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1.

The tensile strength of a wound after in jury can reaches upto 80% till which week
a. 8th week
b. 10th week
c. 12th week
d. 14th week
e. 16th week
2. A patient arrives to OPD with a history of hit on his leg 4 hours ago. On examination there was a pain
on stretching and distal pulses are palpable. What is your diagnosis
a.DVT
b. Buerger disease
c.Necrotising fasciitis
d.Compartment syndrome

3. True about wound healing:


a. Infected wound heal by primary intention
b. No Deep dermal wound heal by scar formation
c. Wound contraction is found in healing by secondary intention
d. More intense inflammatory response in primary intention

4. True about chronic wound:


a. Not Found in DM
b. Always require surgical treatment
c. May not be associated with vascular compromise
d. Monofilament sutures prevent infection
e. Any wound that does heal within 3 month

5. Cell not involved in healing of clean wound:


a. Macrophages
b. Platelet
c. Fibroblasts
d. Polymorphonuclear leukocytes

6. Management of an open wound seen 12 hours after the injury:


a. Suturing
b. Debridement and suture
c. Secondary suturing
d. Heal by granulation

7. The vitamin which has inhibitory effect on wound healing is:


a. Vitamin A
b. Vitamin E
c. Vitamin C
d. Vitamin B-complex

8. The tensile strength of the wound starts and increases after:


a. Immediate suture of the wound
b. 3–4 days
c. 7–10 days
d. 6 months

9. In a sutured surgical wound, the process of epithelialization is completed within:


a. 24 hours
b. 48 hours
c. 72 hours
d. 96 hours

10. Factors that may adversely affect the healing of wounds include all the following except:
a. Exposure to UV light
b. Exposure to radiation
c. Obstructive jaundice
d. Advanced neoplasia

11. Primary closure of incised wounds must be done within:


a. 2 hours
b. 4 hours
c. 6 hours
d. 12 hours
e. 16 hours

12. The tensile strength of wound reaches that of normal tissue by:
a. 6 weeks
b. 2 months
c. 4 months
d. None

13. Following are required for wound healing except:


a. Zinc
b. Copper
c. Vitamin C
d.None

14. Patient has lacerated untidy wound of the leg and attended the casualty after 2 hours. His wound
should be:
a. Sutured immediately
b. Debrided and sutured immediately
c. Debrided and sutured secondarily
d. Cleaned and dressed

15. When is the maximum collagen content of wound tissue?


a. Between 3rd to 5th day
b. Between 6th to 17th day
c. Between 17th to 21st day
d. None of the above

16. A patient with grossly contaminated wound presents 12 hours after an accident, his wound should be
managed by:
a. Thorough cleaning and primary repair
b. Thorough cleaning with debridement of all dead and devitalized tissue without primary closure
c. Primary closure over a drain
d. Covering the defect with split skin graft after cleaning

17. Delayed wound healing is seen in all except:


a. Malignancy
b. Hypertension
c. Diabetes
d. Infection

18. In the healing of clean wound the maximum immediate strength of the wound is reached by:
a. 2–3 days
b. 4–7 days
c. 10–12 days
d. 13–18 days

19. A clean incised wound heals by:


a. Primary intention
b. Secondary intention
c. Excessive scaring
d. None of the above

20. Which one of the following surgical procedures is considered to a have a clean-contaminated wound?
a. Elective open cholecystectomy for cholelithiasis
b. Herniorrhaphy with mesh repair
c. Lumpectomy with axillary node dissection
d. Appendectomy with walled off abscess

21. Fibroblasts in healing wound are derived from:


a. Local mesenchyme
b. Epithelium
c. Endothelium
d. Vascular fibrosis

22. Tensile strength of wound becomes normal after:


a. 6 weeks
b. Never
c. 4 months
d. 6 months

23. True statement(s) regarding hypertrophic scar:


a. Grow beyond wound margin
b. More common in female
c. Not familial
d. Rarely subsides

24. All are true about keloid except:


a. Grows beyond would margin
b. Excess collagen deposition
c. More common in female
d. Whites are at high risk
25. Most common site of hypertrophic keloid is:
a. Face
b. Leg
c. Presternal area
d. Arm

26. First line treatment for keloid is:


a. Intralesional injection of keloid
b. Local steroid
c. Radiotherapy
d. Wide excision

27. Drug used for intralesional injection keloid is:


a. Prednisolone
b. Triamcinolone
c. Androgen
d. Hydrocortisone

28. Keloid scar is made up:


a. Dense collagen
b. Loose fibrous tissue
c. Granulamatous tissue
d. Loose areolar tissue

29. What is true about keloids?


a. It appears immediately after surgery
b. It appears a few days after surgery
c. It is limited in its distribution
d. It is common in old people

30. Keloid is best treated:


a. Intralesional injection of trimacinolone
b. Wide excision and grafting
c. Wide excision and suturing
d. Deep X-ray therapy

31. The following statement about keloid is true:


a. They do not extend into normal skin
b. Local recurrence is common after excision
c. They often undergo malignant change
d. They are more common in whites than in blacks

32. The worst position for scars is:


a. Back
b. Shoulder
c. Sternum
d. Abdomen

33. Keloid formation is not seen over:


a. Ear
b. Face
c. Eyelids
d. Neck

34. The best scars are seen in:


a. Infants
b. Children
c. Adults
d. Very old people

35. If suture marks are to be avoided, skin sutures should be removed by:
a. 72 hours
b. 1 week
c. 2 weeks
d. 3 weeks

36. Degloving injury is:


a. Surgeon made wound
b. Lacerated wound
c. Blunt injury
d. Avulsion injury
e. Abrasive wound

37. In treatment of hand injuries, the greatest priority is:


a. Repair of tendons
b. Restoration of skin cover
c. Repair of nerves
d. Repair of blood vessels

38. During the surgical procedure:


a. Tendons should be repaired before nerves
b. Nerves should be repaired before tendons
c. Tendons should not be repaired at the same time
d. None is true

39. ‘Lims salvage’ primarily depends on:


a. Vascular injury
b. Skin cover
c. Bone injury
d. Nerve injury

40. Most appropriate management of recurrent keloid scar?


a.excisional surgery
b.intramarginal excision followed by radiation
c.cryosurgery
d.silicone gel sheating

41. Criteria for viability of muscle are all except:


a. Colour
b. Intact fascia
c. Contractibility
d. Bleeding on cutting

42.During proliferative phase of wound healing the fibroblast requires which vitamin to produce collagen.
a.Vit.A
b. Vit.B
c. Vit.C
d.Vit D.

43.The maturation of collagen fibers is achieved when type 1 replace type 3 until a ratio of

a. 2.1
b. 3.1
c. 4.1
d. 6.1

44.which organ has highest chances of graft rejection response


a.cornea
b. gut
c.liver
d. skin

45. If a person falls from a height and lands on


feet, the pattern of fracture will be all except:
A. Calcaneus fracture bilaterally
B. Pilon fracture at ankle
C. Vertebral crush fracture
D. Fracture of femur

46. In green stick fracture:


A. Bone strength is abnormal
B. Load is abnormal
C. Both are abnormal
D. None is abnormal

47. Butterfly fracture is due to:


A. Direct trauma
B. Indirect trauma
C. Twisting force
D. Repeated stress

48. Spiral fracture is due to:


A. Blunt trauma
B. Axial compression
C. Twist
D. Direct impact

49. Most common type of epiphyseal fracture in


Salter Harris classification is:
A. Type 1
B. Type 2
C. Type 3
D. Type 4

50. Epiphyseal injuries causing growth disturbances in children are due to:
A. Avascular necrosis of the plate
B. Crushing or infection of the plate
C. Hypermia of the plate
D. Formation of a callus bridge between bony
epiphysis and metaphysis
E. All of the above

51. Which form of growth plate injury requires


open reduction and internal fixation:
A. Separation of epiphysis from metaphysis but
without fracture
B. Severe ‘end on’ crush
C. Intra-articular fracture, the line passing
through plate and part of metaphysis
D. All of the above

52. Type of epiphyseal fracture most difficult to


diagnose is:
A. Type 2
B. Type 3
C. Type 5
D. All of the above

53. 32 B3.2 in AO classification refers to fracture:


A. Simple proximal fracture femur
B. Simple distal fracture femur
C. Distal comminuted fracture femur
D. Distal comminuted fracture tibia

54. All are true of closed reduction except:


A. Relies on soft tissue attachments to reduce
the fragments
B. Rarely adequate for intra-articular fractures
C. Difficult to perform in children
D. Damage to blood vessel is likely

55. In fracture open reduction is needed in


presence of:
A. Failed closed reduction
B. Intra-articular fracture in children
C. Displaced intra-articular fracture
D. Unstable fracture
E. Each of the above
56. Normal callus formation is prevented by:
A. Rigid fixation
B. Non-rigid fixation
C. Both of the above
D. None of the above

57. Ideally to hold two fragments by screw


fixation, the screw should have:
A. Thread at the tip
B. Thread throughout
C. Thread only proximally
D. None of the above

58. The function of plate fixation is to:


A. Neutralise
B. Butress
C. Compress
D. All of the above

59. Butress plates are best for:


A. Oblique fracture
B. Green stick fracture
C. Transverse fracture
D. Comminuted fracture

60. Figure of eight wire construction is commonly done in fracture:


A. Clavicle
B. Medical femoral condyle
C. Patella
D. Talus

61. Fracture reduction, internal fixation achieves:


A. Accurate reduction
B. Stable fixation
C. Strong fixation
D. All of the above

62. Disadvantages of internal fixation include:


A. Demand strong aseptic technique
B. The alloy can be allergenic, toxic and
carcinogenic
C. Local osteoporosis
D. Each of the above

63. Advantage of intramedullary nails are:


A. Early mobilisation
B. Locking screws give better stability
C. Periosteal blood supply is preserved
D. All of the above
64. Removal of internal fixation is due to risk of:
A. Osteoporosis
B. Allergy by transitional metals
C. Stress raiser causing further fracture
D. All of the above

65. Advantages of external fixation include:


A. Rigid fixation
B. Adjustable
C. Allows good wound toilet
D. All of the above

66. Indications for external fixator include all


except:
A. Compound fracture tibia
B. Pelvic fracture
C. Fracture surgical neck of humerus
D. Presence of bone loss in limb fractures

67. The basic philosophy of fracture is:


A. Rest
B. Immobilisation
C. Stabilisation
D. None of the above

68. Compartment syndrome is common in:


A. Upper arm
B. Fore arm
C. Thigh
D. Foot

69. Compartment syndrome be suspected best in


presence of:
A. Absent pulse
B. Numb fingers
C. Pain on extension of finger
D. Any of the above

70. Sings and symptoms of vascular impairment


in a limb include:
A. Pain B. Paresthesia
C. Pallor D. Paralysis
E. All of the above

71. In compartment syndrome which of the


following is only a false sign of vascular
security:
A. Rest pain
B. Muscle tenderness
C. Normal distal pulse
D. Pain on passive stretching

72.Trauma to spleen in a stable patient is best diagnosed


by:
a. X-ray abdomen
b. USG
c. CTscan
d. Diagnostic peritoneal lavage

73. Investigation of choice for diagnosing intra-abdominal bleeding in an unstable patient:


a. CT scan
b. MRI scan
c. USG
d. diagnostic peritoneal lavage

74. A man sustained injury and presented with fluid coming out through nose. What could be the possible
fracture?
a. Fracture base of skull
b. Fracture of mandible
c. Fracture of maxilla
d. None of the above

75. What is not found in head injury?


a. Confusion
b. Loss of consciousness
c. Lucid interval
d. GCS score of 0

76. Minimum score in glasgow coma scale:


a. 0
b. 1
c. 2
d. 3

77. True statement regarding fracture base of the


skull are all of the following, except:
a. Prophylactic antibiotics are usually not required
b. Associated with 8 cranial nerve palsy
c. Early surgery is indicated for optimal outcome
d. May present with CSF otorrhea

78. Emergency management for tension pneumothorax is:


a. Thoracotomy
b. Insertion of a chest tube
c. Needle decompression
d. Tracheostomy

79. Management of flail chest with respiratory failure is:


a. Chest tube drainage
b. Oxygen administration
c. IPPV
d. Internal operative fixation of the fractures segments

80. True about flail chest are all, except:


a. Ultimately leads to respiratory failure
b. Paradoxical respiration
c. Fracture of 3–4 ribs at 2 or more places
d. Mediastinal shift

81. Condition which builds within hemithorax


resulting in collapsed lung, flattened diaphragm,
contralateral mediastinal shift and compromised
venous return to right side of heart is known as:

a. Open pneumothorax
b. Flail chest
c. Massive pulmonary hemorrhage
d. Tension pneumothorax

82. IPPV is useful in:


a. Hemopneumothorax
b. Pneumothorax
c. Flail chest
d. Hemothorax

83. Glasgow coma scale in death is:


a. 0
b. 1
c. 2
d. 3

84. In an adult patient with pleural effusion, the most appropriate site for pleurocentesis done by inserting a
needle is in:
a. 5th intercostal space in midclavicular line
b. 7th intercostal space in midaxillary line
c. 2nd intercostal space adjacent to the sternum
d. 10th intercostal space adjacent to the vertebral
column

85. A 24-year-old man falls on the ground when he is struck in the right temple by a baseball. While being
driven to the hospital, he lapses into coma. He is unresponsive with the dilated right pupil when he reaches
the emergency department. The most important step in initial management is:
a. Craniotomy
b. CT scan of the head
c. X-ray of the skull and cervical spine
d. Doppler ultrasound examination of the neck

86. According to the glassgow coma scale a verbal


score of 1 indicates:
a. No response
b. In appropriate words
c. Incomprehensive sounds
d. Disoriented response

87. The most common site of leak in CSF rhinorrhea is:


a. Spenoidal sinus
b. Frontal sinus
c. Cribriform plate
d. Tegmen tympani

88. The earliest manifestation of increased intracranial pressure in head injury is:
a. Ipsilateral pupillary dilatation
b. Contralateral pupillary dilatation
c. Altered mental status
d. Hemiparesis

89. The dangerous complication of flail chest:


a. Pneumothorax
b. Hemothorax
c. Respiratory failure
d. all the above

90. Lucid interval is associated with:


a. Intracerebral hematoma
b. Extradural hematoma
c. Subarachnoid hemorrhage
d. All the above

91. Positive pressure ventilation is useful for:


a. Pneumothorax
b. Flail chest
c. Hemothorax
d. Hemopneumothorax

92. Shock in trauma is most likely due to:


a. Head injury
b. Intra-abdominal organ injury
c. Rib fracture
d. Fracture tibia

93. Source of chronic subdural hematoma is:


a. Arterial
b. Tear of bridging veins
c. Capillaries
d. None of the above

94. Extradural hemorrhage commonly occurs from tearing of:


a. Maxillary artery
b. Middle meningeal artery
c. Bridging veins
d. All of the above

95. What is the site for putting needle in chest in a


patient with tension pneumothorax:
a. 2nd intercostal space, midclavicular line
b. 7th intercostal space, midaxillary line
c. 5th intercostal space, midclavicular line
d. 5th intercostal space, just lateral to vertebral
column

96. Which of the following is the cause of sudden and unexpected onset of dyspnea at rest:
a. Severe anemia
b. Spontaneous pneumothorax
c. COPD
d. Large pleural effusion

97. Glasgow coma scale (GCS) in case of mild head injury:


a. 15 with no loss of consciousness
b. 14-15 with loss of consciousness
c. 9–13
d. 3–8

98. First aid to control external hemorrhage is:


a. Endoscopic control
b. Apply pressure
c. Drugs
d. Operation

99. Seat belt injury causes damage to:


a. Head injury due to wind screen
b. Thorax injury
c. Duodenum
d. All the above

100. The hormone that is not released in trauma


a. Thyroxine
b. Glucagon
c. ADH
d. GH

101. Regarding compartmental syndrome of lower


limb all are true, except: (Sep 2010)
a. m/c occurs in closed lower limb injuries
b. Early sign is absent distal pulse
c. Fasciotomy done in longitudinal direction of
limb
d. Two incisions are used on either side of subcutaneous
border of tibia.

102. Regarding compartment syndrome in lower limb: the fasciotomy is done when pressure is above
____mm Hg
a. 10 mm Hg
b. 20 mm Hg
c. 30 mm Hg
d. 40 mm Hg

103. Calculate the Glasgow coma scale of a patient with eye opening on pain, conscious but confused
cannot tell time and exhibits flexion on painful stimuli?
a.8
b.9
c.10
d.11

104. A patient with multiple rib fracture presents to surgery department.He is conscious and speaking
single words. On examination RR-40 and BP -90/40 mm of Hg . What is the next immediate step,
a.urgent Iv fluids
b.intubate the patient
c.chest x-ray
d.Insert needle in 2nd IC space

105. According to “rule of nines”, burns involving perineum are:


a. 1%
b. 9%
c. 18%
d. 27%

106. A five years old child presents to the emergency department with burns. The burn area
corresponding to the size of his
palm is equal to:
a. 1% BSA
b. 5% BSA
c. 10% BSA
d. 20%

107. Head and neck involvement in burns in infant is:


a. 9%
b. 18%
c. 27%
d. 32%

108. An adult whose both lower limbs are charred along with genitalia has……..burns.
a. 18%
b. 19%
c. 36%
d. 37%

109. In a 6 years old child with burns involving the whole of head and trunk, estimated body surface area
of burns is:
a. 44%
b. 52%
c. 55%
d. 58%

110. Rule of nine of estimate surface area of a burnt patient was introduced by:
a. Mortix Kaposi
b. Alexander Wallace
c. Joseph Lister
d. Thomas Barclay

111. Best method to assess burns in 5 years old child caused by boiling water:
a. Palm method
b. Rule of 9
c. Lund and Browder chart
d. Rule of one

112. A child has circumferential burn of both of thighs and buttocks, face and scalp with singeing of
hairs. Calculate the
percentage of burns:
a. 24
b. 27
c. 37
d. 45

113. Head and face burn in infant is:


a. 15%
b. 18%
c. 12%
d. 32%

114. Percentage of burn in children is best assessed by?


a. Rule of 9
b. Rule of palm = 1%
c. Lund and Browder chart
d. Wallace rule

115. A burn patient is referred when:


a. 10% superficial burn in child
b. Scald in face
c. 25% superficial burn in adult
d. 25% deep burn in adult
e. Burn in palm
116. In burns heat loss is by/due to:
a. Dilatation of veins
b. Shock
c. Exposed area by evaporation
d. None of the above

117. Metabolic derangements in severe burns are all except:


a. ↑corticosteroid secretion
b. Hyperglycemia
c. ↑secretion of HCl
d. Neutrophil dysfunction

118. Pus in burns form in:


a. 2-3 days
b. 3-5 days
c. 2-3 weeks
d. 4 weeks

119. Fever in burnt patient is caused by:


a. Septicemia
b. Decreased sweating
c. Release of pyrogens from dead product
d. Dehydration

120. Undue restlessness in a patient during the immediate post


burn period is often a manifestation of: (Karnataka 95)
a. Hypoxia
b. Hypovolemia
c. Hyperkalemia
d. Anxiety

121. All require hospitalization except:


a. 5% burns in children
b. 10% scalds in children
c. Electrocution
d. 15% deep burns in adults

122. True about burns:


a. Hyperglycemia is seen in early burns
b. Child with burns should have damp dressing
c. Chemical powder burns should be kept dry
d. 3rd degree burns are painfull

123. In a patient with the burn wound extending into the superficial epidermis without involving the
dermis would present all of the following except:
a. Healing of the wound spontaneously without scar formation
b. Anesthesia at the site of burn
c. No Blister formation
d. Painful
124. A third degree circumferential burn in the arm and forearm region, which of the following is most
important for monitoring?
a. Blood gases
b. Carboxy-oxygen level
c. Macroglobinuria cryoglobinuria
d. Peripheral pulse and circulation

125. In 3rd degree burns, all are seen except:


a. Vesicles are absent
b. Painful
c. Leathery skin
d. Reddish due to Hb infiltration

126. Degree of burns in a patient with prominent vessels with


decreased needle prick sensation and dryness:
a. Superficial partial thickness burns
b. Deep partial thickness burns
c. Electric burns
d. Full thickness burns

127. Burn involving epidermis and full thickness of dermis:


a. First degree burns
b. Partial-thickness second degree burns
c. Full-thickness second degree burns
d. Third degree burns

128. True about burn is:


a. Full thickness burn feels, leathery, painless
b. Electric burn are superficial
c. IV fluid formula used Curreri and Brooke
d. Skin grafting done after 48 hours

129. Which of the following is not seen in 3rd degree burns?


a. Loss of skin appendages
b. No vesicles
c. Red color
d. Extremely painful

130. In second degree burns, re-epithelialisation occurs around:


a. 1 week
b. 2 weeks
c. 3 weeks
d. 4 weeks

131. Which of the following is false regarding deep 2nd degree burns?
a. Heal by scar deposition
b. Painless
c. Damage to deeper dermis
d. Less blanching
132. Superficial burns; true is/
a. Always requires skin grafting
b. Dry and inelastic
c. Blister formation
d. Painless

133. Not a feature of deep burn is:


a. Black charred skin
b. White leathery skin
c. Loss of pain sensation
d. Blisters

134. Burns with vesiculation, destruction of the epidermis and upper dermis is:
a. 1st degree
b. 2nd degree
c. 3rd degree
d. 4th degree

135. Blisters are seen in which type of burns?


a. Superficial first degree
b. Superficial second degree
c. Third degree
d. Deep first degree

136. All may be seen in deep burns except:


a. Hyperthermia
b. Increase vascular permeability
c. Fluid loss by evaporation
d. Vasodilation

137. 2nd degree burns indicate involvement of:


a. Epidermis
b. Dermis
c. Subcutaneous tissue
d. Deep fascia

138. Parkland formula is:


a. Percentage of burns × weight (kg) × 4 = volume in ml
b. Percentage of burns × weight (kg)/2 = 1 volume in ml
c. Percentage of burns × weight (kg) × 9 = volume in ml
d. 500 ml/m2 BSA + 1500 ml/m2 = volume in ml

139. IV formula for burn is:


a. Total % body surface area x weight x 4 = volume in ml
b. Total % body surface area x weight x 5 = volume in ml
c. Total % body surface area x weight x 6 = volume in ml
d. Total % body surface area x weight x 7 = volume in ml

140. Which of the following formula for fluid administration in a patient with burns is not correct?
a. Parkland: 4 ml Kg/%TBSA burn of RL
b. Brooks: 1.5 ml Kg/%TBSA burn of RL + 0.5ml kg % burn+2000 ml D5W
c. Shrine: 5000 ml m2 TBSA burn + 2000 ml m2 TBSA
d. Evans: 8ml Kg/% TBSA burn of RL

141. The ideal temperature of water to cool the burnt surface is:
a. 15°C
b. 10°C
c. 8°C
d. 6°C

142. What should be the ideal temperature of the cool water to be applied over burns?
a. Ice cold
b. 3-4ºC
c. 8-10ºC
d. 14-15ºC

143. Safest strategy of treatment for a patient of inhalational burn injury who has presented within 4-5
hours:
a. Binasal catheter O2 inhalation
b. O2 therapy with well-fitting face mask
c. Elective cricothyroidotomy
d. Elective endotracheal intubation

144. In burns management, which of the following is the fluid of choice?


a. Dextrose 5%
b. Normal saline
c. Ringer lactate
d. Isolyte-M

145. All of the following are true regarding fluid resuscitation in burn patients except:
a. Consider intravenous resuscitation in children with burns greater than 15% TBSA
b. Oral fluids must contain salts
c. Most preferred fluid is Ringer’s lactate
d. Half of the calculated volume of fluid should be given in first 8 hours

146. What is the most important aspect of management of burn injury in the first 24 hours?
a. Fluid resuscitation
b. Dressing
c. Escharotomy
d. Antibiotics

147. In excessive burns, least useful is:


a. Blood
b. Dextran
c. Ringer lactate
d. Nasogastric intubation

148. True statement about burn resuscitation:


a. Colloid preferred in initial 24 hours
b. Colloid preferred if burnt area is >15% of total BSA
c. Half of the calculated fluid given in initial 8 hours
d. Diuretics should be given to all patients of electric burn

149. Which of the following is true about burns?


a. 3rd generation cephalosporin is drug of choice
b. S. aureus is most common infection of burn
c. Toxic shock syndrome is most common in burns patients
d. Pseudomonas is most common infection in dry wound

150. Which of the following is true about burn management?


a. Intravenous access fluid is done and antibiotics is not given in children
b. Escharotomy should be done for peripheral circumscribed lesion
c. Moist dressing is done
d. Parkland formula is used with 8ml/kg body weight

151. Exposure treatment is done for burns of the:


a. Upper limb b. Lower limbs
c. Thorax d. Abdomen
e. Head and neck

152. Deep skin burn is treated with:


a. Split thickness graft
b. Full thickness graft
c. Amniotic membrane
d. Synthetic skin derivatives

153. The cold water treatment of burns has the disadvantage that it increase the chances of:
a. Pain
b. Exudation
c. Infection
d. None of the above

154. The best guide to adequate tissue perfusion in the fluid management of a patient with burns, is to
ensure a minimum hourly urine output of:
a. 10-30 ml
b. 30-50 ml
c. 50-70 ml
d. 70-100 ml

155. Burns in which part of body are nursed without occlusive dressing?
a. Hands
b. Legs
c. Head and Neck
d. Chest

156. Which of the following is effected against Pseudomonas and is used in burns patients?
a. Silver sulphadiazine
b. Silver sulphazine
c. Sulphamethoxazole
d. Sulphadoxine

157. In children with burns, maintenance IV fluid normally given is ?


a. Ringer lactate
b. 5% dextrose
c. Normal saline
d. Dextrose saline

158. Late deaths in burns is due to:


a. Sepsis
b. Hypovolemia
c. Contractures
d. Neurogenic

159. Most common cause of death due to burns in early period is:
a. Sepsis
b. Hypovolemic shock
c. Both
d. None

160. Most common carcinoma after burns is:


a. Squamous cell carcinoma
b. Adenocarcinoma
c. Melanoma
d. Mucoid carcinoma

161. Most common cause of death in burns is:


a. Primary shock
b. Secondary shock
c. Hemorrhagic shock
d. Septicemic shock

162. Burns shock is:


a. Hypovolemic
b. Neurogenic
c. Endotoxic
d. Cardiogenic

164. Death from burns in first 10 days is due to all except:


a. Shock
b. Infection
c. Renal failure
d. Respiratory distress

165) False regarding carbuncle is


a) infective gangreen of subcutaneous tissue
b) caused by staphylococcus
c) diabetics are more prone
d) caused by streptococcus
166) Not true about carbuncle is
a) red, swollen
b) painful cluster of boils
c) occurs usually single
d) caused byStaphylococcus aureus 

167) In carbuncles bacteria can cause infection by


a) entering the skin through a hair follicle, small scrape, or puncture
b) blood vessels
c) entering through cut injury
d) after post surgery

168)not Risk Factors for Carbuncles


a)Older age, 
b)obesity,
c)poor hygiene
d) high fat diets

169) Not true about carbuncles


a) There is surrounding soft-tissue infection (cellulitis
b) A person has a weakened immune system
c) An infection has spread to other parts of the body
d) bacteria from a carbuncle can not escape into the bloodstream and will not cause serious
complications

170) Not true about furuncle is


a) red, swollen
b) painful cluster of boils
c) occurs usually single
d) caused byStaphylococcus aureus 

171) Is not sign of furuncle


a) Boils are bumpy,
b) red, pus-filled lumps around a hair follicle that are tender,
c) warm
d) not painful.

172) In Paraproctitis symptoms do not include


a) acute pain in the rectal region,
b)tenderness during defecation,
c) decreased body temperature,
d) appearance of an infiltrate in the anal region

173) Treatment of Paraproctitis includes administration of 


a) antibiotics
b) anti-inflammatory 
c) surgical lancing of the abscess in the suppurative stage
d) all of above

174) Lymph nodes are filled with ------------ blood cells that help your body fight off infections
a) RBC b) WBC c) Platelets d) none

175) Infections that spread to lymph nodes are usually not caused by
a) bacteria, b) viruses, c) fungi d) none
176) Symptom of lymphadenitis excludes
a) Nodes that increase in size suddenly ,
b) Nodes that are filled with pus (an abscess)
c) Both a and b
d) None

177) lymphadenitis is diagnosed by following test


a) Blood tests to look for infection
b) Taking a piece of the lymph node or fluid from inside the lymph node to study under a microscope
c) Placing fluid from the lymph node into a culture to see what type of germs grow
d) All of above

178) Treatment for lymphadenitis may include


a) Antibiotics
b) Medication to control pain and fever , reduce swelling
c) Surgery to drain a lymph node that has filled with pus
d) all of above

179) Mastitis is an infection and inflammation


a) Breast b) lymph nodes
c) hair follicle d) none

180) Bacteria causing mastitis enter through


a) crack in the skin of the breast b) lymph node c) hair folices d) all

181) Symptoms of mastitis excludes


a) redness, b) pain c) swelling d) clogged milk duct

182) In mastitis, the treatment includes


a) by taking antibiotics b) to practice prevention c) fever-reducing agents d) all

183) If you are breastfeeding, following is true in case of mastitis


a) you will most likely be encouraged to continue breastfeeding
b) this often actually helps relieve pressure
c) the infection will not enter the breast milk
d) all of above

184) Generalized lymphadenitis is related to


a) This type of lymph node infection occurs in two or more lymph node groups
b) may be caused by an infection that spreads through the bloodstream
c) may be caused by an infection that spreads through another illness that affects the whole body
d) all of above

185) Microbe causing tetanus is


a) Clostridium tetani b) Clostridium botulinum c) Clostridium difficile  d) Clostridium perfringens

186) C. tetani spores can be found in


a) soil b)intestines and feces of many household and farm animals and humans
c)both c)none

187) False about C. tetani


a)spores can be found in the soil and in the intestines and feces of many household and farm animals and humans.
b)The bacteria usually enter the human body through a puncture (in the presence of anaerobic [low oxygen]
conditions, the spores will germinate).
c)Tetanus is not spread from person to person.
d) C. tetani bacteria can very well grow in the presence of oxygen

188) The incubation period varies from


a)3–21 days, with an average of 8 days b) 23–41 days, with an average of 18 days
c) 30–121 days, with an average of 60 days d) 19–21 days, with an average of 20 days

189) The symptoms of tetanus excludes


a)spasm of the jaw muscles, b)stiffness of the neck, c) difficulty in swallowing, d) none

190)First appearing symptoms of tetanus


a)spasm of the jaw muscles,
b)stiffness of the neck,
c)difficulty in swallowing,
d) stiffness of the abdominal muscles

191) If it occurs , complete recovery of patients suffering from tetanus


a) within few minutes b)as soon as medication
c)with in few hours d)may take months

192) Diagnosis of tetanus is based on


a)the clinical signs and symptoms only b)blood reports
c)CT scan c)history alone

193) Tetanus bacilli live in the


a)soil, b)animal feces, c)manure d)all

194) Not true about treatment for tetanus


a) There is no complete "cure" for tetanus once a person develops symptoms,
b) just supportive treatment and management of complications.
c)The best "treatment" is prevention through immunization
d)spontaneous treatment soon after medication

195) Vaccines preparations are all given as


a)injection b)tablets c)capsules d)oral drops

196) Vaccines preparations are all given as injection in


a)the anterolateral thigh muscle b)the deltoid muscle c)gluteal muscles d)a and b

197) The usual schedule of vaccine for infants is a series of


a)4 doses of DTaP b)5 doses of DtaP c) 6 doses of DTaP d)3 doses of DtaP

198) The usual schedule for infants is a series of doses of DTaP given at
a)2, 4, 6, and 15–18 months of age b) 2, 4, 6, and 15–18 weaks of age
c) 2,4,8, and 25–28 months of age c) 2, 4, 8, and 25–28 weaks of age
199) A fifth shot, or booster dose, is recommended between-------------, unless the fourth dose was given late (after
the fourth birthday)
a) age 4 and 6 years b) age 14 and 16 years c) age 24 and 26 years d)not required

200)True about doses of tetanus vaccine is


a) For people who were never vaccinated or who may have started but not completed a series of shots, a 3-
dose series of Td should be given with 1 to 2 months between dose #1 and #2, and 6 to 12 months
between dose #2 and #3.
b) One of the doses, preferably the first, should also contain the pertussis component in the form of Tdap.
c) Because immunity to diphtheria and tetanus wanes with time, boosters of Td are needed every ten years.
d) All above are true

201) Pregnant women should receive Tdap


a)during each pregnancy, preferably between 27 and 36 weeks’ gestation
b)only in first pregnency
c)never
d)in first trimester as soon as pregnency is confirmed

202) Reduced opening of the jaws caused by spasm of the muscles of mastication
a) Trismus b)risus sardonicus c)ophisthotonus d)non

203)Rigid spine is
a) Trismus b)risus sardonicus c)ophisthotonus d)non

204)The rigidity of facial muscles that can lead to grimace is referred to


a) Trismus b)risus sardonicus c)ophisthotonus d)non

205) The symptoms of tetanus are caused by the tetanus toxin acting on the
a)central nervous system b)major arteries c)heart and circulatory system d)ligaments,tendons

206) Tetanus has a -----------fatality rate


a)high b)low c)100% death rate d)100% survival rate

207. What is not true of osteomyelitis in neonates:


A. Only clue to diagnosis is failure to move the limb
B. Prematures are more susceptible
C. Staph. aureus is always the pathogen
D. Treatment should not await blood culture

208. Prevention of osteomyelitis in open fractures


is by:
A. Remove all dead tissue
B. Leave wound open
C. Stabilise fragments by external fixators
D. All of the above

209. Acute osteomyelitis is commonly caused by:


A. Staph. aureus
B. S. pyogenes
C. H. influenzae
D. Salmonella
210. Regarding investigations in osteomyelitis all
are true except:
A. MRI is the investigation of choice
B. CT may show bone erosion and collection
C. Isotope scans are sensitive but less specific
D. X-ray change is present at outset

211. In osteomyelitis, pus culture will only yield


organism, if antibiotic is stopped before:
A. 3 days
B. 7 days
C. 10 days
D. 15 days

212. Improper treatment of osteomyelitis in


children leads to:
A. Septic arthritis
B. Growth arrest
C. Joint deformity
D. Each of the above

213. In acute long bone osteomyelitis, surgery is


indicated if:
A. Sever symptoms
B. Delayed presentation
C. Poor response to antibiotic
D. B + C

214. Acute osteomyelitis usually begins at:


A. Epiphysis
B. Metaphysis
C. Diaphysis
D. Any of the above

215. The treatment of a child with suspected


osteomyelitis seen 48 hours after onset of
symptoms is:
A. IV cloxacillin + Ampicillin
B. Incision
C. A + B
D. None of the above

216. In Cierny and Madar classification of chronic


osteomyelitis involvement of both cortical and
cancellous bone conforms to:
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4

217. What is true of surgical intervention in chronic


osteomyelitis:
A. Removal of sequestrum
B. Wound packing with gentamicin beads
C. Obliteration of dead space by muscle flap/
cancellous bone chips
D. All of the above

218. The definite way of establishing malignancy


in bone tumour is:
A. X-ray
B. Bone scan
C. Biopsy
D. CT scan

219. The radiological features of benign bone lesion


are all except:
A. Smooth distinct sclerotic borders
B. Geographic bone destruction
C. Codman’s triangle
D. Uninterrupted periosteal reaction

220. Constant bone pain not affected by activity and


awakening patient at night is most likely to
be due to:
A. Osteomyelitis
B. Malignant bone tumour
C. Bone tuberculosis
D. Brodie’s abscess
221. In osteogenesis imperfecta, collagen defect
manifests with:
A. Fragile capillaries
B. Lax ligaments
C. Dental problems
D. All of the above

222. The articular tissue first affected in rheumatoid


arthritis is:
A. Articular cartilage
B. Subchondral bone
C. Synovial membrane
D. Periarticular tissue

223. The bone infarct in acute osteomyelitis is


known as:
A. Involucrum
B. Sequestrum
C. Cloacs
D. All of the above

224. Heberden’s nodes of osteoarthritis are seen in:


A. Carpometacarpal joint
B. Proximal interphalangeal joint
C. Distal interphalangeal joint
D. Metacarpophalangeal joint

225. The joint rarely affected by osteoarthritis is:


A. Hip
B. Knee
C. Shoulder
D. Elbow

226. Primary osteoarthritis first affects:


A. Articular bone
B. Articular cartilage
C. Synovial lining
D. Joint capsule

227. The first X-ray abnormality in osteoarthritis is:


A. Marginal lipping
B. Narrow joint space
C. Sclerosis of periarticular bone
D. Subchondral cysts
228. Surgical options for advanced osteoarthritis
include:
A. Osteotomy
B. Arthrodesis
C. Joint replacement
D. All of the above

229. Mallet finger is treated with reduction and


splintage in full extension for:
A. 2 weeks
B. 4 weeks
C. 6 weeks
D. 8 weeks

230. Mallet finger refers to:


A. Hyperextension of thumb
B. Hyperflexion of thumb
C. 30° flexion of terminal phalanx
D. 60° flexion of terminal phalanx

231. Bennett’s fracture refers to:


A. Fracture of first metacarpal
B. Dislocation of base of first metacarpal
C. Dislocation of first metacarpal
D. None of the above

232. Felon, in surgical language refers to infection


of:
A. Subcuticular space
B. Proximal pulp space
C. Terminal pulp space
D. Epinychium

233. What is true of chronic paronychia:


A. Usually follows acute paronychia
B. Antibiotics are helpful
C. Griseofulvin is useful in long-term treatment
D. All are true

234. In infection of webspace, the incision for


drainage should be:
A. Longitudinal
B. Transverse
C. Oblique
D. Any of the above

235. Incision for the drainage of space of Parona


should be:
A. Transverse
B. Longitudinal
C. Oblique
D. All of the above

236. Lymphatics accompany veins everywhere in


body except in:
A. Heart
B. Lungs
C. CNS
D. Kidney

237. All the following are part of lymphatic system


except:
A. Spleen
B. Tonsil
C. Thymus
D. Liver

238. In liver lymphatics take origin from:


A. Portal triad
B. Porta hepatis
C. Space of Disse
D. Venous sinusoids

239. Lymph trunks are innervated by:


A. Sympathetic
B. Parasympathetic
C. Sensory endings
D. All of the above

240. Pressure in interstitial fluid compartment of


skin and subcutaneous tissue is:
A. 5-10 mmHg
B. 1-5 mmHg
C. 5-10 cm H2O
D. – 2 to – 6 mm H2O

241. Contractility of lymph channels is increased


by all except:
A. Serotonin
B. Thromboxane
C. Nitric oxide
D. Endothelin

242. Daily lymph drainage to circulation is:


A. 1-2 lit
B. 2-4 lit
C. 4-6 lit
D. 6-7 lit

243. Lymphoedema tarda presents at:


A. Birth
B. Puberty
C. Adulthood
D. None of the above

244. The most common cause of primary lymphoedema


is:
A. Congenital hyperplasia
B. Proximal obliteration
C. Distal obliteration
D. All of the above

245. In chyluria, all the following occurs except:


A. Renal colic
B. Hypoproteinemia
C. Haematuria
D. Milky white urine

246.Which of the following is not scanned by FAST technique


a.pericardium
b.pleural cavity
c.spleen
d.liver

247.Seat belt injury leads to


a.splenic laceration
b.splenic contusion
c.gut ischemia
d.mesenteric adenitis

248.Which ulcer is likely to develop in a lonf standing chronic venous ulcers


a.marjolin ulcer
b.apthous ulcer
c.Bazin ulcer
d.arterial ulcer

249. A 58-year-old cattle farmer normally a resident in the subcontinent, on a short visit to the
United Kingdom, was brought into the A&E department with convulsions. The episode started
with lassitude, irritability, dysphagia and spasm of facial muscles. He showed generalised
tonic and clonic spasm.
1 Abscess
2 Bacteraemia and sepsis
3 Cellulitis and lymphangitis
4 Clostridium tetani

250.A 68-year-old woman underwent an amputation of her right leg following severe crush injury.
Three days postoperatively she has pyrexia and tachycardia and looks toxic. The amputation
site looks red and brawny with the limb swollen with crepitus in the intermuscular planes.
1 Abscess
2 Bacteraemia and sepsis
3 Cellulitis and lymphangitis
4. Gas gangrene

251.A 75-year-old man underwent a low anterior resection. Five days postoperatively he became
toxic. A contrast CT scan showed an anastomotic leak.
1 Abscess
2 Bacteraemia and sepsis
3 Cellulitis and lymphangitis
4 Clostridium tetani

252. A 38-year-old woman sustained a superficial wound of her thumb from a puncture while
gardening. Twenty-four hours later, her thumb became swollen and very painful, with red
inflamed streaks all along the skin up to the axilla.
1 Abscess
2 Bacteraemia and sepsis
3 Cellulitis and lymphangitis
4 Clostridium tetani

253. A 25-year-old man presented with a tender lump in the right supraclavicular area of 3 days’
duration. The lump is red and fluctuant. He looks unwell with pyrexia. A week before the
onset of this episode he had his right ear pierced, which became infected.
1 Abscess
2 Bacteraemia and sepsis
3 Cellulitis and lymphangitis
4 Clostridium tetani

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