Surgery 1) 7d after biliary surgery, chest pain and SOB, dx a) PE b) Atelelacsis c) UTI d) Primary haemorrhage 2) Hx of R sided CA colon, what is the characteristic features of investigations a) Microcytic anaemia, b) Intestinal obstruction c) Megaloblastic anaemia d) NcNc anaemia 3) Pt presented with inguinoscrotal swelling, how do you confirm it a) If you can’t get about the above the lump, it’s inguinoscrotal lump b) Brilliantly translluminate c) Fluid thrill d) Can’t differentiate the testis from the swelling 4) Intestinal obstruction for 18 hours, what is the least consistent clinical signs a) Distensionof abdo b) Exacerated BS c) Voluntary guarding d) Empty rectum e) Tympanic percussion 5) What is the sign of ovarian tumour a) Dullness of anteriorly and tympanic laterally b) Dullness lateral and tympanic anteriorly 6) Epi pain radiating to the back, p/w dark urine, chills & fever, ALP greatly elevated and amylase normal, AST, ALT elevated, what is the likely dx / a) Choledocholithiasis b) CA ampulla c) Pancreatitis 7) Pt who has hx of reflux oesophagitis, her xray shows regular stricture of the oesophagus, mx a) OGD & biopsy b) Manometry c) Check Ph d) Ba swallow 8) man p/w fever & scrotal pain, scrotum red and increased prostration, pus in the urine, dx ? a) Acute epididymo-orchitis b) Acute prostates c) Torsion of testis d) Strangulated hernia 9) All of the following food can predispose to cancer, except a) Smoked food b) Alcohol c) Fatty food d) Glutamate 10) AOF are signs of lower limb ischarmia except a) Ulcer at hallux b) Intermitten claudication c) Rest pain d) Elevated leg reduced pain
11) footballer injured during the game, P/E found normal dorsal flexure but planter flexure is diminished, WOF may happen a) L4 disc protrusion b) Ruptured Archilles tendon c) Ruptured anterior tibialis tendon 12) xray : RUQ several calcifications a) Gallstone b) Renal stones c) Hydatid disease d) Chronic pancreatitis 13) a female presented with a lump under the inguinal ligament & medial to the femoral pulse, what is the likely diagnosis a) Direct inguinal hernia b) Indirect inguinal hernia c) Femoral hernia d) Saphenous varix 14) WOF is damaged in mid humerus fracture a) Axillary nerve b) Radial nerve c) Median nerve d) Ulnar nerve e) Musculocutaneous nerve 15) what is the commonest content of linea alba hernia a) omentum b) Extraperitoneal fat c) Small bowel d) Rectus muscle 16) young woman p/w a breast lump, what is your next step a) FNAC b) Core biopsy c) Wide excision d) Mastectomy 17) pt has single nodule in the thyroid gland, AOF suggest malignancy except a) single nodule b) USG dx solid nodule c) Thyroid scan showed hot nodule d) Associated with horseness of voice e) Patient is male 18) after surgery, serum Na increased, urine osmolatity 205, what is the diagnosis a) DI b) SIADH c) Dehydration 19) AOF are true regarding staghorn calculi except a) Due to increased Ca intake b) Consistent with increase uric acid c) Increase oxalate intake d) Urine is alkaline 20) patient presents with sudden ruptured of extensor pollicis longus tendon, dx ? a) Tendonitis b) Tenosynovitis
c)
RA
21) which is the best nerve for grafting a) Digital nerve b) Radial nerve c) Medial nerve 22) small hand muscle wasting with thenar sparing, what nerve is involved a) Median n b) Ulcer n c) Radial n 23) patient presented with intracerebral haemorrhage, AOF are true except a) Hypotension b) Bradycardia c) Papilloedema d) Hypertension 24) pt presented with prolonged bleeding after massive blood transfusion, what is true a) Dilution of platelets b) Hypocalcemia c) hypothermia 25) A man presents with pain in the calf which is alleviated after walking. What is the diagnosis? a) Rest pain b) Muscle cramps 26) What is true regarding abdominal aortic aneurysm? a) Can be seen in ultrasound b) If more than 5 cm. do immediate surgery 27) What is not true regarding occlusive arterial disease? a) Rest pain b) Pain on the thigh while walking c) Sudden shooting pain at posterior aspect of the thigh 28) There is chronic occlusion in the femoropopliteal region. What is your initial management? a) ABI b) Aortography c) Surgery 29) What is the commonest site of atherosclerosis in the lower limb? a) Superficial femoral a. b) Common iliac a. 30) A patient present with chest pain. Soft murmur. History of hypertension. On x-ray, there is widening of the mediastinum. Typical picture of abdominal aortic aneurysm. What is the management? a) B-Blocker b) Morphine c) transesophageal echocardiography 31) Patient present with tension pneumothorax. What is the management? a) Insertion of wide bore needle at 2nd intercostals space 32) Urethral injury after accident. There is blood at external urethral meatus. What is the management? a) Suprapubic puncture b) Retrograde urethrogram 33) What is the commonest ureteric stone in acidic urine? a) Ca oxalate
b) Uric acid 34) A small boy with history of traction injury to the forearm. A hand is limping on the side, hanging down and pronated. What is the diagnosis? a) Post. Dislocation of the elbow b) Radial head dislocation c) Shoulder dislocation d) Post. Dislocation of the shoulder 35) What is true regarding scaphoid fracture? a) Avascular necrosis is more common in proximal segment than distal 36) A man presents with an open fracture of right ankle joint. On examination, pedal pulse can’t be palpated. The ankle is dislocated. What is your initial management? a) Realign immediately and reassess the pulse b) IV antibiotic c) Tetanus toxoid d) Debridement 37) A 40 year old man presents with pain and scrotal swelling. What is the diagnosis? a) Epididymoorchitis b) Hernia c) Testicular torsion 38) An elderly man presents with a scrotal mass, fever and tenderness. The mass is adhered to the upper pole of the testes. What is the diagnosis? a) Epididymitis b) Hernia c) Testicular torsion 39) Teratoma of the testes, where can it metastasis? a) Paraaortic LN b) Inguinal LN 40) All these food are carcinogenic except a) Fat b) Aflatoxin c) Monosodium glutamate 41) All are true regarding thyrotoxicosis, except a) Wasting of small muscles of the hand b) Tremor 42) A patient on warfarin for mitral valvular disease undergoes surgery. What is the management? a) Stop warfarin and start heparin. Do surgery after INR –normal 43) Prophalactic antibiotic is required in all procedure , except a) Fundoplication b) Hemorrhoidectomy c) Appendectomy 44) Which surgical procedure that we don’t stop anticoagulant ? a) Embolectomy b) Gastrectomy c) Appendicectomy 45) What is the definite indication of thyroidectomy in multinodular goiter? a) Compression of trachea b) Compression of esophagus c) Thyrotoxicosis
46) The football player get the injury to the finger and develop mallet finger a) Difficulty of flexion and extension of DIP joint b) Difficulty of flexion and extension of PIP joint c) Ulnar deviation 47) A patient had a trauma to the hand and presented with palmar space abscess , very infected with fever. What s the immediate management? a) Immediate incision and drainage b) IV antibiotic c) Elevate 48) Child with 2nd degree 15% burn in the chest area. The patient can’t breath and become anxious. What is the management? a) IV fluid b) Immediate intubation and ventilation c) Tetanus toxoid d) IV antibiotic 49) All are true regarding biliary stone, except a) Stone in the bile duct presents with sepsis of the gall bladder 50) Cervical LN biopsy shows thyroid cell. What is the diagnosis? a) Thyroid carcinoma metastasis to the LN 51) 25 year old female with mobile breast lump. What is the diagnosis? a) Fibroadenoma b) Breast cancer 52) 45 year old woman presented with breast lump. What is true? a) Consider CA Breast until proven otherwise 53) A patient with CA breast develop osteoporosis. What is the treatment? a) Bisphosphonate b) Cyclical estrogen and progesterone c) Continuous estrogen and progesterone d) Increase dietary calcium 2000 g/day 54) Which is least likely metastasis to brain? a) Prostate CA b) Thyroid CA c) Renal CA d) Breast CA 55) 80 year old lady with unilateral proptosis. Increased ESR. What is the diagnosis? a) Retrobulbar tumor b) Sinusitis c) Frontal sinus infection 56) All are true regarding uncomplicated hemorrhoid, except a) Pain b) Bleeding
