Quiz

Question :1 Which of the following cancers rarely metastasize to the liver

Colon cancer
Breast cancer
Prostate cancer
Melanoma

Question :2 Primary indication for fine-needle aspiration of renal mass is which suspected clinical diagnosis

Renal cell carcinoma
Renal oncocytoma
Renal angiomyolipoma
Renal metastasis

Question :3 Medial displacement of both pelvic ureteral segments might result from:

Pelvic lipomatosis
Postabdominoperineal surgery
Postabdominoperineal surgery
All of the above

Question :4 Which of the following is true regarding Poland's syndrome

Both breasts are typically involved
Men are more commonly affected
It classically presents with a sunken chest
It is due to an absence Of the chest wall muscles

Question :5 Which of the following is true regarding femoral hernias

Watchful waiting or surgical repair are both reasonable options to consider in otherwise healthy patients diagnosed with asymptomatic femoral hernia
Mesh plug repair is the pre erred approach in emergent cases
Rate of incarceration and strangulation is reported as greater than 40%.
Men are more likely than women to experience this type of hernia

Question :6 Indications for percutaneous puncture of renal collecting system is

Antegrade pyelography
Nephrostomy catheter drainage
Dilatation of ureteral strictures
All of the above

Question :7 Transfusion of a unit of pRBCs into hemodynamically stable patient with hemoglobin 7.5 g/dL does which of the following

Increases systemic oxygen delivery (D02)
Increases tissue extraction of oxygen
Increases systemic oxygen uptake (V02)
Increases arterial 02 saturation (Sa02)

Question :8 An asymptomatic patient is found to have serum calcium level of 13.5 mg/dL. Which of the following medications should be avoided?

Bisphosphonates
Thiazide diuretics
Mithramycin
Calcitonin

Question :9 A 46-year-old male is undergoing an anterior cervical disk fusion. Which of the following is correct with regard to the RLN

Left RLN loops around the subclavian artery and ascends medially into the neck
Right RLN loops around the inferior thyroid artery, ascends laterally to medially, and enters cricothyroid membrane.
Right inferior laryngeal nerve is nonrecurrent in 0.5%—1% of patients
RLNs innervate the true vocal cords and cricothyroid muscles

Question :10 Which of the following is not a suitable wound bed for a skin graft

Muscle without overlying fascia
Muscle with overlying fascia
Tendon devoid of paratenon
Bowel with a layer of granulation tissue

Question :11 Which testicular cancer cell type is extremely radiosensitive (DNB SS 2015)

Embryonal carcinoma
Yolk sac tumor
Seminoma
Choriocarcinoma

Question :12 Level II cervical lymph node basin is subdivided into IIA and IIB by:

Spinal accessory nerve
Sternomastoid
Internal jugular vein
Posterior belly digastrics

Question :13 Most common type of gastric lymphoma is

GIST
Diffuse large B cell lymphoma
MALToma
Burkitt’s lymphoma

Question :14 Not considered as high grade tumour in carcinoma parotid (NEET SS 2018)

Malignant pleomorphic adenoma
Squamous cell carcinoma
Acinic cell carcinoma
Adenocarcinoma

Question :15 Stewart treves syndrome is

Epitheloid angiosarcoma
Radiation induced angiosarcoma
Angiosarcoma in the context of lymphoedema
Idiopathic angiosarcoma

Question :16 All the following genetic disorders are associated with Pancreatic neuroendocrine tumors Except

MEN I
Von Hippel Lindau syndrome
Von Recklinghaussen syndrome
Heriditary pancreatitis

Question :17 Most common location of missed adenoma in patients undergoing reoperative parathyroid surgery is in

Thymus
Normal upper position
Normal lower position
Tracheoesophageal groove

Question :18 Ultrasound features of thyroid malignancy include all except

Microcalcification
Hyperechogenic
Intranodular vascularity
More taller than wide

Question :19 Which of the following is not true about testicular cancer

Most common solid malignancy in men age 15 to 35 years
Most men are diagnosed with an symptomatic enlarging mass
A major risk for the development of testicular cancer is cryptorchidism
Most neoplasms arise from the germ cells

Question :20 All are clinical grading for SAH except

Hunt & Hess
WFNS
Botterell
Modified Fischer

Question :21 "Ebb" and "flow" phase response to injury concept was given by

Cushing
Murphy
Maldwyn
David Cuthbertson

Question :22 In Scaphocephaly there is premature fusion of

Metopic suture
Sagittal suture
Coronal suture
Lambdoid suture

Question :23 Characteristic loss of long arm of chromosome 1 & short arm of chromosome 19 seen in

Glioblastoma Multiforme
Oligodendroglioma
Ganglioglioma
Neurocytoma

Question :24 Ulcerative colitis differs from Crohn’s disease by the following features

Rectum is always involved
Granuloma formation
Strictures are more common
Associated with perianal lesions

Question :25 A boy of 10 yrs came with abdominal pain.Which of the following is true

He would be having multiple hamartomatous GI polyps
It is autosomal recessive syndrome
Genetic defect is on 18q & 10q (MADH4 & BMPR1A)
Likely diagnosis is Cowden syndrome

Question :26 Which of the following is largely restrictive & mildly malabsorptive

Roux-NY Gastric bypass
Vertical band gastroplasty
Duodenal switch
Laproscopic sleeve gastrectomy

Question :27 Which of the following is true regarding anorectal anatomy?

Levator ani marks the transition point between the rectum and sigmoid colon
Presacral fascia separates the rectum from presacral venous plexus and pelvic nerves
Waldeyer fascia is anterior to Denonvilliers fascia
In men, Denonvilliers fascia separates rectum from sacrum

Question :28 Which of the following cancers most commonly metastasizes to the thyroid

Parathyroid gland
Kidney
Lung
Breast

Question :29 A flexible endoscopic examination demonstrates an endoscopically unresectable mass or cancer is located at approximately 14 cm from anal verge and a biopsy is performed. Next best step to evaluate the lesion is

CT pelvis
Rigid proctoscopy
Serum CEA level
Hepatic function tests

Question :30 Which of the following is contraindication for negative-pressure wound therapy

Newly grafted skin
Wounds with a fistula
Diabetic wounds
Ischemic wounds

Question :31 A 62-year-old male with a history of diverticulitis presents with pneumaturia, urinary frequency and dysuria for several days. He is afebrile and hemodynamically stable. Urine culture grows multiple organisms. For this patient the definitive management consists of:

Total parenteral nutrition, bowel rest, and antibiotics
Colon resection with primary closure Of bladder
Colon resection and excision Of cuff Of bladder
Colon resection and excision Of cuff Of bladder

Question :32 A 75 year-old man has a 1 week history of left iliac fossa pain. He is feverish and generally unwell, and has vomited on several occasions. He has a history of diverticular disease. On examination he is pyrexial and tachycardic. Abdominal examination shows a tender mass in the left iliac fossa. Remainder of abdomen is nontender. What is the single most likely complication of diverticular disease to have occurred

Colonic stricture
Diverticular haemorrhage
Pericolic abscess
Sigmoid perforation with generalized peritonitis

Question :33 A 25 year-old man has noticed a lump in his right testis. It is painless and his general health is good. He had a right orchidopexy for an undescended testis at age of 5 yrs. Examination shows a 3cm firm and irregular lump arising from right testis. What is the single most likely diagnosis

Acute epididymitis
Epididymal cyst
Hydrocele
Testicular tumour

Question :34 Polyhydramnios is frequently observed in all of the following conditions except:

Esophageal atresia
Duodenal atresia
Pyloric atresia
Hirschsprung's disease

Question :35 Neonates with NEC may demonstrate all of following findings on abdominal films Except:

Pneumatosis intestinalis
Portal vein air
Pneumoperitoneum
Colovesical fistula

Question :36 Bloody stools with ileus is seen in which stage of NEC

Stage 1
Stage 2
Stage 3a
Stage 3b

Question :37 Operative management of a newborn with chest X-ray shown in figure is done

Immediately after birth
Within 24 hours
Within 72 hours
Within 2 to 4 days

Question :38 True about Acral lentigenous melanoma are all except

Common on mucosal surfaces
Etiology is likely dependent on UV Exposure
Accounts for <5% melanoma
Has prolonged RGP

Question :39 Hemobilia is commonly associated with

Hepatic hemangioma
Hepatocellular carcinoma
Blunt injury of liver
Budd-Chiari syndrome

Question :40 Febrile transfusion reaction is due to

Anaphylactic reaction
Graft -versus- host response from leukocytes of transfused blood
It is a blood group antigen antibody reaction
None of the above

Question :41 Muscle viability judged by all except

Color
Bleeding pattern
Edema
DContractility

Question :42 Critical length of jejunum with jejunocolic anastomosis will always require long term TPN

<100 cm
<50 cm
<150 cm
<200 cm

Question :43 Most common site of damage in Endotracheal intubation is

Epiglottis
Subglottis
At cricoid cartilage
Trachea

Question :44 According to frankel classification which scale have no sensation at all

A
B
C
D

Question :45 Substitution urethroplasty has a success rate of

80%
60%
70%
90%

Question :46 False about Anal fissure is

Longitudinal split in anoderm of distal anal canal
Extends from the anal verge proximally towards, but not beyond dentate line
Location is usually Anterior midline
Anterior anal fissure is more common in women following vaginal delivery

Question :47 True regarding results of surgery of rectal cancer

Resectability rate for rectal cancer is less than 5%
Operative mortality is as high as 95%
Overall, the 5-year survival rate is about 30%
Survival rates with node +ve patients doing worse than those with node -ve lesions

Question :48 Risk factors for perforation of the appendix is

Extremes of age
Diabetes mellitus
Pelvic appendix
All of the above

Question :49 All are indications for early surgical intervention in Acute intestinal obstruction except

Obstructed external hernia
Clinical features suspicious of intestinal strangulation
Obstruction in a ‘virgin’ abdomen
None of the above

Question :50 Which of the following is true about Carcinoma colon

Carcinoma of the colon is most common in the 5th decade of life
Emergency presentation occurs in 80% of cases and is associated with worse prognosis
Those with 1st degree relatives who have developed CRC <45 years may be part of one of familial syndromes
Tumours of right side of colon usually present with change in bowel habits

Question :51 Which of the following is true about Small Bowel Lymphoma

Small bowel lymphoma more commonly primary lymphoma
Incidence of small bowel lymphoma is High in Crohn’s Disease and AIDS
Hodgkin’s lymphoma doesn’t affect the small bowel at all
T-cell lymphoma develops in patients with Crohn’s disease

Question :52 Which of the following are Pro inflammatory mediators except

IL-1
IL-4
IL-6
TNF Alpha

Question :53 Which of the following is not a limitation of minimal access surgery

Reliance on remote vision and operating
Best tactile feedback
Difficulty with haemostasis
Extraction of large specimens

Question :54 Oxygen carrying capacity of crystalloids and colloids is

100 percent
90 percent
50 percent
Zero percent

Question :55 Which of the following is true about Hayflick hypothesis

Normal cells are permitted to undergo infinite number of divisions
Abnormal cells are permitted to undergo only a finite number of divisions
Normal cells are permitted to undergo only a finite number of divisions
Abnormal cells are permitted to undergo infinite number of divisions

Question :56 Gastroenterologist is evaluating a 3-month-old patient with polysplenia for surgery. Which of the following anomalies is classically associated with this syndrome?

Choanal atresia
Necrotizing enterocolitis
Common atrioventricular canal
Bilateral trilobed lungs

Question :57 Most sensitive test for the diagnosis of biliary dyskinesia

Abdominal CT scan
ERCP
Cholecystokinin-Tc-HIDA scan
Abdominal US

Question :58 Normal amount of bile produced by the liver daily

500–1000 ml
1000–2000 ml
1000–1500 ml
200–400 ml

Question :59 Which of following medications is used postoperatively to prevent gallstone formation after bariatric surgery

Cholestyramine
Ursodiol
Octreotide
Simvastatin

Question :60 Small intestinal motility is characterized by which of the following?

A “pacemaker potential” that is responsible for initiating peristaltic contractions
Both peristaltic and segmental contractions
Mean transit time through the small intestine of 24 hrs
A migrating motor complex that facilitates digestion of consumed protein

Question :61 Which of the following has been shown to increase LES pressure?

Cholecystokinin
Ethanol
Estrogen
Motilin

Question :62 All are true about microscopic anatomy of liver EXCEPT:

Divided into concepts of hepatic lobule and hepatic acinus
Histopathology of liver is discussed on basis of lobular architecture
Space of Disse represent mononuclear phagocyte system
Canals of Hering connect bile canaliculi to bile ductules in periportal region

Question :63 A 30-year-old patient with H/O antibodies to HCV for 6 months duration and his AST/ALT is normal. There is no symptom or stigmata of liver disease. Most appropriate approach:

Reassure the patient
Repeat titre every 3 years
Repeat enzymes yearly
Do liver biopsy and start antiviral drugs accordingly

Question :64 Greatest predisposition to pancreatic cancer is associated with:

Peutz-Jeghers syndrome
Hereditary pancreatitis
Familial breast and ovarian cancers
HNPCC

Question :65 Most commonly seen mutation in Hereditary pancreatitis:

PRSS1
SPINK1
CFTR
All of the above

Question :66 Which of the following assesses the health care currently being provided against standard guideline

Clinical audit
Research proposal
Service evaluation
Project

Question :67 Non parametric test used to compare three/more independent groups of sampled data

Chi square test
F test
Kruskal Wallis test
McNemar test

Question :68 Which statement is true concerning the surgical anatomy of the pancreas?

The head lies over the first lumbar vertebra
The lesser duct enters the third part of the duodenum
The superior mesenteric vessels pass behind the uncinate process
SMA lies to the left of the SMV

Question :69 Entire colon of a patient was evaluated and 4 cm sessile polyp is noted in the distal descending colon. Subsequent biopsy is done which shows moderately differentiated adenocarcinoma with extension past the lamina propria. No other lesions are seen in colon. Which of following is next best step in management

Left colectomy
Repeat colonoscopy to determine if the lesion is amenable to endoscopic resection
CT/PET scan
CT scan

Question :70 A decision is made to take the patient to the operating room for a laparoscopic appendectomy. Regarding possibilities that may occur during the operation, which of the following is correct?

If the appendix appears normal, a diagnostic laparoscopy should be performed to look for other potential causes of the patient’s right lower quadrant pain. The appendix should not be removed in such cases.
If subcentimeter mass identified at appendiceal tip, one should perform an ileocecectomy.
If an enterotomy occurs during trocar placement, one should perform a bowel resection and not attempt primary repair.
If one encounters a perforated appendix, leaving a drain has not been shown to reduce the rate of abscess formation.

Question :71 Surgical management of the ileosigmoid fistula in crohn’s disease patient is best approached with which of following techniques?

En bloc resection of all inflamed tissue with proximal diversion
Debridement and primary closure of fistula site on sigmoid colon if there are no secondary signs of inflammation
Enterectomy, debridement of fistula tract, and segmental colectomy
Small bowel resection with primary anastomosis alone

Question :72 Preoperative staging reveals a 4 cm moderately differentiated adenocarcinoma T2N1M0 located at 9 cm from the anal verge.What is preferred treatment strategy

Pre-operative chemotherapy followed by chemoradiation therapy followed by full thickness transanal excision of the primary lesion
Low anterior resection o the rectum followed by chemotherapy or chemoradiation therapy based on pathologic evaluation o the resection specimen
Pre-operative chemotherapy ollowed by chemoradiation therapy followed by low anterior resection of the rectum
Chemoradiation followed by low anterior resection of the rectum

Question :73 Which of the following is a component of the pentalogy of Cantrell?

Coloboma
Gigantism
Ectopic cordis
Genital hypoplasia

Question :74 A 63-year-old woman is admitted to the hospital with a UGI bleed that subsides spontaneously within a short time after admission. A barium study shows a gastric ulceration that is described by the radiologist as having a “doughnut sign.” What is most likely diagnosis?

Lipoma
Gastric ulcer
Ectopic pancreas
GIST

Question :75 A patient has been diagnosed with achalasia. He refused surgery initially, preferring to try nonoperative therapy. He tried life style modification, calciumchannel blockers, botulinum toxin injection, and endoscopic pneumatic dilatation.None of the treatments alleviated his symptoms. What are his surgical options?

Esophagectomy
Surgical esophagomyotomy proximal to the LES
Modified Heller myotomy and partial fundoplication
Repeat pneumatic dilation using pressures of loops

Question :76 Which statement is true regarding operative management in patients undergoing pancreaticoduodenectomy?

Pancreaticogastrostomy has lowered incidence of pancreatic leak than pancreaticojejunostomy
External drainage of pancreaticojejunostomy has decreased pancreatic leak rate
Octreotide has decreased incidence o clinically significant pancreatic leak rate
Internal drainage of pancreaticojejunostomy has decreased pancreatic fistula rate

Question :77 Orally administered glucose provokes a greater insulin response than an equivalent amount of intravenously administered glucose. Incremental response to ingested glucose is due to the effects of which of following hormones

Gastric inhibitory peptide
Somatostatin
Pancreatic polypeptide
Secretin

Question :78 Investigations of a 43-year-old woman with pluriglandular syndrome were scheduled to determine if a gastrinoma (ZES) was present. The serum gastrin level was slightly elevated. Further assessment to establish the diagnosis can be made by repeating the serum gastrin level after stimulation with which of the following?

Phosphate
Potassium
Calcium
Chloride

Question :79 A patient has compressive symptoms of the esophagus. He has a barium esophagram that shows posterior extrinsic compression of esophagus. Which of following is true?

Vascular rings are acquired atherosclerotic lesions
Both the trachea and esophagus can be affected by vascular rings
2 most common types of complete vascular rings- double aortic arch & left aortic arch
There is no role for Echo and Doppler

Question :80 A patient is diagnosed with Boerhaave’s syndrome. Best Management is

Administration of intravenous antibiotics and TPN
Administration of iv antibiotics,TPN and insertion of Chest and Nasogastric tubes
Administration of iv antibiotics and TPN, and insertion of a nasogastric tube
Resuscitation and emergency surgery either by laparotomy or thoracotomy

Question :81 Most common urological complication in Crohn’s disease

Ureteral obstruction
Glomerulonephrtitis
Nephrotic syndrome
Amyloidosis

Question :82 In remodeling phase all are true except

Type 3 replacing type 1
Realignment of fibres along lines of tension
Decreased vascularity
Wound contraction

Question :83 Not true about Compartment syndrome

Pain on passive flexion of affected muscle
Distal sensory disturbance
Absence of pulse distally
Can't occur with an open injury

Question :84 Complications of massive transfusion includes all except

Hypokalemia
Hyperkalemia
Hyponatremia
Hypocalcemia

Question :85 Regarding damage control resiscitation all are true except

Anticipate and treat traumatic coagulopathy
Permissive hypotension until hemorrhage control
Excess crystalloid and colloid infusion
DCS to control hemorrhage and physiology

Question :86 Jefferson fracture is

Fracture of atlas ring
Atlantoaxial fracture
Odontoid fracture
Occipito atlantal fracture

Question :87 Critical length of jejunum with diverting jejunostomy will always require long term TPN

<100 cm
<50 cm
<150 cm
<200 cm

Question :88 Snake like ulcer pattern may be seen in

Tuberculous colitis
Crohn’s disease
Ulcerative colitis
Amebic colitis

Question :89 Most common hormone produced by small intestinal neuroendocrine tumor is

Serotonin
Secretin
Peptide Y
Somatostatin

Question :90 What is the initial diagnostic test of choice after pancreas transplantation

Colour Doppler flow imaging
Ultrasound
Blood glucose level
Serum lipase level

Question :91 All are absolute contraindications for liver transplantation except

Cholangiocarcinoma
Too short survival after transplantation
Unacceptable postoperative quality of life
Active alcoholism

Question :92 Factors that favour development of diffuse peritonitis include all except

Speed of peritoneal contamination is a prime factor
Stimulation of peristalsis by the ingestion of food or even water hinders localisation
Virulence of infecting organism is great as to render localisation of infection difficult or impossible
Perforation distal to an obstruction is associated with severe generalised peritonitis and a high mortality rate

Question :93 True regarding 24 hr pH Monitoring is

Patterns of reflux cant be made out
Not useful in patients with atypical reflux symptoms
Total time when pH is <4 in a 24'hour period does not exceed 4% in a healthy adult
Intermittent measurement of pH is accepted as most accurate method for the diagnosis of GERD

Question :94 All are true about Arterial supply of stomach and duodenum except

On lesser curve, left gastric artery forms anastomosis with right gastric artery
Gastroduodenal artery passes behind 2nd part of the duodenum
Superior pancreaticoduodenal artery supplies the duodenum and pancreatic head
Right gastroepiploic artery runs along greater curvature of the stomach

Question :95 Conditions associated with severe and complex obesity include

Non-alcoholic fatty liver disease
Obstructive sleep apnoea
Gastro-oesophageal reflux disease
All of the above

Question :96 Which of the following match of conditions with common presentation is not true

Budd chiari syndrome-Ascites
Primary sclerosing cholangitis- Jaundice
Caroli disease- Jaundice
Polycystic liver disease- Hepatomegaly

Question :97 All are true about splenic artery aneurysm except

Twice as common in women
Usually multiple
May be consequence of intra-abdominal sepsis and pancreatic necrosis
They are more likely to be associated with arteriosclerosis in elderly patients