Surgery MCQ 3


  1.  In acute osteomyelitis,
a.       Polymicrobial aetiology is common
b.      Raised CRP indicates an acute infective process
c.       Collection of pus is identifies ultrasonically
d.      MRI is contraindicated
e.      Plain radiographs remain normal for the 1st 7-10 days

  1. A 55 year old diabetic man presents to the local hospital with a painless heel ulcer of 3 months duration. He does not claudicate and all the peripheral pulses are present. The ulcer is clean and there is no cellulitis. His HbA1c is 8.5 (non-diabetic <6.7). He uses regular foot ware at all times. The factors that contribute to non healing in this man are,
a.       Wound infection
b.      Weight bearing on the ulcer
c.       Macrovascular occlusive disease
d.      Peripheral neuropathy
e.      Poor bleed sugar control

  1. Papillary CA of the thyroid,
a.       Occurs commonly in long standing nodular goiters
b.      Spread via lymphatics
c.       Is reliably diagnosed on FNAC
d.      Is effectively treated with radioiodine as an alternative to surgery
e.      Has excellent long term survival

  1. Regarding renal transplantation,
a.       Brain dead, heart beating cadavers are an important source worldwide
b.      Live donors do not need life long surveillance
c.       HLA mismatch is a contraindication
d.      Cellular rejection is mediated by neutrophils
e.      Immunosupression is required in the long term for recipients

  1. A 45 year old woman is noted to have 2cm solitary stone in the gall bladder on a routine abdominal US study. She,
a.       Most likely has a cholesterol stone
b.      Is likely to develop obstructive jaundice as a complication
c.       Has a significant risk of gall bladder CA
d.      Should undergo CT confirmation of the US diagnosis as the next step
e.      Should have a cholecystectomy in the next 3 months to prevent complications

  1. Intermittent claudication due to arterial occlusive disease,
a.       Is worse at night
b.      In diabetics, progress to gangrene in >50% of instances
c.       Improves with low dose aspirin therapy
d.      Is an independent risk factor for MI
e.      Is best treated with early bypass surgery

  1. Causes of an umbilical discharge include,
a.       Umbilical granuloma
b.      Umbilical hernia
c.       Patent vitello-intestinal duct
d.      Patent urachus
e.      Unobliterated umbilical vein

  1. Familial adenomatous polyposis,
a.       Spares small bowel
b.      Is due to a defect in the DNA repair system genes
c.       Is diagnosed when more than 100 polyps are present
d.      If suspected, screening of the family is indicated
e.      Is treated by total proctocolectomy

  1. CA of tongue,
a.       Presents as a painless ulcer
b.      Spreads to the submandibular LNs
c.       In the anterior 2/3rd carries worse prognosis than when it is in the posterior third
d.      In the posterior part presents with dysphagia
e.      Is resistant to radiotherapy

  1. A 60 yr old diabetic pt underwent anterior resection for rectal cancer. He has an IV infusion and a urinary catheter. On the 4th post-op day, he becomes tachypnoeic, tachycardic, & hypotensive. WOTF causes must be considered?
a.       Metastatic disease
b.      Pul. embolism
c.       Inadequate analgesia
d.      Anastamotic leakage
e.      UTI

  1. Duodenal ulcer,
a.       If due to H. pylori, treated with amoxicillin & metronidazole
b.      Are pre malignant
c.       Vagotomy is an essential component in the management
d.      Perforation is managed conservatively in the majority
e.      Bleeding may require surgical Mx in minority

  1. 35yr old female (wt-60kg) had 2o burns in anterior aspect of face, head and neck
a.       BSA is approximately 10%
b.      IM pethidine is contraindicated
c.       Fluid requirement in the first 8 hrs is 50% of that for 24 hrs
d.      Urinary catheter is required to monitor UOP
e.      tracheostomy is a procedure to be prepared for
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