate to malignancy

Q 77 Which of the following physical examination findings may be seen in patients with dehydration?

a. Capillary refill of 4 s
b. Capillary refill of 1 s
c. Hypertension
d. Bradycardia

Q 78 Signs and symptoms of hemolytic transfusion reactions include ?

A ) Hypothermia

B ) Hypertension

C ) Polyuria

D ) Abnormal bleeding

Q 79 What are the signs and symptoms of early sepsis?

A ) Respiratory acidosis

B ) Decreased cardiac output

C ) Hypoglycemia

D ) Cutaneous vasodilation

Q 80 An obese 63 year old lady presents with jaundice. There is no history of abdominal pain. Examination of her abdomen reveals a palpable gall bladder. There is evidence of extensive pruritis.

She tells you she drinks 42 units of alcohol a week.

Her blood results are as follows

Albumin 32 (35-50)
Alk Phos 456 (<110)
ALT 88 (<40)
Bilirubin 120 (<20)
INR 1.6
GGT 400 (0-70)

What’s the most likely diagnosis?

a. Gallstones
b. Paracetamol Overdose
c. Pancreatic cancer
d. Alcoholic Hepatitis