​GENERAL SURGERY- PAGE 4

GENERAL SURGERY- PAGE 4

GENERAL SURGERY MCQs-PAGE 4

1. Bilateral cleft lip surgery should be done at the age of
(A) 15-18 months (B) 7-8 months (C) 4-5 months (D) 9-10 months
Ans: C

2. Which flap is commonly used for finger tip transection injury
(A) V-Y advancement flap (B) Transposition flap (C) Bilobed flap (D) Rotation flap
Ans: A

3. Pyoderma gangrenosum is associated with following conditions EXCEPT
(A) Inflammatory bowel Disease (B) Churg- Strauss Syndrome (C) Rheumatoid arthritis (D) Wegner's granulomatosis
Ans: B

4. Erysipelas is
(A) Caused by staphylococcus (B) Necrotising Infection (C) Diffuse (D) Sharply demarcated
Ans: D

5. Primary spontaneus pneumothorax occurs in
(A) Old & tall men (B) Young & tall men (C) Young & short men (D) Old & short men
Ans: B

6. Spegalian fascia is the aponeurosis of _______
(A) Transversus abdominis (B) External oblique (C) Internal oblique (D) Rectus
Ans: A

7. Weight of light mesh for hernia repair is
(A) < 60 gram per meter square (B) < 40 gram per meter square
(C) < 80 gram per meter square (D) 40 milligram per meter square
Ans: B

8. For diabetic patient on metformin undergoing for contrast C.T. Scan. When will you stop metformin ?
(A) No need to stop metformin (B) When eGFR below 60 (C) When eGFR below 50 (D) When e GFR below 40
Ans: B

9. How much negative pressure applied in vaccum assisted closure dressing ?
(A) Minus 120 mm of Hg (B) Minus 70 mm of Hg (C) Minus 125 mm of Hg (D) Minus 50 mm of Hg
Ans: C

10. Regarding synergistic gangrene, the wrong statement is
(A) Scrotal Infection is known as fournier's gangrene (B) Abdominal wall Infection is known as Meleney's gangrene
(C) Anaerobic bacteria will destroy the living tissue & produce anaerobic environment (D) Extensive debridement may be required
Ans: C

11. Lefort classification is given for :
(A) Facial fracture (B) Spine fracture (C) Femur fracture (D) Pelvic fracture
Ans: A

12. Cerebral perfusion pressure ( CPP ) is calculated by following formula
(A) ICP + mean arterial pressure (B) ICP - diastolic pressure
(C) ICP - mean arterial pressure (D) ICP- Systolic arterial pressure
Ans: C

13. A 20 years old female patient presented with thyroid swelling . Most probably FNAC will not diagnose _______
(A) Papillary carcinoma of thyroid (B) Medullary carcinoma of thyroid
(C) Lymphoma of thyroid (D) Follicular carcinoma of thyroid
Ans: D

14. A patient admitted with 3rd episode of DVT. There is no history of any associated medical illness. All of the following investigations are required for establishing the diagnosis EXCEPT
(A) Antibody to factor VIII (B) Protien C deficiency
(C) Anticardiolipin antibody (D) Factor V Leiden mutation
Ans: A

15. All of the following are clinical features of thromboangitis obliterans EXCEPT
(A) Rest pain (B) Absence of popliteal pulsation (C) Digital gangrene (D) Raynaud's phenomenon
Ans: B

16. Following are the principles for management of hand infection EXCEPT
(A) Tendonsheath pus needs irrigation (B) Hand elevation, splinting & antibiotics
(C) Surgical drainage of pus (D) Delayed mobilisation
Ans: D

17. Abdominal groans, psychic moans & renal stones suggests
(A) Acute hypercalcemia (B) Chronic hypercalcemia (C) Hypermegnesaemia (D) Hyponatremia
Ans: B

18. Large fibre neuropathy in diabetes can be assessed by followings EXCEPT
(A) 10 g monofilament (semmes- Weinstein monofilament) (B) 129- hz tuning fork
(C) Achillis deep tendon reflexes (D) Severity of burning sensation
Ans: D

19. Following nerves are at risk during removal of submandibular gland EXCEPT
(A) Glossopharyngeal nerve (B) Lingual nerve (C) Hypoglossal nerve (D) Marginal mandibular branch of facial nerve
Ans: A

20. Following are variable vessel vasculitis EXCEPT
(A) Bachet's disease (B) Kawasaki disease (C) Cogan Syndrome (D) Buerger's disease
Ans: B

21. Following is not a high risk lesion for malignant transformation for oral cancer
(A) Discoid lupus erythematosus (B) Erythroplakia (C) Proliferative verrucous leucoplakia (D) Chronic hyperplastic candidiasis
Ans: A

22. According to AAST spleen injury scale - injury Grade - III suggests following EXCEPT
(A) Capsular tear, 1 to 3 cms. of parenchymal depth not involving trabecular vessels
(B) Subcapsular haematoma involving > 50% surface area or expanding
(C) Intraparenchymal haematoma  5 cm or expanding
(D) >3 cm laceration of parenchymal depth or invoving trabecular vessels
Ans: A

23. In extradural haematoma pupillary size is as follows
(A) Ipsilateral dilatation (B) Contralateral dilatation
(C) Ipsilateral constriction (D) Contralateral constriction
Ans: A

24. When third degree burn wounds encompass the circumferance of extremities. Patient should be monitored by following
(A) Hourly UOP (B) Repeated Doppler study of digital arteries and palmer & planter arteries
(C) Myoglobinuria (D) C.V.P. monitoring
Ans: B

25. In which tumour of parotid gland, surgery should be supported by adjuvant radiotherapy ?
(A) Mucoepidermoid carcinoma (B) Acinic cell carcinoma (C) Adenoid cystic carcinoma (D) Warthin's tumour
Ans: C

26. Crotalinae classes of snakes have following features. EXCEPT
(A) Circular pupils (B) Triangular heads (C) Heat sensing facial pits (D) Large, retractable anterior fangs
Ans: A

27. Which antibiotic is effective against stenotrophomonas maltophilia?
(A) TMP-SMX (B) Meropenem (C) Aztreonam (D) Colistin
Ans: A

28. Following are examples of clean contaminated surgery. EXCEPT
(A) laparoscopic Cholecyctectomy (B) Elective colon surgery (C) Enteric perforation surgery (D) Gastrojejunostomy
Ans: C

29. In remodelling phase of wound healing maturation of collagen occurs. Type I collagen replacing Type III collagen until ratio of _______ achieved.
(A) 3:01 (B) 1:01 (C) 5:01 (D) 4:01
Ans: D

30. Patient shows following objective criteria:
Resting AP <50-70 mm of Hg
Ankle or metadorsal PVR flat
TP
< 40 mm of Hg in nondiabetics
< 50 mm of Hg in diabetics
tc Po2 < 30 mm of Hg
Tell what is the Rutherford category ?
(A) Category 5& 6 (B) Category 4 (C) Category 3 (D) None of above
Ans: A

31. Which is the most common anomaly of the scalene muscle associated with nTOS ?
(A) Splitting of the anterior scalene around C5 & C6 (B) Scalene minimus muscle
(C) Congenital bands & ligaments (D) Interdigitating muscle fibres
Ans: D

32. In Ertl procedure for below knee amputation
(A) Posterior flap is kept long (B) Medial flap is kept long
(C) Skew flaps are made (D) Uses a bone bridge between tibia & fibula
Ans: D

33. Following statements are true for Ray amputation of toes. EXCEPT
(A) The “handle” of racket incision should lie in the midline for 2nd through 4th toe & away from midline for first & fifth toe
(B) Sesamoid bones are not excised
(C) Metatarsal shaft should be excised
(D) Care should be taken to avoid injury to digital arteries & nerves
Ans: B

34. H/P report of appendicectomy shows carcinoid tumour of more than 2 cms with involvement of base of caecum. what will you do?
(A) Observation (B) Chemotherapy (C) Colonoscopy to rule out caecal adenocarcinoma (D) Right hemicolectomy
Ans: D

35. Gall bladder polyps larger than 10 mm should be managed by
(A) Open Cholecystectomy (B) Conservative management (C) Radical Cholecystectomy (D) Laparoscopic Cholecystectomy
Ans: A

36. Followings are contraindications for rubber band ligation of Haemorrhoids EXCEPT
(A) Immunocompromised patient (B) Patient on Warfarin (C) Presence of coagulopathy (D) Patient on Aspirin
Ans: D

37. Investigation of choice for detecting liver metastasis due to Gastric cancer is
(A) MRI (B) C.T. Scan (C) laparoscopic ultrasound (D) A & C
Ans: D

38. H. Pylori bacteria is responsible for
(A) Hypergastrinaemia (B) Hypogastrinaemia (C) Direct stimulation of parietal cell (D) Increased histamin release
Ans: A

39. Most common type of intussusception in children is
(A) Ileo-colic (B) Colo-colic (C) Ileo-ileal (D) Caeco-colic
Ans: A

40. In congenital diaphragmatic hernia, diaphragmatic defect occurs in _______ .
(A) Left anterolateral diaphragm (B) Left posterolateral diaphragm (C) Right anterolateral diaphragm (D) Central diaphragm
Ans: B

41. “Double bubble” appearance of plain X-Ray abdomen of a neonate will suggest
(A) Duodenal atresia (B) Meconium ileus (C) Intestinal malrotation (D) Congenital diaphragmatic hernia
Ans: A

42. Which type of fundoplication done with Heller's myotomy for achalasia cardia?
(A) Nissen fundoplication (B) Dor fundoplication (C) Toupet fundoplication (D) None of above
Ans: B

43. In modified Johnson classification class-III peptic ulcer is associated with
(A) Increased acid level (B) Normal acid level (C) Low acid level (D) NSAID - induced
Ans: A

44. Curling ulcer occurs in
(A) Fundus & body of stomach (B) Antrum of stomach (C) Prepyloric region (D) Pylorus
Ans: A

45. If there is > 3 cm size duodenal perforation, following are the surgical option EXCEPT
(A) Suturing of jejunal serosa to the defect of Roux-en-y type limb (B) Pyloric exclusion with gastrojejunostomy
(C) Antrectomy and Billroth-II or Roux-en - y reconstruction (D) Pyloric exclusion without Gastric jejunotomy
Ans: D

46. Combination of PPI & H2 blocker have following effect
(A) Additive effect (B) Synergistic effect (C) Deleterious effect (D) Absorption of PPI will decrease
Ans: C

47. Following orifices can be used for natural orifice transluminal Endoscopic Surgery (NOTES). EXCEPT
(A) Mouth (B) Vagina (C) Anus (D) Urethra
Ans: D

48. Following is monobactam class of antibiotics
(A) Aztreonam (B) Vancomycin (C) Meropenem (D) Daptomycin
Ans: A

49. Alchohol Gel hand cleanser is effective against all organisms. EXCEPT
(A) Clostridium difficile (B) MRSA staphylococcus (C) Pseudomonas (D) Bacteroids
Ans: A

50. Refeeding syndrome can cause following electrolyte disturbances. EXCEPT
(A) Hypophosphotaemia (B) Hypocalcemia (C) Hypercalcemia (D) Hypomagnesaemia
Ans: C

51. Which is the major complication of pneumatic dilatation of achalasia cardia?
(A) Haemorrhage (B) Perforation (C) Restenosis (D) Broncho-oesophageal fistula
Ans: B

52. To detect eradication of H.Pylori infection following test can be done EXCEPT
(A) Urea breath test (B) Enzyme linked immunosorbent assay (C) Stool Antigen test (D) Invasive Histology
Ans: B

53. Vaccine for OPSI is given against all EXCEPT
(A) Pneumococci (B) Meningococci (C) E. coli (D) H. Influenzae
Ans: C

54. While doing distal Gastrectomy for distal stomach cancer of body/ antrum. Safe proximal margin from tumour is
(A) 2 cms (B) 8 cms (C) 10 cms (D) 6 cms
Ans: D

55. Caroli disease is
(A) Type V choledochal cyst (B) Type II choledochal cyst (C) Type IV-a choledochal cyst (D) Type IV-b choledochal cyst
Ans: A

56. 45 Yrs old adult presented with appendicular abscess on C.T. Scan, what will you do?
(A) C.T. guided drainage, antibiotics & interval appendicectomy
(B) C.T. guided drainage, anitibiotics followed by colonoscopy & then interval appendicectomy
(C) Immediate appendicectomy
(D) Oschner sherren regimen followed by interval appendicectom
Ans: B

57. Treatment of choice for chronic anal fissure is
(A) Anal stretch (B) Fissurectomy (C) V-Y anoplasty (D) Lateral Internal Sphincterotomy
Ans: D

58. Followings are used for secondary prophylaxis to prevent recurrent variceal bleeding in Portal Hypertension EXCEPT:
(A) Esophageal variceal band ligation [EVL] (B) Propranolol with Isosorbide
(C) Sclerotherapy (D) TIPS for recurrent bleeding refractory to pharmacotherapy& EVL
Ans: C

59. According to AJCC staging of Pancreatic cancer, in stage 1B tumour size & location will be
(A) Tumour less than or equal to 2 cm in greatest diameter, tumour limited to pancreas
(B) tumour limited to pancreas, tumour > 2 cm in greatest diameter
(C) Tumour extends beyond pancreas but without involvement of Celiac Axis or Sup. Mesenteric artery
D) Tumour of > 2 cm with regional lymphnode metastasis.
Ans: B

60. Aspiration of Amoebic Liver Abscess is indicated in following condition EXCEPT:
(A) Abscess > 4 cm diameter (B) Abscess > 10 cm diameter in right lobe of liver
(C) Failure of medical therapy after 7 days (D) Age more than 55 years
Ans: A

61. Gastric Antral Vascular Ectasia [GAVE] has following type of endoscopic appearance
(A) Cherry stomach (B) Rugged stomach (C) Water melon stomach (D) Punctate haemorrhage
Ans: C

62. Most common neoplasm of appendix is
(A) Adenocarcinoma (B) Carcinoid tumour (C) Mucinous tumour (D) GIST
Ans: B

63. Which marker correlates with the severity of acute pancreatitis between 48 to 72 hrs?
(A) CRP (B) Amylase (C) Lipase (D) LDH
Ans: A

64. Following statements regarding management of asymptomatic gall stones are right EXCEPT:
(A) Diabetic patient should be given expectant treatment.
(B) Patient who had previous bariatric surgery should be given expectant treatment.
(C) Patient having chronic liver disease should be given expectant treatment.
(D) Patient with Sickle Cell anaemia should be given expectant treatment.
Ans: D

65. Followings are the contraindications for resection of HCC EXCEPT:
(A) Single nodule less than or equal to 3 cm with normal portal pressure and bilirubin
(B) Extrahepatic metastasis
(C) Multiple bilobar tumours
(D) Presence of tumour thrombus in the main portal vein / vena cava
Ans: A

66. Ectopic varices in portal hypertension occurs commonly at following sites EXCEPT:
(A) Anorectal region (B) Duodenum (C) Transversre colon (D) Ostomies
Ans: C

67. Procedure of choice for patient of chronic pancreatitis having ductal obstruction in head & tail and a smaller inflammatory mass in head of pancreas.
(A) Partington - Rochelle Procedure (B) Bern Procedure (C) Berger Procedure (D) Frey Procedure
Ans: D

68. Rapid & effective restoration of circulating volume in c/o acute pancreatitis is achieved by infusing
(A) Normal Saline (B) Ringer lactate (C) Hydroxyethyl startch (D) Dextrose Saline
Ans: B

69. Umbilicated nodule of Liver suggests
(A) Secondaries in Liver (B) Hepatocellular Carcinoma (C) Haemangioma of Liver (D) Amoebic liver Abscess
Ans: A

70. 70 Years old male presented with Lump in epigastrium, swelling is hard,irregular, swelling is mobile above-downwards & very slightly sideways. Patient is having anaemia, weight loss & anorexia most likely diagnosis can be
(A) Pseudocyst of pancreas (B) Omental secondaries (C) Intussception (D) Transverse colon malignancy
Ans: D

71. 18 yrs old boy presented with tender, irregular & fixed lump in right iliac fossa with muscular gaurding & rigidity in RIF. Patient had H/O RIF pain since last 5 days. Likely diagnosis:
(A) Carcinoma of ceacum (B) Crohn's disease
(C) Appendicular lump (D) Hyperplastic ileocaecal TB
Ans: C

72. In sliding hernia, wall of sac is formed by
(A) Sigmoid colon (B) Caecum (C) Urinary bladder (D) All of the above
Ans: D

73. Most common complication after splenectomy
(A) Haematemesis (B) Acute dilatation of stomach (C) Left basal atelectasis (D) Pancreatic fistula
Ans: C

74. Meckle's diverticulum is a derivative of
(A) Vitellointenstinal duct (B) Allantoic diverticulum (C) Ventral mesogastrium (D) Urachus
Ans: A

75. Apple peel or Christmas tree deformity with large mesentric gap is feature of which type of Jejunoileal atresia?
(A) Type-I (B) Type-IIIa (C) Type-II (D) Type-IIIb
Ans: D

76. Valentino's syndrome is due to
(A) Perforation of Gall bladder (B) Retroperitoneal perforation of duodenal peptic ulcer
(C) Pancreatitis (D) Diverticulitis
Ans: B

77. Soave procedure is done for
(A) Hurschprung's disease (B) Imperforate anus (C) Ileal atresia (D) Congenital hypertrophic pyloric stenosis
Ans: A

78. The most common presenting symptom of Meckel's diverticulum is
(A) Inflammation (B) Obstruction of bowel (C) Painless, massive lower GI bleeding (D) Intussception
Ans: C

79. The most common cause of colonic volvulus is
(A) Trasverse colon volvulus (B) Ileosigmoid knotting (C) Caecal volvulus (D) Sigmoid volvulus
Ans: D

80. Local Excision in ca rectum is done in all EXCEPT:
(A) Within 3 to 5 cm of anal verge (B) Lesion < 3 cm
(C) T1 & T2 cancer with lymphnode involvement (D) Involvement of < 30% circumferen
Ans: C

81. Following can be used to treat squamous cell carcinoma of anus EXCEPT:
(A) Pacletaxel (B) 5 FU (C) Mitomycin (D) External beam radiation
Ans: A

82. Operation of choice for chronic anal fissure is
(A) Fissurectomy (B) Lateral internal sphincterectomy (C) Anal dilatation (D) Endoanal advancement flap
Ans: B

83. For vey large prostate, following surgery can be done EXCEPT:
(A) TURP (B) Freyer's prostatectomy (C) Milin's prostatectomy (D) HoLEP
Ans: A

84. All are true about total mesorectal excision for Ca Rectum EXCEPT:
(A) Decreases local recurrence rates (B) Decreases survival
(C) Decreases incidence of impotence (D) Decreases incidence of bladder dysfunction
Ans: B

85. 5α - Reductase is more effective if prostate size
(A) < 25 gm (B) < 35 gm (C)> 50 gm (D) < 30 gm
Ans: C

86. Primary effect of Bladder Outflow Obstruction (BOO) is as follows (If voided volume is more than 200ml) EXCEPT
(A) Maximum flow rate of < 10 ml/s (B) Voiding Pressure of > 80 cm H2O
(C) Residual urine volume 100 to 250 ml (D) Flow rate > 16 ml/s
Ans: D

87. Treatment of choice for large, long standing, thick walled & loculated Hydrocele is
(A) Excision of Sac (B) Jaboulay bottleneck technique (C) Lord plication (D) Sclerotherapy
Ans: A

88. All Germ cell tumours arise from intratubular Germ cell Neoplasia EXCEPT
(A) Syncytiotrophoblastic Seminoma (B) Spermatocytic Seminoma (C) Embryonal Carcinoma (D) Yolk sac tumour
Ans: B

89. Half life of serum AFP is
(A) 5 to 7 days (B) 24 to 36 hrs (C) 5 to 7 hrs (D) 10 to 15 days
Ans: A

90. Following statement is wrong for No-Scalpel Vasectomy
(A) It was described by Li in china in 1974 (B) It significantly decrease the rate of haematoma, pain & infection
(C) Routine antibiotics are given to the patient (D) Patient can resume sexual activity soon
Ans: C

91. The most frequent cause of secondary Hydrocele is
(A) Torsion of tests (B) Tuberculosis of epididymis (C) Testicular tumours (D) Acute & chronic epididymo-orchitis
Ans: D

92. 60 yrs old male presented with left varicocele of recent origin, which is not reducible on lying down, what investigation will you do?
(A) Sonography of kidney (B) Doppler study of left scrotum (C) Near infrared spectroscopy of left scrotum (D) Pelvic sonography
Ans: A

93. Untwisting of testis, upto which time will cause salvage of testis 100% in c/o torsion of testis?
(A) 6 to 12 Hrs (B) Within 0-6 Hrs (C) Within 12 to 24 Hrs (D) 24-48 Hrs
Ans: B

94. Following statement is wrong for insitu ca of penis
(A) When it involves penile shaft it is known as Buschke-Lowenstein
(B) When it involves glans penis or prepuce it is known as Erythroplasia of Queyrat
(C) It it treated by 5 FU cream / CO2 laser ablation
(D) It can be managed by surgicaal excision
Ans: A

95. What is minimum margin of lower border of tumour of rectum from anorectal junction required to perform anterior resection for Ca Rectum?
(A) 5 cm (B) 4 cm (C) 3 cm (D) greater than or equal to 2 cm
Ans: D

96. Hirschprung's disease is best diagnosed by
(A) Anal Manometry (B) C.T. Scan (C) Rectal Biopsy (D) MRI
Ans: C

97. Contraindication for ESWL are as follows EXCEPT:
(A) Diabetes mellitus (B) Pregnant patient (C) Patient taking oral anticoagulant (D) Morbidly obese patient
Ans: A

98. Most common site for ureteric tuberculosis
(A) Pelviureteric junction (B) Mid ureter (C) Vesicoureteric junction (D) Upper ureter
Ans: C

99. Circumcision should not be performed when child is having following associated conditions EXCEPT:
(A) Balanitis Xerotica obliterans (B) Hypospadias (C) Dorsal hood deformity (D) Penile curvature
Ans: A

100. Before 4 yrs of age, what is the size of external urethral meatus
(A) 12 Fr (B) 10 Fr (C) 8 Fr (D) 14 Fr
Ans: B