SOAL UJIAN BEDAH DIGESTIFDr. Errawan R. Wiradisuria. SpBD

1. The liver is divided into anatomical segments based on………..

A. bile duct drainage

B. hepatic arterial supply

C. hepatic venous drainage

D. portal vein distribution

E. umbilical fissure

2. A 17-year-old boy is admitted to the hospital after an automobile accident. Except for a

quiet abdomen. He as no localizing physical findings. After receiving 2000 mL of

lactated ringer’s solution intravenously, his pulse rate is 90 beats per minute and blood

pressure 110/70 mmHg Abdominal CT scan reveals a laceration of the left lobe of the

liver extending from the dome more than halfway trough the parenchyma. Appropriate

management at this time would be………

A. bed rest and observation

B. abdominal exploration and ligature of intrahepatic blood vessels

C. Abdominal Exploration and packing of the hepatic wound

D. Abdominal exploration and left hepatic artery ligation

E. abdominal exploration and left hepatectomy

3. A 45-year-old woman is seen because of the abrupt onset of steady severe right upper

quadrant paint after ingestionof a heafy meal. On examination, there is a palpable, tender

right upper quadrant mass. The appropriate diagnostic step is…………

A. Abdominal first ultrasonography

B. MRCP

C. Computed Tomography (CT)

D. Endoscopic retrograde cholangiopancreatography (ERCP)

E. Oral Cholecystography (PTC)

4. The most common cause of acute cholecystitis is…………….

A. Cystic duct obstruction

B. Escherichia coli infection

C. Klebsiella infection

D. multiple gallstones

E. salmonella infection

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RS. Persahabatan

5. A large retained stone impacted in the distal common bile duct is noted when T- tube

cholangiography is performed after choledochostomy. The best management of the stone

is …………………….

A. dissolution with sodium cholate

B. dissolution with heparin

C. Catheter Extraction via the tract of of the T-tube

D. Operative removal

E. transduodenal papillotomy with endoscopic stone extraction

6. The best initial procedure in defining the cause of obstructive jaundice in a 75-year-old

man is………………

A. Endoscopoc retrograde cholangiopancretography (ERCP)

B. Percutaneous transhepatic cholangopgraphy (PTC)

C. Ultrasonography

D. CT Scanning

E. Radionuclide scanning

7. Abdominal ultrasonography is carried out during evaluation for a possible abdominal

aortic aneurysm. The presence of stones in the gallbladder is identified on this study. The

patient’ s only abdominal symptom is a sense of fullness after eating. The appropriate first

step in managing the gallstones is……….

A. Observation

B. Laparascopic cholecystectomy

C. Open cholecystectomy

D. Ursodeoxycholic acid therapy

E. Electroshock wave lithotripsy (ESWL)

8. Which of the following is absorbed from the colon………….

A. Dextrose

B. Fatty acid

C. Fiber

D. Lactulose

E. Protein

9. A 60-year-old woman undergoes a sigmoid resection for stage III cancer of the colon.

The best therapy for this patient consist of operation…………..

A.Alone

B. And radiation therapy

C. And Tretment wit 5-FU

D. And Tretment with levamisole

E. And Tretment with 5-FU plus Falinic acid

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10. An 80-year-old womwn is seen with abdominal pain and obstipation. On examination.

She is afebrile with slight tachycardia. Her abdomen is distended and tympanitic, but

there ar e no peritoneal signs. Abdominal X-rays sugest the presence of sigmoid volvulus.

The first step in her management should be…………

A. administration of laxsatives and cleansing enemes

B. Barium enema

C. Rigid Sigmoidoscopy

D. Sigmoid resection

E. tranverse colostomy

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JAWABAN SOAL UJIAN BEDAH DIGERTIFDr. Erawan R. Wiradisuria. SpBD.

1. C 6. C

2. A 7. A

3. A 8. B

4. A 9. C

5. E 10. C

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