Surgery

1) 7d after biliary surgery, chest pain and SOB, dx

a) PE
b) Atelelacsis
c) UTI
d) Primary haemorrhage
2) Hx of R sided CA colon, what is the characteristic features of investigations
a) Microcytic anaemia,
b) Intestinal obstruction
c) Megaloblastic anaemia
d) NcNc anaemia
3) Pt presented with inguinoscrotal swelling, how do you confirm it
a) If you cant get about the above the lump, its inguinoscrotal lump
b) Brilliantly translluminate
c) Fluid thrill
d) Cant differentiate the testis from the swelling
4) Intestinal obstruction for 18 hours, what is the least consistent clinical signs
a) Distensionof abdo
b) Exacerated BS
c) Voluntary guarding
d) Empty rectum
e) Tympanic percussion
5) What is the sign of ovarian tumour
a) Dullness of anteriorly and tympanic laterally
b) Dullness lateral and tympanic anteriorly
6) Epi pain radiating to the back, p/w dark urine, chills & fever, ALP greatly elevated and amylase
normal, AST, ALT elevated, what is the likely dx /
a) Choledocholithiasis
b) CA ampulla
c) Pancreatitis
7) Pt who has hx of reflux oesophagitis, her xray shows regular stricture of the oesophagus, mx
a) OGD & biopsy
b) Manometry
c) Check Ph
d) Ba swallow
8) man p/w fever & scrotal pain, scrotum red and increased prostration, pus in the urine, dx ?
a) Acute epididymo-orchitis
b) Acute prostates
c) Torsion of testis
d) Strangulated hernia
9) All of the following food can predispose to cancer, except
a) Smoked food
b) Alcohol
c) Fatty food
d) Glutamate
10) AOF are signs of lower limb ischarmia except
a) Ulcer at hallux
b) Intermitten claudication
c) Rest pain
d) Elevated leg reduced pain

11) footballer injured during the game, P/E found normal dorsal flexure but planter flexure is
diminished, WOF may happen
a) L4 disc protrusion
b) Ruptured Archilles tendon
c) Ruptured anterior tibialis tendon
12) xray : RUQ several calcifications
a) Gallstone
b) Renal stones
c) Hydatid disease
d) Chronic pancreatitis
13) a female presented with a lump under the inguinal ligament & medial to the femoral pulse, what is
the likely diagnosis
a) Direct inguinal hernia
b) Indirect inguinal hernia
c) Femoral hernia
d) Saphenous varix
14) WOF is damaged in mid humerus fracture
a) Axillary nerve
b) Radial nerve
c) Median nerve
d) Ulnar nerve
e) Musculocutaneous nerve
15) what is the commonest content of linea alba hernia
a) omentum
b) Extraperitoneal fat
c) Small bowel
d) Rectus muscle
16) young woman p/w a breast lump, what is your next step
a) FNAC
b) Core biopsy
c) Wide excision
d) Mastectomy
17) pt has single nodule in the thyroid gland, AOF suggest malignancy except
a) single nodule
b) USG dx solid nodule
c) Thyroid scan showed hot nodule
d) Associated with horseness of voice
e) Patient is male
18) after surgery, serum Na increased, urine osmolatity 205, what is the diagnosis
a) DI
b) SIADH
c) Dehydration
19) AOF are true regarding staghorn calculi except
a) Due to increased Ca intake
b) Consistent with increase uric acid
c) Increase oxalate intake
d) Urine is alkaline
20) patient presents with sudden ruptured of extensor pollicis longus tendon, dx ?
a) Tendonitis
b) Tenosynovitis

c)

RA

21) which is the best nerve for grafting

a) Digital nerve
b) Radial nerve
c) Medial nerve
22) small hand muscle wasting with thenar sparing, what nerve is involved
a) Median n
b) Ulcer n
c) Radial n
23) patient presented with intracerebral haemorrhage, AOF are true except
a) Hypotension
b) Bradycardia
c) Papilloedema
d) Hypertension
24) pt presented with prolonged bleeding after massive blood transfusion, what is true
a) Dilution of platelets
b) Hypocalcemia
c) hypothermia
25) A man presents with pain in the calf which is alleviated after walking. What is the diagnosis?
a) Rest pain
b) Muscle cramps
26) What is true regarding abdominal aortic aneurysm?
a) Can be seen in ultrasound
b) If more than 5 cm. do immediate surgery
27) What is not true regarding occlusive arterial disease?
a) Rest pain
b) Pain on the thigh while walking
c) Sudden shooting pain at posterior aspect of the thigh
28) There is chronic occlusion in the femoropopliteal region. What is your initial management?
a) ABI
b) Aortography
c) Surgery
29) What is the commonest site of atherosclerosis in the lower limb?
a) Superficial femoral a.
b) Common iliac a.
30) A patient present with chest pain. Soft murmur. History of hypertension. On x-ray, there is
widening of the mediastinum. Typical picture of abdominal aortic aneurysm. What is the management?
a) B-Blocker
b) Morphine
c) transesophageal echocardiography
31) Patient present with tension pneumothorax. What is the management?
a) Insertion of wide bore needle at 2nd intercostals space
32) Urethral injury after accident. There is blood at external urethral meatus. What is the management?
a) Suprapubic puncture
b) Retrograde urethrogram
33) What is the commonest ureteric stone in acidic urine?
a) Ca oxalate

b) Uric acid
34) A small boy with history of traction injury to the forearm. A hand is limping on the side, hanging
down and pronated. What is the diagnosis?
a) Post. Dislocation of the elbow
b) Radial head dislocation
c) Shoulder dislocation
d) Post. Dislocation of the shoulder
35) What is true regarding scaphoid fracture?
a) Avascular necrosis is more common in proximal segment than distal
36) A man presents with an open fracture of right ankle joint. On examination, pedal pulse cant be
palpated. The ankle is dislocated. What is your initial management?
a) Realign immediately and reassess the pulse
b) IV antibiotic
c) Tetanus toxoid
d) Debridement
37) A 40 year old man presents with pain and scrotal swelling. What is the diagnosis?
a) Epididymoorchitis
b) Hernia
c) Testicular torsion
38) An elderly man presents with a scrotal mass, fever and tenderness. The mass is adhered to the
upper pole of the testes. What is the diagnosis?
a) Epididymitis
b) Hernia
c) Testicular torsion
39) Teratoma of the testes, where can it metastasis?
a) Paraaortic LN
b) Inguinal LN
40) All these food are carcinogenic except
a) Fat
b) Aflatoxin
c) Monosodium glutamate
41) All are true regarding thyrotoxicosis, except
a) Wasting of small muscles of the hand
b) Tremor
42) A patient on warfarin for mitral valvular disease undergoes surgery. What is the management?
a) Stop warfarin and start heparin. Do surgery after INR normal
43) Prophalactic antibiotic is required in all procedure , except
a) Fundoplication
b) Hemorrhoidectomy
c) Appendectomy
44) Which surgical procedure that we dont stop anticoagulant ?
a) Embolectomy
b) Gastrectomy
c) Appendicectomy
45) What is the definite indication of thyroidectomy in multinodular goiter?
a) Compression of trachea
b) Compression of esophagus
c) Thyrotoxicosis

46) The football player get the injury to the finger and develop mallet finger
a) Difficulty of flexion and extension of DIP joint
b) Difficulty of flexion and extension of PIP joint
c) Ulnar deviation
47) A patient had a trauma to the hand and presented with palmar space abscess , very infected with
fever. What s the immediate management?
a) Immediate incision and drainage
b) IV antibiotic
c) Elevate
48) Child with 2nd degree 15% burn in the chest area. The patient cant breath and become anxious.
What is the management?
a) IV fluid
b) Immediate intubation and ventilation
c) Tetanus toxoid
d) IV antibiotic
49) All are true regarding biliary stone, except
a) Stone in the bile duct presents with sepsis of the gall bladder
50) Cervical LN biopsy shows thyroid cell. What is the diagnosis?
a) Thyroid carcinoma metastasis to the LN
51) 25 year old female with mobile breast lump. What is the diagnosis?
a) Fibroadenoma
b) Breast cancer
52) 45 year old woman presented with breast lump. What is true?
a) Consider CA Breast until proven otherwise
53) A patient with CA breast develop osteoporosis. What is the treatment?
a) Bisphosphonate
b) Cyclical estrogen and progesterone
c) Continuous estrogen and progesterone
d) Increase dietary calcium 2000 g/day
54) Which is least likely metastasis to brain?
a) Prostate CA
b) Thyroid CA
c) Renal CA
d) Breast CA
55) 80 year old lady with unilateral proptosis. Increased ESR. What is the diagnosis?
a) Retrobulbar tumor
b) Sinusitis
c) Frontal sinus infection
56) All are true regarding uncomplicated hemorrhoid, except
a) Pain
b) Bleeding