UHS MS (CIP) IMM past MCQs
Chapter # 1
1- Normal flora micro-organisms — 10*14
2- DRAF association with skin cancer — 80%
3- Deep burn of left arm and neck — 3-4 crystalloid in 24 hours
4- LMWH after knee replacement surgery — 2-3 weeks
5- Half circle needle used in — G.I surgery
6- Standard surgeon’s knot is — Reef knot
7- Sign on written consent — is not proof of valid consent
8- Definition of coagulation from Bailey
9- Aminoglycosides are not orally prepaired because of — poor
absorption from Gut.
10- Granuloma is an accumulation of — macrophages
11- 15-30% loss of blood — class II shock.
12- Fall from height, spinal injury at T10 — Spinal shock
13- Run over injury , mayocardial changes on ECG — Diaphragm
rupture
14- Transplant rejection within six months — acute rejection
15- 8HB , coagulopathy and per-op , which product indication — FFP
16- Trigon is the area of — bladder
17- Re-feeding syndrome — Hypophosphatemia & Hypocalcemia
18- Not contraindication of laparoscopy — jaundice
19-For tumors of tale of pancreas is not a contraindication of resection
— infiltration of splenic artery or vein
20- Cosmetic outcome in Whipple procedure is by — Rooftop
21- After which disease transplantation has highest risk of rejection —
IgA nephropathy.
22- Seat belt prevent serious injury by — 50%
1
Chapter # 2
1- Responders have an improvement in their cardiovascular status that
is sustained.
2- Transient responders have an improvement but this then reverts to
the previous state over the next 10-20 minutes.
3- Non-responders are severely volume depleted and are likely to have
major ongoing loss of intravascular volume, usually through persistent
uncontrolled hemorrhage.
4- Hemorrhage leads to a state of hypovolemic shock. The combination
of tissue trauma and hypovolemic shock leads to the development of an
endogenous coagulopathy called acute traumatic coagulopathy ( ATC ).
5- Primary hemorrhage is hemorrhage occurring immediately due to an
injury( or surgery). Reactionary hemorrhage is delayed hemorrhage
within 24 hours and is usually due to dislodgment of a clot by
resuscitation, normalization of blood pressure and vasodilation.
6- Reactionary hemorrhage may also be due to technical failure such as
slippage of a ligature.
7- Secondary hemorrhage is due to sloughing of the wall of a vessel. It
usually occurs 7-14 days after injury and is precipitated by factors such
as infection, pressure necrosis (such as from a drain ) or malignancy.
8- The balance transfusion approach cannot, however, correct
coagulopathy. Therefore coagulation should be monitored routinely,
either with the point of care testing (thromboelastometry ) or with
laboratory tests ( fibrinogen ,clotting times ).
9- FFP is first line of therapy in treatment of coagulopathic hemorrhage.
2
Chapter # 3
1- Pressure sore frequency in descending order is —
Ischium, greater trochanter ,sacrum, heel, malleolus ( lateral then
medial )and occiput.
2- Applying intermittent negative pressure of approximately 125mmHg
appears to hasten debridement and the formation of granulation tissue in
chronic wounds and ulcers.
3- Greyish drainage — dishwater pus
4- Hypertrophic scar is defined as excessive scar tissue that does not
extend beyond the boundary of the original incision or wound.
5- A keloid scar is defined as excessive scar tissue that extends beyond
the boundaries of the original incision or wound.
Chapter # 5
1- Koch’s postulates proving whether a given organism is the cause of a
given disease
(i) it must be found in every case
(ii) it should be possible to isolate it from the host and grow in culture
(iii) it should reproduce the disease when injected into another healthy
host.
3
(iv) it should be recovered from an experimentally infected host.
2- The human body harbors approximately 10*14 organisms.
3- Micro organisms are normally prevented from causing infection in
tissues by intact epithelial surfaces, most notably the skin.
4- There is up to 4-hours interval before bacterial growth becomes
established enough to cause an infection after a breach in the tissues,
wether caused by trauma or surgery.
5- Granulation tissue ( macrophages ,fibroblasts and new blood vessels
proliferation) forms later around suppurative process and leads to
collagen deposition.
6- Gas gangrene wounds infections are associated with sever local
wound pain and crepitus (gas in the tissues which may also be visible on
plain radiographs ).
7- Aminoglycosides are not available in red preparation due to poor GI
deposition.
8- These glycopeptide antibiotics( vancomycin & teicoplanin ) are most
active against gram- positive aerobic and anaerobic and proved to be
affective against MRSA, so are often used as prophylactic antibiotics
when there is a high risk of MRSA.
4
Chapter # 6
1- In the small intestine, the parasite hatches into trophozoites, which
invade the submucosa to produce flash-shaped ulcers
2- An ‘apple-core’ deformity on barium enema would arouse suspicion of
a carcinoma.
Chapter # 7
1- The 22-blade is often used for abdominal incisions, the 11-blade for
arteriotomy and the 15-blade for minor surgical procedures.
2- Half circle needles are commonly utilized in the gastrointestinal tract.
4- The standard surgical knot is the reef knot.
5- In coagulation, a heating effect leads to cell death by dehydration and
protein denaturation.
6- New technology such as the Ligasure system (Medtronic ) involves
advanced bipolar technology that uses the body’s own collagen and
elastin to both seal and divide, allowing surgeons to reduce instrument
handling when dissecting, ligating and grasping.
7- the harmonic scalpel is an instrument that uses ultrasound technology
to cut tissues while simultaneously sealing them. During use the scalpel
vibrates in the 20000-50000 Hz range and cuts through tissues.
5
Chapter # 8
1- The advantages for the surgeon include better visualization higher
magnification with the stereo scopic views……. ( Robotic surgery )
Chapter #9
1- A tension pneumothorax should be suspected clinically before the
chest x-ray ( CXR ) is requested an immediate needle thoracocentesis
(second intercostal space midclavicular line) performed. A chest drain is
then placed (fifth intercostal space, mid axillary line).
2- orchidopexy before 1 year of age improve fertility and may reduce the
risk of malignancy.
Chapter #10
1- cancer cells are psychopaths.
2- fungal and plant toxins (aflatoxins) have associated tumors hepatoma.
6
Chapter #11
1- randomized controlled ; includes a control group with standard
treatment.
Chapter #13
1- inadequate communication between healthcare staff, or between
medical staff and their patients or family members, ranks highest in
frequency.
2- the accident pyramid proposes that for every 300 near misses there
are 29 Miner injuries and one minor injury.
3- Several studies have shown that the majority of surgical errors ( 5370%) occur outside the operating room, before or after surgery, and that
a more substantial improvement in safety can be achieved by targeting
the entire surgical pathway.
Chapter # 14
1- For instance, fat, methemoglobin and mucinous fluid are bright on T1
weighted images, whereas water and thus most pathological processes,
7
which tend to increase tissue water content, are bright on T2 weighted
images. Cortical bone, air, Hemosiderin and ferromagnetic materials are
a very low signal on all puls sequences. In general, T1 weighted images
are superior in definition of anatomy, while T2 weighted images tend to
highlight pathology better.
Chapter # 16
1- The main histological features of malignancy are metastasis, invasion,
architectural changes and cytological features, but the criteria for a
diagnosis of malignancy differ between anatomical sites and between
tumor types.
Chapter # 18
1- KEY FEATURES OF COMMONLY USED INTRAVENOUS ANESTHETIC
AGENTS;
Propofol (di-isopropyl phenol) smooth induction, better hemodynamic
stability, blunting of autonomic reflexes and ability to use as a
continuous infusion.
Theopentone (barbiturate) rapid induction, myocardial depression.
Reduced metabolic rate and lowering of intracranial pressure is useful in
neurosurgical patients but drop in blood pressure can give detrimental
effects.
Etomidate ( steroid derivative ) good hemodynamic stability, brief
duration of action, but concern over adrenocortical depression.
Ketamine (phencyclidine derivative) preservation of blood pressure
and respiratory reflexes together with excellent analgesia makes it an
ideal choice for field anesthesia. Emergence delirium is associated with
administration of ketamine.
8
2- THE COMMON LOCAL ANESTHETIC DRUGS;
NAME
MAXIMUM DOSE
COMMENTS
Lignocaine
3mg/kg (7mg/kg with
adrenaline)
Early onset, short acting, good
sensory Block
Bupivacaine
2mg/kg
Long-lasting, more cardiotoxic,
must never be used intravenously
Prilocaine
6mg/kg (9mg/kg with
adrenaline)
Least systemic toxicity, causes
methemoglobinaemia
Ropivacaine
3-4mg/kg
Less cardiotoxic, greater sensorymotor separation
Levobupivacaine
2mg/kg
Isomer of bupivacaine with fewer
cardiotoxic properties
3- Injection of local anesthetic into the facial plane between the internal oblique
and transversus abdominis muscle allows a block of all these nerves, and
excellent anesthesia of the anterior abdominal wall.
4- Spinal cord stimulation by dorsal column stimulation is now recognized and
effective management of intractable neuropathic pain.
9
Chapter # 19
1- average daily water balance of a healthy adult in a temperate climate (70kg);
OUTPUT
VOLUME (ML)
INTAKE
VOLUME (ML)
Urine
1500
Water from beverage
200
Insensible losses
900
Water from food
1000
Faeces
100
Water from oxidation
300
2- fluid losses occur by 4 roots; lungs, skin, faeces and urine.
3- Refeeding syndrome results in hypo phosphataemia, hypocalcaemia
and hypomagnesaemia.
Chapter # 20
1- Risk factors for PONV (post operative nausea & vomiting) include
female gender, non-smoking, and a history of the PONV, motion
sickness or migraine. Use of volatile anesthetic agents, Opioids and
nitrous oxide add to the risk. Duration and type of surgery also affect the
incidence of PONV.
10
Chapter # 21
1- Surgical hemorrhage:
Reactionary; occurs 4-6 hours after surgery and is caused by ligature
slippage, clot displacement or cessation of Vasospasm after mobilization
or coughing
secondary ; occurs more than 24 hours after surgery and is due to
infection eroding a vessel.
2- discharge criteria;
(i) Vital signs stable for at least one hour
(ii)Correct orientation as to time, place and person
(iii)Adequate pain control with supply of oral analgesia
(iv)Understands how to use oral analgesia supplied
(v)Ability to dress and walk where appropriate
(vi)Minimal nausea, vomiting or dizziness
(vii)Has taken oral fluids
(viii)Minimal bleeding or wound drainage
(ix)Has passed urine if appropriate
(x)Has a responsible adult to take them home
(xi)Written and verbal instructions given about post operative care
11
(xii)Knows when to come back for follow up (if appropriate)
(xiii)Emergency contact number supplied.
Chapter # 24
1- National institute for health and care excellence discharge criteria in
minor and mild ;
- GCS 15/15 with no focal deficits
- Normal CT brain if indicated
- Patient not under the influence of alcohol or drugs
- Patient accompanied by a responsible adult
- Verbal and written head injury
- Advise seek medical attention if ;
~ Persistent/ worsening headache despite analgesia
~ Persistent vomiting
~ Drowsiness
~ Visual disturbance
~ Limb weakness or numbness
2- National Institute for health and care excellence guidelines for
computed tomography (CT) in hand injury.
Indications for city imaging within one hour;
- GCS<13 at any point
- GCS<15 at two hours
- Focal neurological deficit
- Suspected open, depressed or basal skull fracture
- More than one episode of vomiting
- Post-traumatic seizure
Indications for CT imaging within eight hours;
- Age > 65 years
- Coagulopathy (e.g. aspirin, warfarin or rivaroxaban use )
- Dangerous mechanism of injury (e.g. fall from a height, Road traffic
accident)
- Retrograde amnesia > 30 minutes
12
Chapter # 27
1- The’ deadly dozen’ threats to life from chest injury.
(i) Immediately life-threatening;
Airway obstruction
Tension pneumothorax
Pericardial tamponade
Open pneumothorax
Massive haemothorax
Flail chest
(ii) Potentially life-threatening
Aortic injuries
Tracheobronchial injuries
Myocardial contusion
Rupture of diaphragm
Esophageal injuries
Pulmonary contusion
2- Treatment of tension pneumothorax consists of immediate
decompression, initially by rapid insertion of a large bore cannula into
the second intercostal space in the mid-clavicular line of the affected
13
side, then followed by insertion of a chest tube through the fifth
intercostal space in the anterior auxiliary line.
3- Flail chest is defined as three or more ribs fractured in two or more
places.
4- The liver can be definitively packed, restoring the anatomy as closely
as possible. Placing a mental mental cracks in the liver is not
recommended.
5- The operative management of liver injuries can be summarized as the
four P’s — push, Pringle, plug, pack
14
Chapter # 29
1- Triage categories.
Priority Colour
Medical
need
First I
Immediate Critical, but likely to
survive if treatment
given early
Severe facial
trauma, tension
pneumothorax,
profuse external
bleeding,
hemothorax, flail
chess, major
intra-abdominal
bleeding,
extradural
hematomas
Second Yellow
II
Urgent
Critical, likely to
survive a treatment
given within hours
Compound
fractures,
degloving
injuries, ruptured
abdominal viscus,
pelvic fractures,
spinal injuries
Third III Green
Nonurgent
Stable, likely to
survive even if
treatment is delayed
four hours to days
Call fractures,
sprains, minor
lacerations
Last 0
Unsalvage Not breathing,
able
pulseless, so
severely injured that
no medical care is
likely to help
Red
Black
Clinical status
15
Examples
Severe brain
damage, very
extensive burns,
major
disruption/loss of
chest or
abdominal wall
structures
2- Renal failure may occur as a result of hypervolemia and
cardiovascular collapse caused by septic shock.
IMM PAST MCQ’s
1- 1 week old FAI Rt. Leg with local wound pain,air on radiograph.thin
brown with sweet smell exudate .if left untreated will lead to —
Sepsis, SIRS, MODS, MSOF ?
Bailey 27th Ed. pages 49-51
2- When should the shave of area of surgery be done,of a patient? In
ward at night before operation In theatre
Operative surgery books. new guidelines
3- After antibiotic treatment which of following bacteria can grow in gut
flora&produce pain that can lead to diarrhea?
Clostridium difficile
Bailey page 44
4- RTA,Rt.lower chest pain with bruising &tense tender abdomen which
type of shock?
Hemorrhagic
Bailey page 13
5- Immunocompromised patient, spreading infection of left lower limb
after trauma &extensive cellulitis. C/S of wound showed both aerobic
&anaerobic organism growth. diagnosis?
Necrotizing fasciitis
Bailey page 50
6- Scenario of tension pneumothorax
Bailey page 366
7- How to prevent MI in known c/o IHD,DM patient who is undergoing
GA ? Avoid tachycardia ,HTN& hypotension
Bailey page 265
8- PG put patient on list for laparoscopic procedure on elective list
because the patient was having—
IHD, DM , Jaundice
9- Radiolabelled iodine after total thyroidectomy for CA is used
because— Local effects, systemic effects ?
Bailey pages 818-819
16
10- Patient shifted to recovery room after surgery&ordered to shift to
ward in a while because—
To monitor O2 sats &post op analgesia
Bailey page 290
11- CVP line inserted in—
S.C Vein & Int. Jug .Vein
Bailey page 287
12- Standard guidelines to correct coagulation profile are?
Washington manual 7th Ed. page 99-111
13- Drug used in DVT which directly act on thrombus?— Heparin,
warfarin, Streptokinase ?
Bailey page 990 DVT?
14- For whipple’s procedure avg. time is 5 hours.prophylactic
antibiotics should be given—
At the time of induction&repeat after 4 hours
Bailey page 46. Decisive period.
15- Scenario of penetrating trauma to abdomen.which type of shock
?— Hemorrhagic
Bailey page 13
16- Minimum modalities of monitoring the shock include — Pulse Ox.
Bailey Page 16
17- Radiotherapy was given prior to resection of advanced CA
rectum.after resection the factor now responsible for major wound
dehiscense?
Bailey page 153
18- Problem with light source was pointed out by the surgeon at the
end of procedure.which part of the WHO surgical safety check list was
it?—
Time out, time in, sign in, sign out
Bailey page 183
19- Definition of flail chest is— 3 or more ribs Fx at 2 or more points
Bailey page 368
20- How will you explain to the patient when you are about to remove
the chest drain(PG tells HO,scenario was given)—
Take a deep breath&hold while removing the drain
Bailey page 101
21- How will you manage if there is Na is less than 120mmol/L —
Restriction of water?
Washington manual +Bailey?
22- MRSA sensitive to the following drug ?
Cipro, Flagyl, Linezolid, Vancomycin
Bailey page 56
17
23- Postop scenario of lap cholecystectomy .after 4 hours tense tender
abdomen .suspicion of ligature slipped from cystic artery. type of
hemorrhage is?
Primary, secondary, reactionary
Bailey page 19&305
24- Due to deficient skin & dirty wound, surgeon left it open after
debridement &wash and after few days put a skin graft on it. which type
of healing is this?—
Primary intention, sec. intention, Tertiary intention
Bailey page 25&89
25- Gas used to create pneumoperitoneum is Oxygen CO Argon helium
26- Transplant rejection is example of — Type 3 hypersensitivity
reaction
27- Tumour marker of CA pancreas is— CA 19-9
Bailey page 1235
28- Surgical blade size used for excision of fibroadenoma should be of
— #11, #15, #23
Fig. 7.1, bailey page 85
29- Major salivary gland tumours how to approach for diagnosis? —
FNAC ?
trucut biopsy, incision biopsy, excision biopsy
Bailey page 235
30- Chronic smoker.now new onset of unilateral vocal cord
paralysis.how to investigate to rule out malignancy—
CT chest&neck.
Bailey page 196
31- Most effective treatment of morbid obesity — Gastrectomy
Bailey page 1135.washington manual 333 page
32- Crepitus& extensive cellulitis on anterior abdominal wall in an
immunocompromised patient.diagnosis?
Fourneirs , gas gangrene , Melenys gangrene
Bailey page 50
33- Golf hole ureter+contracted bladder is seen on cystoscopy of patient
with Urinary symptoms.diagnosis?
UTI, CA bladder, TB
Topic of TB in Bailey pages 1405,1492.
34- Vaccum dressing is done at— 125mmHg intermittent pressure
Bailey page 30
35- After endoscopy patient felt neck&chest pain and drooling of
saliva— Esophageal perforation
Bailey page 225, box 15.6
18
36- Electrolyte disturbance in a malnourished patient who is on TPN
&overnutritioned?—
Hypophosphatemia&hypomagnesemia
Bailey page 288,box 19.4
37- For carpel tunnel syndrome,biers block is given in Rt. Upper arm
.agent of choice for this block is—
Lignocaine, bupicaine , prilocaine
Bailey page 275.
38- After crush injury to Rt. calf, pain and swelling occurs. pain
increases on dorsiflexion of foot. Immediate management of this should
be—
Leg elevation , Oxygen, amputation , Fasciotomy
Bailey page 28
39- 70 kg with full thickness burn left arm &neck. Fluids (how many
crystalloids/colloids) for first 24 hours ?
Bailey page 624 (burns)
40- Surgeon advised his assistant to give roof top incision for an
elective procedure as it is (benefits )—
Cosmetically better, easy to close, none?
Bailey page 1161.
41- 3POD after esophagectomy patient developed productive
cough,38*C fever.likely complication is—
Pleural effusion, pulm.Embolism , basal pneumonia?
Bailey page 293
42- BTA .After opening of abdomen there is grade 3 liver laceration.
Management is—
Surgicell , vertical mattress prolene, horizontal mattress prolene
Catgut
Packing?
Bailey page 1161.
43- After BTA, 300ml N/Saline challenge was given. Vitals improved
but fall again. Which category ?
Early responsder , late, full Transient responders
Bailey page 16, Dynamic fluid responders.
44- While retrieving CBD stone stuck in ampulla via ERCP ,which test is
predictive of bleeding diathesis at this point?
Bleeding time , PT, aPTT ?
Bailey page 22,23
45- 30 cm ischemic small & large bowel resected and ETEA was done.
Nutrition will be—Oral, liquids, NG , TPN
19
Bailey page 287
46- Quarter circle surgical needles used in—
Eye, gut , mouth, vagina
Bailey page 94
47- Following surgery of the ipsilateral submandibular gland ,dropping
of side of mouth nerve involved is—
Marginal mandibular branch of facial.N
Anatomy
48- 2POD after total hip replacement patient developed tachycardia,
fever & central cyanosis, diagnosis?—
Pulmonary embolism
Bailey page 296 & table 20.3
49- INR is more than 1.4 what will be asked from the patient to arrange
before exploratory laparotomy—
Whole blood, platelets, PCVs, FFPs
Bailey page 220& 258?
50- Patient have pacemaker & underwent appendectomy. Diathermy
used should—
Away from the heart, near to heart , bipolar
Bailey page 103
51- Surgeon used clips for closure after nephrectomy .reason ? —
Scarless,
Low risk of infection?
Bailey page 96
52- Professor of surgery told that continuous suture should end at—
Reef knot, square, surgeons , Aberdeen knot
Bailey page 95
53- Basic principle of open drain is—
Capillary action, suction , Gravity
Bailey page 100
54- Registrar while applying sutures on wound telling HO that sutures
should be—
Absorbable suture, Under no tension
Bailey page 94
55- Principles of coagulation in diathermy depends upon— Intensity of
current, waveform, size of electrode, All
Bailey page 102
56- BTA-----DPL was carried out-----positive DPL will be if ;
>5ml blood , >100000 red cells, >300 WBCs , 10ml free blood
Bailey page 373
57- SR stopped Registrar to start DPL because—
Not indicated, patient wasn’t fit, NG& folleys was not passed
20
Bailey page 373
58- Dynamic response after bolus given in shock is checked by— HR,
BP, CVP, ALL
Bailey page 16
59- BTA scenario----Shock----which fluid shouldn’t be given ? — N/S,
R/L , Blood, 5% Dextrose
Bailey page 15&16.It’s hypotonic &poor volume expander
60- Left sided penetrating chest injury. increase central venous
pressure ,tachycardia & muffled heart sounds—
T .Pneumothorax , pericardial temponade
Bailey page367&368 Classical Beck’s triad
61- C-spine injury can be ruled out after—
XRay, USG, clinical observation, MRI
Bailey page 199&345. CT WAS NOT IN OPTIONS
62- Hemorrhagic shock scenario with 30-40 % blood loss belongs to
class? — 1, 2, 3, 4
Bailey page 19 table 2.4
63- Post CVP line insertion CXR is done to check—
Tip of CVP in proximal Internal Jug vein /SVC ?? Hemo& pneumothorax
64- Scenario on boundaries of triangle of safety?
Bailey page 919,921
65- Scenario of tension pneumothorax management?
Bailey.
66- A man met severe RTA& went into hemorrhagic shock..he got no
First Aid till half hour...He died just after reaching the hospital ER.which
of following avoidable factors would have saved his life ? —
Coagulopathy, M.acidosis, hypothermia
Bailey page 18 fig. 2.1 triad of death.
67- How to decrease risk of DVT in obese , hypertensive &diabetic
patient undergoing total hip replacement?—
LMWH for 3-6 months?
Bailey page 990
68- Post –op bleeding scenario.surgeon , anesthetist & hematologist
were called .which test should be advised ?—
aPTT?
Washington manual 7th Ed. Chapter 5.
21
69- How is LMWH is monitored? —aPTT?
Washington manual page 95
70- For tension pneumothorax,
Insert wide bore cannula in 2nd intercostal space.
Basic Sciences and specialty specific
71- Most important sequel of hypokalemia is — Bradycardia,
tachycardia & arrest?
Physiology
72- Child having multiple blood transfusions .blood test should have
been done?—
Hb. Electrophoresis
Physiology
73- Anisocytosis is—
Un-equal size of RBCs (not shape)
Pathology
74- All are lab tests for biliary excretion function except — LDH
Pathology
75- Child with 3 days of acidic vomiting. Level of obstruction would be
at?— Pylorus
Bailey page 129 Peds. Surgery (speciality)
76- Autoclave works at—
121*C, 15 PSI pressure, for 30 minutes
Pathology
77- Injection dopamine used in type of shock? — Septic shock?
Pharmacology
78- Regarding gall bladder emptying? — CCK causes contractions
Physiology
79- Due to IBD, resection of gut including ileum is done. Consequences
will be— Bile salts absorption compromised
Anatomy, physiology
80- Energy stored as glycogen in —Kidneys, brain, Liver
Physiology
81-1 litre of 0.9% NaCl in a 12 years old boy with moderate isotonic
dehydration is given. The expected change will be
?
Physiology , Washington manual S/E chapter.
82- Conjugated hyperbilirubinemia is when direct bilirubin is—
Less than 5% , less than 10%, less than 15%?, less than 20% ?
Physiology
22
83- Pre-term baby is put on TPN.ideal distribution of calories should be
(peds.surgery)
CHO 60%,Fat 30%,Protein 10%
Coran 7thEd.page179.&washington manual 7th Ed. page 561
84- 28 years old female with 27 week gestational fetus whose pre-natal
USG showed 3.5 cm cystic mass in left lower lobe & clear shift of
mediastinum but no hydrops. next step of management ?
Intra-uterine resection, early delivery, observe?
Coran page 825. Congenital lung cyst/CCAM?
85- 6 months old with purple colored 6cm cutaneous lesion on lateral
side of lower chest with pale surface halo but now decreased in size as
compared to initial. Diagnosis?
Infantile hemangioma, RICH, NICH(non involuting congenital
hemangioma)
Coran page 1614
86- Contents of inguinal canal in male except? — Iliohypogastric nerve?
Anatomy
87- CSF flow from 4th ventricles to cisterns;
Foramen of lushka , monro , megendie ?
( Anatomy)
88- 2nd part of duodenum develops from— Foregut, mid gut , hind gut
Anatomy/embryology
89- Boundaries of epiploic foramen include all except?
23
IVC, caudate lobe, CBD, Quadrate lobe of liver
Anatomy
90- Left testicular vein drains in —IVC Left, renal vein
Anatomy
91- Muscle used in correction of fecal incontinence in post PSARP
patient? Gracilis
Pediatric surgery
92- ATPase of which protein altered to regulate skeletal muscle
contraction — Troponin? Tropomyosin
Physiology
93- In 8 year old child daily Na requirements are—
1mEq/kg, 1.5 , 2.5 mEq/kg
Coran page 190.
94- 9 months old infant with 9*7 cm heterogenous mass in Rt. Abdomen
crossing midline pushing Rt. kidney downwards, liver upwards&having
solid +cystic areas with bone like densities of calcification.diagnosis?
Neuoblastoma , RCC, wilms, Teratoma?
Coran page 44,543
95- 5 year old with his father on bike having severe BTA after RTA. He
had duodenal injury. Best surgical option will be
Duodenal repair with triple tube safety(gastrostomy ,duodenostomy
,jejunostomy)
Coran page 304
96- Classical double bubble sign beyond stomach. Procedure will be
Duodeno-duodenostomy
Coran page 1053,bailey page 133
97- 2 year old ingested alkaline watch battery 4 hours earlier. X-ray
showed it was beyond stomach in intestine. Best option will be —
Laparotomy, laparoscopy remove, endoscopy , wait and observe?
Bailey page 132-acc. To book serial xrays.
98- A 7 year boy with trauma was sent for FAST. Which of the following
is not included in FAST?
Xiphoid sternum pleural morrrisons pouch Pouch of douglas
Anatomy(male patient)bailey page123,207,366
99- During pyeloromyotomy , a deep mucosal incision&injury in the
distal aspect occurred . What should be done now ?
Lavage & antiobiotics antiobiotics leave&repair later Repair the mucosa
&leave pyeloromyotomy as such.
24
Coran page 1025.bailey page 128
100- DSD baby with small phallus ,testes palpable B/L & markedly
raised 17- hydroxyprogesterone was markedly raised? CAH.
True male female hermaphrodite ??
Coran page 1569-70.
25