1.
Care din următoarele caractere se găsesc în hernia inghinală directă:
Correct Answer
A. Nu coboară niciodată în scrot
Explanation
The correct answer is "Nu coboară niciodată în scrot". This is because a direct inguinal hernia does not descend into the scrotum.
2.
Strangularea diverticulului Meckel poartă denumirea de hernie:
Correct Answer
C. Littre
Explanation
The correct answer is Littre. Strangularea diverticulului Meckel refers to the strangulation of a diverticulum in the small intestine, specifically the Meckel's diverticulum. This condition is named after the French surgeon Alexis Littré, who first described it in the 17th century. The other options listed are not associated with this specific condition.
3.
Peretele posterior al canalului inghinal este reprezentat de:
Correct Answer
A. Fascia transversalis
Explanation
The correct answer is Fascia transversalis. The posterior wall of the inguinal canal is formed by the fascia transversalis. This fascia is a fibrous layer that covers the inner surface of the abdominal wall and helps to provide support and protection to the structures within the inguinal canal. The oblique muscles (internal and external) are located anteriorly and do not contribute to the posterior wall of the canal. The conjoint tendon is a fusion of the internal oblique and transversus abdominis muscles and is also located anteriorly. The crural arch is a fibrous band that forms the lower border of the inguinal canal and is not part of the posterior wall.
4.
Locul II după frecvenţa strangulării îl ocupă hernia:
Correct Answer
D. Inghinală oblică la bărbaţi
Explanation
The correct answer is "Inghinală oblică la bărbaţi". The question is asking for the second most frequent type of hernia after strangulation. The options provided are different types of hernias. Among these options, "Inghinală oblică la bărbaţi" refers to inguinal hernia in men, which is the correct answer.
5.
Strangularea parietală antimezocolică poarta denumirea de hernie:
Correct Answer
D. Riсhter
Explanation
The correct answer is Richter. Richter hernia refers to the partial strangulation of the antimesenteric border of the bowel, where only one wall of the bowel is involved. This type of hernia is characterized by the absence of bowel obstruction symptoms, as only a portion of the bowel is trapped. It is important to note that the other options listed (Brock, Gheselbah, Maydl, and Littre) do not specifically refer to the type of hernia described in the question.
6.
Gâtul herniei femurale tipice se găseşte:
Correct Answer
B. Medial de vasele femurale
Explanation
The correct answer is "Medial de vasele femurale" which translates to "Medial to the femoral vessels." This means that the hernia sac is located on the inside of the femoral vessels.
7.
În stadiul de ischemie a unei hernii strangulate găsim următoarele semne:
Correct Answer(s)
A. Ansa destinsă, pronunţat cianotică
B. Tromboza venelor mezoului
C. Perete îngroşat cu false membrane pe suprafaţă
E. Ansa eferentă palidă, colabată
Explanation
In the ischemic stage of a strangulated hernia, the following signs can be observed: the dilated loop of intestine appears bluish due to lack of oxygen (cyanotic), there is thrombosis of the mesenteric veins, the wall of the intestine becomes thickened with the formation of false membranes on the surface, there is presence of purulent or fecaloid fluid in the peritoneal cavity, and the efferent loop of intestine appears pale and collapsed.
8.
Tranzitul intestinal este păstrat în următoarele forme ale herniilor strangulate:
Correct Answer(s)
A. Hernia Littre
C. Hernia Broсk
E. Hernia Riсhter
Explanation
The correct answer includes Hernia Littre, Hernia Broсk, and Hernia Riсhter. These are all forms of strangulated hernias that can occur in the intestinal transit.
9.
În care din următoarele situaţii sacul herniar lipseşte:
Correct Answer
E. Hernie diafragmală posttraumatică
Explanation
The correct answer is Hernie diafragmală posttraumatică. This is because a posttraumatic diaphragmatic hernia occurs as a result of a traumatic injury to the diaphragm, often caused by a severe blow or penetrating injury to the chest or abdomen. In this situation, the hernia sac is absent because the diaphragm has been directly damaged, allowing abdominal organs to protrude into the chest cavity. In contrast, the other types of hernias listed (congenital inguinal hernia, umbilical hernia, inguinal hernia through cleavage, perineal hernia) involve the presence of a hernia sac.
10.
Hernia Brock sau pseudostrangularea la un purtător de hernie poate avea loc în următoarele situaţii:
Correct Answer(s)
A. Colecistita acută
C. Ulcerul gastroduodenal perforat
D. Apendicita acută perforativă
11.
Tratamentul conservator (bandajul) al unei hernii este indicat:
Correct Answer(s)
A. În caz de refuz categoric al pacientului
C. La bătrîni când starea generală contraindică intervenţia chirurgicală
Explanation
The conservative treatment (bandage) of a hernia is indicated in cases where the patient categorically refuses surgery and in elderly patients when their general condition contraindicates surgical intervention. This means that if a patient refuses to undergo surgery for their hernia, or if they are elderly and their overall health is not suitable for surgery, the conservative treatment with a bandage can be used as an alternative. It is important to consider the patient's preferences and overall health when deciding on the appropriate treatment for a hernia.
12.
Selectaţi afirmaţiile corecte cu privire la herniile inghinale oblice:
Correct Answer(s)
A. Sacul herniar constă din procesul vaginalis
C. Sacul se află medial de vasele epigastrice inferioare
D. Sacul se extinde lateral de cordonul spermatic
E. Este mai rar bilaterală decât cea directă
Explanation
The correct answer states that the hernia sac consists of the vaginal process, the sac is located medial to the inferior epigastric vessels, the sac extends laterally to the spermatic cord, and oblique inguinal hernias are less commonly bilateral than direct hernias.
13.
Dacă la deschiderea sacului herniar vom depista o ansă de culoare roşie închisă, destinsă, cu seroasa fără luciu şi cu sufuziuni în regiunea şanţului de strangulare vom constata:
Correct Answer(s)
A. Stadiul de congestie
E. Ansă viabilă
Explanation
If we detect a dark red, distended loop with a dull serosa and suffusions in the strangulation groove upon opening the hernia sac, we can conclude that it is in the stage of congestion. Additionally, if the loop is viable, it means that it is still alive and functioning properly.
14.
Selectaţi afirmaţiile corecte privind hernia strangulată:
Correct Answer(s)
B. Hernia femurală are o rată de strangulare mai mare decât cea inghinală
D. Hernia Brock nu se caracterizează prin ischemie
E. În strangularea Maydl suferă cel mai mult ansa intermediară
Explanation
The correct answer states that hernia femoral has a higher rate of strangulation compared to inguinal hernia. This is because the femoral canal is narrower and has less space for the herniated tissue, increasing the risk of strangulation. The answer also states that hernia Brock does not involve ischemia, which means that there is no compromised blood supply to the herniated tissue. Lastly, it mentions that in Maydl strangulation, the intermediate loop of the intestine is the most affected.
15.
Selectaţi afirmaţiile corecte referitor la hernia inghinală prin alunecare pe stânga:
Correct Answer(s)
A. Porţile herniare sunt mari
C. Colonul sigmoid face parte din sacul herniar
E. Uneori ajunge la dimensiuni mari
Explanation
The correct answer suggests that in left inguinal hernia, the hernia gates are large, the sigmoid colon is part of the hernia sac, and sometimes the hernia can reach large sizes. This means that the hernia can contain not only the small intestine but also the sigmoid colon, leading to potential complications and larger hernia sizes. It also implies that left inguinal hernias can vary in size and may occasionally become quite large.
16.
În herniile inghinale oblice scopul major este plastia peretelui anterior al canalului inghinal. Cel mai frecvent este indicată metoda:
Correct Answer
B. Girard-Spasokukoţki cu sutura Kimbarovski
Explanation
The correct answer is Girard-Spasokukoţki cu sutura Kimbarovski. This method is commonly used for oblique inguinal hernias to repair the anterior wall of the inguinal canal.
17.
Cel mai frecvent utilizat procedeu de plastie în herniile femurale este:
Correct Answer
E. Bassini
Explanation
The most commonly used procedure for femoral hernias is the Bassini technique.
18.
În herniile ombilicale cu inelul herniar până la 3 cm mai preferabilă este metoda:
Correct Answer
E. Lexer
Explanation
In umbilical hernias with a hernia ring up to 3 cm, the preferred method is Lexer.
19.
Care din urmatoarele reprezinta complicatii ale herniilor?
Correct Answer(s)
C. Strangularea
D. Flegmonul herniar
E. Ireductibilitatea
Explanation
The complications of hernias include strangulation, flegmonul herniar, and ireductibilitatea. Strangulation refers to the condition where the blood supply to the herniated tissue is cut off, leading to tissue death. Flegmonul herniar is a complication characterized by inflammation and infection of the herniated tissue. Ireductibilitatea refers to the inability to reduce or push the herniated tissue back into its normal position. These complications can cause severe pain, infection, and tissue damage, and may require surgical intervention.
20.
Semnele clinice constante intr-o hernie strangulata cu strangularea parietala a intestinului (Richter) sunt:
Correct Answer(s)
A. Este pastrat tranzitul intestinal
C. Tumoră ireductibilă la nivelul zonei herniare respective
Explanation
The correct answer is "Este pastrat tranzitul intestinal,Tumoră ireductibilă la nivelul zonei herniare respective" because in a strangulated hernia with parietal strangulation of the intestine (Richter), the symptoms include the preservation of intestinal transit and an irreducible tumor at the level of the hernia.
21.
Indicati trei semne ale herniei inghinale congenitale:
Correct Answer(s)
C. Portile herniare sunt mari
D. Evolueaza intr-o hernie inghino-scrotala
E. Sacul herniar contine testicul
Explanation
The correct answer is "Portile herniare sunt mari, Evolueaza intr-o hernie inghino-scrotala, Sacul herniar contine testicul." This is because these three signs are characteristic of congenital inguinal hernia. The presence of large hernia gates, the progression into an inguinoscrotal hernia, and the inclusion of the testicle in the hernia sac are all indicative of a congenital inguinal hernia.
22.
Cel mai frecvent herniaza:
Correct Answer(s)
B. Epiploonul
D. Intestinul subtire
Explanation
The correct answer is Epiploonul and Intestinul subtire. The question is asking which organ most commonly herniates, and the correct answers are the omentum (epiploonul) and the small intestine (intestinul subtire). Herniation occurs when an organ or tissue protrudes through a weak spot in the surrounding muscle or connective tissue. The omentum and small intestine are particularly prone to herniation due to their mobility and the potential for weak spots in the abdominal wall.
23.
Durerea intr-o hernie necomplicata poate fi:
Correct Answer(s)
A. Sub forma de greutate sau jena dureroasa
D. Se accentueaza la efort fizic
E. Poate fi absenta
Explanation
The correct answer is a combination of three statements. The pain in an uncomplicated hernia can be in the form of a feeling of heaviness or discomfort, it can worsen with physical effort, and it can also be absent at times.
24.
Diagnosticul diferenţial al herniei inghinoscrotale se face cu:
Correct Answer(s)
A. Hidrocelul
B. Varicocelul
D. Tumora testiculară
Explanation
The correct answer is Hidrocelul, Varicocelul, Tumora testiculară. These conditions are included in the differential diagnosis of inguinoscrotal hernia. A hydrocele is a fluid-filled sac around the testicle, varicocele is the enlargement of veins within the scrotum, and testicular tumor refers to abnormal growth in the testicles. These conditions can present with similar symptoms as inguinoscrotal hernia, such as swelling or pain in the groin or scrotum. Therefore, it is important to consider these conditions when evaluating a patient with inguinoscrotal hernia to ensure an accurate diagnosis.
25.
Alegeţi trei semne clinice ale herniei inghinale directe:
Correct Answer(s)
B. Forma sferica
C. Nu coboara in scrot
E. Frecvent este bilaterală
Explanation
The correct answer is "Forma sferica, Nu coboara in scrot, Frecvent este bilaterală." This is because a direct inguinal hernia typically presents as a spherical protrusion that does not descend into the scrotum. Additionally, direct inguinal hernias are more commonly bilateral, meaning they occur on both sides of the groin.
26.
Examenul clinic al unui bolnav cu hernie inghinala oblica poate prezenta:
Correct Answer(s)
A. Coboara în scrot
B. Pulsatia arterei epigastrice se afla lateral de sac
D. Expansiune la tuse
Explanation
The correct answer is "Coboara în scrot, Pulsatia arterei epigastrice se afla lateral de sac, Expansiune la tuse". In the case of an oblique inguinal hernia, the hernia sac descends into the scrotum. The pulsation of the epigastric artery is located laterally to the hernia sac. There is also an expansion of the hernia sac when the patient coughs (expansiune la tuse). However, the statement "Traiectul herniar este perpendicular pe peretele abdominal" is incorrect as the trajectory of an oblique inguinal hernia is not perpendicular to the abdominal wall.
27.
Care dintre variantele de hernii enumerate sunt hernii externe?
Correct Answer(s)
A. Hernia femurală
B. Hernia ombilicală
D. Hernia lombară
E. Hernia inghino-scrotală
Explanation
The correct answer is Hernia femurală, Hernia ombilicală, Hernia lombară, Hernia inghino-scrotală. These are all examples of external hernias, which occur when an organ or tissue protrudes through a weak spot in the surrounding muscle or connective tissue. In the case of a femoral hernia, the protrusion occurs in the femoral canal, while an umbilical hernia occurs at the belly button. A lumbar hernia occurs in the lower back, and an inguinoscrotal hernia occurs in the groin and scrotal area.
28.
Care sunt semnele unei hernii strangulate ombilicale cu interesarea unei anse intestinale?
Correct Answer(s)
A. Tumoarea herniară este tensionată si dureroasă
B. Oprirea tranzitului pentru materii si gaze
C. Ireductibilitate aparută brusc
E. Vărsaturi
Explanation
The signs of a strangulated umbilical hernia with involvement of an intestinal loop include a tense and painful hernia, cessation of bowel movements and gas, sudden irreducibility, and vomiting.
29.
Care situaţii nu se încadrează în hernia Maydl ?
Correct Answer(s)
C. Hernierea diverticului Meckel
D. Hernia obturatorie
E. Strangularea parietală a intestinului
Explanation
The correct answer is hernierea diverticului Meckel, hernia obturatorie, strangularea parietală a intestinului. These situations do not fit into the category of Maydl hernia. Maydl hernia refers to a type of hernia where the hernial sac contains two strangulated intestinal loops. Hernierea diverticului Meckel, hernia obturatorie, and strangularea parietală a intestinului are different types of hernias or conditions that do not involve the specific characteristics of Maydl hernia.
30.
Care din urmatoarele tipuri de hernii interesează mai multe anse intestinale?
Correct Answer(s)
C. Hernia Brock
D. Hernia Maydl
Explanation
Hernia Brock and Hernia Maydl are types of hernias that involve multiple intestinal loops. In these hernias, more than one loop of the intestine protrudes through the weakened abdominal wall or muscle. This can lead to complications such as obstruction or strangulation of the intestines. Therefore, these two types of hernias are more likely to involve multiple intestinal loops compared to the other options listed.
31.
Care din urmatoarele gesturi pot deveni riscuri si erori intr-o hernie strangulată?
Correct Answer(s)
B. Interventia chirurgicală programată
C. Reducerea prin taxis
E. Eliberarea la domiciliu din secţia de primire a unui bolnav dupa reducerea spontană a herniei
Explanation
The correct answer options all involve actions that can potentially increase the risk or lead to errors in a strangulated hernia. Interventia chirurgicală programată (scheduled surgery) can be risky if the hernia is already strangulated and immediate surgery is required. Reducerea prin taxis (reduction by taxis) can be dangerous if not performed correctly, as it may cause further damage to the hernia. Eliberarea la domiciliu din secţia de primire a unui bolnav dupa reducerea spontană a herniei (discharge from the receiving department after spontaneous reduction of the hernia) can be a mistake if the patient is not properly monitored and complications arise after the reduction.
32.
Care din urmatoarele gesturi pot fi riscuri in hernia ireponibilă?
Correct Answer(s)
C. Reducerea prin taxis
D. Bandajul compresiv al porţii herniare
Explanation
Reducerea prin taxis și bandajul compresiv al porții herniare pot fi riscuri în cazul unei hernii ireductibile deoarece aceste gesturi pot exercita presiune sau tracțiune asupra țesuturilor herniate, ceea ce poate agrava hernia sau poate duce la strangularea herniei. Intervenția chirurgicală de urgență poate fi necesară în cazul unei hernii ireductibile pentru a evita complicațiile și a rezolva problema. Radiografia abdominală de ansamblu poate fi utilă pentru a confirma diagnosticul de hernie, dar nu reprezintă un gest care poate fi un risc în cazul unei hernii ireductibile.
33.
Procedeele chirurgicale de refacere a peretelui abdominal în hernii cuprind:
Correct Answer(s)
D. Autodermoplastia
E. Aloplastia
Explanation
The correct answer is Autodermoplastia and Aloplastia. These are two surgical procedures used in the reconstruction of the abdominal wall in hernias. Autodermoplastia refers to the use of the patient's own skin to repair the abdominal wall, while Aloplastia involves using synthetic materials or grafts to reconstruct the wall. These procedures are commonly used to strengthen the abdominal wall and prevent hernia recurrence.
34.
Sarcinile tratamentului chirurgical în herniile simple reponibile cuprind:
Correct Answer(s)
A. Eliminarea sacului
B. Repunerea conţinutului sacului herniar
E. Hernioplastia
Explanation
The correct answer includes three tasks that are typically performed during surgical treatment of reducible hernias: removal of the hernia sac, repositioning of the contents of the hernia sac, and hernioplasty (a surgical repair of the hernia using synthetic mesh or other materials). This combination of procedures helps to eliminate the hernia and prevent its recurrence.
35.
În ocluziile intestinale prin strangulare se încadrează:
Correct Answer(s)
B. Ocluziile prin volvulus
D. Hernia strangulată
Explanation
The correct answer is "Ocluziile prin volvulus, Hernia strangulată". This is because both volvulus and hernia strangulată are conditions that can cause intestinal obstruction by strangulation. Volvulus occurs when a segment of the intestine twists around itself, leading to a blockage, while hernia strangulată occurs when a part of the intestine becomes trapped in a hernia sac, cutting off its blood supply and causing obstruction.