GENERAL SURGERY- PAGE 3
GENERAL SURGERY MCQs-PAGE 3
1. Regarding carcinoma gall bladder following features are true except:
(a) One can have similar presentation with benign biliary disease (b) Squamous cell carcinoma is 40% of all cases
(c) Most patients present with advanced disease (d) Prognosis is poor
Ans: B
2. A 45 year old female presented with a cystic lesion in the lesser sac on CT scan. Endoscopic ultrasound guided aspiration showed amylase to be 500 IU and carcinoembryonic antigen as 500ng/ml. What was she suffering from?
(a) Pseudocyst pancreas with ductal communication (b) Chronic pseudocyst
(c) Pancreatic adenocarcinoma (d) Mucinous neoplasm of pancreas
Ans: D
3. During Pylorus preserving pancreatico-duodenectomy (PPPD) the following organs are removed except:
(a) Distal Bile Duct (b) Stomach (c) Gall bladder (d) Head of pancreas
Ans: B
4. In Crohn’s disease all are true except:
(a) Can occur anywhere in GIT (b) Fistula formation is common
(c) Crypt abscess are common (d) Full thickness bowel involvement
Ans: C
5. Glasgow Coma Score Scale pertains to:
(a) Head injury only (b) Head and cervical injury (c) Chest injury (d) Level of consciousness
Ans: A
6. Muscle relaxant ideal for rapid intubation and short procedures is:
(a) Vecuronium (b) Atracurium (c) Rocuronium (d) Suxamethonium
Ans: D
7. A 22 year old male addicted to alcohol and abused with pan-masala-arecanut comes to the clinic with limited mouth opening and restricted tongue movement. The clinical suspicion will be of:
(a) Chronic hyperplastic candidiasis (b) Sub-mucous fibrosis
(c) Leukoplakia (d) Sideropenic dysphagia
Ans: B
8. A 56 year old male comes with history of claudication pain in both buttocks, thighs and calves. He also gives history of impotence. The probable site of arterial occlusion is:
(a) Aortoiliac occlusion (b) Iliac obstruction
(c) Proximal femoral artery occlusion (d) Distal femoral artery occlusion
Ans: A
9. The earliest clinical sign of an impending burst abdomen is:
(a) Serous wound discharge (b) Erythema of the wound
(c) Tachycardia and high grade fever (d) Pus discharge from the wound
Ans: A
10. Most common neoplasm of thyroid gland is:
(a) Papillary carcinoma (b) Squamous cell carcinoma (c) Follicular carcinoma (d) Hashimoto’s disease
Ans: A
11. Which of the following blood components has the shortest shelf life?
(a) Red Blood Cells (b) Platelets (c) Fresh frozen plasma (d) Cryoprecipitate
Ans: B
12. Consider the following features:
1. Visible gastric peristalsis 2. Bilious vomiting 3. Palpable tumour 4. Melena
Which of these is/are feature/features of infantile hypertrophic pyloric stenosis?
(a) 1, 2 and 3 (b) 1 and 3 only (c) 2 and 4 (d) 4 only
Ans: B
13. A 24 year old married lady presents with sudden onset right iliac fossa pain. On examination she has marked pallor and is hypotensive. What is the most likely diagnosis?
(a) Appendicular perforation (b) Ruptured ectopic pregnancy (c) Twisted ovarian cyst (d) Small bowel perforation
Ans: B
14. Which of the following layers is most important in intestinal anastamosis?
(a) Mucosa (b) Submucosa (c) Muscularis propria (d) Serosa
Ans: B
(a) One can have similar presentation with benign biliary disease (b) Squamous cell carcinoma is 40% of all cases
(c) Most patients present with advanced disease (d) Prognosis is poor
Ans: B
2. A 45 year old female presented with a cystic lesion in the lesser sac on CT scan. Endoscopic ultrasound guided aspiration showed amylase to be 500 IU and carcinoembryonic antigen as 500ng/ml. What was she suffering from?
(a) Pseudocyst pancreas with ductal communication (b) Chronic pseudocyst
(c) Pancreatic adenocarcinoma (d) Mucinous neoplasm of pancreas
Ans: D
3. During Pylorus preserving pancreatico-duodenectomy (PPPD) the following organs are removed except:
(a) Distal Bile Duct (b) Stomach (c) Gall bladder (d) Head of pancreas
Ans: B
4. In Crohn’s disease all are true except:
(a) Can occur anywhere in GIT (b) Fistula formation is common
(c) Crypt abscess are common (d) Full thickness bowel involvement
Ans: C
5. Glasgow Coma Score Scale pertains to:
(a) Head injury only (b) Head and cervical injury (c) Chest injury (d) Level of consciousness
Ans: A
6. Muscle relaxant ideal for rapid intubation and short procedures is:
(a) Vecuronium (b) Atracurium (c) Rocuronium (d) Suxamethonium
Ans: D
7. A 22 year old male addicted to alcohol and abused with pan-masala-arecanut comes to the clinic with limited mouth opening and restricted tongue movement. The clinical suspicion will be of:
(a) Chronic hyperplastic candidiasis (b) Sub-mucous fibrosis
(c) Leukoplakia (d) Sideropenic dysphagia
Ans: B
8. A 56 year old male comes with history of claudication pain in both buttocks, thighs and calves. He also gives history of impotence. The probable site of arterial occlusion is:
(a) Aortoiliac occlusion (b) Iliac obstruction
(c) Proximal femoral artery occlusion (d) Distal femoral artery occlusion
Ans: A
9. The earliest clinical sign of an impending burst abdomen is:
(a) Serous wound discharge (b) Erythema of the wound
(c) Tachycardia and high grade fever (d) Pus discharge from the wound
Ans: A
10. Most common neoplasm of thyroid gland is:
(a) Papillary carcinoma (b) Squamous cell carcinoma (c) Follicular carcinoma (d) Hashimoto’s disease
Ans: A
11. Which of the following blood components has the shortest shelf life?
(a) Red Blood Cells (b) Platelets (c) Fresh frozen plasma (d) Cryoprecipitate
Ans: B
12. Consider the following features:
1. Visible gastric peristalsis 2. Bilious vomiting 3. Palpable tumour 4. Melena
Which of these is/are feature/features of infantile hypertrophic pyloric stenosis?
(a) 1, 2 and 3 (b) 1 and 3 only (c) 2 and 4 (d) 4 only
Ans: B
13. A 24 year old married lady presents with sudden onset right iliac fossa pain. On examination she has marked pallor and is hypotensive. What is the most likely diagnosis?
(a) Appendicular perforation (b) Ruptured ectopic pregnancy (c) Twisted ovarian cyst (d) Small bowel perforation
Ans: B
14. Which of the following layers is most important in intestinal anastamosis?
(a) Mucosa (b) Submucosa (c) Muscularis propria (d) Serosa
Ans: B
15. A 50 year old man with long history of swelling in his right parotid region had sudden history of occasional pain, nerve weakness along with paresthesia. His fine needle aspiration cytology was inconclusive. What should be the next step?
(a) Superficial Parotidectomy (b) Trucut Biopsy (c) MRI (d) CT Scan
Ans: A
16. A 70 year old man with history of smoking has a 1 cm ulcerative lesion over the vermilion of his upper lip. What is he likely to be suffering from?
(a) Squamous cell carcinoma (b) Basal cell carcinoma (c) Spindle cell carcinoma (d) Adenoid squamous carcinoma
Ans: B
17. A 55 year old male came with history of hoarseness of voice for which direct laryngoscopy was done and the lesion was biopsied to detect squamous cell carcinoma. He now requires investigation to detect extent of cartilage involvement, imaging of pre and paraglottic spaces and any extension to deep neck structures. Most appropriate investigation of choice will be:
(a) CT Scan (b) Endo Ultrasound (c) MRI (d) Repeat direct laryngoscopy under general anaesthesia
Ans: A
18. Breast imaging reporting and data system (BI-RADS): Final assessment categorized a 45 year old female to have Category 5 disease. What does the report signify?
(a) Incomplete assessment (b) Negative- Annual screening can be recommended.
(c) Probably benign (≤2% malignant) (d) Highly suggestive of malignancy (≥95% malignant)
Ans: D
19. In a male patient of road traffic accident with blood at the tip of external meatus, the likely injury is:
(a) Injury to urethra (b) Injury to urinary bladder (c) Injury to kidney (d) Injury to all of these
Ans: A
20. A 35 year old female has inflammatory carcinoma of left breast, with clinically palpable two left axillary lymph nodes and no clinically or radiologically detectable metastasis. Her TNM staging will be:
(a) T4 N2 M0 (b) T4b N2 M0 (c) T4d N1 M0 (d) T4d N2 M0
Ans: C
21. Milan trial, NSABP trial and EORTC trial in breast cancer compared:
(a) Chemotherapy vs Radiotherapy in breast cancer (b) Breast conservative therapy vs Mastectomy
(c) Neo adjuvant chemotherapy vs Adjuvant chemotherapy (d) Hormonal vs Chemotherapy
Ans: B
22. Regarding breast conservative therapy and issue of post operative local recurrence, all are true except:
(a) Lumpectomy can be considered in any size provided the tumour can be excised with clear margins and acceptable cosmetic results
(b) Margins should be clear for invasive cancer
(c) Margins should be clear for ductal carcinoma in situ (DCIS)
(d) Margins should be clear for lobular carcinoma in situ (LCIS)
Ans: D
23. A 75 year old lady came with an incidentally diagnosed splenic artery aneurysm which after radiological investigation confirmed to be calcified. She should be offered:
(a) Observation (b) Embolisation
(c) Endovascular stenting (d) Laparoscopic splenic artery ligation and splenectomy
Ans: A
24. Regarding choledochal cysts following features are true except:
(a) Congenital cysts (b) 60% are diagnosed before 10 years
(c) Older presentations have an acquired variant (d) Increased risk of cholangiocarcinoma in older presentations
Ans: C
25. A 55 year old gentleman presented with history of right upper quadrant discomfort, jaundice, pruritis, fever, fatigue and weight loss. His serum bilirubin and alkaline phosphatase levels are raised and he also gives history of treatment for inflammatory bowel disease. He is most likely to be suffering from:
(a) Benign bile duct stricture with cholangitis (b) Biliary worms
(c) Bile duct malignancy (d) Primary sclerosing cholangitis
Ans: D
26. The best cure rates for keloids are achieved by:
(a) Surgical excision (b) Localised irradiation
(c) Intralesional injection of triamcinolone (d) Intralesional excision followed by radiotherapy
Ans: D
27. The benefits associated with the best alternative use of resources is called :
(A) Health economics (B) Health resources (C) Opportunity cost (D) Alternative acivities
Ans: C
28. Correct order of triage categories :
(A) Severe brain damage > tension pneumothorax > sprains > degloving injury
(B) Degloving injury > sprains > tension pneumothorax > severe brain damage
(C) Tension pneumothorax > degloving injury > sprains > severe brain damage
(D) Sprains > degloving injury > tension pneumothorax > severe brain damage
Ans: C
29. Following statements are true for “H2O2 with plasma” sterilisation EXCEPT:
(A) It is having very rapid cycle (B) It is enviornmental friendly to many products
(C) It can be used with cellulose (paper), cotton, linen, liquids (D) It is thought not be carcinogenic with plasma
Ans: C
30. Following statements regarding perioperative blood transfusion criteria are true EXCEPT:
(A) < 6 gm% Hb - Probably benefit from transfusion
(B) 6-8 gm% Hb - Transfusion unlikely to be of benefit in the absence bleeding or impending surgery
(C) > 8 gm% Hb - No indication for transfusion in the absence other risk factors.
(D) > 10 gm% Hb is required for all surgeries routinely.
Ans: D
31. Following statements are true for cryoprecipitate EXCEPT:
(A) It is supernatent precipitate of FFP (B) It is rich in fibrinogen
(C) It is given in factor V deficiency (D) It is stored at -30° C with 2 year shelf life
Ans: C
32. Which of the following is preferred for preoperative skin preparation?
(A) On table clipping of hairs (B) On table shaving of hairs (C) Shaving of hair one day before (D) None of above
Ans: A
33. All are metabolic response to starvation EXCEPT:
(A) Low plasma glucagon (B) Low plasma insulin (C) Protein catabolism (D) Lipolysis
Ans: A
34. If diabetic patient is posted in afternoon list, which of the following steps should be taken?
(A) He should be given breakfast in the morning (B) If he is on Regular intermediate acting insulin, half the dose of Regular dose is given
(C) If he is on oral antidiabetics then full dose should be given at breakfast time (D) all of above
Ans: D
35. Following statements are true for aerobic Gram Negative bacilli EXCEPT:
(A) Most organisms in this group act in synergy with Bacteroides to cause SSI after bowel surgery.
(B) There is increasing concern about the development of extended spectrum? - Lactamases in this group
(C) Pseudomonas become resitant to ? - Lactamase as resistance can be transferred by plasmids
(D) Proteus is lactose fermenting organism
Ans: D
36. Following test is used to diagnose latent or subclinical tuberculosis
(A) Interferon - gamma release assay (B) Mantoux test (C) CRP (D) C - ANCA
Ans: A
37. Mixed Venous Oxygen saturation levels below 50% is suggestive of :
(A) Spinal cord injury (B) Cardiogenic Shock (C) Septic Shock (D) Anaphylaxis
Ans: B
38. Young adult whose both thighs & leg were crushed under construction debris following earthquack. What first treatment will you give before extracting him out of the debris?
(A) I.V. Antibiotics (B) I.V.Normal Saline 0.9% (C) I.M. analgesics (D) I.V. Hestar
Ans: B
39. The most reliable test for Rhabdomyolysis is
(A) LDH (B) High Potassium Level (C) Creatine - Kinase Level (D) Myoglobinuria
Ans: C
40. Vancomycin or Fluroquinolones should be given _______ before surgery as chemoprophylaxis.
(A) 60 minutes (B) 3 hours (C) 120 minutes (D) 4 hours
Ans: C
41. Most frequent sarcoma in head & neck region in paediatric patient is
(A) Fibrosarcoma (B) Leiomyosarcoma (C) Rhabdomyosarcoma (D) Liposarcoma
Ans: C
42. Which of the following is not associated with left sided portal hypertension?
(A) Secondary to pancreatic inflammation or neoplasm (B) Normal superior mesentric and portal venous pressure
(C) Easily reversed by splenectomy (D) Isolated esophageal varices present
Ans: D
43. Maximum margin of excision is needed for
(A) Malignant Melanoma (B) Dermatofibrosarcoma Protuberans (DFSP) (C) Basal cell carcinoma (D) Squamous cell carcinoma
Ans: B
44. Lymphatic filariasis is caused by following organisms EXCEPT
(A) Wucherreria Bancrofti (B) Brugia Malayi (C) Brugia Timori (D) Loa Loa
Ans: D
45. The pathognomonic feature is the traid of painless subcutaneus mass, multiple sinuses and seropurulent discharge is seen in
(A) Lymphogranuloma venereum (B) Chancroid (C) Mycetoma (D) Kaposi's Sarcoma
Ans: C
46. Fluid of choice for burns in less than 2 yrs aged child is
(A) 5% Dextrose in Lactated Ringer (B) Ringer Lactate (C) Normal Saline (D) Plasma
Ans: A
47. Telemedicine projects in India are sponsored by following organisation Except:
(A) Rabindranath Tagore International Institute of Cardiac Sciences (B) Swami Vivekanand Memorial Trust
(C) Narayan Hrudayalay (D) ISRO
Ans: B
48. Which type of Biological waste is collected in Red container?
(A) Contaminated waste [Recyclable] (B) Glassware (C) Human anatomical waste (D) Waste sharps including metals
Ans: A
49. Damage control surgery is indicated when venous lactate is _______
(A) < 2 mmol/L (B) > 5 mmol/L (C) > 10 mmol/L (D) > 25 mmol/L
Ans: B
50. ASA Grade IV means:
(A) Severe systemic disease, constant threat to life (B) Severe systemic disease, without threat to life
(C) Emergency Surgery (D) Severe systemic disease, definite function limitation
Ans: A
(a) Superficial Parotidectomy (b) Trucut Biopsy (c) MRI (d) CT Scan
Ans: A
16. A 70 year old man with history of smoking has a 1 cm ulcerative lesion over the vermilion of his upper lip. What is he likely to be suffering from?
(a) Squamous cell carcinoma (b) Basal cell carcinoma (c) Spindle cell carcinoma (d) Adenoid squamous carcinoma
Ans: B
17. A 55 year old male came with history of hoarseness of voice for which direct laryngoscopy was done and the lesion was biopsied to detect squamous cell carcinoma. He now requires investigation to detect extent of cartilage involvement, imaging of pre and paraglottic spaces and any extension to deep neck structures. Most appropriate investigation of choice will be:
(a) CT Scan (b) Endo Ultrasound (c) MRI (d) Repeat direct laryngoscopy under general anaesthesia
Ans: A
18. Breast imaging reporting and data system (BI-RADS): Final assessment categorized a 45 year old female to have Category 5 disease. What does the report signify?
(a) Incomplete assessment (b) Negative- Annual screening can be recommended.
(c) Probably benign (≤2% malignant) (d) Highly suggestive of malignancy (≥95% malignant)
Ans: D
19. In a male patient of road traffic accident with blood at the tip of external meatus, the likely injury is:
(a) Injury to urethra (b) Injury to urinary bladder (c) Injury to kidney (d) Injury to all of these
Ans: A
20. A 35 year old female has inflammatory carcinoma of left breast, with clinically palpable two left axillary lymph nodes and no clinically or radiologically detectable metastasis. Her TNM staging will be:
(a) T4 N2 M0 (b) T4b N2 M0 (c) T4d N1 M0 (d) T4d N2 M0
Ans: C
21. Milan trial, NSABP trial and EORTC trial in breast cancer compared:
(a) Chemotherapy vs Radiotherapy in breast cancer (b) Breast conservative therapy vs Mastectomy
(c) Neo adjuvant chemotherapy vs Adjuvant chemotherapy (d) Hormonal vs Chemotherapy
Ans: B
22. Regarding breast conservative therapy and issue of post operative local recurrence, all are true except:
(a) Lumpectomy can be considered in any size provided the tumour can be excised with clear margins and acceptable cosmetic results
(b) Margins should be clear for invasive cancer
(c) Margins should be clear for ductal carcinoma in situ (DCIS)
(d) Margins should be clear for lobular carcinoma in situ (LCIS)
Ans: D
23. A 75 year old lady came with an incidentally diagnosed splenic artery aneurysm which after radiological investigation confirmed to be calcified. She should be offered:
(a) Observation (b) Embolisation
(c) Endovascular stenting (d) Laparoscopic splenic artery ligation and splenectomy
Ans: A
24. Regarding choledochal cysts following features are true except:
(a) Congenital cysts (b) 60% are diagnosed before 10 years
(c) Older presentations have an acquired variant (d) Increased risk of cholangiocarcinoma in older presentations
Ans: C
25. A 55 year old gentleman presented with history of right upper quadrant discomfort, jaundice, pruritis, fever, fatigue and weight loss. His serum bilirubin and alkaline phosphatase levels are raised and he also gives history of treatment for inflammatory bowel disease. He is most likely to be suffering from:
(a) Benign bile duct stricture with cholangitis (b) Biliary worms
(c) Bile duct malignancy (d) Primary sclerosing cholangitis
Ans: D
26. The best cure rates for keloids are achieved by:
(a) Surgical excision (b) Localised irradiation
(c) Intralesional injection of triamcinolone (d) Intralesional excision followed by radiotherapy
Ans: D
27. The benefits associated with the best alternative use of resources is called :
(A) Health economics (B) Health resources (C) Opportunity cost (D) Alternative acivities
Ans: C
28. Correct order of triage categories :
(A) Severe brain damage > tension pneumothorax > sprains > degloving injury
(B) Degloving injury > sprains > tension pneumothorax > severe brain damage
(C) Tension pneumothorax > degloving injury > sprains > severe brain damage
(D) Sprains > degloving injury > tension pneumothorax > severe brain damage
Ans: C
29. Following statements are true for “H2O2 with plasma” sterilisation EXCEPT:
(A) It is having very rapid cycle (B) It is enviornmental friendly to many products
(C) It can be used with cellulose (paper), cotton, linen, liquids (D) It is thought not be carcinogenic with plasma
Ans: C
30. Following statements regarding perioperative blood transfusion criteria are true EXCEPT:
(A) < 6 gm% Hb - Probably benefit from transfusion
(B) 6-8 gm% Hb - Transfusion unlikely to be of benefit in the absence bleeding or impending surgery
(C) > 8 gm% Hb - No indication for transfusion in the absence other risk factors.
(D) > 10 gm% Hb is required for all surgeries routinely.
Ans: D
31. Following statements are true for cryoprecipitate EXCEPT:
(A) It is supernatent precipitate of FFP (B) It is rich in fibrinogen
(C) It is given in factor V deficiency (D) It is stored at -30° C with 2 year shelf life
Ans: C
32. Which of the following is preferred for preoperative skin preparation?
(A) On table clipping of hairs (B) On table shaving of hairs (C) Shaving of hair one day before (D) None of above
Ans: A
33. All are metabolic response to starvation EXCEPT:
(A) Low plasma glucagon (B) Low plasma insulin (C) Protein catabolism (D) Lipolysis
Ans: A
34. If diabetic patient is posted in afternoon list, which of the following steps should be taken?
(A) He should be given breakfast in the morning (B) If he is on Regular intermediate acting insulin, half the dose of Regular dose is given
(C) If he is on oral antidiabetics then full dose should be given at breakfast time (D) all of above
Ans: D
35. Following statements are true for aerobic Gram Negative bacilli EXCEPT:
(A) Most organisms in this group act in synergy with Bacteroides to cause SSI after bowel surgery.
(B) There is increasing concern about the development of extended spectrum? - Lactamases in this group
(C) Pseudomonas become resitant to ? - Lactamase as resistance can be transferred by plasmids
(D) Proteus is lactose fermenting organism
Ans: D
36. Following test is used to diagnose latent or subclinical tuberculosis
(A) Interferon - gamma release assay (B) Mantoux test (C) CRP (D) C - ANCA
Ans: A
37. Mixed Venous Oxygen saturation levels below 50% is suggestive of :
(A) Spinal cord injury (B) Cardiogenic Shock (C) Septic Shock (D) Anaphylaxis
Ans: B
38. Young adult whose both thighs & leg were crushed under construction debris following earthquack. What first treatment will you give before extracting him out of the debris?
(A) I.V. Antibiotics (B) I.V.Normal Saline 0.9% (C) I.M. analgesics (D) I.V. Hestar
Ans: B
39. The most reliable test for Rhabdomyolysis is
(A) LDH (B) High Potassium Level (C) Creatine - Kinase Level (D) Myoglobinuria
Ans: C
40. Vancomycin or Fluroquinolones should be given _______ before surgery as chemoprophylaxis.
(A) 60 minutes (B) 3 hours (C) 120 minutes (D) 4 hours
Ans: C
41. Most frequent sarcoma in head & neck region in paediatric patient is
(A) Fibrosarcoma (B) Leiomyosarcoma (C) Rhabdomyosarcoma (D) Liposarcoma
Ans: C
42. Which of the following is not associated with left sided portal hypertension?
(A) Secondary to pancreatic inflammation or neoplasm (B) Normal superior mesentric and portal venous pressure
(C) Easily reversed by splenectomy (D) Isolated esophageal varices present
Ans: D
43. Maximum margin of excision is needed for
(A) Malignant Melanoma (B) Dermatofibrosarcoma Protuberans (DFSP) (C) Basal cell carcinoma (D) Squamous cell carcinoma
Ans: B
44. Lymphatic filariasis is caused by following organisms EXCEPT
(A) Wucherreria Bancrofti (B) Brugia Malayi (C) Brugia Timori (D) Loa Loa
Ans: D
45. The pathognomonic feature is the traid of painless subcutaneus mass, multiple sinuses and seropurulent discharge is seen in
(A) Lymphogranuloma venereum (B) Chancroid (C) Mycetoma (D) Kaposi's Sarcoma
Ans: C
46. Fluid of choice for burns in less than 2 yrs aged child is
(A) 5% Dextrose in Lactated Ringer (B) Ringer Lactate (C) Normal Saline (D) Plasma
Ans: A
47. Telemedicine projects in India are sponsored by following organisation Except:
(A) Rabindranath Tagore International Institute of Cardiac Sciences (B) Swami Vivekanand Memorial Trust
(C) Narayan Hrudayalay (D) ISRO
Ans: B
48. Which type of Biological waste is collected in Red container?
(A) Contaminated waste [Recyclable] (B) Glassware (C) Human anatomical waste (D) Waste sharps including metals
Ans: A
49. Damage control surgery is indicated when venous lactate is _______
(A) < 2 mmol/L (B) > 5 mmol/L (C) > 10 mmol/L (D) > 25 mmol/L
Ans: B
50. ASA Grade IV means:
(A) Severe systemic disease, constant threat to life (B) Severe systemic disease, without threat to life
(C) Emergency Surgery (D) Severe systemic disease, definite function limitation
Ans: A
51. Which of the following is not a feature of clinical audit?
(A) No randomisation (B) May involve comparing internventions particularly new one
(C) No allocation to interventions (D) Designed to answer question “Does this service reach a predetermined standard?”
Ans: B
52. Followings are telecommunication technologies except:
(A) Integrated Services Digital Network [ISDN] (B) Internet
(C) D.C. Motor (D) Plain Old Telephone Service [POTS]
Ans: C
53. In gunshot wound , high velocity wound occurs when projectile's speed is
(A) 340 m/s (B) 340 to 610 m/s (C) > 610 m/s (D) None of above
Ans: C
54. Radiation of CT abdomen & pelvis is equivalent to how many times the radiation of X-Ray chest?
(A) 65 (B) 35 (C) 50 (D) 500
Ans: D
55. What should be the temparature of water which is poured on burn wound to decrease the depth of burn wound ?
(A) Less than 4° C temperature (B) 5° C temperature (C) 15° C temperature (D) Room temperature
Ans: D
56. Nicoladoni's sign is used to diagnose
(A) Thoracic outlet syndrome (B) A-V fistula (C) Pectoralis minor syndrome (D) To check the patency of radial & ulnar artery
Ans: B
57. Following are the types of allograft rejection EXCEPT
(A) Acute on chronic rejection (B) Hyperacute rejection (C) Acute rejection (D) Chronic Rejection
Ans: A
58. Morrissey's cough impulse test is seen in
(A) Sephanofemoral Valve incompetence (B) Sephanopopliteal valve incompetence (C) Perforator incompetence (D) Varicocele
Ans: A
59. Most frequent defect in boys with imperforate anus is
(A) Cloacal malformation (B) Rectoperineal fistula (C) Rectobulbar fistula (D) Anterior anus
Ans: C
60. Which bacterial spores are used as a biological indicator for autoclave?
(A) Thermodesulfobacteria (B) Acinetobacter Baumannii (C) Geobacillus Stearothermophilus (D) Bacillus Atrophaeus
Ans: C
61. 3MTM DuraprepTM surgical antiseptic solution contains:
(A) Chlorhexidine gluconate & Isopropyl alchohol (B) Iodine Povacrylex & Isopropyl alchohol (C) Triclosan & alchohol (D) Polyhexamethylene Biguanide (PHMB)
Ans: B
62. Before going for Ramstedt pyloromyotomy Serum Bicarbonate level should be
(A) Below 30 meq/L (B) Below 31meq/L (C) Below 35 meq/L (D) Below 33 meq/L
Ans: A
63. What is pneumocystis jirovecii?
(A) Protozoa (B) Bacteria (C) Virus (D) Fungus
Ans: D
64. What is the single most important factor for chronic rejection after kidney transplantation?
(A) Inadequate immunosupression (B) Cytomegalovirus (CMV) infection
(C) Previous episodes of acute rejection (D) Poor HLA match
Ans: C
65. Which investigation is useful to identify ectopic thyroid tissue in c/o thyroglossal cyst?
(A) Radionuclide scanning (B) Sonography (C) MRI (D) C.T. Scan
Ans: A
66. OK-432 (Picibanil), which is used as intraleisonal injection for cystic hygroma, is derived from
(A) H. Influenzae (B) Staphylococcus (C) E.Coli (D) Streptococcus Pyogenes
Ans: D
67. Hypertrophic pyloric stenosis will cause
(A) Hypokalemic, Hypochloremic alkalosis (B) Metabolic acidosis (C) Bilious vomiting (D) Respiratory acidosis
Ans: A
68. Injury of central slip of extensor tendon over proximal interphalangeal joint will cause
(A) Mallet finger (B) Drop finger (C) Boutonniere deformity (D) Swan neck deformity
Ans: C
69. During surgery of proximal esophageal atresia with distal tracheoesophageal fistula (TEF)
(A) Proximal oesophagus is mobilised liberally (B) Distal oesophagus is mobilised liberally
(C) Both ends are mobilised liberally (D) None of the end is mobilised
Ans: A
70. Which is the most common type of esophageal atresia with tracheoesophageal fistula (TEF)?
(A) Both ends of oesophagus are blind (Type A) (B) Upper TEF with lower blind end of oesophagus (Type B)
(C) Upper oesophageal blind end with distal TEF (D) No atresia with TE fistula
Ans: C
71. Best intrapleural fibrinolytic for empyema management is
(A) Tissue plasminogen activator & DNase together (B) Streptokinase (C) Urokinase (D) rt -TPA
Ans: A
72. Concurrent administration of trastuzumab with anthracycline is not recommended because of
(A) Combination is not effective (B) Increased cardiotoxicity
(C) Increased bone marrow suppression (D) Life threatening thrombocytopenia
Ans: B
73. Sentinel Lymphnode biopsy should not be performed in which patients?
(A) Large or locally advanced invasive breast cancer (tumour size T3 or T4)
(B) Inflammatory breast cancer
(C) Women with DCIS who will be undergoing mastectomy
(D) Pregnancy
Ans: C
74. Post mastectomy radiation is recommended for
(A) Positive post mastectomy margins (B) Primary tumour > 5 cm
(C) Involvement of 4 Lymphnodes (D) All of above
Ans: D
75. Lymphangiosarcoma occurs in
(A) Lymphangioma (B) Lymphoma (C) Lymphedema (D) Serous cavity tumour
Ans: C
76. Which of the following is the most pathogenic sign of impending burst abdomen?
(A) Fever (B) Shock (C) Copious serosanguinous discharge (D) Pain
Ans: C
77. When reduction of the obturator hernia is difficult intraoperatively via Lower midline transperitoneal approach ; obturator membrane should be
(A) Incised from anterior to posterior (B) Incised from inferior to superior
(C) Should be incised laterally (D) Dilated with the fingers
Ans: A
78. Hyperacute graft rejection is more common in
(A) Liver transplant (B) Kidney transplant (C) Heart transplant (D) Small Bowel transplant
Ans: B
79. Following are the higher risk factors for postoperative respiratory complication EXCEPT
(A) Diabetes Mellitus (B) Obstructive Sleep apnoea syndrome (C) Smoking (D) Obesity
Ans: A
80. Investigation of choice to diagnose flail segment of chest is
(A) 3D C.T. Scan (B) X-Ray Chest (C) USG (D) Fluoroscopy
Ans: A
81. Following are the side effects of Radioactive Iodine ablation of thyroid for hyperthyroidism EXCEPT
(A) Worsening of ophthalmopathy (B) Exacerbation of cardiac arrythmias
(C) Hoarseness of voice (D) Thyroid storm
Ans: C
82. Following statements for medial pectoral nerve are true EXCEPT
(A) It is a useful landmark to identify axillary vein (B) It lies medial to pectoralis minor muscle
(C) It should be preserved in MRM (D) It lies lateral to pectoralis minor muscle
Ans: B
83. Oncoplastic technique for conservative breast surgery should be employed _______
(A) 6 week after original simple excision (B) At the time of initial surgery
(C) 2 years after radiotherapy (D) None of above
Ans: B
84. Unilocular breast abscess should be treated by
(A) Antibiotics only (B) Incision & drainage (C) Aspiration & antibiotics (D) Pig tail catheterization
Ans: C
85. Following statements are true for Paget disease EXCEPT
(A) A biopsy of skin of nipple contains paget cell
(B) More than 95% of patients with paget disease have underlying breast carcinoma
(C) Nipple-areolar reconstruction should be done immediately after surgery.
(D) Mastectomy or local wide excision with axillary staging with radiation therapy is applicable treatment
Ans: C
86. Sappey's plexus is found _______ .
(A) Under the nipple & areola (B) Around umbilicus
(C) Around porta hepatis (D) At rectosigmoid junction
Ans: A
87. Peau d'orange sign of carcinoma of breast occurs because of
(A) Inflammation of lymphatics (B) Obstruction of dermal lymphatics by emboli of carcinoma cells
(C) obstruction of lymph channels by bulky breast tumour (D) Involvement of cooper's ligament
Ans: B
88. Surgical excision in case of nipple discharge is usually indicated in
(A) All of below (B) Discharge from multiple ducts of one breast
(C) Milky discharge from multiple duct of both breast (D) Bloody discharge from single duct of breast
Ans: D
89. Galactorrhea is because of
(A) Increased production of prolactin (B) Increased production of LH
(C) Increased production of oestogen (D) Increased production of androgen
Ans: A
90. A 50 years old female presented with breast lump & core needle biopsy shows Atypical Duct Hyperplasia (ADH), what will you do next? (A) MRI (B) Regular follow up (C) Excision biopsy (D) Simple mastectomy
Ans: C
91. During intraoperative aortic injury during nephrectomy, what will be your first step to control aortic bleeding?
(A) Packing with surgical mop
(B) Compression on injury site
(C) Compression of aorta at oesophageal hiatus with sponge on holder
(D) Direct clamping of aorta with Robert's clamp at injury site
Ans: B
92. Estimated female to male ratio of Lymphedema Praecox is
(A) 5:01 (B) 4:01 (C) 10:01 (D) 8:01
Ans: C
93. Non endothermal , non tumescent ablation of varicose veins can be done with following method
(A) Endovenous laser ablation (B) Endovenous Radiofrequency ablation
(C) Endovenous steam sclerosis (D) MOCA ( Mechanochemical ablation)
Ans: D
94. According to Boston University Group If caprini score for VTE is more than 8 then prophylaxis for VTE is to be extended for how many days after discharge?
(A) 10 days (B) 30 days (C) 7 days (D) 45 days
Ans: B
95. Suture material of choice for vascular repair is
(A) Polypropelene (B) Nylon (C) Silk (D) PDS
Ans: A
96. Following statements regarding branchial cyst & Branchial fistula are true EXCEPT
(A) Branchial fistula is lined by ciliated columnar epithelium & brachial cyst is lined by squamous epithelium
(B) Branchial cyst lies at junction of upper 3rd & middle 3rd of sternomastoid
(C) Branchial cyst lies at the junction of middle 1/3rd & lower 3rd of sternomastoid
(D) External opening of branchial fistula always situated in lower 3rd of sternomastoid
Ans: C
97. If you don't stick to midline & do lateral dissection while doing traecheostomy, the most likely complication is
(A) Bleeding from large vessels (B) Injury to recurrent laryngeal nerve (C) Oesophageal injury (D) Pneumothorax
Ans: D
98. Prevention of Frey's syndrome following parotid surgery can be achieved by following methods EXCEPT
(A) Extracapsular parotid dissection (B) Sternomastoid muscle flap (C) Digastric muscle flap (D) Temporalis fascial flap
Ans: C
99. Features to differentiate parathyroid adenoma from hyperplasia would include which of the following ?
(A) Identifying hyperplasia in all 4 glands at surgery in parathyroid hyperplasia (B) High level of parathormone
(C) Infiltration of capsule (D) Presence of excess chief cells
Ans: A
100. A 52 years female patient presents with symptoms of pheochromocytoma. She also had thyroid carcinoma. Her thyroid carcinoma will be of which type ?
(A) Papillary carcinoma (B) Medullary carcinoma (C) Follicular carcinoma (D) Anaplastic carcinoma
Ans: B
(A) No randomisation (B) May involve comparing internventions particularly new one
(C) No allocation to interventions (D) Designed to answer question “Does this service reach a predetermined standard?”
Ans: B
52. Followings are telecommunication technologies except:
(A) Integrated Services Digital Network [ISDN] (B) Internet
(C) D.C. Motor (D) Plain Old Telephone Service [POTS]
Ans: C
53. In gunshot wound , high velocity wound occurs when projectile's speed is
(A) 340 m/s (B) 340 to 610 m/s (C) > 610 m/s (D) None of above
Ans: C
54. Radiation of CT abdomen & pelvis is equivalent to how many times the radiation of X-Ray chest?
(A) 65 (B) 35 (C) 50 (D) 500
Ans: D
55. What should be the temparature of water which is poured on burn wound to decrease the depth of burn wound ?
(A) Less than 4° C temperature (B) 5° C temperature (C) 15° C temperature (D) Room temperature
Ans: D
56. Nicoladoni's sign is used to diagnose
(A) Thoracic outlet syndrome (B) A-V fistula (C) Pectoralis minor syndrome (D) To check the patency of radial & ulnar artery
Ans: B
57. Following are the types of allograft rejection EXCEPT
(A) Acute on chronic rejection (B) Hyperacute rejection (C) Acute rejection (D) Chronic Rejection
Ans: A
58. Morrissey's cough impulse test is seen in
(A) Sephanofemoral Valve incompetence (B) Sephanopopliteal valve incompetence (C) Perforator incompetence (D) Varicocele
Ans: A
59. Most frequent defect in boys with imperforate anus is
(A) Cloacal malformation (B) Rectoperineal fistula (C) Rectobulbar fistula (D) Anterior anus
Ans: C
60. Which bacterial spores are used as a biological indicator for autoclave?
(A) Thermodesulfobacteria (B) Acinetobacter Baumannii (C) Geobacillus Stearothermophilus (D) Bacillus Atrophaeus
Ans: C
61. 3MTM DuraprepTM surgical antiseptic solution contains:
(A) Chlorhexidine gluconate & Isopropyl alchohol (B) Iodine Povacrylex & Isopropyl alchohol (C) Triclosan & alchohol (D) Polyhexamethylene Biguanide (PHMB)
Ans: B
62. Before going for Ramstedt pyloromyotomy Serum Bicarbonate level should be
(A) Below 30 meq/L (B) Below 31meq/L (C) Below 35 meq/L (D) Below 33 meq/L
Ans: A
63. What is pneumocystis jirovecii?
(A) Protozoa (B) Bacteria (C) Virus (D) Fungus
Ans: D
64. What is the single most important factor for chronic rejection after kidney transplantation?
(A) Inadequate immunosupression (B) Cytomegalovirus (CMV) infection
(C) Previous episodes of acute rejection (D) Poor HLA match
Ans: C
65. Which investigation is useful to identify ectopic thyroid tissue in c/o thyroglossal cyst?
(A) Radionuclide scanning (B) Sonography (C) MRI (D) C.T. Scan
Ans: A
66. OK-432 (Picibanil), which is used as intraleisonal injection for cystic hygroma, is derived from
(A) H. Influenzae (B) Staphylococcus (C) E.Coli (D) Streptococcus Pyogenes
Ans: D
67. Hypertrophic pyloric stenosis will cause
(A) Hypokalemic, Hypochloremic alkalosis (B) Metabolic acidosis (C) Bilious vomiting (D) Respiratory acidosis
Ans: A
68. Injury of central slip of extensor tendon over proximal interphalangeal joint will cause
(A) Mallet finger (B) Drop finger (C) Boutonniere deformity (D) Swan neck deformity
Ans: C
69. During surgery of proximal esophageal atresia with distal tracheoesophageal fistula (TEF)
(A) Proximal oesophagus is mobilised liberally (B) Distal oesophagus is mobilised liberally
(C) Both ends are mobilised liberally (D) None of the end is mobilised
Ans: A
70. Which is the most common type of esophageal atresia with tracheoesophageal fistula (TEF)?
(A) Both ends of oesophagus are blind (Type A) (B) Upper TEF with lower blind end of oesophagus (Type B)
(C) Upper oesophageal blind end with distal TEF (D) No atresia with TE fistula
Ans: C
71. Best intrapleural fibrinolytic for empyema management is
(A) Tissue plasminogen activator & DNase together (B) Streptokinase (C) Urokinase (D) rt -TPA
Ans: A
72. Concurrent administration of trastuzumab with anthracycline is not recommended because of
(A) Combination is not effective (B) Increased cardiotoxicity
(C) Increased bone marrow suppression (D) Life threatening thrombocytopenia
Ans: B
73. Sentinel Lymphnode biopsy should not be performed in which patients?
(A) Large or locally advanced invasive breast cancer (tumour size T3 or T4)
(B) Inflammatory breast cancer
(C) Women with DCIS who will be undergoing mastectomy
(D) Pregnancy
Ans: C
74. Post mastectomy radiation is recommended for
(A) Positive post mastectomy margins (B) Primary tumour > 5 cm
(C) Involvement of 4 Lymphnodes (D) All of above
Ans: D
75. Lymphangiosarcoma occurs in
(A) Lymphangioma (B) Lymphoma (C) Lymphedema (D) Serous cavity tumour
Ans: C
76. Which of the following is the most pathogenic sign of impending burst abdomen?
(A) Fever (B) Shock (C) Copious serosanguinous discharge (D) Pain
Ans: C
77. When reduction of the obturator hernia is difficult intraoperatively via Lower midline transperitoneal approach ; obturator membrane should be
(A) Incised from anterior to posterior (B) Incised from inferior to superior
(C) Should be incised laterally (D) Dilated with the fingers
Ans: A
78. Hyperacute graft rejection is more common in
(A) Liver transplant (B) Kidney transplant (C) Heart transplant (D) Small Bowel transplant
Ans: B
79. Following are the higher risk factors for postoperative respiratory complication EXCEPT
(A) Diabetes Mellitus (B) Obstructive Sleep apnoea syndrome (C) Smoking (D) Obesity
Ans: A
80. Investigation of choice to diagnose flail segment of chest is
(A) 3D C.T. Scan (B) X-Ray Chest (C) USG (D) Fluoroscopy
Ans: A
81. Following are the side effects of Radioactive Iodine ablation of thyroid for hyperthyroidism EXCEPT
(A) Worsening of ophthalmopathy (B) Exacerbation of cardiac arrythmias
(C) Hoarseness of voice (D) Thyroid storm
Ans: C
82. Following statements for medial pectoral nerve are true EXCEPT
(A) It is a useful landmark to identify axillary vein (B) It lies medial to pectoralis minor muscle
(C) It should be preserved in MRM (D) It lies lateral to pectoralis minor muscle
Ans: B
83. Oncoplastic technique for conservative breast surgery should be employed _______
(A) 6 week after original simple excision (B) At the time of initial surgery
(C) 2 years after radiotherapy (D) None of above
Ans: B
84. Unilocular breast abscess should be treated by
(A) Antibiotics only (B) Incision & drainage (C) Aspiration & antibiotics (D) Pig tail catheterization
Ans: C
85. Following statements are true for Paget disease EXCEPT
(A) A biopsy of skin of nipple contains paget cell
(B) More than 95% of patients with paget disease have underlying breast carcinoma
(C) Nipple-areolar reconstruction should be done immediately after surgery.
(D) Mastectomy or local wide excision with axillary staging with radiation therapy is applicable treatment
Ans: C
86. Sappey's plexus is found _______ .
(A) Under the nipple & areola (B) Around umbilicus
(C) Around porta hepatis (D) At rectosigmoid junction
Ans: A
87. Peau d'orange sign of carcinoma of breast occurs because of
(A) Inflammation of lymphatics (B) Obstruction of dermal lymphatics by emboli of carcinoma cells
(C) obstruction of lymph channels by bulky breast tumour (D) Involvement of cooper's ligament
Ans: B
88. Surgical excision in case of nipple discharge is usually indicated in
(A) All of below (B) Discharge from multiple ducts of one breast
(C) Milky discharge from multiple duct of both breast (D) Bloody discharge from single duct of breast
Ans: D
89. Galactorrhea is because of
(A) Increased production of prolactin (B) Increased production of LH
(C) Increased production of oestogen (D) Increased production of androgen
Ans: A
90. A 50 years old female presented with breast lump & core needle biopsy shows Atypical Duct Hyperplasia (ADH), what will you do next? (A) MRI (B) Regular follow up (C) Excision biopsy (D) Simple mastectomy
Ans: C
91. During intraoperative aortic injury during nephrectomy, what will be your first step to control aortic bleeding?
(A) Packing with surgical mop
(B) Compression on injury site
(C) Compression of aorta at oesophageal hiatus with sponge on holder
(D) Direct clamping of aorta with Robert's clamp at injury site
Ans: B
92. Estimated female to male ratio of Lymphedema Praecox is
(A) 5:01 (B) 4:01 (C) 10:01 (D) 8:01
Ans: C
93. Non endothermal , non tumescent ablation of varicose veins can be done with following method
(A) Endovenous laser ablation (B) Endovenous Radiofrequency ablation
(C) Endovenous steam sclerosis (D) MOCA ( Mechanochemical ablation)
Ans: D
94. According to Boston University Group If caprini score for VTE is more than 8 then prophylaxis for VTE is to be extended for how many days after discharge?
(A) 10 days (B) 30 days (C) 7 days (D) 45 days
Ans: B
95. Suture material of choice for vascular repair is
(A) Polypropelene (B) Nylon (C) Silk (D) PDS
Ans: A
96. Following statements regarding branchial cyst & Branchial fistula are true EXCEPT
(A) Branchial fistula is lined by ciliated columnar epithelium & brachial cyst is lined by squamous epithelium
(B) Branchial cyst lies at junction of upper 3rd & middle 3rd of sternomastoid
(C) Branchial cyst lies at the junction of middle 1/3rd & lower 3rd of sternomastoid
(D) External opening of branchial fistula always situated in lower 3rd of sternomastoid
Ans: C
97. If you don't stick to midline & do lateral dissection while doing traecheostomy, the most likely complication is
(A) Bleeding from large vessels (B) Injury to recurrent laryngeal nerve (C) Oesophageal injury (D) Pneumothorax
Ans: D
98. Prevention of Frey's syndrome following parotid surgery can be achieved by following methods EXCEPT
(A) Extracapsular parotid dissection (B) Sternomastoid muscle flap (C) Digastric muscle flap (D) Temporalis fascial flap
Ans: C
99. Features to differentiate parathyroid adenoma from hyperplasia would include which of the following ?
(A) Identifying hyperplasia in all 4 glands at surgery in parathyroid hyperplasia (B) High level of parathormone
(C) Infiltration of capsule (D) Presence of excess chief cells
Ans: A
100. A 52 years female patient presents with symptoms of pheochromocytoma. She also had thyroid carcinoma. Her thyroid carcinoma will be of which type ?
(A) Papillary carcinoma (B) Medullary carcinoma (C) Follicular carcinoma (D) Anaplastic carcinoma
Ans: B
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