Mcqs Surgery Liaqat-farhan.docx

MCQ,s SURGERY Q1; All of the following homones regulate the Ebb Phase of metabolic response except a. Glucagon b. Cortisol c. Aldosterone d. Catecholamines Q2; Compartment syndrome is characterized by a. Typically occur in closed fracture of lower limb b. Mild pain c. Pain on active movement d. Compartment pressure less than 30mm Hg. Q3 Daily Na requirement of adult a. a)70- 90 mM/day b. b) 50-70 mM/kg c. c) 90- 110mM/kg d. 30-40mM/kg Q4. Identification of which of the following is NOT an essential part of the primary survey? a. A: Tension Pneumothorax b. B: Open Pneumothorax c. C: Flail Chest d. D: Cardiac Tamponade e. E: Rib Fractures Q5. Entonox is mixture of a. O2 and CO2 b. O2 and N2O c. O2 and Xenon d. O2 and Halothane e. O2 and air Q6. 30 years old man heavy smoker came to you with severe pain in calf after a walk of 500m and relieved by rest means a. Claudication b. b) sciatica c) myalgia c. disc prolapse d. No one of the above Q7 A patient with history of fall from 30 feet hight came to ER in shook,decreased chest movement and hyper resonant percussion note on right side,diagnosis his. a. a)Massive Hemothorax b. b) tension Pneumothorax c. c)Cardiac temponate d. Lung contusion e. a and c Q8: Which of the following is NOT a clinical sign of cardiac tamponade? a. A: Distended neck veins. b. B: Hypotension. c. C: Kussmaul’s sign. d. D: Pulsus Paradoxus. e. E: Bradycardia.

Q9. 40 year old man suddenly fell down in hot climate and has no pulse a. a)start CPR b. b) primary survey c. c) call 112 for help d. give oral water and remove all clothes e. start CPR and call 112 Q10. Damage control surgery is decided when a. Coagulopathy

b. b) acidosis c. c) hypothermia d. all of above e. none of above Q11. All are immediate life threatening chest injuries except a. Tension pneumothorax b. massive hemothorax c. cardiac temponade d. pulmonary contusion e. flail chest Q12. Regarding polytrauma do all initially except . a. Oxygen inhalation b. connect pulse oxilator c. Fluid resuscititon d. Cervical collar e. Hypothermia Q13 18 years medical student came in ER after RTA, When we call him by name , he opens his eyes and obeys the command but confused .His GCS a. 11 b. 13 c. 9 d. 3 Q14. A patient with history of fall from 30 feet hight came to ER in shook,decreased chest movement and hyper resonant percussion note on right side,diagnosis his. a. a)Massive Hemothorax b. b) tension Pneumothorax c. c)Cardiac temponate d. Lung contusion e. a and c Q15. Which one of the following will not exacerbate the metabolic response to surgery a. Hypothermia b. Hypertension c. Starvation d. Immobilization Q16 Which one of the following promotes the hepatic acute phase response in injury a. IL-4 b. IL-5 c. IL-6 d. IL-9 Q17 In wound healing following factors attract neutrophils to the wound in inflammatory phase a. PDGF b. Platelets c. TGF- beta d. Bacteria Q18.Order of Cells to a wound healing a. Platelets --- PMNs----Macrophases----Fibroblast b. PMNs--- Macrophases--- Fibroblast----- Platelets c. Platelets---Lymphocytes---PMNs---- Macrophases d. Lymphocytes---Monocytes---PMNs-- Fibroblast Q19. Ratio of type 1 to type 3 Collagens in Normal healed scar a. 4:1 b. 6:1 c. 8:1 d. 16:1 Q20. ATLS o f trauma mostly is focused on prevention of a. Immedite death b. b) early death

c. c) late death d. all e) none Q21 Hemorrhagic shock characterized by blood loss 15 to 30 %, tachycardia, hypotension & urine less than 0.5ml/kg/hour is a. Class 1 b. Class 2 c. Class 3 d. Class 4 Q22 complications of massive blood transfusion a. Hypothermia b. Coagulopathy c. Acidosis d. Hyperkalemia e. All of the above Q23 Which of the following is not a cause of acute shortness of breath on the first post-operative day a. a)atelectasis b. b) pulmonary embolism c. c) myocardial infarction d. chest infection e. pneumothorax Q24 Best route for nutritional support a. Enteral nutrition b. Total Parenteral nutrition(TPN) c. Peripheral Parenteral nutrition(PPN) d. combined Q25 Reactionary haemorrhage, all true except a. occur within 24 hours after operation b. usually caused by slippage of ligature c. not associated with wound infection d. may need re-exploration5) it is usually venous Q26 preoperative preparation includes all except a. detailed history b. medical condition of patient is not optimized c. good communication d. informed consent Q27 Which of the following is not surgical risk in a diabetic patient a. infection b. myocardial infarction c. pressure sore d. poor wound healing e. pain control Q28 Fluid and electrolyte balance a. Total body water in adult 60-70% of body weight b. 2/3rd is intracellular c. 1/3rd is extracellular d. water content is highest in elderly women Q29 Maintenance fluid therapy of healthy adult is a. 1000ml/24hr b. 1500ml/24hr c. 2000ml/24hr d. 2500-3000ml/24hr

. Q30 a. b. c.

Upon Identification of a Tension Pneumothorax, which is the correct management pathway? A: A chest X-ray to confirm the clinical diagnosis. B: Insertion of a chest drain in the 5th intercostals interspace in mid-axillary line. C: Immediate decompression with a 14g 5cm needle in the 2 nd intercostal interspace in mid-calvicular line.

d. D: An ECG to assess for concurrent cardiac contusion. e. E: Completion of a secondary survey to exclude any concurrent injury.

MCQ SURGERY

Q31- 65 years old man presented with dysphagia due to carcinoma esophagus,before surgery his nutritional assessment was done,which of the following markers is best; abcd-

Albumin Weight loss Skin fold thickness Urea

Q32—A young woman with anorexia underwent laparotomy,her BMI is 18.5Kg/m2, nutritional support is plan to start,which of following risks more likely; abcd-

Vomiting Diarrhea Electrolytes imbalance Re-feeding syndrome

Q33-A young female underwent laparotomy for Inflammatory bowel disease and had short bowel syndrome, she is on standard TPN for 5 months at home,which of following need weekly monitoring; abcd-

ABGS Weight of patient Mg, Phosphate Blood sugar and electrolytes

Q34- Daily K requirement of an adult abcd-

1mmol/kg/day 20mmol/kg/day 50mmol/kg/day 70mmol/kg/day

Q35- Which of following is not included in the malnutrition universal screening tool; abcd-

BMI Weight loss in 3-6 months Acute disease effect Serum proteins level

Q36-A30 year man after road traffic accident is admitted in ICU on ventilator and TPN for 3weeks , the patient has difficulty in weaning off from ventilator,which of nutritional element need to change; abcd-

Carbohydrate Proteins Lipids Essential vitamins

Q37- Which of the following organisms is not a gastrointestinal source of peritonitis; abcd-

E-coli Streptococcus Bacteriodes Chlamydia

Q38- A characteristic feature of sebaceous cyst abcd-

Contain sebum It moves particularly in skin crease Skin free except at punctum Punctum is absent in majority of cases

Q39- The aetiological factors of diabetic foot ulcer are all except a- Peripheral vascular disease

b- Neuropathy c- DM diet controlled d- Infection Q40- All are examples of specific ulcers abcd-

Venous ulcer Diabetic foot ulcer Tuberculous ulcer Marjolin ulcer

Q41- All are examples of dermoid cyst abcd-

Thyroglossal cyst Ovarian cyst causing hyperthyroidism Any cyst in midline may be dermoid ganglion

Q42- Raised and everted edges, a characteristic feature of skin ulcer abcd-

Neuropathic ulcer Chronic ulcer Squamous cell carcinoma Bazin”s ulcer

Q43-Subphrenic abscess is common on right side due to all except abcd-

Majority of diseases affect right side Left paracolic gutter is narrow Right paracolic gutter is large Right lung is large

Q44- The most common organisms of secondary peritonitis are all except abcd-

H-pylori Enterococci Streptococci Staphylococci

Q45- The most common type of peritonitis abcd-

Primary peritonitis Secondary peritonitis Biliary peritonitis Tuberculous peritonitis

Q46- Following tumours can occur in the abdominal wall except abcd-

Desmoid tumour Endometrioma Dermoid tumour Fibromatosis

Q17-The intra-abdominal mass which does not move with respiration a) Kidney b) Hepatic flexure c) Tail of pancreas d) Mesenteric cyst Q48- which of following cystic swellings does not have cross- fluctuation abcd-

Iliopsoas abscess Plunging ranula Tuberculous abscess Cystic hygroma

Q49- All are the causes of uniform abdominal distention except abcd-

Intestinal obstruction Massive ascities Morbid obesity Pregnancy

Q50- A 70 year old man with diabetic foot has superficial ulceration on toes and loss of vibration sense, the best plan is abcd-

Start broadspectrum antibiotics X-Ray foot to see osteomyelitis ABI and vascular opinion Re-vascularisation of foot

Q51 Following are true for Marjolin”s ulcer except abcd-

It arises from scar tissues It does not spread by lymphatics It is rapidly growing It is painless

SEQS SURGERY Q1- A 40year old woman is admitted in general surgical ward with esophageal stricture after corrosive intake,her BMI is 18.5kg/m2; a) How will you assess her nutritional status b) Which method of nutritional support you will prefer and why? c) what are complications of long term TPN Q2- Define ulcer and its componants Q3write clinical and pathological classification of ulcer Q4what is Marjolin ulcer?write various types of edges of ulcer

Q5- A56 year old man presented in emergency with diabetic foot ulcer,fever and drowsy.X-Ray foot shows gas in soft tissue,how will you manage this patient? Q6- what is the pathophysiology of Re-Feeding syndrome Q7- A 45year old woman presented with jaundice and mass in right upper abdomen, discuss the differential diagnosis Q8- write aetiology, clinical features and management of acute peritonitis Q9-( a) write indications, contraindications of enteral nutrition (b)- what are complications of enteral nutrition ©- whaat are various methods of enteral nutrition Q10- what is pseudocyst? Write complications of cyst

1.What is normal cerebral blood flow ? a)10ml/100gm/min b)25ml/100gm/min c)55ml/100gm/min d)100ml/100gm/min 2. Cerebral auto regulation maintains normal cerebral blood flow in what range of mean aterial blood pressures ? a) 50-150mm Hg b) 10-50mmHg c) 80- 200mmHg

d) 25-50mmHg 3.Cerebral perfusion pressure is defined as a)systolic blood pressure minus diastolic blood pressure. b)systolic minus venous pressure. c)mean arterial blood pressure minus venous pressure. d) mean arterial blood pressure minus intracranial pressure. 4.compensatory mechanism to maintain ICP in face of mass occupying lesion include a)Reduction in venous blood volume. b)increase in CSF production c)sunsetting eyes. d) increase in CSF volume. 5. which of the following statements regarding Glasgow coma scale. a) the minimum score is 0 b)a GCS of 12 means patient is in coma. c)eye opening on command is GCS 2. d)a GCS 8 or less means patient is in coma. 6. which of the following clinical signs is evidence of basal skull fracture. a) hemotympanum b) Black eye. c) Parietal hematoma. d) Bleeding from mouth.

7.which of the following is correct regarding extradural hematoma. a) it is not necessarily caused by skull fracture. b)it commonly occurs in the occipital region. c) Treatment is Burrhole. d) There is often a lucid interval. 8. which of the following statements regarding subdural hematoma is correct a)it is collection of blood between pia and arachanoid mater. b) it is caused by laceration of brain. c) it is due to laceration of middle meningeal artery.

d) its biconvex on CT scan. 9. which of the the following is correct regarding third nerve palsy? a) it causes dilated and reactive pupil. b)it causes fixed and dilated pupil. c)it usually occurs on the opposite side to the hematoma. d) its never bilateral 10. Reason for low sodium after severe head injury is a)the syndrome of inappropriate ADH secretion. b)diabetes insipidus. c)diabetes mellitus.s d) fluid overload. Q11- Metabolic response to injury is characterized by abcd-

Hyper-metabolism Increase in lean body mass Anorexia Immobility

Q12- All are avoidable factors that compound the response to injury abcd-

Continuing bleeding Hypothermia starvation age

Q13- The modern surgical practice is based on abcd-

natural homeostasis by body perioperative care Better understanding of metabolic response to injury all of above

Q14- All can exacerbate the metabolic response to injury abcd-

hypotension prolonged NPO anaesthesia early mobilisation

Q15- The metabolic response to trauma is abcd-

Graded response Transient response Always help in survival Not related to severity of injury

Q16- Shock can be defined as abcd-

Hypotension Hypoperfusion of tissues Coma All of the above

Q17- Clinical types of shock abcd-

5 6 2 Many

Q18 –The most common type of shock abcd-

Hypovolemic Cardiogenic Septic Obstructive

Q19- The common effect in all types of shock abcd-

Low cardiac output High vascular resistance low mixed venous oxygen saturation high base deficit

Q20- A 20 year old student was brought to E/R after motorbike accident in a prolonged state of shock,after resuscitation,his vitals are normal but patient died after few hours, the most possible cause of death abcd-

Ischemic-reperfusion syndrome Irreversible shock Cardiopulmonary arrest Acute renal failure

Q21- The patient is in shock when there is at least loss of blood volume abcd-

15% 15-30% >40% One unit of donation

Q22-After maintaining airway, breathing of shocked patient,the first line therapy is abcd-

i/v fluids vasopressor antibiotics treat the cause

Q23- The minimum monitoring for patients in shock abcd-

Pulse oximetry Central venous pressure Invasive blood pressure Cardiac output

Q24- The vasopressor of choice in septic shock abcd-

Norepinephrine Dopamine Dobutamine Activated protein C

Q25-The best monitor of adequacy of shock therapy abcd-

Level of consciousness Normal B.P/ECG Urine output Base deficit/Lactate

Q26-Ruptured aortic aneurysm,the haemorrhage is abcd-

Concealed Revealed Reactionary Secondary

Q27- The post haemorrhoidectomy, patient is bleeding on 7th day abcd-

Reactionary haemorrhage Secondary haemorrhage Surgical haemorrhage Bleeding disorder

Q28- All are causes of secondary haemorrhage abcd-

Clot dislodgement Increase B.P Slippage of ligature Infection

Q29-All are indications of blood transfusion except abcd-

Acute massive blood loss Perioperative anaemia for adequate oxygen delivery Symptomatic chronic anaemia without haemorrhage/impending surgery Asymptomatic chronic anaemia,Hb <7gm/dl without major surgery

Q30-All are pre-requisites for emergency blood transfusion abcd-

Confirm patient grouping, cross-matching labeling Informed consent Universal donor group O without cross-match can be transfused Quality of blood eg expiry date, hep B,C,etc

Q31-All are the most common sites of bed sores except abcd-

Ischium Greater trochanter Sacrum Occiput

Q32-A young girl is operated for acute appendicitis,the type of operation by risk of infection abcd-

Clean Clean-contaminated Contaminated Dirty

Q33- In clean-contaminated operation, infection rate is abcd-

1-2% < 10% 15-20% <40%

Q34-Which one is not a component of SIRS abcd-

Hyperthermia > 38C Tachycardia >90/min W.B.C count > 12(10)9/L Pus in wound

Q35-After appendectomy, patient has high grade fever,tachycardia and pelvic collection on USG, will be called as abcd-

SIRS Sepsis Septicemia Septic shock

Q36-Prophylactic antibiotics,the best time to give is abcd-

Peroperative Postoperative I/V at the time of induction of anaesthesia Mid-night

Q37-Regarding control of surgical site infection which one is best abcd-

Aseptic surgical techniques Postoperative and prophylactic use of antibiotics Delayed primary, or secondary closure remains useful in contaminated wounds All of above

Q38-The Synergistic gangrene,the most important causative agent abcd-

Clostridium perfringens Clostridium tetani Pseudomonas Polymicrobial including coliforms,staphylococci,anaerobic streptococci,bacteriodes etc

Q39-Suppurative wound infection develops after surgery abcd-

7-10 days 3-4 days After decisive period 4hour Related to duration of operation

Q40-The treatment of necrotisinng fasciitis abcd-

Broadspectrum antibiotics Immediate exploration of wound and extensive debridement Circulatory support abc

Q41-Preoperative skin shaving should be done to prevent SSI abcd-

immediately before surgery in OR night before not useful ,most surgeons donot recommend it antiseptic bath usually with chlorhexidine is must for all patients

Q42-The most common organism involved in hospital acquired infection abcd-

Pseudomonas aeruginosa Shigella Staph aureus Atypical mycobacterium

Q43- The rate of SSI can be significantly reduced by abcd-

Avoid perioperative hypothermia supplemental oxygen during recovery a and b no one of above

Q44- The antibiotic which is not effective for pseudomonas aeruginosa abcd-

Augmentin Azlocilin Ceftazidime Gentamicin

Q45-Which one is not minimal access surgery abcd-

Laparoscopy Thoracoscopy Arthroscopy Proctoscopy

Q46-Preoperative plan that results in bad patient outcomes abcd-

Gather and record all relevant informations Optimize the patient medical condition Informed consent Emergency surgery without supervision

Q47-The following drugs are stopped before elective surgery abcd-

Oral contraceptive pills Aspirin Steroids Oral hypoglycemic agents

Q48- The patients who need thromboprophylaxis in the perioperative period abcd-

Age < 30years BMI > 30kg/m2 Pregnancy Family history of DVT

Q49-Radiotherapy is best to damage cancer cells abcd-

Hypoxic cancer cells Well oxygenated cancer cells By fractional doses of radiation By radiosensitivity of cancer cells

Q50- The anti-cancer therapy given before surgery abcd-

Adjuvant therapy Neo-adjuvant therapy Palliative therapy Curative therapy

Q51-WHO surgical safety checklist,which one is not its part abcd-

Sign in Time out Sign out Risk out

Q52- Routine preoperative investigations for excision of sebaceous cyst abcd-

CBC UREA and CREATININE X-RAY chest Urine analysis

Q53- 65 year old patient came for surgery of ingrowing toe nail,which investigation is more helpful abcd-

CBC ECG Blood sugar Doppler study

Q54- 40years old woman is admitted for laparoscopic cholecystectomy, she has 4 children by c-section without perioperative complications, which investigation is least helpful. abcd-

CBC LFTs X- ray chest Bleeding disorder

Q55- 18 years old healthy boy is admitted for inguinal hernia repair, which investigation is mandatory abcd-

CBC, UREA/CREATINE X-ray chest ECG Blood sugar random/Fasting

Q56 - 30 year old patient is admitted in emergency with generalized peritonitis in a critical state, your next step will be abcd-

Complete all investigations first Optimization and shift to OR is priority Need only informed consent NPO of 6 hours is must

Q57- 27 year old woman is admitted with acute appendicitis, all are relevant investigations except abcd-

LFTs USG Pregnancy test CBC

Q58- All are high risk factors for perioperative mortality abcd-

Recent MI Emergency surgery Morbid obesity Age >60 year

Q59-On first postoperative day after appendectomy,patient has fever abcd-

Check wound for infection Check for chest infection Send blood for malaria and typhoid Stress response

Q60- 40 years old patient is admitted in general surgical ward with excessive vomiting, Lab shows hypokalemia, hyponatremia, pH=7.58 and acidic urine , which shows severity of fluid and electrolyte disorder abcd-

Hypokalemia Hyponatremia pH=7.58 acidic urine

Q61- After laparoscopic cholecystectomy, 2nd day patient has mild puffiness of face and no other complaint. Lab shows Na=125meq/L,other lab values are normal, what is your next step a- observe and restrict I/V fluid

b- Give I/V hypertonic saline c- Repeat serum electrolytes d- ABGs for acid- base disturbance Q62-After modified radical mastectomy, on 2nd post op-day, patient is in acute confusion and no other complaint, what is in your mind? a- Septic shock b- Brain metastasis c- Secondary haemorrhage d- Fluid and electrolytes disorder Q63- The post- operative vomiting, which is false abcd-

May be due to severe pain Best treated by NG in all abdominal operation, Anti-emetics may help May be due to drugs

Q64-A diabetic patient complain of leg pain at night and relieved by sitting esp when feet are hanged down abcd-

Claudication Rest pain due to severe ischemia Diabetic neuropathy Sciatica

Q65- A diabetic patient complain of severs pain in buttocks while exercising , he is married for 3years but no children due to severe impotency,the most likely diagnosis abcd-

Diabetic neuropathy Leriche syndrome External iliac arteries stenosis psychological

Q66- A 20 year old girl has large swelling on Left shoulder,firm,non-tender and mobile, visible scar of previous surgery,according to her mother,this started after BCG vaccination in childhood and 8month before was removed by surgeon, on work up no distant metastasis found,the most likely diagnosis abcd-

lipoma keloid cold abscess Marjolin tumour

Q67- Which of following is an indication of surgery in varicose veins in our country abcd-

Skin changes like ulcer,lipodermaosclerosis Itching Cosmesis DVT

Q68- A young female patient presents with small punched out,painful ulcers over the dorsum of her foot,likely diagnosis abcd-

Venous ulcer SLE Tuberculous ulcer Raynaud”s phenomenon

Q69- 5 days after cholecystectomy, an asymptomatic patient has serum Na=125mEq/L,your appropriate plan abcd-

Use normal saline Restriction of free water Dialysis Observation

Q70- one week after appendectomy,a young girl c/o fever102F, B.P100/70,pulse110/min and respiratory rate26/min. USG shows pelvic abscess,she is in metabolic state abcd-

SIRS Sepsis Septic shock MODS

Q71-A patient with abnormal coagulation studies requires urgent cholecystectomy.A transfusion of FFP is planned.e what is optimal time for this transfusion? abcd-

Day before surgery Night before surgery On call to surgery Intraoperative

Q72- An acutely injured patient becomes hypotensive shortly after induction which one is responsible abcd-

N2O Morphine Succinylcholine Atracurium

Q73- All initiate afferent impulses to CNS which then triggers neuroendocrine response abcd-

Alkalosis Hypothermia Pain Bleeding

Q74- An unconscious patient with systolic B.P=80mmHg and pulse74,most likely has abcd-

Cardiogenic shock Hemorrhagic shock Neurogenic shock Septic shock

Q75-Most common indication for intubation in a trauma patient abcd-

Altered mental status Neck injury Facial injury Confusion

Q76-Massive hemothorax is abcd-

500ml blood >1000ml blood blood1500ml 500 ml in both pleural cavities

Q77- One feature which differentiate keloid from malignant growth abcd-

Recurrence Excessive growth into normal skin Increased angiogenesis Metastasis

Q78-Chronic scar can change into a- Martorell”s ulcer b- Marjolin ulcer c- Meleney ulcer

d- Malignant melanoma Q79-The ideal solution to clean the wound is abcd-

Saline Povidone Hydrogen peroxide Eusol

Q80- which hormone level does not rise during injury abcd-

ACTH Adrenaline Glucagon Thyroxine

Q81-Albumin level decreases during stress response because of abcd-

Decreased production Decreased intake due to anorexia Liver failure Increased capillary permeability

Q82- The ideal treatment of carbuncle is abcd-

Drainage Incision and drainage Excision Aspiration

Q83- Following are true for carbuncle except abcd-

Nape of neck is the commonest site Cribriform appearance is diagnostic Abscesses are not communicating with each other Staphylococcus is the commonest organism

Q85-Treatment of cold abscess is abcd-

Excision Incision and drainage Marsupialization Nondependent aspiration

Q86-Following facts are false in gas gangrene except abcd-

It is caused by Clostridium welchii It is caused by Clostridium perfringens It is caused by beta hemolytic streptococci Brownish fluid has foul odour

Q87- Following are true for terminal pulp space infection except abcd-

It is called felon May cause digital artery thrombosis Not so painful Treated by volar longitudinal incision

Q88-Pyogenic granuloma is due to a- Bacterial infection b- Viral infection c- Fungal infection

d- Trauma Q89- Following are the principles of treatment of hand infections except abcd-

Hand elevation Early splinting Tetanus prophylaxis in high risk patient Pencillins are the drug of choice

Q90-HIV associated lymphoma can be following except abcd-

B cell lymphoma Diffuse large cell Burkitt”lymphoma Hodgkin”lymphoma

Q91-Characteristic feature of critical limb ischemia is one abcd-

Intermittent claudication Ankle pressure is less than70 mm of Hg Toe systolic pressure is less than 30 mm of Hg Absent pulses

Q92- Following are true for subclavian artery except abcd-

Cervical rib can compress the artery It gives internal mammary artery Adson”s test is used to check subclavian artery compression by cervical rib Post-stenotic dilatation called venture effect

Q93- About Cervical rib abcd-

It is of 4-types Type4 is easily seen in X ray neck It is excessive development of transverse process of 7 th cervical vertebra Common in young patient

Q94- Dry gangrene, all are true except abcd-

Slow occlusion of the arteries Line of demarcation is present Dry, shrivelled and mummified Emergency amputation to prevent sepsis

Q95-Trendelenburg test is done to find out abcd-

Sapheno-popliteal incompetency Sapheno- femoral incompetency Deep vein thrombosis Site of perforators

Q96 – Following are true for venous perforators except abcd-

Communicate superficial and deep veins Mostly present in the legs They do not have valves SEPS is the endoscopic surgery done on perforators

Q97- The most common complications of varicose veins except a- Venous ulcer b- Bleeding c- Lipodermaosclerosis

d- DVT Q98-Characteristic feature of basal cell carcinoma is abcd-

Keratin pearls Orphan Annie nucleoli Skip lesions Excellent prognosis

Q99-About melanoma, all are true except abcd-

Malignant tumour of melanocytes More common in white skinned people May occur after renal transplantation Melanoma 3mm thickness has good prognosis

Q100- Malignant melanoma, all are true except abcd-

Painless ulcer Edges are irregular Induration is absent Always pigmented as black

Q102- Regarding diagnosis of malignant melanoma abcd-

Mostly diagnosis is clinical Alpha fetoproteins are raised Excision biopsy Sentinel lymph node biopsy

Q103-An albinism patient was admitted in surgical ward with melanoma on sole of foot about 0.76mm in thickness, according to Breslow staging, it is abcd-

Stage 1 Stage 2 Stage 3 Stage 4

Q104- Breslow stage 2 melanoma needs wide excision with resection margin as abcd-

1cm 2cm 3cm 5cm

Q105- Following factors contribute to burn shock except abcd-

Increased capillary permeability Increased plasma oncotic pressure Increased capillary hydrostatic pressure Depressed myocardial function

Q106-Tangential excision of burn refers to abcd-

Excision and leaving the wound open immediately after admission Excision within 6 hours and primary closure Excision after 2-3 days and skin grafting Excision after 10 days

Q107-Following are true for split skin graft except a- It is partial thickness graft b- It is called Thiersch graft

c- Humby”s knife is often used d- Cosmetically superior to full thickness graft Q108- A malignant tumour was removed by surgery and histopathological report was R0.what does it mean? abcd-

Resection margins are clear Resection margins are not clear Macroscopic residual tumour Need fresh frozen facility

Q109-Following are radiosensitive tumours except abcd-

Oral cancer Seminoma Carcinoma breast Malignant chordoma

Q110- which one of the following is commonly associated with paraneoplastic syndrome? abcd-

Carcinoma stomach Carcinoma colon Carcinoma pancreas Carcinoma lung

Q111- polycythemia as paraneoplastic syndrome is seen in abcd-

Hepatoma Wilms tumour Apudoma Hypernephroma

Q112-Which one is more commonly associated with paraneoplastic syndrome? abcd-

Hypernatraemia Hyponatraemia Hypercalcaemia Hypocalcaemia

Q113- All are transluminant swellings in the body abcd-

Cystic hygroma Ranula Vaginal hydrocele Thyroglossal cyst

Q114-Which one of the following swelling does not contain cholesterol crystals? abcd-

Branchial cyst Sebaceous cyst Dental cyst Hydrocele

Q115- Componants of Horner”s syndrome are all except abcd-

Miosis Ptosis Anhydrosis Exophthalmos

e- Induration is absent f-

e-

+