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Surgery MCQ

By AdminPosted On 05-Oct-2016

1. Umbilical Hernia : Surgery MCQ

Spontaneous closure of which of the following congenital abnormalities of the abdominal wall generally occurs by the age of 4 yrs?


a) Umbilical hernia

b) Patent urachus

c) Patent omphalomesenteric duct

d) Omphalocele

e) Gastroschisis

Correct Answer: a) Umbilical hernia. Many small ( 1 to 1.5 cm) umbilical hernias will close spontaneously as the child grows between birth and 4 years of age, thus eliminating the need for surgical repair. If spontaneous closure has not occurred by this time, then surgical repair is indicated before the age of 5 yrs.

2. What is the most common type of skin cancer?

a) Melanoma

b) Basal cell carcinoma

c) Squamous cell carcinoma

d) Merkel cell carcinoma

Correct Answer: b) Basal cell carcinoma. Non-melanoma skin cancers (NMSC) are extremely common, but relatively few deaths are caused by them. The majority of NMSCs are basal cell carcinomas (BCCs, 74%) or squamous cell carcinomas (SCCs, 23%).32 The remainder comprises a mixed group of rare skin cancers; almost three in ten of these are Merkel cell carcinoma.


3. Nasogastric Tube : Surgery MCQ

All of the following are contraindications to passing a nasogastric tube EXCEPT


a) suspected perforation of the esophagus

b) confirmed perforation of the esophagus

c) history of esophageal varices

d) nearly complete obstruction of the esophagus due to benign or malignant strictures

e) presence of an esophageal foreign body

Correct Answer: c) history of esophageal varices. Insertion of a nasogastric tube to assess and confirm the severity of the bleeding and to lavage gastric contents before performing endoscopy is part of the resuscitation for Bleeding esophageal varices. Esophageal varices are NOT a contraindication for nasogastric tube.


4. What is the most common types of melanoma?

a) Superficial spreading melanoma

b) Acral lentiginous melanoma

c) Mucosal melanoma

d) Nodular melanoma

e) Polypoid melanoma

Correct Answer: a) Superficial spreading melanoma is by far the most common type, accounting for about 70 percent of all cases.


5. Variceal Bleed : Surgery MCQ

In a patient with compensated liver cirrhosis presented with history of esophageal variceal bleed. The treatment of choice in this patient is


a) Endoscopic sclerotherapy

b) Liver transplantation

c) TIPS (Trans jugular intrahepatic portal shunt)

d) Propranolol

Correct Answer: c) TIPS is preferred method for treating portal hypertension that is refractory to medical therapy. By TIPS placement a functional portacaval side-to-side shunt is established. TIPS is indicated in patients with refractory acute variceal bleeding that could not be sufficiently controlled by endoscopic and/or medical therapy and in patients with recurrent bleeding despite optimal endoscopic therapy.


6. Insulinoma : Surgery MCQ

Insulinoma is most commonly located in which part of the pancreas


a) Head

b) Body

c) Tail

d) Can be located at head neck or body equally distributed

Correct Answer: None. Insulinomas arise equally in the head, body and tail of the pancreas. This question was asked in some exam. Option “d” they should have put ‘tail’ instead of ‘neck’.


7. The following receive blood supply via the coeliac artery

a) Pancreas

b) Jejunum

c) Stomach

d) Fourth part of duodenum

e) Gall bladder

Correct Answer: a,c,e. Pancreas, Stomach and Gall bladder. The celiac artery supplies oxygenated blood to the liver, stomach, abdominal esophagus, spleen and the superior half of both the duodenum and the pancreas.


8. Duodenum : Surgery MCQ

Blood supply to the first two cms of duodenum is from all of the following except


a) Supradoudenal

b) Gastrodoudenal

c) Hepatic

d) Superior pancreaticodoudenal

Correct Answer: c) Hepatic. The first 2 cm of the duodenum is called the duodenal cap. The proximal half of the duodenum is a foregut structure and so is supplied by the coeliac trunk through the gastroduodenal artery and its branch Supradoudenal and, the superior pancreaticoduodenal artery.


9. The femoral triangle : Surgery MCQ

a) The lateral border is vastus lateralis

b) Pectineus lies in the floor

c) Psoas major laterally rotates the femur

d) The femoral vein lies medial to the artery

e) The femoral vein lies lateral to the nerve

Correct Answer: b and d. Correct FALSE statements: a) The lateral border is medial border of the sartorius muscle. c) Psoas major contributes to flexion in the hip joint. Unilateral contraction bends the trunk laterally, while bilateral contraction raises the trunk from its supine position. e) The femoral nerve lies lateral to the vein.


10. Wound healing by organization usually occurs in EXCEPT

a) The epidermis

b) Infarcts

c) Thrombi

d) Fibrinous inflammatory exudate

e) Chronic inflammation

Correct Answer: a) The epidermis.

After injury, structural tissue heals with incomplete or complete regeneration. Tissue without an interruption to morphology almost always completely regenerates. An example of complete regeneration without an interruption of the morphology is non-injured tissue, such as skin. Non-injured skin has a continued replacement and regeneration of cells which always results in complete regeneration.


11. Wound healing by regeneration invariably occurs

a) In the liver

b) In the small intestine

c) In the renal tubular epithelium

d) In the neuronal system

e) In the thyroid


Correct Answer: b) In the small intestine.


The small intestine is an exquisitely regenerative organ. It is an elegant model to better understand organ-specific stem cells and the regenerative cells can be harnessed to make new gastrointestinal tissue for eventual clinical applications.


12. Casoni’s test is done for the diagnosis of

a) Cysticercosis

b) Hydatid cyst disease

c) Brucellosis

d) Cryptococosis

e) Actinomycosis


Correct Answer: b) Hydatid cyst disease. (Q should have been “was done” instead of ‘is”). Historically, an intradermal skin test (Casoni test) was used and had a sensitivity of 70%. It is now largely abandoned because of its low sensitivity, low accuracy, and potential for severe local allergic reaction. The indirect hemagglutination test and ELISA have a sensitivity of 90% in hepatic echinococcosis and are the initial screening tests of choice.

Immunodiffusion and immunoelectrophoresis provide specific confirmation of reactivity.


13. Therapeutic measures for paralytic ileus includes all EXCEPT


a) Naosgastric suction

b) I V infusion

c) Para sympathomimetis

d) Correction of electrolytes

e) Nil by mouth


Correct Answer: c) Para sympathomimetis. Although Neostigmine which is a parasympathomimetic used in the treatment of Ogilvie syndrome. Ogilvie syndrome is the acute pseudoobstruction and dilation of the colon in the absence of any mechanical obstruction in severely ill patients. A study published in the NEJM showed that neostigmine is a potent pharmacological way of decompressing the colon.


14. Three Glass Urine Test : Surgery MCQ


“Three Glass Urine Test” with first glass specimen of urine showing ‘threads’ is diagnostic of


a) Epididymitis

b) Urethritis

c) Prostatitis

d) Cystitis

e) Tuberculosis


Correct Answer: b) Urethritis. Three-glass test is a test to determine the location of an infection affecting the male urinary system.

The bladder is emptied by passing urine into a series of 3-ounce test tubes, and the contents of the first and the last are examined; the first tube contains the washings from the anterior urethra, the second, material from the bladder, and the last, material from the posterior urethra, prostate, and seminal vesicles. If flakes or threads of pus are passed in the urine, their source is usually urethral.


15. Which pathogen is commonly responsible for cellulitis?

a) Clostridium perfringens

b) Pseudomonas aeruginosa

c) Staphylococcus aureus

d) Staphylococcus epidermidis

e) Streptococcus pyogenes


Correct Answer: e) Streptococcus pyogenes. Streptococcus pyogenes is responsible for approximately two-thirds of cellulitis infections and Staphylococcus aureus approximately one-third. Pseudomonas aeruginosa is a rare cause.


16. Stridor following thyroidectomy may be caused by all EXCEPT

a) Recurrent laryngeal nerve damage

b) Wound haematoma

c) Thyroid storm

d) Hypocalcaemia

e) Tracheomalacia


Correct Answer: c) Thyroid storm does not cause stridor. Laryngospasm due to hypocalcemia is a rare cause of stridor secondary to clinical hypoparathyroidism.


17. Breast Lump : Surgery MCQ

29-year-old woman has right breast lump since 4 mths. It was aspirated at that time, and cytology was negative, but the cyst recurred about 1 month later. The cyst was re-aspirated 2 months ago and, again, the cytology was negative. The lump has recurred now. Examination reveals a mass at 10 o’clock, approximately 4 cm from the areola. Ultrasound demonstrates a cystic lesion. Which of the following is the most appropriate next step in management?


a) Mammography in 1 year

b) Ultrasound in 1 year

c) Tamoxifen therapy

d) Open biopsy

e) Mastectomy

Correct Answer: d) Open biopsy

When a lesion recurs twice, as has occurred in this patient, open biopsy is warranted. To wait to perform mammography in 1 year (choice A) or ultrasound in 1 year would be incorrect management. First, if a malignancy is present, waiting another year will allow progression of the cancer. Second, the mammogram is not definitive. Imaging can contribute information to the workup of a breast mass, but the definitive diagnosis rests on histologic evaluation.


18. Anal incontinence is caused by all EXCEPT

a) Obstetrical injury

b) Infectious diarrhoea

c) Previous radiation

d) Anal intercourse


Correct Answer: d) Anal intercourse is not the cause of anal incontinence.


19. Puborectalis Muscle Ring : Surgery MCQ

The mechanism of anal continence is multifactorial. Which of the following is necessary for maintaining continence?


a) Soft or liquid stools

b) Perineal sensation

c) An intact puborectalis muscle ring

d) Urinary continence


Correct Answer: c) An intact puborectalis muscle ring. The puborectalis muscle by itself can only maintain continence of solid feces; the internal and external anal sphinctor maintain continence of liquid stool and flatus.


20. Painting before Surgery

Preoperative showering with antiseptic solution like Betadine and spirit is recommended by CDC. Which of the following swabbing/ painting technique has least infection rate (SSI)?


a) Swabbing from left to right

b) Swabbing from right to left

c) Concentric circles inside out

d) Concentric circled outside in

e) Swabbing vertically up to down

f) Swabbing vertically down to up


Correct Answer: c) The patient’s skin is prepared by applying an antiseptic in concentric circles, beginning in the area of the proposed incision and working out for several inches. This inhibits the immediate re-contamination of the site with local skin bacteria.


21. Betadine Stain

What neutralizes Betadine, so that if your clothes or shoes were stained with Betadine it would make it colorless?


a) Vinegar

b) Mixture of 1/3 salt, 1/3 vinegar, 1/3 water

c) Urine

d) Common spot remover available at grocery stores

e) Hydrogen Peroxide (H2O2)

f) Isopropyl rubbing alcohol.

Correct Answer: f) Isopropyl rubbing alcohol. Rubbing alcohol is the best agent for betadine stain removal. Most households have rubbing alcohol.Isopropyl rubbing alcohol is meant to clean cuts and scrapes the same as betadine, but it can break apart betadine stains. If you do not have rubbing alcohol on hand, then peroxide can be used as a great substitute. Three percent hydrogen peroxide is perfect for drawing out a betadine stain, but is diluted enough not to permanently damage any clothing. If you have ammonia in your home, that can be used for betadine stain removal as well, particularly a non-sudsing ammonia.

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Dr. Niraj Mahajan

MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.

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