Surgery Previous Year Questions 2016
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Questions and Answers

Which diagnosis is the least likely for a child presenting with a thyroid nodule and appearing euthyroid?

  • Papillary carcinoma
  • Follicular carcinoma
  • Simple adenoma
  • Dysgenetic thyroid gland (correct)
  • Which of the following symptoms is least associated with cancer of the pancreatic head?

  • Palpable gallbladder
  • Jaundice
  • Esophageal varices (correct)
  • Weight loss
  • What is the most serious complication associated with a large abdominal aortic aneurysm?

  • Embolization to tibial artery
  • Rupture (correct)
  • Infection
  • Compression of neighboring organs
  • Which statement about arterial intermittent claudication of lower limbs is true?

    <p>Cramps relieved by rest (C)</p> Signup and view all the answers

    What is the most accurate method for diagnosing hypertrophic pyloric stenosis?

    <p>Abdominal ultrasound (A)</p> Signup and view all the answers

    Which child is most suitable for a tonsillectomy?

    <p>6-year-old male with five sore throats per year for two years (D)</p> Signup and view all the answers

    In managing a 2-week-old baby with hip instability and a partially dislocated femoral head, what is the next step?

    <p>Surgery (A)</p> Signup and view all the answers

    Which statement about orthostatic proteinuria is true?

    <p>Has a good prognosis (A)</p> Signup and view all the answers

    What is the normal intracranial pressure (ICP) in adults?

    <p>10-15 mmHg (A)</p> Signup and view all the answers

    Which condition is characterized by young females presenting with unclear breast lumps and pain during menstruation?

    <p>Mastopathia (A)</p> Signup and view all the answers

    After subtotal gastrectomy with Billroth I or II reconstruction, which of the following is NOT a common complication?

    <p>Hypothyroidism (C)</p> Signup and view all the answers

    What is the most common clinical manifestation of pancreatic head cancer?

    <p>Abdominal pain, jaundice, weight loss (C)</p> Signup and view all the answers

    What is the first line therapy for prolactinoma?

    <p>Cabergoline (A)</p> Signup and view all the answers

    Which presentation is most common with Meckel's diverticulum?

    <p>GI bleeding (D)</p> Signup and view all the answers

    In a patient with recurrent indolent fistula and gastrointestinal symptoms, what is the likely diagnosis?

    <p>Ulcerative colitis (A)</p> Signup and view all the answers

    Which of the following is NOT a predisposing factor for stress ulceration?

    <p>Isolated tibial fracture (A)</p> Signup and view all the answers

    Which disorder is suggested by symptoms of weakness, sweating, tachycardia, confusion, and headache relieved by eating?

    <p>Insulinoma (D)</p> Signup and view all the answers

    What is the main treatment for an abscess caused by acute mastitis?

    <p>Incision and drainage (C)</p> Signup and view all the answers

    Which organism primarily invades the large intestine?

    <p>Entamoeba histolytica (B)</p> Signup and view all the answers

    Which of the following is NOT a metabolic complication of subtotal gastrectomy?

    <p>Hypothyroidism (D)</p> Signup and view all the answers

    Which statement about gallstones is false?

    <p>Symptoms commonly appear in all patients with gallstones (A)</p> Signup and view all the answers

    Which of the following is NOT contained within the abdominopelvic cavity?

    <p>Lungs (C)</p> Signup and view all the answers

    Which statement regarding post-splenectomy sepsis is false?

    <p>The incidence in adults is about 10% (C)</p> Signup and view all the answers

    Which statement about benign lesions of the liver is true?

    <p>Hemangiomas are the most common benign lesions that require surgical attention. (D)</p> Signup and view all the answers

    What is the diagnostic criteria for prolactin levels indicative of prolactinoma?

    <blockquote> <p>200 ng/ml (C)</p> </blockquote> Signup and view all the answers

    What is the most common complication of enteral nutrition?

    <p>Vomiting and diarrhea (A)</p> Signup and view all the answers

    Which structure is primarily involved in the formation of the superficial inguinal ring?

    <p>External oblique muscle tendon (A)</p> Signup and view all the answers

    What is the basic construction and functional unit of the liver?

    <p>Hepatic lobules (C)</p> Signup and view all the answers

    In the context of abdominal paracentesis, which diagnosis is most likely when extracting non-coagulable blood?

    <p>Parenchymal organ rupture (C)</p> Signup and view all the answers

    Which chemotherapeutic agent is most commonly used for malignant gliomas?

    <p>Temozolomide (C)</p> Signup and view all the answers

    In managing a patient with acute RUQ pain, which statement about diagnosis and treatment is true?

    <p>Antibiotics should be appropriately used. (D)</p> Signup and view all the answers

    Which statement about pancreatic carcinoma is true?

    <p>99% of patients with pancreatic cancer have metastatic disease at the time of diagnosis. (D)</p> Signup and view all the answers

    What is the most dangerous complication of portal hypertension?

    <p>Bleeding of esophageal gastric varices and rupture (C)</p> Signup and view all the answers

    What is the most likely sign for a patient with postprandial abdominal pain?

    <p>Succusion splash positive (A)</p> Signup and view all the answers

    Which statement regarding amylase changes in acute pancreatitis is incorrect?

    <p>The duration of urine amylase increase is shorter than that of blood amylase. (D)</p> Signup and view all the answers

    What is the likely diagnosis for a patient experiencing a dull headache and uncontrollable jerking movements?

    <p>Migraine headache (B)</p> Signup and view all the answers

    Which nerve is primarily responsible for pupil dilation during uncal herniation?

    <p>Oculomotor nerve (III) (C)</p> Signup and view all the answers

    What is the significance of a succusion splash in a patient with abdominal pain?

    <p>Indicates a gastric outlet obstruction. (B)</p> Signup and view all the answers

    What is the most common site for pancreatic cancer?

    <p>Head of pancreas (A)</p> Signup and view all the answers

    Which condition is least likely to cause an increase in serum amylase levels?

    <p>Gastric ulcers (B)</p> Signup and view all the answers

    Which management option is appropriate for a patient with a serum sodium level of 120 meq/L five days after cholecystectomy?

    <p>Administration of hypertonic saline solution (B)</p> Signup and view all the answers

    What does the term 'three without' skin refer to in the anal canal?

    <p>No sweat glands, hair follicles, lymphatics (B)</p> Signup and view all the answers

    Which of the following is NOT a contraindication for highly selective vagatomy?

    <p>Cigarette chain smoking (A)</p> Signup and view all the answers

    A patient with abdominal pain and vomiting is likely diagnosed as having what condition based on the presence of a mass in the right lower quadrant?

    <p>Appendicitis (A)</p> Signup and view all the answers

    Which of the following statements about the clinical course of appendicitis is true?

    <p>Nausea and vomiting usually precedes pain (B)</p> Signup and view all the answers

    Which advantage is associated with minimally invasive surgery?

    <p>Less scarring (A)</p> Signup and view all the answers

    What commonly presents first in a patient with appendicitis?

    <p>Periumbilical pain (B)</p> Signup and view all the answers

    Flashcards

    Most common benign liver lesion needing surgery?

    Hemangiomas are the most common benign liver lesions that require surgical attention.

    What are Adenomas?

    Adenomas are true neoplasms with a higher risk of complications and usually require surgical removal.

    What is the diagnostic prolactin level for prolactinoma?

    Prolactin levels above 200 ng/ml suggest a prolactinoma.

    What is the most common complication of enteral nutrition?

    Vomiting and diarrhea are the most frequent complications of enteral nutrition.

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    What forms the superficial inguinal ring?

    The superficial inguinal ring is formed by the external oblique muscle tendon.

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    What is the basic functional unit of the liver?

    The basic functional unit of the liver is the hepatic lobule.

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    What does non-coagulable blood in paracentesis mean?

    Non-coagulable blood in a diagnostic abdominal paracentesis indicates a rupture of a hollow organ.

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    What is the primary chemo drug for malignant gliomas?

    Temozolomide is the most commonly used chemotherapeutic agent for malignant gliomas.

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    Normal ICP in Adults

    Normal intracranial pressure (ICP) in adults is typically between 10 and 15 mmHg.

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    Mastopathia

    Mastopathia is a condition characterized by painful breast lumps that are often worse during menstruation.

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    GCS Score of 5

    A GCS score of 5 indicates a patient is localized to painful stimuli, meaning they respond to pain but not verbal commands or other stimuli.

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    Pancreatic Head Cancer Symptoms

    The most common clinical manifestation of pancreatic head cancer is abdominal pain, jaundice, and weight loss.

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    Subphrenic Abscess

    Subphrenic abscess is a collection of pus located between the diaphragm and the liver, often developing after abdominal surgery.

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    Ulcerative Colitis

    Ulcerative colitis is a chronic inflammatory bowel disease that primarily affects the colon and rectum, leading to recurrent bouts of diarrhea, blood in stools, weight loss, and abdominal pain.

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    First-line Therapy for Prolactinoma

    Cabergo line is a medication used as first-line therapy for prolactinomas, a type of pituitary tumor causing high prolactin levels.

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    Meckel's Diverticulum

    Meckel's diverticulum is a common congenital abnormality in which a small pouch forms in the small intestine, often causing painless GI bleeding, especially in children.

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    What is hypertrophic pyloric stenosis?

    A condition where the opening between the stomach and small intestine (pylorus) narrows, making it difficult for food to pass through.

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    What is a 'cold' thyroid nodule?

    A type of thyroid nodule that does not take up radioactive iodine, making it appear 'cold' on a scan. It can be benign or cancerous.

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    What is arterial intermittent claudication?

    A condition that causes pain in the legs during exercise, relieved by rest. It's caused by narrowing of the arteries in the legs, reducing blood flow.

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    What is orthostatic proteinuria?

    A condition that causes protein to be present in the urine, particularly when standing. It typically has a good outcome.

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    What is pancreatic head cancer?

    A type of cancer that arises in the head of the pancreas. It can cause jaundice due to blockage of the bile duct.

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    What is the most serious complication of a large abdominal aortic aneurysm?

    A severe complication of a large abdominal aortic aneurysm, where the weakened vessel wall bursts, leading to life-threatening internal bleeding.

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    When is a tonsillectomy considered?

    A condition where the tonsils are repeatedly infected, leading to frequent sore throats (5 or more per year for 2 years). Removal of the tonsils (tonsillectomy) might be considered.

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    What is a partially dislocated femoral head in a baby?

    A condition where the hip joint is unstable, often due to a partially dislocated femoral head. It may resolve on its own without surgery.

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    Appendicitis

    A condition where the appendix becomes inflamed and infected, often causing severe abdominal pain.

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    Thrombophlebitis

    A type of blood clot in a vein, often in the legs. It can cause pain, swelling, and redness.

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    Typical Appendicitis Pain Course

    Starts with vague abdominal pain, then shifts to around the belly button (periumbilical), and finally settles in the lower right abdomen.

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    Hyponatremia

    A condition where the body has low sodium levels, often caused by dehydration. It can cause fatigue, confusion, and seizures.

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    Head of the Pancreas

    The most common location for pancreatic cancer.

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    Anal Canal Skin: "Three Without"

    The skin of the anal canal lacks hair follicles, sweat glands, and sebaceous glands.

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    Minimally Invasive Surgery

    A type of surgery that involves smaller incisions and less tissue damage compared to traditional open surgery.

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    Highly Selective Vagotomy

    A surgical procedure to reduce acid production in the stomach by selectively cutting specific nerves.

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    Pancreatic Carcinoma Prognosis

    Pancreatic carcinoma is a highly aggressive cancer with a poor prognosis, often presenting with metastatic disease at diagnosis.

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    Most Dangerous Portal Hypertension Complication

    Bleeding from esophageal and gastric varices is the most serious complication of portal hypertension, which is characterized by increased pressure in the portal vein.

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    Postprandial Pain & Peptic Ulcer Disease

    Postprandial pain, especially after meals and relieved by antacids, is a hallmark symptom of peptic ulcer disease, suggesting an ulcer in the stomach or duodenum.

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    Amylase in Acute Pancreatitis

    While amylase levels are often elevated in acute pancreatitis, they are not always directly proportional to the severity of the disease. Amylase can also be elevated in other conditions, such as ascites and hydrothorax.

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    Uncal Herniation and Pupil Dilation

    The affected pupil dilates due to compression of the oculomotor nerve (CN III) in the uncal herniation, a medical emergency where brain tissue is pushed through a narrow opening.

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    Cluster Headache

    Cluster headaches are severe, recurring headaches that typically occur in clusters, often accompanied by unilateral facial flushing and sweating. They are more frequent in the morning.

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    Murphy's Sign

    A positive Murphy's sign, characterized by pain and tenderness when deep palpation is applied to the right upper quadrant, is highly suggestive of acute cholecystitis.

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    Border of Dullness Disappearance

    The border of dullness disappears in the abdomen when the patient is sitting up, suggesting a possible pneumothorax (collapsed lung).

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    Intussusception

    A condition where the small intestine telescopes into itself, causing blockage and pain. It can be caused by various factors, including infections, polyps, or tumors.

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    Prolactinoma

    A common hormonal disorder characterized by excess prolactin production in the pituitary gland. It can cause symptoms like irregular periods, infertility, and milk production.

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    Insulinoma

    A rare but serious condition caused by a tumor in the pancreas that secretes insulin, resulting in low blood sugar levels. Symptoms often occur after fasting and include weakness, sweating, and confusion.

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    Acute Mastitis

    A bacterial infection of the breast tissue, often accompanied by redness, swelling, and pain. It's usually treated with antibiotics but can be difficult to manage during breastfeeding.

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    Entamoeba histolytica

    A parasitic infection that primarily affects the large intestine. It can also invade other organs like the liver, leading to abscess formation. In severe cases, it can be life-threatening.

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    Dumping Syndrome

    Digestive complications that can occur after a portion of the stomach is removed. It involves rapid emptying of food into the small intestine, leading to symptoms like nausea, diarrhea, and low blood sugar.

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    Gallstones

    A condition where gallstones become lodged in the gallbladder or the common bile duct, leading to pain, inflammation, and digestive problems. Symptoms often worsen after eating fatty foods.

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    Abdominopelvic cavity

    The pouch that holds the organs of the abdomen and pelvis. It includes important structures like the stomach, intestines, liver, and bladder.

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    Study Notes

    Surgery Previous Year Questions 2016

    • Question 1: Concentration of mannitol used in elevated ICP is 0.2.
    • Question 2: Nerve responsible for dilation of affected pupil in uncal herniation is III.
    • Question 3: Preferred method of examination for biliary diseases is abdominal USG.
    • Question 4: Normal ICP in adults is less than 10-15 mmHg.
    • Question 5: Young female with unclear breast lumps and pain during menstruation is likely mastopathia.
    • Question 6: Patient localized to painful stimuli, GCS score of 3.
    • Question 7: Most common clinical manifestation of pancreatic head cancer is abdominal pain, jaundice, and weight loss.
    • Question 8: Complications of subtotal gastrectomy (Billroth I or II) reconstruction, except hypothyroidism.
    • Question 9: Basic construction and functional unit of the liver is hepatic lobules.
    • Question 10: First muscle group affected by tetanus is the masticatory muscles.
    • Question 11: Diagnosis for a 25-year-old man with recurrent indolent fistula in ano, weight loss, and recurrent diarrhea with blood in stools is ulcerative colitis.
    • Question 12: First-line therapy for prolactinoma is cabergoline.
    • Question 13: Commonest presentation of Meckel's diverticulum is gastrointestinal bleeding.
    • Question 14: For a 34-year-old male with acute appendicitis and localized peritonitis (5 days post-appendectomy), the first diagnostic check should be subphrenic abscess.
    • Question 15: Predisposing factors for stress ulceration, excluding isolated tibial fracture.
    • Question 16: Characteristics of gastrinoma include peptic ulcer being common.
    • Question 17: Reliable way to diagnose early gastric cancer is exfoliated cell examination.

    Other Questions from the Document

    • Question 18: Surgical intervention in portal hypertension is variceal hemorrhage.

    • Question 19: Quicker and safer method to detect ferromagnetic material near a patient is CT.

    • Question 20: Most common benign tumor of small intestine is adenoma.

    • Question 21: Patient with GSC score of 6 or less is considered severe TBI.

    • Question 22: Simple way to clarify inspection for amylase is peritoneal puncture fluid.

    • Question 23: After portal vein blockage, the first sign is congestive splenomegaly.

    • Question 24: In thoracic spinal injury with complete paralysis of limbs, the muscle strength level is 0.

    • Question 25: Most important treatment before splenic rupture surgery is blood volume supplementation.

    • Question 26: Polyps associated with highest malignant degeneration incidence are villous adenomas.

    • Question 27: Main cause of portal hypertension is cirrhosis of the liver.

    • Question 28: In thyroid adenoma, the part of neck mass often considered is in front middle part of neck that goes up and down with swallowing activities.

    • Question 29: Order of repairing stomach, jejunum, and ileum perforation is ileum, jejunum, stomach.

    • Question 30: Crohn's disease is associated with mycobacterium paratuberculosis.

    • Question 31: Most common pathological type of pancreatic head cancer is duct cell carcinoma.

    • Question 32: Diagnostic criteria for prolactinoma is a prolactin level over 200 ng/mL.

    • Question 33: Blood supply of the liver coming from portal vein is 70-75%.

    • Question 34: Space of the rectum and anal canal excluding anal canal space is ischiorectal space, pelvirectal space, retrorectal space.

    • Question 35: Commonest complication after appendectomy is incision infection.

    • Question 36: Nipple discharge (associated with small mass) in a 36-year-old female is likely intraductal papillary adenoma.

    • Question 37: Peptic ulcer disease excludes spicy foods.

    • Question 38: Main clinical manifestations of pancreatic head cancer include abdominal pain, weight loss (and anemia).

    • Question 39: Length of the rectum is 5-15 cm.

    • Question 40: Correct statement about Crohn's disease is that it is caused by mycobacterium paratuberculosis.

    • Question 41: Most common presentation of pancreatic head cancer is Obstructive jaundice

    • Question 42: Common cause for perforation during closed abdominal surgery is ileum perforation.

    • Question 43: In acute generalized peritonitis of young patients, abdominal contracture suggests surgery.

    • Question 44: True statement about colonic carcinoma is left-sided colon cancer and liver metastasis don't preclude surgery

    • Question 45: Most reliable way to diagnose early gastric cancer is exfoliated cell examination

    • Question 46: Most common incarcerated abdominal hernia is femoral hernia.

    • Question 47: Most easily damaged substantive organ from closed abdominal injury is the spleen.

    • Question 48: Hypersplenism is associated with immune response, and may occur without obvious illness.

    • Question 49: Useful methods for detecting splenic injuries include diagnostic peritoneal lavage, and MRI.

    • Question 50: In a 70-year-old male with urinary dysfunction, the next diagnostic step before assuming BPH is a urinalysis with culture.

    • Question 51: Normal ICP in adults is less than 15 mmHg.

    • Question 52: Important treatment for splenic rupture is blood volume supplementation.

    • Question 53: Most frequent type of colonic polyp associated with malignant degeneration is the villous adenoma.

    • Question 54: A 30-year-old female with intermittent, worsening headaches, especially in the morning, suggesting uncontrollable jerks, is likely to have cluster headache.

    • Question 55: Dilated pupil in uncal herniation is caused by compression of oculomotor nerve by uncus of temporal lobe.

    • Question 56: Focal nodular hyperplasia (FNH) of the liver is typically associated with birth control pills and usually requires resection.

    • Question 57: Diagnostic criteria for prolactinoma are prolactin levels greater than 200 ng/ml.

    • Question 58: The most common complication of enteral nutrition is hypoglycemia

    • Question 59: The most frequent functional pituitary tumor is growth hormone secreting tumor.

    • Question 60: Advantages of minimally invasive surgery include shorter hospitalization, less blood loss, less pain, and less scarring.

    • Question 61: All options are contraindications to a highly selective vagotomy except fundic peptic ulceration.

    • Question 62: A patient with abdominal pain, vomiting, and hyperactive bowel sounds in the RLQ is likely intussusception.

    • Question 63: First-line therapy for prolactinomas is cabergoline rather than bromocriptine.

    • Question 64: Symptoms such as weakness, sweating, tachycardia, and confusion, especially with fasting, are associated with insulinoma (rather than other options).

    • Question 65: Main treatment for acute mastitis is incision and drainage.

    • Question 66: Entamoeba histolytica primarily invades the large intestine (LI).

    • Question 67: Metabolic complications of subtotal gastrectomy (Billroth I or II) do not include hypothyroidism.

    • Question 68: Regarding gallstones, large stones are not easily incarcerated, and symptoms are often worsened after a fatty meal..

    • Question 69: The abdominopelvic cavity does not contain lungs.

    • Question 70: Heamophilus influenzae, streptococcus pneumonia and Neisseria meningitidis are the most common causes of post-splenectomy sepsis.

    • Question 71: Ducts in the liver, not wrapped in the Ghisson sheath, are the hepatic artery.

    • Question 72: Common auxiliary diagnosis and follow-up for pancreatic cancer is CA19-9.

    • Question 73: The most frequent functional pituitary tumor is prolactinomas, rather than other options given.

    • Question 74: Avoidance of hypocalcemia after radical thyroidectomy is important.

    • Question 75: Depth of epidural hematoma for surgical removal is 0.5-1.5 cm.

    • Question 76: Portal vein blockage leads to congestive splenomegaly.

    • Question 77: Preferred method for examining biliary disease is Abdominal ultrasound (US).

    • Question 78: Common benign tumor in small intestine is leiomyoma

    • Question 79: A valid diagnostic sign of acute pancreatitis is the presence of Grey-Turner's sign.

    • Question 80: Common intracranial tumor in adults is glioma.

    • Question 81: Gastrinoma is characterized by peptic ulcers.

    • Question 82: Combined glutamine use in nutritional support is beneficial for intestinal mucosa, liver protection, and cell function.

    • Question 83: Low-grade gliomas include gangliomas, oligodendrogliomas, and astrocytomas.

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    Description

    Test your knowledge with this quiz featuring previous year questions from surgery in 2016. It covers various topics including mannitol use, nerve functions in herniation, and complications of surgical procedures. Perfect for medical students preparing for exams!

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