FMGE recall: Surgery

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Questions and Answers

Which instrument is used in a laparoscopic procedure?

  • Hegar's dilator
  • Karman's canula
  • Veress needle (correct)
  • Hassan's canula

A 27-year-old male presents with right iliac fossa pain and melena. Examination reveals tenderness, nausea, and vomiting. Post-surgical findings are shown on the image. What is the most likely diagnosis?

  • Carcinoid appendix
  • Meckel's diverticulum (correct)
  • Mucocele appendix
  • Appendiceal serous tumor

A child is brought to the ER with half the chest, half the abdomen, half of one upper arm, and one leg (front and back) involved in a burn. What is the estimated total body surface area (TBSA) percentage burned?

  • 40-50% (correct)
  • 20-30%
  • 10-15%
  • 50-60%

During laparoscopic surgery, insertion of a trocar increases the risk of injury to which structure?

<p>Superior and Inferior epigastric artery (D)</p> Signup and view all the answers

A 45-year-old male with diffuse peritonitis undergoes laparotomy, and the abdomen is left open. Which strategy best promotes wound healing and prevents complications?

<p>Vacuum-Assisted Closure (VAC) therapy (B)</p> Signup and view all the answers

Which characteristic listed is NOT typically considered when determining cancer prognosis?

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

A 1.5-month-old baby presents with vomiting after feeding and failure to thrive. A firm, olive-shaped mass is palpated in the upper abdomen. What is the likely diagnosis?

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

Based on the image, what level of lymph node in the neck is marked?

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

Which type of catheter is specifically designed for irrigation of blood clots following a Transurethral Resection of the Prostate (TURP) procedure?

<p>21 French 3 lumen catheter (D)</p> Signup and view all the answers

A patient presents with diffuse abdominal pain, tenderness throughout the abdomen and "cardboard-like" rigidity. Imaging is shown. What is the most likely diagnosis?

<p>Perforation peritonitis (B)</p> Signup and view all the answers

A 30-year-old male cannot pass urine, reports severe urgency, presents with blood at the urethral meatus, and perineal swelling after blunt pelvic trauma. Where is the most likely site of injury?

<p>Membranous urethra (B)</p> Signup and view all the answers

A patient has right scrotal swelling and a right hydrocele. Pre-aortic lymph nodes are enlarged, suggesting metastasis. Which investigation is most appropriate?

<p>Biopsy of lymph nodes (A)</p> Signup and view all the answers

A patient presents with dilated neck veins and a palpable cord-like structure in the neck, indicated in the image. What structure is marked?

<p>External jugular vein (A)</p> Signup and view all the answers

Following surgery for grade 4 hemorrhoids, the image shows the instrument used. What instrument is shown in the image?

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

In the image of an ulcer, which structure is incorrectly labeled?

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

A 30-year-old female has a painless, rapidly growing, well-defined, mobile, firm lump in her left breast. Ultrasound reveals a solid mass, and biopsy shows a leaf-like pattern with stromal overgrowth. What is the most likely diagnosis?

<p>Phyllodes tumor (B)</p> Signup and view all the answers

A woman 2 weeks postpartum has fever and difficulty breastfeeding. Examination reveals a tender, warm, erythematous lump under the areola. What is the likely diagnosis?

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

A 35-year-old woman presents with a 3cm subareolar mass in her left breast and reports bloody nipple discharge, without pain, redness, or systemic symptoms. The mass is firm and non-tender. What is the most likely diagnosis?

<p>Intraductal papilloma (B)</p> Signup and view all the answers

A patient diagnosed with varicose veins is classified as C4a according to the CEAP classification. What is the most appropriate treatment?

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

A 32-year-old female with immune thrombocytopenic purpura (ITP) is scheduled for splenectomy, with the surgeon intending to remove all splenic tissue. What location needs to be searched for an accessory spleen?

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

What is the most specific clinical use of Prostate-Specific Antigen (PSA) in the management of prostate cancer?

<p>Monitoring the response to treatment (C)</p> Signup and view all the answers

A 30-year-old male presents with swelling and discomfort over the dorsal aspect of the middle phalanx of the middle finger, and history of penetrative trauma. Examination reveals a gelatinous, firm, tender mass with limited mobility at the DIP joint. What is the likely complication?

<p>Involvement of synovial joint (C)</p> Signup and view all the answers

A patient has a soft, non-tender fluctuant swelling on the upper back with a black punctum and foul-smelling, cheesy discharge. What is the most appropriate management?

<p>Surgical excision of the cyst (D)</p> Signup and view all the answers

A female patient develops massive abdominal swelling post-hysterectomy. What is the most likely cause?

<p>Small Bowel ischemia (A)</p> Signup and view all the answers

Which measurement is the most accurate for assessing fetal anemia?

<p>Peak systolic velocity in the fetal Middle cerebral artery (B)</p> Signup and view all the answers

A patient presents with dysphagia that is more pronounced for liquids than solids. Which radiological sign is most likely?

<p>Irregular filling defect (C)</p> Signup and view all the answers

A patient with a history of left upper quadrant breast cancer underwent Cobalt-60 radiotherapy and now presents with respiratory distress. The chest X-ray shows haziness in the left lung. What is the most likely diagnosis?

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

A non-smoker with a history of cardiac disease suddenly develops chest pain and breathlessness. What is the most likely diagnosis based on the provided X-ray?

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

A 70-year-old patient with absolute constipation and abdominal distension has an erect abdominal X-ray. What is the most likely diagnosis according to the image?

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

A child with a history of intubation presents with new-onset shortness of breath 6 weeks later. Which condition does the radiological image suggest?

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

What investigation modality is shown in the image?

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

Following a hammer injury to the head, which type of skull fracture is most likely based on X-ray findings?

<p>Depressed fracture (B)</p> Signup and view all the answers

A boxer receives a blow near the eye and presents to the ER with a hematoma. What radiological sign is shown in the provided CT scan?

<p>Tear-drop sign (A)</p> Signup and view all the answers

What is the primary use of the imaging modality depicted in the image?

<p>Evaluation of hiatal hernia (D)</p> Signup and view all the answers

A 45-year-old female underwent total thyroidectomy and started Iodine-131 therapy for thyroid disorder. What adverse effect is most likely associated with this Iodine-131 treatment?

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

Which condition is associated with the radiographic sign shown in the CT image, known as the "Hollman Miller sign?"

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

A 20-year-old male has localized bone pain that has worsened over time. Imaging reveals a "sunburst" appearance. What is the most likely diagnosis?

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

What instrument is shown in the image?

<p>Bohler braun splint (C)</p> Signup and view all the answers

A 23-year-old male with epilepsy has shoulder pain. Examination shows right upper limb abduction and external rotation. What is the most likely diagnosis?

<p>Anterior shoulder dislocation (C)</p> Signup and view all the answers

A 25-year-old man develops difficulty breathing, increased heart rate, tachypnea and visible cyanosis 48 hours after suffering a tibia fracture in a car accident. What is the most likely diagnosis?

<p>Fat embolism (B)</p> Signup and view all the answers

A 40-year-old male presents with chronic back pain, fever, night sweats, unintentional weight loss, and localized tenderness over the lower thoracic and lumbar spine. What is the most likely diagnosis based on the image?

<p>Pott's spine (A)</p> Signup and view all the answers

A 20-year-old male presents with a swelling on the dorsal aspect of the wrist, fluctuation in size, mild numbness, and occasional pain. Identify the marked swelling:

<p>Ganglion cyst (B)</p> Signup and view all the answers

A carpenter presents with knee pain; the MRI is shown below. What is the likely diagnosis?

<p>Anserine bursitis (B)</p> Signup and view all the answers

Flashcards

Veress needle

Instrument used in laparoscopic procedures.

Meckel's diverticulum

Often presents with pain in right iliac fossa, nausea, and melena and can resemble a tumor.

Area burn %

Half chest, half abdomen, half of upper arm and one leg front and back involved

Epigastric artery

Artery most prone to injury during laparoscopic trocar insertion.

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Vacuum-Assisted Closure (VAC) therapy

Management strategy for an open abdomen with severe peritonitis.

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Tumor duration

Element not related to cancer prognosis.

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Pyloric stenosis

Likely diagnosis with firm olive mass in upper abdomen and vomiting after feeding

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21 French 3 lumen catheter

Instrument used for irrigation of blood clots after TURP.

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Perforation peritonitis

Likely diagnosis with tenderness and cardboard-like rigidity in abdomen.

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Bulbar urethra

Likely site of injury in blood at urethral meatus and perineal swelling.

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Biopsy of lymph nodes

Investigation for pre-aortic lymph node enlargement with scrotal swelling.

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External jugular vein

Structure presenting with dilated neck veins and a palpable cord-like structure

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The Margin

Wrongly marked structure from the image of an ulcer.

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Phyllodes tumor

Likely diagnosis with painless, rapidly growing breast lump and leaf-like pattern

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Lactational mastitis

Likely diagnosis with fever, breastfeeding difficulty, and lump under areola

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Intraductal papilloma

Likely diagnosis with bloody nipple discharge but no pain.

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Compression

Treatment for C4a varicose veins

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Splenic hilum

Common location to search for accessory spleen during splenectomy

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Following response to treatment

The clinical use of PSA in management of prostate cancer

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Gangrene of finger tip

Complication with persistent swelling over middle finger after trauma

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Incision and drainage only

Management for fluctuant swelling on back with black punctum

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Colonic hemorrhage

Abdominal swelling post hysterectomy likely cause

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Peak systolic velocity in the fetal Middle cerebral artery

Best way to measure fetal anemia.

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Smooth filling defect

Radiological sign likely with dysphagia more pronounced for liquids.

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Radiation Pneumonitis

Likely diagnosis with respiratory distress and haziness in left lung after radiotherapy

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Pulmonary edema

Likely diagnosis with cardiac disease, chest pain, and breathlessness on X-ray

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Sigmoid volvulus

Likely diagnosis with absolute constipation and distension on X-ray

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Recovery and rehabilitation

Last link in ACLS chain of survival.

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Study Notes

  • Arise Medical Academy provides FMGE (Foreign Medical Graduate Examination) coaching and recall materials for the JAN 2025 examination.
  • Contact Arise Medical Academy at 7680929292 or visit their website at www.arisemedicalacademy.com.

Laparoscopic Procedures

  • A Veress needle is used in laparoscopic procedures.

Abdominal Pain and Diagnosis

  • For a 27-year-old male with right iliac fossa pain and melena, exhibiting tenderness, nausea, and vomiting, Meckel's diverticulum is a possible diagnosis.

Burn Area Calculation

  • For a child with burns on half the chest, half the abdomen, half of one upper arm and one leg (front and back), the estimated burn area is 40-50%.

Laparoscopic Surgery Injuries

  • When inserting a trocar during laparoscopic surgery, the superior and inferior epigastric arteries are most prone to injury.

Peritonitis Management

  • Vacuum-Assisted Closure (VAC) therapy is a beneficial management strategy for a 45-year-old male with diffuse, severely contaminated peritonitis undergoing laparotomy in order to promoting wound healing and preventing complications

Cancer Prognosis

  • Site is not directly related to cancer prognosis. Duration, depth, and stage are factors related to cancer prognosis.

Infant Vomiting Diagnosis

  • For a 1.5-month-old baby with vomiting after feeding and failure to thrive, presenting a palpable olive mass in the upper abdomen, Pyloric stenosis is the likely diagnosis.

Lymph Node Levels

  • Level II lymph node is identifed.

TURP Catheter

  • A 21 French 3 lumen catheter is used for irrigation of blood clots after TURP (Transurethral Resection of the Prostate).

Abdominal Rigidity

  • Perforation peritonitis is the likely diagnosis, in a patient presenting with diffuse abdominal pain and cardboard like abdominal rigidity

Urethral Trauma

  • Following blunt trauma to the pelvis, blood at the urethral meatus, and perineal swelling, membranous urethra is the most likely injury site in a 30-year-old male.

Scrotal Mass Investigations

  • In a patient who is presenting with an enlargement of the pre-aortic lymph nodes with suspected metastasis, biopsy of lymph nodes is more appropriate to identify the underlying cause.

Neck Anatomy

  • Structures of the neck presenting with dilated neck veins and a palpable cord-like structure indicate an external jugular vein.

Hemorrhoid Instruments

  • Stapler kit is the instrument used in grade 4 hemorrhoid surgery.

Ulcer Identification

  • In an image of an ulcer, "edge" is the wrongly marked structure

Breast Lump Diagnosis

  • A 30-year-old female has a painless, rapidly growing, well-defined, mobile, firm left breast lump, histopathology shows a leaf-like pattern with stromal overgrowth; this suggests Phyllodes tumor.

Postpartum Breast Issues

  • 2 weeks postpartum, a woman presents with fever, difficulty breastfeeding, and diffuse lump under areola with redness, tenderness, warmth = Lactational mastitis

Nipple Discharge Diagnosis

  • A 35-year-old woman has a 3cm subareolar mass, bloody nipple discharge, firm non-tender mass = Intraductal papilloma

Varicose Veins Treatment

  • A patient is diagnosed with varicose veins, classified as C4a according to the CEAP classification = Compression

Splenectomy Considerations

  • A 32-year-old female is scheduled for splenectomy due to ITP (immune thrombocytopenic purpura) = the splenic hilum is the most common location for accessory spleens

Prostate Cancer Management

  • Monitoring the response to treatment is the most specific clinical use of PSA (Prostate-Specific Antigen) in the management of prostate cancer

Finger Injury Complication

  • A 30-year-old male with a penetrative trauma to the middle finger presents with persistent swelling and discomfort = Involvement of synovial joint

Soft Tissue Swelling

  • A patient has a soft, non-tender, fluctuant swelling on the upper back, it has a black punctum, along with cheesy material draining from the lesion. Surgical excision of the cyst is the appropriate intervention.

Post Hysterectomy Complications

  • A female patient develops massive abdominal swelling post hysterectomy = Small bowel ischemia

Measuring Fetal Anemia

  • Peak systolic velocity is the best method to measure fetal anemia.

Dysphagia Signs

  • Dysphagia for liquids more than solids suggests Corkscrew esophagus on radiology.

Cancer Radiotherapy

  • Patient experiences Cobalt-60 radiotherapy and now presents with respiratory distress/difficulty and haziness = Radiation Pneumonitis

Cardiac Disease diagnosis

  • Non-smoker with cardiac disease develops sudden chest pain and breathlessness, perform X-ray = Pulmonary edema

Absolute Constipation Diagnosis

  • 70-year-old person, constipation and abdominal distension = Sigmoid volvulus

History Of Intubation Diagnosis

  • Child has a history of intubation and breathlessness = Laryngotracheobronchitis

Investigation Modality

  • Intravenous pyelography is an investigation modality.

Hammer Fracture

  • Hammer falling on your head show X-ray Fracture = Depressed fracture

Radiological Signs

  • Young boxer blow near eye ct scan = Tear-drop sign

Medical Conditions

  • Staging of esophageal cancer as a primary use of imaging modality

Thyroid treatment side effects

  • Hypothyroidism is a total side effect that a patient with a history of thyroid disorder can have after undergoing a total thyroidectomy

Medical association

  • JNA is Hollman miler sign shown in the ct image shown

Bone Pain Diagnosis

  • Osteosarcoma id most likely diagnosis by the lesion with a sunburst appearance

Medical Instrument

  • Instrument identification from the given options = Bohler braun splint

Medical Symptoms

  • Anterior shoulder dislocation id the right diagnosis for a patient with a right shoulder region for pain examination

Aftermath of A Car Accident

  • Fat embolism is the likely diagnosis in car accident that causes several issue as a result

Spinal Diagnosis

  • Pott’s spine is the most right diagnosis to the spinal concern issue shown

Health Conditions

  • identifying swelling on the dorsal aspect of wrist when in given health conditon = Ganglion cyst

Knee Condition

  • identifying knee condition = Housemaids knee

Cirrhosis

  • Incorrect statement regarding the SAAG (Serum-Ascitic Albumin Gradient) score of a 60-year-old male with cirrhosis ascites= SAAG score > 2.5 is often associated with ascites caused by cirrhosis and heart failure and there is high protein

Heart Murmurs

  • Graham steel murmur is seem in Pulmonary regurgitation

Heart Disease

  • 60 year old Rheumatic Heart Disease shows in Aortic Regurgitation

Heart Diseases

  • Young male with Irregular interval, absent p-wave = Cardioversion

Anemia

  • FEV1/FVC is COPD

Neurological Complications

bilaterally symmetrical lower limb flaccidity over a week = Acute inflammatory demyelinating polyneuropathy Proteins higher than 80% is Ceftriaxone + vancomycin

Child Syndromes

  • Child suffering from nephrotic syndrome = steroids

Thyroid Inflammation

  • Female undergoes thyroidectomy then develops perioral tingling = Hypocalcemia

Examination Of The Speech and The Pain That a patient Feels.

  • What is the correct GCS calculation if RTA patient brought pain and he was confused during speaking = 12

Iron Metabolism

  • Given from the symptoms of fatigue, paleness ,and dizziness = Reduced serum iron

Anemia Diagnosis

  • Plasmodium among males family. Before initiating treatment = G6PD levels

Medical Disorders

  • Patient reports having uncontrolled hand movements when trying to tap the fingers = Dysdiadochokinesis

Gallstones

  • Shortness is cause by is Sickle cell anemia

Clinical Management

  • Acetaminophen and caffeine for less than a maximum of 24 hours

Most Likely Diagnosis

  • Tension pneumothorax

Diagnoses

  • Dents syndrome for hypertension.

Markers

  • Serum amylase is diagnosing a pancreatitis.

Health Examination

  • The LMN is best describes based on facial weakness

Diagnoses Of Medical Conditions

  • Patient has petechiae will be Dengue shock syndrome

Correct Diagnoses

  • the kidneys shows in prerenal AKI

Glioblastoma

  • Meningioma

Likely Diagnoses

  • Papillary carcinoma

Tcc Staining

  • 10-24hours

Soft Well-Circumnised

  • Mucinous carcinoma

Pallisading Formation

  • Basal cell carcinoma

Conditions Of Bleb Formation

  • Bleb Formation

Liver Marker

  • Hepatoma

Common Metastasis

  • Lymphatic

Diseasess With Transference

  • Mother and grandmonther

Gene Mutation

  • BCL2

Platelet

  • Gp 1b/1x

Health Care For Individuals

  • Prader willi syndrome

Aid The Cell

  • Type 1 pneumocytes

Health Care Surgery

  • Sodium dantrolene

Tablets On A Daily Basis

  • Stop aspirin

Medical symptoms

  • Patients develops lung collapse Right endobronchial intubation

Health care

  • Recovery and rehabilitation

Medicolegally

  • Before DD, oath is not to be taken

Health and Safety

  • 174CrPC /194 BNss death Under Dowry

Skull Investigation

  • Neurose

Medical Assistance

  • Force

Records Of Evidence In Court

  • Should attend civil court

Health Conditions

  • The person is doing Cross exam

Clinical HealthCare

  • In a given hour

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