50 FMGE Repeat Questions PDF

Section A : GENERAL  Question 1 Correct position of inserting a Nasogastric Tube is a. Supine with Neck flexed b. Supine with Neck extended c. Sitting with Neck flexed d. Sitting with Neck Extended Ans. C. Sitting with Neck flexed Nasogastric tube NEX and NEMU rules Method to insert Ry...

Section A : GENERAL  Question 1 Correct position of inserting a Nasogastric Tube is a. Supine with Neck flexed b. Supine with Neck extended c. Sitting with Neck flexed d. Sitting with Neck Extended Ans. C. Sitting with Neck flexed Nasogastric tube NEX and NEMU rules Method to insert Ryles tube Identification of Tip in Stomach  Question 2 Which of the following is not scanned by e-FAST? a. Pericardium b. Liver c. Bowel d. Spleen Ans. C. Bowel FAST Focussed Assessment with Sonography for Trauma. To assess presence of blood in peritoneum or pericardium. Focuses on four areas only: Epigastric (pericardial), splenic, hepatic, pelvic e-FAST Two more places are also examined- Left and right thoracic cavities. Helps to detect Pneumothorax and Collection in Thoracic cavity.  Question 3 Prophylactic antibiotics to minimise the SSI are given a. 60 minutes before skin incision b. 1-3 hours before skin incision c. At time of surgical incision d. Night before surgery Ans. a. 60 minutes before skin incision  Question 4 Calculate the GCS of a patient exhibiting eye opening on painful stimulus, Conscious but confused and unable to tell time and exhibits flexion on painful noxious stimuli to the arm a. 8 b. 9 c. 10 d. 11 Ans. C 10 Glassgow coma scale (EVM-456)  Question 5 Amount of Blood lost in Class III Hemorrhagic Shock a. 15-30% b. 30-40% c. 40- 45% d. 45-50% Ans. B 30-40%  Question 6 50 kg patient has 40% Burns on his body surface area. Calculate the Ringer lactate fluid to be given in 1st 8 hours. a. 1L b. 2L c. 4L d. 8L Ans. C PARKLAND FORMULA  Question 7 Which of the following needle is used to suture skin? a. Cutting needle b. Reverse cutting needle c. Round Body needle d. Straight body needle Ans. A  Question 8 Which of the following is the best parameter to monitor the response to shock management? a. Urine output b. Respiratory rate c. BP d. CVP Ans. a. urine output  Question 9 What is the investigation of choice in hemodynamically stable blunt injury abdomen patient? a. USG b. CECT abdomen c. MRI d. Diagnostic Peritoneal Lavage Ans. B  Question 10 Identify the procedure shown here for providing nutrition a. Feeding Jejunostomy b. Percutaneous endoscopic gastrostomy c. Central vein insertion d. Hickman lines Ans. B Percutaenous endoscopic gastrostomy Techniques Direct Stab Push Through Section B- Head and Neck, Thyroid and Breast  Question 11 What is the location of Kilian’s dehiscence? a. Below Superior Constrictor b. Below Inferior Constrictor c. Below Cricopharyngeal muscle d. Below upper third of Smooth musces in esophagus Ans. B Below Inferior Constrictor  Question 12 Which procedure is done for Ranula Management? a. Incision and drainage b. Aspiration c. Excision of Sublingual gland d. Marsupialization Ans. C. Excision of Sublingual gland  Question 13 Which cancer in thyroid arises from Parafollicular C cells? a. Anaplastic cancer b. Medullary cancer c. Follicular cancer d. Papillary cancer Ans. B. Medullary cancer  Question 14 FNAC can diagnose all the following lesions except a. Follicular cancer b. Papillary cancer c. Medullary cancer d. Hashimotos thyroiditis Ans. A  Question 15 Warthin’s Tumor is seen arising from a. Submandibular gland b. Parotid gland c. Sublingual gland d. Minor salivary glands Ans. B Parotid Gland Warthin Tumor  Question 16 Most common nerve injured in Thyroid Surgery a. RLN b. ELN c. ILN d. Vagus nerve Ans. B. ELN Course of Recurrent Laryngeal Nerve ❑The nerve runs posteriorly and enters at the level of cricothyroid joint where the BERRY Ligament is attached. ❑Please remember Berry Ligament is the posterior attachment of Pretracheal fascia that binds Trachea and Thyroid ( One important reason for Gland moving with deglutition. ❑This is the point where nerve is at highest risk of injury** ❑This point is known as BEAHR’S Triangle Beahr’s triangle Boundaries : Tracheo Oesophageal Groove Common Carotid artery Inferior Thyroid Artery  Question 17 Stage the Breast cancer – Size 3cm and 4 axillary nodes in Axilla a. Stage I b. Stage II c. Stage III d. Stage IV Ans. B Stage II Question 18 Which is correct regarding paeu de orange in breast cancer? a. Infiltration of Cooper’s ligament b. Infiltration of subdermal lymphatics c. Associated with Lobular cancer d. Good prognosis Ans. B. Infiltration of Subdermal lymphatics  Question 19 For Sentinel Node Biopsy in Breast cancer , where is the Dye injected ideally. a. Subareolar b. Axilla c. Tail of Spence d. Peritumoral Ans. D Peritumoral  Question 20 What is the diagnosis of this mammography picture shown here : a. Fibroadenoma b. Fibroadenosis c. Cancer breast d. Paget disease Ans. A. Fibroadenoma Section C GIT  Question 21 Which of the following is not done in Cancer esophagus evaluation? a. Biopsy b. pH metry c. CT Chest d. PET Scan Ans. B pH Metry Identify this investigation SURGERY SIXER BY RRM Rat tail appearance in ca esophagus SURGERY SIXER BY RRM  Question 22 Gastric outlet obstruction leads to a. Hypochloremic metabolic alkalosis b. Hypochloremic metabolic acidosis c. Hypernatremic metabolic alkalosis d. Hyponatremic metabolic acidosis Ans. A. Hypochloremic Metabolic Alkalosis  Question 23 Congenital Hypertrophic Pyloric stenosis presents at a. 3 days b. 4 weeks c. 3 months d. 4 years Ans. B. 4 weeks CHPS Ramstaed’s Pyloromyotomy  Question 24 Achalasia Cardia presents with all except a. Increased LES tone b. Normal Peristalsis c. Proximal Dilatation d. Malignant risk Ans. B Normal Peristalsis Identify this investigation? SURGERY SIXER BY RRM SURGERY SIXER BY RRM  Question 25 Boerhaave syndrome is a. Spontaneous rupture of esophagus b. Traumatic rupture of esophagus c. Tear at GE junction d. Foreign Body esophagus Ans. a. Spontaneous Rupture of esophagus SURGERY SIXER BY RRM  Question 26 What is the diagnosis of this Barium enema? a. Diverticulum b. Intussusception c. Volvulus d. Fistula Ans. B Intussusception  Question 27 A 26 year old male patient presented with RIF pain and Fever. USG image is shown below: a. Acute diverticulitis b. Crohns disease c. Acute appendicitis d. Perforation Ans. C. Acute Appendicitis  Question 28 Which is false about Crohn’s Disease? a. No occurrence after surgery b. Apthous ulcers c. Skip lesions d. Fistula formation Ans. A No occurrence after surgery Fistula Cobble stoning Serpiginous ulcers Terminal Ileitis Strictures  Question 29 Best treatment for Anal Cancer Squamous cell cancer a. Chemoradiation b. Radiation only c. Surgery d. Chemo only Ans. A Chemoradiation  Question 30 Which is true about Carcinoid Tumor? a. Always Benign b. Kulchisky cells origin c. Present with Paroxysmal hypertension d. Punch biopsy is done Ans. B. Kulchisky cell origin  Question 31 Which of the following polyp is least likely to turn malignant? a. Inflammatory polyp b. Hamartomatous polyp c. Hyperplastic polyp d. FAP polyps Ans.C Hyperplastic polyps  Question 32 Most common location of Lymphoma in GIT? a. Ileum b. Stomach c. Colon d. Rectum Ans. B Stomach  Question 33 All are true about Femoral hernia except: a. Common in Nulliparous women b. Lockwood infrainguinal approach is done c. Cough impulse is seen d. High incidence of strangulation Ans. A. Common in Nulliparous women Obstructed Femoral hernia  Question 34 The content of Littre’s hernia is a. Omentum b. Bladder c. Meckel’s diverticulum d. Appendix Ans. C. Meckel’s Diverticulum  Question 35 In Nyhus Classification Type 3A stands for which hernia? a. Femoral b. Direct c. Pantaloon d. Indirect Ans. B Direct hernia Section D HBP and Spleen  Question 36 MC immediate complication of splenectomy: a. Fistula b. Bleeding from Gastric mucosa c. Pancreatitis d. Hemorrhage Ans. D. Hemorrhage  Question 37 A 6 year old girl brought with high fever with rigors for 5 days with pain in right hypochondrium. On examination patient is anicteric and tenderness is noted in right upper quadrant. What is the best investigation in this case? a. USG b. Serology c. SGOT/LFT d. Contrast CT scan Ans. D. Contrast CT scan CT scan- Irregular margins CT scan- Rim enhancement smooth edges: Amoebic liver abscess  Question 38 What is the name of the investigation shown here? a. MRCP b. ERCP c. PTC d. T tube cholangiogram Ans. B ERCP  Question 39 A patient with RUQ pain – USG done shows this image: Diagnosis is a. GB malignancy b. GB stones c. GB polyps d. Porcelain GB Ans. B GB Stones  Question 40 Pringle’s manuever is used to control bleeding from a. IVC b. Cystic artery c. Hepatic artery d. Hepatic vein Ans. C  Question 41 Severity of Acute pancreatitis is assessed by a. Serum Amylase b. Stool Trypsin c. RANSON score d. ARDS development Ans. C RANSON Score  Ranson’s Score On Admission At 48 Hours L- LDH > 350 Units/L B- Base deficit > 4 mmol/L A- AST>250 Units/L U-Urea Nitrogen > 5mg/dl G- Glucose>1.1mmol/L ( >200 mg/dl) C- Calcium < 2 mmol/L A- Age > 55 years H- Hematocrit fall > 10% W- WBC count > 16X10^9/L O- PaO2 < 60 mmHg ( 8 Kpa) W- Water Fluid Sequestration >6 L  Question 42 In case of Annular Pancreas, what is the surgery of Choice a. Duodeno-duodenostomy b. Duodeno-Jejunostomy c. Pancreatico jejunostomy d. Porto enterostomy Ans. A. Duodeno Duodenostomy Section E Specialty topics  Question 43 Which of these is the best for management of a 3cm stone in renal pelvis without evidence of hydronephrosis? a. ESWL b. PCNL c. Antegrade pyeloplasty d. Retrograde pyeloplasty Ans. PCNL Surgery Sixer UNDER THE KNIFE 94 PCNL Surgery Sixer UNDER THE KNIFE 95  Question 44 A 40 year old man after TURP for BPH develops seizures in post operative state. What is the diagnosis? a. Water intoxication b. Anaesthetic Over dosage c. Mismatched Blood Transfusion d. Malignant Hyperthermia Ans. a. water intoxication Surgery Sixer UNDER THE KNIFE 97 Surgery Sixer UNDER THE KNIFE 99 Surgery Sixer UNDER THE KNIFE 100 Post op irrigation Remember that normal saline is used after the operation it is used for post operative irrigation ( but not for resection) Surgery Sixer UNDER THE KNIFE 102  Question 45 Bell Clapper testis predisposes to a. Torsion b. Varicocele c. Cancer d. Hydrocele Ans. A torsion Torsion testis Predisposing factors: - Undescended testis - Testicular Inversion - Bell Clapper deformity ( MC anomaly) in which the tunica vaginalis is highly invested Surgery Sixer 104 Bell clapper  ▫ In the 1st hour the torsion can be treated by manipulation (but later on surgery has to be done to fix the testis ) ▫ If not correctable by manipulation or more than one hour has passed then surgery has to be done. ▫ Surgery must be done within 4 hours. Otherwise the testis will be dead Surgery Sixer UNDER THE KNIFE 106  Question 46 Chordee is associated with a. Hypospadias b. Phimosis c. Paraphimosis d. Posterior urethral valve Ans. a. Hypospadias Hypospadias Surgery Sixer UNDER THE KNIFE 108 Clinical features ❑MC anomaly of Lower Urinary System ❑1 in 250 ❑No treatment needed for Glandular type ( MC type) ❑Cryptorchidism may be associated- 8% ❑Indirect hernia may be associated ❑Best time to operate 6 months- 12 months ❑Circumcision is Contraindicated.  Question 47 Most common complication of stripping varicose veins below knee is a. Hemorrhage b. Neuralgia c. Thromboembolism d. Infection Ans. B Neuralgia GSV stripping  Question 48 All are true about Buerger’s disease except a. Ulnar and peroneal vessels involved b. Nerve involvement can occur c. Superficial thrombophlebitis seen d. Small acral vessels of limb involvement causes Hypohidrosis Ans. D  Question 49 What is xenograft? a. Transplant from one relative to other b. Transplant between identical twins c. Transplant of tissues self d. Transplant from one other species to human Ans. D  Question 50 Craniopharyngioma is a brain tumor arising from a. Posterior Pituitary b. Median eminence c. Neurohypophysis d. Rathke pouch Ans. D