MCQ DR MURALI

1. Complication of TPN include :

a. Hypercalcemia
b. Hyperglycemia
c. Hypophosphatenia
d. Hyperkalemia
e. All of the above

2. A 45 Years old young female presented with H/O greenish brown discharge from the breast with
pain and redness. O/E she is found to have sub-areolar lump with slight nipple retraction.
Categorize the most probable cause of her problem.

a. Firbocyctic diseases
b. Intraductal papilloma
c. Duct ectasia
d. Invasive ductal ca
e. Retention cysts

3. Regarding Gas gangrene:

a. Is caused by Clostridium Welchii

b. Kappa toxin produces MI
c. Gases produced are Carbon dioxide, Helium and Hydrogen
d. Foul smelling odor and soft tissue crepitus are characteristic of the gas membrane
e. Radiography can visualize gas in the tissue
4. The nerve that may injured during varicose vein surgery include :

a. Saphenous Nerve
b. Common Peroneal Nerve
c. Sural Nerve
d. Tibial Nerve
e. Popliteal Nerve

5. A 19 years old college student present to the emergency department by ambulance with a stab
wound adjacent to the left nipple region. His blood pressure is 50/30 mmHg and he is
unresponsive. Catagorize the associated type of shock in the patient

a. Anaphalatic Shock
b. Haemorrhagic shock secondary to blood loss
c. Neurogenic shock
d. Cardiogenic shock due to extrinsic factor
e. Obstructive Shock

6. Experimental Study include:

a. 2 random allocated treatment

b. Evaluation of the conditionor treatment in define population
c. Allocation to treatment groups is under the control of the researcher
d. Includes a control group and standard treatment
e. 2 or more treatment are compared
7. A 45 Years old woman presented with hypertension, development of facial hair and a 7cm
suprarenal mass. Which of the following is the likely diagnosis?

a. Cushing Diseases
b. Adrenocortical Carcinoma
c. Pheochromocytoma
d. Carcinoid
e. Myelolipoma

8. Adynamic causes of intestinal obstruction include:

a. Paralytic ileus
b. Bezos
c. Gall Stone
d. Pseudo-obstruction
e. Henia

9. A 25 years old man fell 15 feet from a tree. A brief LOC were witnessed by his friends. IN A&E he
ws noted to have a left temporal scalp laceration with GCS of 13. An hour later it dropped to 8.
Categorize the type pf head injury in this patient.

a. Acute subdural hematoma

b. Extradural hematoma
c. Subarachnoid hematoma
d. Petrous temporal skull fracture
e. None of the above
10. Pheochromocytoma is knows as 10% tumour as 10% of tumor are

a. Bilateral
b. Benign
c. Malignant
d. Inherited
e. Single

11. Moh’s micrographic surgery can be used for excision of:

a. Lentigo Maligna
b. Basal cell Ca.
c. Keratoacanthoma
d. Bowen’s diseases
e. Squamous cell Ca.

12. After an automobile accident, a 28 years old woman dound to have an extraperitoneal bladder
rupture by retrograde urethrogram. Treatment of this patient include:
a. Insertion of foley’s catheter through urethra
b. Open repair of the injury
c. Observation and evidence of continuing urinary leak
d. Suprapubic cystostomy
e. All of the above
MCQ DR ADEL

1. The strategies of damaged control resuscitation include

a. Damage control surgery to control hemorrhage (T)

b. Do not treat acute traumatic coagulopathy (F)
c. Limit colloid and crystalloid infusion to avoid dilutional coagulopathy (T)
d. Undergo all investigation prior to hemorrhage control (F)
e. Permissive hypotension until hemorrhage control. (T)

2. Complication of short bowel syndrome

a. Gastric hypo secretion (F)

b. Decreased protein absorption (T)
c. Increased gall stone formation (T)
d. Slurred speech and ataxia (T)
e. Reduced renal stone formation (F)

3. Triple assessment in breast include

a. Age (T)
b. MRI (F)
c. Core biopsy (T)
d. Receptor study (F)
e. Physical Examination (T)
4. Pancoast tumor is associated with cancer of

a. Thyroid (F)
b. Thymus (F)
c. Apical lobe lung (T)
d. Pyiriform fossa (F)
e. Lingual lobe (F)

5. Organism causing overwhelming post-spelnectomy infection (OPSI)

a. H. Influenza
b. Staph. Aureus
c. Pseudomonas
d. N. meningitides
e. S. Pneumoniae

6. Regarding Hepatoma:

a. 80 of cases have elevated a- feto protein

b. Fibrolamellar variant has worse prognosis
c. Hep. C virus infection can lead to hepatoma
d. Octreotide can be used along with other chemotherapy agent
e. Left lobe is commonly affected

7. .

8. Features of carcinoid syndrome include:

a. Flushing
b. Cardiac lesion on left side
c. Wheezing
d. Hepatomegally
e. Constipation
9. .

10. Clinical Features of early rectal Ca.

a. Perineal pain (F)

b. Progressive constipation (T)
c. Palpable nodular liver (F)
d. Sense of incomplete evacuation (T)
e. Early morning blood and mucus in stool (T)

11. Hemorrhoids

a. Are symptomatic anal cushion (T)

b. Have a genetic predisposition (T)
c. Present with painful bleeding (F)
d. Can occur along with rectal ca (T)
e. Are treated preferably by stapled hemorrhoidopexy in grade III (T)

12. Regarding Acute Limb Ischemia

a. Aspirin is a drug of choice (F)

b. Fixed mottling is an early sign (F)
c. Emergency embolectomy is the treatment of choice (T)
d. Emboli is common in patient with sinus rhythm (F)
e. Long term anticoagulant therapy is indicated after surgery (T)
13. Shock

a. Treated with crystalloids (T)

b. Characterized by lactic acidosis (T)
c. A systemic state of high tissue perfusion (F)
d. The most common cause of death in surgical patient (T)
e. Failure of Sodium and Potassium pump in cell membrane (T)

14. .

15. . Regarding inguinal hernia

a. Descend into scrotum

b. Contain broad ligament in female (F)
c. Earliest complication is irreducibility (T)
d. Direct hernia only occur in male (T)
e. Hernioplasty is the preferred treatment (T)

16. Regarding hydrocele

a. Its secondary type is more common (F)

b. It’s an abnormal collection of serous fluid (T)
c. Dine needle Aspiration is the standard treatment (F)
d. Accumulated fluid contain albumin and fibrinogen (T)
e. It is typically translucent (T)

17. .
 18. Surgical management of liver injury

a. Pull (F)
b. Push (T)
c. Pringle (T)
d. Peel (F)
e. Pack (T)

1. Causes of raised temperature postoperatively between day 3 to day 5 include:

a. Chest infection (F)

b. Superficial wound infection (T)

c. Thrombophlebitis (F)

d. Deep wound infection (T)

e. Anastomotic leakage (F)

2. Regarding skin grafting

a. Split thickness graft involves epidermis and part of dermis

b. Skin graft survive initially by inosculation of blood

c. Thinner donor sites heal better

d. Full thickness graft includes epidermis with full dermis

e. Thinner grafts heal with less contracture and are more durable
1. A car-racer decelerates rapidly after hitting a parked vehicle. He is waring a seat belt and the car is
equipped with an air bag, The organ most likely to be injured are

a. Small intestine (T)

b. Liver (F)
c. Spleen (F)
d. Diaphragm (F)
e. Large intestine (T)

2. A 60 year-old healthy man presented with severe abdominal pain. On examination, he had diffuse
tenderness and rigidity all ocer the abdomen. Chest X-ray recealed a radiolucency under right
diaphragm. Regarding his condition

a. A left lateral decubitus abd. X-ray is compulsory to confirm the diagnosis (F)

b. It is a perforated Peptic Ulcer (T)

c. Serum amylase is raised in the condition (T)

d. Perforated transverse colon carcinoma is a differential diagnosis (T)

e. He could be treated endoscopy. (F)

3. A 43 year old farmer presented to the emergency with lacerated injury of 5 cm and pain over his left
leg which occurred 2 days ago. AS the bleeding stopped he did not seek medical attention. Initial steps in
the treatment of this patient are:

a. Admission and close observation of the wound (F)

b. Wound inspection, irrigation and debridement. (T)

c. Oral antibiotic and advice for follow-up as an outpatient (F)

d. Immediate closure of the wound and cover with broad spectrum antibiotic (F)

3. Administration of ATT (T)

4. A 50 year old man underwent elective laparoscopic hernia repair for his right sliding inguinal hernia. 2
days later he developed painful distention of the abdomen with vomiting. On abdominal examination
there was rebound tenderness with guarding. The probable cause of this condition are

a. Intragenic bowel injury (T)

b. Strangulation of the bowel (F)

c. Adhesion formation (F)

d. Recurrence of hernia (F)

e. Bladder injury. (T)

5. A superior media sternal mass was incidentally detected in the thorax CT scan of 70 years old man
who has been having occasional symptoms of dyspnea with no other symptoms. Possible differential
diagnosis of this mediastinal mass are:

a. Thymoma (F)

b. Retrosternal thyroid (T)

c. Lymphoma (T)

d. Neurogenic tumor (F)

e. Parathyroid gland (F)

6..

7. In compare to Crohn’s diseases, Ulcerative colitis

a. Affects all the layer of the large bowel (T)

b. Hypoalbuminemia is one of the criteria in assessing the severity (F)

c. Stricture and fistulae are the usual complications (F)

d. 40-60% will have anal lesion (F)

e. Pipstem colon is a barium enema findings. (T)

8. Regarding ‘Rest pain’

a. It could be anywhere in the body at rest. (F)

b. It is in the thigh of patient in Buerger’s diseases. (F)

c. It could be in calf of the patient with intermittent claudication (F)

d. It is a pain in the foot of the patient with severe vascular insuffiency (T)

e. It is associated with good prognosis (F)

9. The boundaries of inguinal canal

a. anteriorly – transversalis fascia (F)

b. posteriorly – psoas (F)

c. superiorly – rectus abdominis (F)

d. Inferiorly- inguinal ligament (T)

3. Medially – iliopectineal ligament (T)

10. A 40 year old lady presents with recent onset of unilateral circumferential retraction of the nipple.
On clinical examination no breast lump is palpable. The differential diagnosis includes

a. Simple nipple retraction due to aging (T)

b. duct ectasia (T)

c. Chronic periductal mastitis (F)

d. Breast carcinoma (T)

e. Fibroadenoma (F)
11. In patient with venous ulceration due to superficial venous incompetence it is recommended to :

a. Treat the ulcer conservatively (F)

b. Delay varicose vein surgery till ulcer heals (F)

c. Perform surgery eary to aid ulcer healing (T)

d. Perform surgery only if infection controlled (T)

e. Do a high ligation and stripping (T)

12. A patient presented to outpatient department with locally advanced anaplastic cancer of the thyroid
and tracheal obstruction. Regarding her management

a. Due to poor prognosis has to counsel family for taking no action (F)

b. Chemotherapy is treatment option (F)

c. Isthmuesctomy is the treatment of choice (T)

d. The intubation should be done ealier as prophylactic mean (T)

e. It is best to avoid tracheostomy (T)

13. There is an association of gastric cancer with

a. achlorhydia of stomach (T)

b. atrophic gastritis (T)

c. Adenomatous gastric polyps (T)

d. Duodenal ulceration (F)

e. History of previous surgery on stomach (T)

14. Rectal cancer

a. Is usually squamous cell origin (F)

b. Frequently requires a barium enema for accurate diagnosis (F)

c. Is diagnosed by raised CEA (F)

d. Has a 90% 5-year survival rate if diagnosed in stage 1 (T)

e. Is treated via anterior resection without creating stoma (T)

15. Pancreatic pseudocysts

a. Are developmental in origin (F)

b. Usually arise in the lesser peritoneal sac (T)

c. Produce a smooth epigastric mass which moves with respiration (F)

d. May be effectively treated by internal drainage (T)

e. May be complicated by haemorrhage (T)

16. Renal stone

a. Are usually radiopaque in plain radiograph (T)

b. Are commonly associated with UTI (T)

c. Maybe associated with renal tubular acidosis (T)

d. May be improved by reduce oral fluid intake (F)

e. can be effectively treated extracorporeal laser therapy (F)

17. Torsion of testis

a. Is associated with abnormalities if scrotal development. (F)

b. often presents with lower abdominal pain (T)

c. produce gangrene of testis (T)

d. May initially be treated by non-surgical means (T)

e. Always requires surgical treatment. (T)

18. Brain tumor

a. In adults are mostly glioblastoma multifome (T)

b. In children are mainly medulloblastoma (T)

c. Of childhood are most commonly found in posterior cranial fossa. (T)

d. which arise extra cerebrally are most commonly acoustic neuroma (F)

e. Metastases in approximately 20 percent of cases (F)

19. Treatment of malignant melanoma should include

a. A preliminary incisional biopsy (F)

b. wide excision of the tumor (T)

c. ‘enbloc’ removal of adjacent involved lymph node (T)

d. immediate excision of any enlarging lymph node on postoperative period (T)

e. radiotherapy to the surgical area and adjacent lymph node. (F)

20. Heavily contaminated and dirty wound

a. Require surgical toiler and delayed closure (T)

b. Require the administration of systemic antibiotic (T)

c. can usually be treated by wound toiled and primary closure (F)

d. Should be initially be allowed to heal by secondary intention (T)

e. Should be excised totally (F)