Final Examination – MCQ, 2 Hour, 40 points

In case of the testicular torsion the following treatment is necessary: 

• Administration of the spasmolytics 

• Ice pack application 

• Intravenous heparin 

• Immediate surgical exploration 

Treatment options of the Fournier’s gangrene includes all of the following EXCEPT: Multiple Choice 0.5 

• Intravenous antibiotics 

• Surgical debridement 

• A colostomy in case of the damage to the external anal sphincter 

• Orchectomy 

Treatment option for low-flow/ischemic priapism include all of the following EXCEPT: Multiple Choice 0.5 

• Injection of phenylephrine into the corporal bodies 

• Distal surgical shunt 

• Circumcision 

• Proximal surgical shunt

27 years old pregnant was admitted at your department due to discomfort in her RUQ. Patients has no history associated with liver pathology. Physical examination shows easily palpable liver. Labs are unremarkable except for decreased bleeding time, pT and INR. What is the most likely diagnosis?

• Liver cirrhosis

• Hepatocellular carcinoma obstructing the Vena porta

• Budd-Chiari syndrome

• Liver abscess

A 34-year-old female patient suffered from abdominal pain week ago; no other gastrointestinal problems were noted. On clinical examination, a mass of about 6 cm was palpable in the right lower quadrant, appeared hard, not reducible and fixed to the parietal muscle. CBC: leucocyts – 7,5*109 /l, ESR– 24 mm/hr. Temperature 37,4 ̊C. Make the diagnosis? 

• Appendicular colic;

• Appendicular hydrops;

• Appendicular infiltration (Phlegmon);

• Appendicular abscess;

Patient: 44 years female. Three weeks ago felt acute pain in right upper quadrant after fatty food, spasmolitics were efficient. Complaints on admission: dull pain in right upper quadrant. Examination: temperature 36,8oC, soft mass palpated in Kehr point. CBC: WBC – 6,8x109/l. US: very large gallbladder with thin wall, stone 15 mm in diameter obstructing it, common bile duct 7 mm in diameter. Make the diagnosis?

• Acute cholecystitis;

• Biliary pancreatitis;

• Gallbladder hydropsia;

• Cholangitis;

• Mechanical jaundice.