Professor in Surgery Question Paper and Answer Key

FINAL ANSWER KEY
Question Paper Code: 78/2024/OL
Category Code:625/2023
Exam: Professor in Surgery
Date of Test 28-06-2024
Department Govt Homoeopathic Medical Colleges

Question1:-All are examples of concealed hemorrhage causing hypovolemic shock except
A:-Chest Injury
B:-Fracture long bones
C:-Head Injury
D:-Blunt trauma Abdomen
Correct Answer:- Option-C

Question2:-Best clinical indicator to determine fluid resuscitation in shock is
A:-Blood pressure
B:-Urine output
C:-PCWP
D:-CVP
Correct Answer:- Option-B

Question3:-Golden period for a traumatic wound is
A:-2 Hrs
B:-4 Hrs
C:-6 Hrs
D:-12 Hrs
Correct Answer:- Option-C

Question4:-Among the things used for Donning, all are true except
A:-Shoe cover
B:-Goggles
C:-Face shield
D:-Three layer cap
Correct Answer:- Option-D

Question5:-Regarding massive Blood transfusion which among the following is true
A:-5 Units in 24 Hrs
B:-Can cause Hyperthermia
C:-Replace entire circulating volume in 24 Hrs
D:-2 units in 1 Hr
Correct Answer:- Option-C

Question6:-Class II Hemorrhagic shock is Blood lose of
A:-500 ml
B:-1 L
C:-1.5 L
D:-2 L
Correct Answer:- Option-B

Question7:-Clean contaminated wounds include all except.
A:-Interval Cholecystectomy
B:-LSCS
C:-Bowel surgery after Bowel preparation
D:-Un complicated inguinal Hernia repair
Correct Answer:- Option-D

Question8:-Most common type of shock
A:-Hemorrhagic
B:-Neurogenic
C:-Cardiogenic
D:-Anaphylactic
Correct Answer:- Option-A

Question9:-Grade IV southampton wound score
A:-Deep/severe wound infection with or without tissue break down
B:-Pus/purulent discharge
C:-Serous discharge
D:-Erythema with signs of inflammation
Correct Answer:- Option-B

Question10:-All are blood substitutes except
A:-PEG Hb
B:-Stroma free Hb
C:-PVC Hb
D:-Perflurocarbon
Correct Answer:- Option-C

Question11:-All are parameters of ‘qSOFA score except
A:-Systolic BP < 100 mm Hg
B:-Altered mental status
C:-P.R > 120/min
D:-Respiratory rate > 22/min
Correct Answer:- Option-C

Question12:-Massive pulmonary embolism is an example of
A:-Obstructive shock
B:-Distributive shock
C:-Anaphylactic shock
D:-Hypovolumic shock
Correct Answer:- Option-A

Question13:-Scrofula is
A:-Type of skin malignancy
B:-T.B. infection of lymph node
C:-Fungal infection
D:-Pyogenic abscess of neck
Correct Answer:- Option-B

Question14:-Anti inflammatory cytokines are all except
A:-IL-4
B:-TNF-α
C:-TNF-β
D:-IL-9
Correct Answer:- Option-B

Question15:-In S.S.I. protocol the first dose of prophylactic antibiotic is given
A:-At the time of induction of anesthesia
B:-At 6 am on day of surgery
C:-Previous day of surgery
D:-At the moment of incision
Correct Answer:- Option-A

Question16:-Chronic paronychia is caused by
A:-Streptococcus
B:-Staphylococcus
C:-Candida
D:-Clostridium
Correct Answer:- Option-C

Question17:-Factors presipitating a/c compartment syndrome include all except
A:-Anticoagulants
B:-Limb elevation
C:-Tight compression bandages
D:-Plaster cast application
Correct Answer:- Option-B

Question18:-Complications of massive Blood transfusion are all except
A:-Hypothermia
B:-Hyper calcemia
C:-Hypo magnesemia
D:-TRALI
Correct Answer:- Option-B

Question19:-Methods to prevent contractures are all except
A:-Silicon gel application
B:-Intralesional triamcinolone injection
C:-External pressure garments
D:-Absolute rest
Correct Answer:- Option-D

Question20:-Features of Type II Necrotizing fasciitis include all except
A:-Can affect young individuals
B:-Caused by streptococcus pyogens
C:-Can lead to toxic shock syndrome
D:-Inj. cefoperazone is the choice
Correct Answer:- Option-D

Question21:-During Airway evaluation in poly trauma patients following statements are TRUE EXCEPT
A:-Part of assessment is whether the patient is able to communicate verbally
B:-Assume c-spine injury in patients with multisystem trauma
C:-Unresponsive patients have an airway obstruction until proven otherwise
D:-LEMON assessment criteria is used for deciding the Oxygen flow concentration
Correct Answer:- Option-D

Question22:-Endotracheal intubation in a case of head injury is indicated when GCS is below
A:-7
B:-8
C:-9
D:-10
Correct Answer:- Option-B

Question23:-In tension pneumothorax, following statement are TRUE EXCEPT
A:-Life threatening condition
B:-In emergency needle thorocostomy, 5th intercostal space, anterior axillary line region can also be a site for needle insertion
C:-Size of the needle in Emergency needle thorocostomy is 22 G or 23 G
D:-Tube Thorocostomy site is 5th intercostal space anterior axillary line
Correct Answer:- Option-C

Question24:-In Flail chest.
A:-Bony continuity of ribs preserved
B:-2 ribs are fractured at one site
C:-On inspiration loose segment is displaced inwards
D:-Mechanical ventilation is mandatory in treatment
Correct Answer:- Option-C

Question25:-In cardio pulmonary resuscitation following statements are TRUE EXCEPT
A:-Chest compressions at the rate of 60-90/min
B:-Chin lift/head tilt/jaw thrust maneuvers used for air way patency
C:-30 chest compressions followed by two rescue breathing
D:-Chest compression of up to 5 cm
Correct Answer:- Option-A

Question26:-As per America Heart Association, order of CPR is
A:-A – B – C
B:-C – A – B
C:-C – B – A
D:-B – A – C
Correct Answer:- Option-B

Question27:-FAST refers to
A:-Rapid IV infusion
B:-Emergency Laparotomy
C:-Emergency CT scan
D:-USG for blunt abdominal trauma
Correct Answer:- Option-D

Question28:-In FAST following statements are TRUE EXCEPT
A:-No attempt to assess the nature or extend of injury
B:-Adjuvant to primary survey
C:-> 100 ml of blood can be detected
D:-e FAST is electronic documentation of FAST findings for retrieving the data electronically
Correct Answer:- Option-D

Question29:-Regarding TRIAGE following statements are TRUE EXCEPT
A:-Objective is to deliver effective treatment to appropriate patient at appropriate time
B:-One of the major determinants in TRIAGE is the resources availabe
C:-Triage is a static process
D:-Different colour codes used are Red, Yellow, Green and Black
Correct Answer:- Option-C

Question30:-Overtriage is defined as
A:-More trained personnels, equipments are recruited to the triaging area, than that is required
B:-Proportion of seriously injured patients transported to non trauma center
C:-Proportion of seriously injured patients categorized into inappropriate category
D:-Proportion of patients without serious injuries transported to major trauma center
Correct Answer:- Option-D

Question31:-D V T is associated with all EXCEPT
A:-Thrombin III deficiency
B:-Activated protein S deficiency
C:-Homocysteinemia
D:-Factor V Leiden mutation
Correct Answer:- Option-A

Question32:-In DVT following statements are true EXCEPT
A:-Chronic venous insufficiency is a major consequence of DVT
B:-Soleal sinuses are the most common site of initiation of thrombosis
C:-Stasis is the single most important causative factor
D:-Lupus antibody is associated
Correct Answer:- Option-C

Question33:-Regarding DVT following statements are TRUE EXCEPT
A:-Activation the calf pump mechanism is an effective mean of prophylaxis
B:-In the post operative period patient should be encouraged to walkup early and sit in a chair to prevent DVT
C:-Sequential compressive device can be used as a sole prophylactic measure in low risk patients
D:-LMWH is preferred over un fractionated heparin in thrombo prophylaxis
Correct Answer:- Option-B

Question34:-Regarding DVT following statements are TRUE EXCEPT
A:-d-dimer assay has a high negative predictive value
B:-Test of choice for DVT diagnosis is Duplex USS
C:-MR venography is more appropriate for diagnosis of proximal DVT
D:-CT venography is done to confirm the diagnosis
Correct Answer:- Option-D

Question35:-Regarding DVT following statements are TRUE EXCEPT
A:-LMWH treatment can be administered in outpatient basis
B:-Accepted INR range for oral anticoagulant treatment is 1.5 – 1.9
C:-Minimum period anticoagulation required is 3 months
D:-Catheter directed thrombolysis is indicated in patients with proximal thrombus with moderate to severe symptoms
Correct Answer:- Option-B

Question36:-Regarding BURNS, following statements are TRUE EXCEPT
A:-Suppression of cell mediated immunity in large burns is a major cause of infection
B:-Carbon monoxicde poisoning is one of the major cause of early death
C:-Hydrogen cyanide poisoning in burns can arrest mitochondrial respiration
D:-In Muir and Barclay formula for calculating the colloid requirement, TBSA is multiplied by a factor of 2 and body weight in Kg for one portion
Correct Answer:- Option-D

Question37:-Regarding BURNS following statements is not TRUE
A:-Increased colloid oncotic pressure in burned area is a major reason for early shock in burns
B:-Volume of fluid loss is directly proportional to total burns surface area (TBSA)
C:->15% TBSA burns in adults requires hospitalization for fluid replacement
D:-Lund and Browder chart is usually used to assess TBSA in adult population
Correct Answer:- Option-D

Question38:-Regarding BURNS following statements are TRUE EXCEPT
A:-“Wallace rule of nine” is adequate for first approximation of total burn surface area (TBSA)
B:-In high tension electricity injury renal failure is due to myoglobinuria
C:-Cardiac muscle damage identified by raised cardiac enzymens is common in low tension electricity injury
D:-Acid burns with high concentration HCL (>50%) is associated with hypocalcemia
Correct Answer:- Option-C

Question39:-Regarding Skin grafting following statement is not TRUE
A:-Full thickness graft (Wolfe grafts) is generally preferred in larger area grafting since it produces better cosmetic outcome
B:-Partial thickness skin graft composed of epidermis and part of dermis
C:-Extend of the post graft contracture is determined by the amount of dermis incorporated
D:-Graft with skin and cartilage is an example of composite graft
Correct Answer:- Option-A

Question40:-Following terminology is related to Skin grafting EXCEPT
A:-Osmosis
B:-Inosculation
C:-Imbibition
D:-Fibroblast maturation
Correct Answer:- Option-A

Question41:-Most common salivary gland tumor
A:-Warthin’s tumor
B:-Pleomorphic adenoma
C:-Oncocytoma
D:-Sialadenoma
Correct Answer:- Option-B

Question42:-Most common malignant salivary gland tumor
A:-Adenocarcinoma
B:-Squamous cell carcinoma
C:-Mucoepidermoid carcinoma
D:-Acinic cell carcinoma
Correct Answer:- Option-C

Question43:-What is the relation of size the salivary gland and incidence of malignant tumours ?
A:-No relation between size of the salivary gland and incidence of malignant tumours
B:-Size is inversely proportional to malignancy incidence
C:-Size is directly proportional to malignancy incidence
D:-Size and secretory ability decides the malignant potential
Correct Answer:- Option-B

Question44:-As per the WHO 2017 CLASSIFICATION of salivary gland tumors all TRUE EXCEPT
A:-Clear cell carcinoma is not a salivary gland tumor
B:-Myoepithelioma is a benign salivary gland tumor
C:-Sebaceous Carcinoma is a Malignant salivary tumor
D:-Large cell neuroendocrine cancer is a Malignant salivary tumor
Correct Answer:- Option-A

Question45:-Following are accepted types of Parotidectomy, EXCEPT
A:-Enucleation
B:-Extra capsular dissection
C:-Superficial parotidectomy
D:-Total conservative parotidectomy
Correct Answer:- Option-A

Question46:-Prevention of Frey’s syndrome after parotidectomy can be achieved by reconstruction using following structures, EXCEPT
A:-Sternomastoid flap
B:-Tensor fascia lata flap
C:-Buried free flap
D:-Free fat grafting
Correct Answer:- Option-B

Question47:-Regarding Freys syndrome after parotidectomy following statement is correct
A:-Due to aberrant regrowth of parasympathetic fibers into skin
B:-More common after extra capsular excision
C:-Treated by iodine and starch powder
D:-None of the above is true
Correct Answer:- Option-A

Question48:-Following are common complications of parotidectomy, Except
A:-Facial nerve injury
B:-Pterygoid plexus injury
C:-Salivary fistula
D:-Auriculotemporal syndrome
Correct Answer:- Option-B

Question49:-Regarding treatment of facial nerve injury following statement are correct, Except
A:-Prevention of exposure keratitis is the primary concern
B:-Asymmetry in face can be corrected by Botex injection
C:-Synkinesis is an early sign of guided regeneration
D:-Free muscle flap using gracilis muscle is used
Correct Answer:- Option-C

Question50:-Regarding treatment of facial nerve injury following statement is not TRUE
A:-Best results are obtained, if identified during surgery and primarily sutured irrespective of the primary pathology
B:-After 18 months sling operation are better
C:-Static and dynamic sling surgeries are the major component of facial reanimation surgery
D:-Temporalis muscle is utilized for both Dynamic and static sling surgery
Correct Answer:- Option-D

Question51:-A 50-year old man develops acute pancreatitis due to alcohol abuse Hypera-mylasemia resolves by the third day after admission. By the eighth hospital
day, the patient is noted to have recurrent fever (38.5°C), progressive leukocytosis (18,500 WB/mm3), and tachypnea. The most appropriate management includes which as the next step
A:-Laparotomy with pancreatic debridement
B:-CT guided aspiration of peripancreatic fluid collections
C:-ERCP with sphincterotomy and placement of biliary stent
D:-Intravenous amphotericin B
Correct Answer:- Option-B

Question52:-A 54 yr old female patient presented with c/o recurrent upper abdominal pain. USG showed multiple small cystic swellings with lobulated margin in head of pancreas. It appeared as multisystemic with ‘bunch of grapes’ appearance and a grossly dilated pancreatic duct. Most probable diagnosis is
A:-Mucinous cystadenoma
B:-Large duct variety Intraductal Papillary Mucinous Neoplasm
C:-Solid pseudopapillary epithelial neoplasm
D:-Serous cystadenoma
Correct Answer:- Option-B

Question53:-60 year edentulous male has Ca of alveolar margin on left side 4 nodes are palpable on the level 2 on left side and 1 node 1×2cm s on the level 2 on right side
A:-External beam radiotherapy to head and neck
B:-Segmental mandibulectomy + Modified Radical block dissection on left side and Modified block on right side + PMMC flap
C:-Marginal mandibulectomy + Radical block dissection on both sides + PMMC flap
D:-Hemimandibulectomy and external beam radiation to neck
Correct Answer:- Option-B

Question54:-The Tumor which may occur in the residual breast or overlying skin following wide local excision and radiotherapy for mammary carcinoma is
A:-Leiomyosarcoma
B:-Squamous cell carcinoma
C:-Basal cell carcinoma
D:-Angiosarcoma
Correct Answer:- Option-D

Question55:-A 67 year old man is investigated for biliary colic and a 4.8 cm abdominal aortic aneurysm is identified. Which of the following statements relating to this condition is untrue ?
A:-They are true aneurysms and have all 3 layers of arterial wall
B:-The majority are located inferior to the renal arteries
C:-They occur most often in current or former smokers
D:-He should initially be managed by a process of active surveillance
Correct Answer:- Option-A

Question56:-15 year body is diagnosed as having Medullary Thyroid Ca. His younger sister who is 3 months shows mutation in RET-Proto oncogene mutation at codon 922. Thyroid is clinically normal. Calcifonin is normal. No rise of calculation even with stimulation by pentagastrin and calcium. Advice :
A:-No further procedure
B:-Estimation of calcitonin at 6 month interval
C:-Total thyroidectomy before 6yrs
D:-Total thyroidectomy before 1yr
Correct Answer:- Option-D

Question57:-On routine life insurance screening, an asymptomatic 45-year-old male is found to have a serum calcium level of 12.5 mg/dL. Serum is obtained for
immunoreactive parathyroid hormone level and this is 400 mEq/mL (normal range<64mEq/mL). These findings are most consistent with a diagnosis of which of the following ?
A:-Primary hyperparathyroidism
B:-Secondary hyperparathyroidism
C:-Tertiary hyperparathyroidism
D:-Ectopic hyperparathyroidism
Correct Answer:- Option-A

Question58:-A 45-year-old female is found to have a 2cm solid nodule in her right adrenal gland at the time of an abdominal CT scan following an auto accident. With
regard to the adrenal lesion, she is asymptomatic and it is found to be nonfunctional on evaluation. You would recommend which of the following ?
A:-Extra peritoneal right adrenalectomy through either a flank of posterior approach
B:-Suppression with 5 mg prednisone PO
C:-Follow up CT scan in 1 to 3 months and Excisional biopsy via laparoscopic approach
D:-None of the above
Correct Answer:- Option-C

Question59:-Treatment of choice for a patient with accidental crush injury to the CBD involving 50% of the circumference identified on the intra operative cholangiogram
A:-ERCP and stenting
B:-Intraoperative stenting
C:-Repair over a T tube
D:-Roux en Y Choledochojejunostomy
Correct Answer:- Option-D

Question60:-Most common parotid tumour in infants is
A:-Haemangioma
B:-Pleomorphic adenoma
C:-Warthin’s tumour
D:-Mucoepidermoid Ca
Correct Answer:- Option-A

Question61:-A 65 years old gentle man presented with progressive wt loss and generalized wasting. He also complained of foul smelling vomitus of 8 months duration. O/E there was an upper midline scar following a laparatomy 15 years back and no mass. What is the most probable diagnosis
A:-Gastric carcinoma
B:-Stump carcinoma
C:-Efferent loop obstruction
D:-Gastrojejunocolic fistula
Correct Answer:- Option-D

Question62:-A 23 year old man is stabbed in the right upper quadrant and is hemodynamically unstable. A laparotomy is performed and the liver has some extensive superficial lacerations and is bleeding profusely. Patient becomes progressively more hemodynamically unstable. Which of the following is the best management option ?
A:-Pack the liver and close the abdomen
B:-Occlude the hepatic inflow with a pringles manoeuvre and suture the defects
C:-Occlude vascular inflow and resect the most severely affected area anatomically
D:-Perform a portosystemic shunt procedure
Correct Answer:- Option-A

Question63:-Best incision to explore the chest in massive haemothorax due to bullet injury.
A:-Anterolateral thoracotomy
B:-Median sternotomy
C:-Parasternal thoracotomy
D:-Posterolateral
Correct Answer:- Option-A

Question64:-A 24-year-old computer technician notes a progressive increase in size of left Jaw. X-rays are taken. Biopsy is done. Diagnosis of ameloblastoma is
established. Next step
A:-Radiotherapy
B:-Laser beam therapy
C:-Curettage and bone graft
D:-Excision of lesions with 1-2 cm of normal mandible
Correct Answer:- Option-D

Question65:-A 24 year old male who had a penetrating injury to neck at the root of neck. Patient is haemodynamically stable. What is the next best line of approach
A:-Emergency exploration
B:-MRI scan
C:-Contrast CT Scan
D:-Angiography and exploration
Correct Answer:- Option-D

Question66:-What is tomosynthesis ?
A:-3D mammography
B:-MRI Breast
C:-Sequence of breast carcinoma
D:-Invasion of cancer cells in to pectoral muscle
Correct Answer:- Option-A

Question67:-Imaging feature suggestive of breast carcinoma on mammogram
1. irregular spiculated mass
2. Fine pleomorphic micro calcification
3. Architectural distortion
A:-Only 1
B:-1 & 3
C:-2 & 3
D:-1, 2, 3
Correct Answer:- Option-D

Question68:-Indication for surgical excision of fibroadenoma
1. More than 30 yrs
2. Suspicious features such as atypia
3. Size more than 5 cm
4. Family history of breast carcinoma
A:-1, 2, 3, 4
B:-Only 2
C:-2, 3, 4
D:-1, 2, 3
Correct Answer:- Option-A

Question69:-What is the treatment of choice of cystosarcoma phyllodes
A:-Wide local excision with 2 cm margin
B:-Systemic chemotherapy
C:-Radiotherapy followed by excision
D:-Wide local excision with 2cm margin with overlying skin and under lying pectoralis major muscle
Correct Answer:- Option-D

Question70:-Poland syndrome present as
A:-Unilateral loss of breast issue
B:-Bilateral absence of breast issue
C:-Unilateral variable loss of breast issue pectoralis major, minor and serratus anterior muscle as well as several ribs
D:-Bilateral variable loss of breast issue pectoralis major, minor and serratus anterior muscle as well as several ribs
Correct Answer:- Option-C

Question71:-Most common source of referred pain causing significant breast pain
A:-Scapulo thoracic bursitis
B:-Costo chondritis
C:-Unstable angina
D:-Pneumothorax
Correct Answer:- Option-A

Question72:-Which of the statement are true regarding metastatic work up ?
1. PET CT scan is a must for metastatic work up
2. CECT of chest abdomen and pelvis and isotope bones scan is required in locally advanced breast carcinoma
3. Early breast carcinoma metastatic work is done only if patients show symptoms suggestive of metastatasis/increased Serum alkaline phostphatase
4. No workup is required in case of Early breast carcinoma
A:-1, 2, 3
B:-1, 2, 3, 4
C:-2, 3
D:-Only 2
Correct Answer:- Option-C

Question73:-Correct statement/statements of in case of lobular carcinoma in situ
1. High risk benign lesion not a cancer
2. Is a malignant lesion
3. Develops in females only
4. Anatomic precursor of carcinoma
A:-Only 4
B:-1, 3
C:-2, 4
D:-Only 1
Correct Answer:- Option-B

Question74:-What lymph nodes are removed in Schanlons mastectomy
A:-Level 1
B:-Level 1 & 2
C:-Level 1, 2, 3
D:-Level 2
Correct Answer:- Option-B

Question75:-Which of these is not an example of hereditary breast carcinoma
A:-Peutz Jeghers
B:-Li Fraumeni
C:-FAP
D:-Cowden Syndrome
Correct Answer:- Option-C

Question76:-A 40 yr old male with a 2 cm breast lump with pectoralis major involvement was confirmed to have carcinoma breast with no axillary lymph nodes. What surgery should be done ?
A:-Wide local excision with 2 cm margin
B:-MRM with excision of involved portion of muscle
C:-MRM
D:-Wide local excision with axillary clearance
Correct Answer:- Option-B

Question77:-What is the guideline by American Society of Clinical Oncology regarding adjuvant endocrine theray for breast cancer
A:-Systemic Tamoxifen for 5 years
B:-Systemic Tamoxifen for 5 years in postmenopausal women
C:-Systemic Tamoxifen for premenopausal and postmenopausal women for 5 years. Afeter 5 years if still premenopausal add 5 years more of tamoxifen
D:-Systemic tamoxifen for 10 years
Correct Answer:- Option-C

Question78:-Molecular Classification of breast carcinoma includes except
A:-Luminal A
B:-Luminal B
C:-Claudun high
D:-Her 2 neu enriched
Correct Answer:- Option-C

Question79:-60 year old female with locally advanced breast cancer undergoing NACT after 2 cycles is progressive disease. What should be the next step ?
A:-Surgery
B:-Second line chemotherapy
C:-Surgery second line chemotherapy after surgery
D:-Palliative radiotherapy
Correct Answer:- Option-B

Question80:-What is the absolute contraindication for radiation in breast carcinoma ?
A:-Scleroderma
B:-Collagen disorders
C:-Immunocompramised
D:-Pregnancy
Correct Answer:- Option-D

Question81:-Most commonly isolated organism in perforated appendicitis
A:-E. Coli
B:-Pseudomonas Aeroginosa
C:-Klebsiella pneumoniae
D:-Enterobacter species
Correct Answer:- Option-A

Question82:-Which of the following is an advantages of laparoscopic appendicectomy compared to open appendicectomy ?
A:-Increased postoperative pain
B:-Longer hospital stay
C:-Reduced risk of wound infection
D:-Larger incision
Correct Answer:- Option-C

Question83:-At open operation a normal appendix is found. What is the most common procedure a surgeon should do if he finds a normal appendix ?
A:-Evaluate the pelvis for tubo ovarian abscess pelvic inflammatory disease, malignancy, or ectopic pregnancy
B:-Removal of appendix
C:-Evaluate the terminal ileum and cecum for signs of regional or bacterial enteritis
D:-Evaluate the upper abdomen for cholecystitis or perforated duodenal ulcer
Correct Answer:- Option-B

Question84:-In the adult male, which of the following condition is not a differential diagnosis of acute appendicitis ?
A:-Mesenteric cyst
B:-Right ureteric colic
C:-Perforated peptic ulcer
D:-Crohn’s disease
Correct Answer:- Option-A

Question85:-A 24 year old man, present to the emergency department with a 10- hour history of abdominal pain associated with nausea and vomiting. On examination, the patient is lying still and has tenderness with guarding in the right iliac fossa. His temperature is 37.6 degree Celsius. He has no significant past medical history. What is the most likely diagnosis ?
A:-appendicitis
B:-crohns disease
C:-meckels diverticulitis
D:-mesenteric adenitis
Correct Answer:- Option-A

Question86:-The following structures may be injured during surgery to repair an inguinal hernia
A:-The ilioinguinal, genitofemoral, iliohypogastric, and lateral femoral cutaneous nerves
B:-The femoral nerve
C:-The popliteal nerve
D:-The nerve to the psoas major muscle
Correct Answer:- Option-A

Question87:-At surgery for a right inguinal hernia, a 72 year old man is found to have a hernia sac that is not independent of the bowel wall. The cecum forms part of the wall of the sac. Such a hernia is properly referred to as which of the following ?
A:-Irreducible
B:-Sliding
C:-Richter’s
D:-Interstitial
Correct Answer:- Option-B

Question88:-58 year old male presented to surgical opd with c/o bleeding PR. The attending surgeon on examination found GRADE ii HEMORRHOIDS AT 3’O CLOCK position. On further history, he had undergone angioplasty and is on antiplatelets. At the time of examination, there was no active bleeding and advised high fiber diet
and oral fluids. Even after 8 weeks of conservative management patient has a history of bleeding, so the surgeon decided to proceed with interventional methods. Which is the most suitable method for the patient.
A:-surgical excision
B:-rubber band ligation
C:-sclerotherapy
D:-none of the above
Correct Answer:- Option-C

Question89:-The most common complication following open hemorrhoidectomy is
A:-hemorrhage
B:-acute urinary retention
C:-pelvic sepsis
D:-anal stenosis
Correct Answer:- Option-A

Question90:-Mrs. Thulasi 48 year old female diagnosed with grade III hemorrhoids and is planned for stapler hemorrhoidectomy, which of the below is false regarding the given treatment
A:-create mucosa-mucosa anastomosis
B:-can be used for both internal and external hemorrhoids
C:-done above the dentate line
D:-none of the above
Correct Answer:- Option-B

Question91:-60 yr old male known case of diabetes presented to the surgery casualty with severe abdominal pain, the attending surgical resident diagnosed it as a perianal abscess and did drainage for the same under local anesthesia. 8 weeks later he presented to surgery OPD with persistent discharge from the perianal region, the attending surgeon noted fistula in ano on examination. What is the incidence of the above presentation ?
A:-5%
B:-10%
C:-20%
D:-50%
Correct Answer:- Option-D

Question92:-Which of the following is not a goal fistula treatment ?
A:-eliminate septic foci
B:-remove track
C:-prevent recurrence
D:-none of the above
Correct Answer:- Option-D

Question93:-Most common type of fistula in ano according to Park classification
A:-Type I
B:-Type II
C:-Type III
D:-Type IV
Correct Answer:- Option-A

Question94:-40 year old female presented to casualty with abdominal pain. The attending doctor after evaluation diagnosed as chronic cholecystitis, which among
the following is not a feature of chronic cholecystitis ?
A:-pain after fatty meals
B:-pain for > 24 hrs
C:-bloating and nausea
D:-R hypochondrial pain
Correct Answer:- Option-B

Question95:-Which among the following is true regarding Ultrasound in a/c Cholecystitis
A:-pericholecystic fluid
B:-GB wall thickening
C:-Sonologic Murphy
D:-all of the above
Correct Answer:- Option-D

Question96:-Among the investigation used for acute cholecystitis which is false
A:-HIDA scan shows cystic duct obstruction
B:-CT scan is more sensitive than USG
C:-USG is 95% specific
D:-all are ture
Correct Answer:- Option-B

Question97:-80 year old male with CVA presented to surgical emergency with USg abdomen showing acute acalculous cholecystitis. Which is false among the following
A:-Percutaneous cholecystectomy is performed
B:-found in old age and immunocompromised
C:-HIDA scan is 100% specific
D:-none of the above
Correct Answer:- Option-C

Question98:-During laparoscopic cholecystectomy surgeon noticed a Calot node, which structure lies beneath the calot node
A:-Cystic duct
B:-Cystic artery
C:-CBD
D:-R Hepatic artery
Correct Answer:- Option-B

Question99:-Which statement is true regarding goodsalls rule ?
A:-A fistula with an external opening anterior to an imaginary transverse line across the anus has its internal opening in the midline anteriorly and for an external
opening posterior to this line, the internal opening is in the midline posteriorly with a horseshoe track
B:-A fistula with an external opening anterior to an imaginary transverse line across the anus has its internal opening at the same radial position and for an
external opening posterior to this line, the internal opening is in the midline posteriolrly with a horseshoe track
C:-A fistula with an external opening anterior to an imaginary transverse line across the anus has its internal opening is in the midline posteriorly with a horseshoe track. And for an external opening posterior to this line, the internal opening at the same radial position
D:-None of the above
Correct Answer:- Option-B

Question100:-Most common fistula in ano according to Park’s classification
A:-Transsphincteric fistula
B:-Intersphincteric fistula
C:-Suprasphinteric fistula
D:-Extrasphicteric fistula
Correct Answer:- Option-B