Final MBBS Surgery MCQs
1. In mesh repair for inguinal hernia, he rnia, which type of suture can be used for suturing mesh to muscle? a) b) c) d) e)
silk propylene stai stainl nles esss ste steel el poly polyla lact ctic ic aci acid d catgut
2. Necrotising fasciitis is associated with a) b) c) d) e)
swel swelli ling ng of the the cal calf f redness high fever high !" high #"$
%. In a patient with hypovolaemic shock, which cannular si&e would you ideally choose for infusion? a) b) c) d) e)
1'( 21( 1%( 2( *+(
. de-uate minimum urine output in a +kg man during resuscitation is a) b) c) d) e)
*/ ml0hr 2+ ml0hr /+ ml0hr %/ ml 0hr + ml0hr
. #opper I# prevent pregnancy by the following way3 a) b) c) d) e)
sper spermi mici cidal dal acti action on preventing ovulation preven preventt impl implant antati ation on of embry embryo o all all of of the the abov abovee non non of of the the abov abovee
'. 4hich is important in the antenatal history? a) b) c) d) e)
mens menstr trua uall histo history ry medical history fami family ly hist histor ory y previo previous us contr contrace acepti ptive ve metho methods ds all all of of the the abov abovee
11. 4hich of the statement about a perforated duodenal ulcer is false3 a) b) c) d)
? patch repair ? 2+5 show show free free air air under under diap diaphra hragm gm on #6" #6"
1*. !everal studies have followed up patients with asymptomatic gallstones. 4hat percentage of patients develop symptoms after / 7 2+ years? a) b) c) d) e)
8 25 1+ 7 2+ 5 *+ 7 %+ 5 /+ 7 + 5 +5
1%. !albutamol a) b) c) d) e)
may may caus causee hypok hypokal alae aemi miaa not used with steroid for $9: in ; improve improve outcome outcome when when used used alone alone by prolonging prolonging pregnancy pregnancy negati negative ve chronot chronotrop rophic hic effec effectt on heart heart more more eff effec ecti tive ve in in $"< $"<; ;
1/. 4hich of the following give complications in 1st =>: inection? a) b) c) d) e)
trig trigge gerr fing finger er e@uervainAs tenovaginitis chi chill lles es tend tendin init itis is ? 9enn 9enniis elbo elbow w
1. cute retention of urine, which wh ich is B:!3 a) imperforat imperforatee hymen hymen does not commonl commonly y present present as " " b) herpes simpleC genitalis often presents with voiding voiding difficulties and urinary retention c) can be treated treated by indwelling indwelling cathet catheter er for for %D hours
d) retention is often accompanied by overflow incontinence e) often occurs post vaginal delivery, postEinstrumental vaginal delivery, post surgical instrumentation 1. 4hich of the following is true for basal cell carcinoma? a) b) c) d) e)
metastases to lymph node is rare common at nonEsun eCposed area F light is not a cause morpheous type is easily treated treatment of choice is radiotherapy
1D. Inhalation burn inury 2+ mins earlier, now carbonaceous sputum, respiratory rate 2% breaths per minute. 9"3 a) b) c) d) e)
if stridor and cyanosis not present, then not severe 6Erays, chest signs should be positive G( normal, then watch0treat conservatively bronchoscopy is of no value intubation and oCygen indicated
1'. Farus inury to the knee results in a) b) c) d)
medial meniscus inury medial condyle fracture tear of fibulo?? ligament ?inability to use eCtensor hallucis longus
2+. 4hich is the least likely to be present in ?acute cholecystitis a) b) c) d) e)
nausea right hypocondrial tenderness right hypochondrial guarding elevated conugated bilirubin aundice
21. Bollowing are features of #onnAs 6#$9 a) b) c) d) e)
hypertension low serum potassium low plasma rennin activity raised serum sodium muscle weakness
2*. 4orkman fell on a bar, hit perineum. !crotal haematoma and perEuretral bleeding. 4hich is 9"?
a) catheterise b) surgery to repair urethra c) suprapubic catheter if patient cannot pass urine 2%. 4hich of the following is N<9 a risk factor for bladder cancer a) b) c) d) e)
smoking cyclophosphamide schisostomiasis pelvic irradiation adriamycin
2. 9reatment of dysfunctional uterine bleeding eCcept a) b) c) d) e)
prostaglandin bromocriptine dana&ol traneCamic acid <#$
2. %+ year old male with ulcerative colitis now with eCacerbation of (I symptoms. ssess severity with a) b) c) d) e)
erythema nodosum anaemia dose of sala&opyrine ankylosing spondylitis dysplasia on colonoscopy
2D. #ause of thirst and oliguria in ileostomy a) b) c) d)
hypokalaemia metabolic alkalosis renal calculi high output from ileostomy
2'. ;an went for anterior resection, postEop histo shows uke #. dvise3 a) aduvant chemoE"9 b) neoaduvant "9 c) liver resection
*+. 9ermination of midEtrimester pregnancy can be by applying prostaglandin via
a) b) c) d) e)
intraEamniotic eCtraEamniotic vaginally none of the above all of the above
*1. 2D year old lady complains of painful defecation associated with fresh pe rErectal bleed. $ossible diagnosis to consider3 a) b) c) d) e)
hiradenitis suppurativa dermoid cyst pilonidal sinus anal fissure pruritis ani
*2. 4hich is B:! for colorectal cancer? a) father with colorectal cancer predisposes one to higher risk than general population b) familial adenomatous polypopsis coli is inherited as autosomal dominant c) cancer locali&ed to mucosa can be cured d) N mismatch repair gene mutation predisposes you to 1++5 lifetime risk of colorectal cancer **. ? !ubmandibular stones associated with a) b) c) d) e)
swelling radiolucent stones BreyAs syndrome pain after eating 2 hours eCcision of the whole gland
*%. Not a cause of large bowel intestinal obstruction a) b) c) d) e)
#rohnAs volvulus radiotherapy adhsions recurrent ischaemic colitis
*/. =aemorrhoids a) b) c) d)
are commonly believed to be venous malformation re-uire surgical eCcision if small and symptomatic commonly present with painful bleeding and perianal swelling may undergo malignant metaplasia in those with chronic prolapse
e) pruritis ani *'. 4hat is true about malrotation and volvulus? a) b) c) d) e)
commonly presents with bilious vomiting presents in late childhood barium meal eCcludes it may lead to acute ischaemic colitis is not an emergency and may be treated conservatively
%+. 4hich statement with regards to burns is 9"? a) the commonest cause of deaths is overwhelming infection b) in electrical burns, eCtent of surface inury is a good reflection of underlying inury c) flame burns worse than scalds d) ? e) $artial thickness burns are sensate %1. ;aternal mortality rate is calculated as the number of maternal deaths per3 a) b) c) d) e)
1++ 1+++ 1+ +++ 1++ +++ 1 +++ +++
%2. 4hich is false for s-uamous cell carcinoma a) can be caused by repeated eCposure to chronic skin irritation b) can arise from chronic conditions like ;arolinAs ulcer c) GowenAs and $agetAs are known risk factors d) seborrhoiec keratosis is a preEmalignant lesion e) can present as cutaneous horn %%. 4hich of the following is commonly used to screen for osteoporosis0osteopenia in a menopausal lady? a) b) c) d) e)
;"I of hip lumbar 6Eray 6 mammogram #9 scan
%. 9he osmolality of plasma and interstitial fluid is determined by3
a) b) c) d) e)
bicarbonate potassium chloride protein sodium
/+. In the 2nd stage of labour a) b) c) d) e)
immediate delivery is indicated in early decelerations pushing is encouraged once cervis is fully dilated urinary catheter is routinely done to help foetal head engage persistent late decelerations is suggestive of foetal hypoCia it is never allowed to go beyond 1 hour
/2. (rade III open fracture of tibia best treated with3 eCternal fiCation /*. 9he following signs > symptoms are consistent with acute unruptured appendicitis 6#$93 a) b) c) d) e)
patient writhing in pain pain initially paraumbilical, then moves to right iliac fossa "ovsingAs sign positive "ectal temperature *D.1H# ?
/%. young lady presents with *cm thyroid nodule. BN# shows papillary cells. 9he neCt appropriate management is a) b) c) d) e)
thyroCine radioactive iodine ? Ccise nodule =emithyroidectomy
/. ;enopause is associated with the following eCcept3 a) b) c) d) e)
hot flushes urinary problems #olleAs fracture Increase risk of acute myocardial infarct ysmenorrhoea
/D. =yperprolactinaemia is associated with the following 6#$93 a) b) c) d) e)
=ypothyroid Gitemporal hemianopia
/'. ;an with *cm adrenal mass found on #9 scan. 4hich of the following is N<9 true3 a) b) c) d) e)
do #6" BN# o rennin level !urgery observe
1. 4hich of the following is not associated with increased maternal mortality? a) b) c) d) e)
antepartum haemorrhage postpartum haemorrhage infection ectopic pregnancy preEeCisting diabetes mellitus
*. + year old man fell in bathroom and fractured left hip displaced N
total hip replacement hemiarthroplasty eCcisional arthroplasty internal fiCation and screw dynamic hip screw
%. 4hich of the following is found in diabetes insipidus? a) b) c) d) e)
increase serum urea decrease serum urea increase serum potassium decrease serum potassium decrease creatinine
/. #hronic pelvic pain associated with the following 6#$93 a) b) c) d)
chronic pelvic inflammatory disease previous abdominal operation adenomyosis endometrioma
e) retroverted uterus . ;ost common cause of subEarachnoid haemorrhage is a) b) c) d) e)
hypertension coagulopathy arteriovenous malformation aneurysm tumour
. !I= is associated with a) b) c) d) e)
hypernatraemia hyponatraemia hyperkalaemia hypokalaemia raised serum urea
D. 4hich of the following is not a sign of upper motor neurone lesion? a) b) c) d) e)
sustained clonus hyper refleCia =offmanAs sign pgoing plantar Blaccid paralysis
+. 9he following affect perinatal mortality rate eCcept a) b) c) d) e)
low birth weight asphyCia vacuum aspiration congenital abnormalities prematurity
1. Bollowing a road traffic accident, a motorcyclist presents with a cold pulseless foot. Inuries that may be associated include3 a) b) c) d) e)
posterior knee dislocation closed fracture of the tibia and fibula penetrating inury to the popliteal fossa a>b a, b > c
2. #ontraindications to breast conservation a) multicentric on mammogram
b) c) d) e)
central K + year old diabetes mellitus LehovahAs 4itness
. $ertheAs disease3 which of the following is 9"? a) b) c) d) e)
present K 1+ years old poorer prognosis always bilateral has congenital deformities age range up to 2+ years old early surgery improves prognosis
. 4ide local eCcision M aCillary clearance M radiotherapy compared with simple mastectomy M aCillary clearance3 a) b) c) d) e)
? inprove survival, increase local recurrence same survival and recurrence inprove survival, reduced local recurrence studies inconclusive
D. $atient going for right hemicolectomy. #onsultant asks you to prescribe ampicillinE sulbactam. fter checking no drug allergy, you would administer3 a) b) c) d) e)
oral route 2%hr before surgery oral route 1+ 7 *+ min before surgery IF route hr before skin incision IF 1+ 7 *+ min before skin incision IF + 7 *+ min before surgery and continue for * days after
'. 4hich is not a cause of pancreatitis? a) b) c) d) e)
hypercalcaemia hypokalaemia hyperlipidaemia obstruction at ampulla of Fater thia&ide
D1. + year old man, +kg with oesophageal carcinoma. $oor feeding for 2 wks because of dysphagia, lost 12kg in % wks. 4hat would you do for him? a) b) c) d)
do not need nutritional correction IF parenteral nutrition 1 day before operation IF parenteral nutrition 1 wk before operation IF parenteral nutrition after surgery
e) ? D2. ;onteggia fractureEdislocation. 4hich is 9"? a) b) c) d) e)
fracture of proCimal ulnar M radial head ulnar nerve palsy weak finger eCtension crossEunion treat conservatively with aboveEelbow cast
D*. $atient with colorectal #a /cm metastasis to liver. 92N1;1. $rimary is treated. 4hat to do with liver mets? a) b) c) d) e)
liver resection 9# transarterial chemoEembolisation) "adiotherapy #hemoradiotherapy 4ait and see
D%. In which of the following tumours does radiotherapy offered as a 1st line treatment) have the same results as surgical resection? a) b) c) d) e)
renal cell carcinoma adenocarcinoma of stomach malignant melanoma s-uamous cell carcinoma of oesophagus carcinoma of rectum
D/. #losed fracture of the shaft of humerus may be associated with inability to3 a) b) c) d) e)
eCtend distal interphalangeal oint of little finger oppose thumb fleC wrist fleC proCimal metacarpophalangeal oint of thumb eCtend the interphalangeal oint of thumb
D. Normal menstrual cycle, true 6#$93 a) :;$ taken as final day of last menstrual period b) B!=, := change continuously throughout cycle c) midEcycle pain and bleeding is physiological D. 11 year old male cyclist had an accident, sustained laceration over left thigh eCtending over left inguinal area into left iliac fossa.
a) b) c) d) e)
patient is a minor and his consent for any operation is not needed patient and 2 senior doctors can sign the consent form toilet > suture is minor procedure so consent is not re-uired if patient refuses treatment, it is not necessary to trace the parents to inform them no consent is needed if procedure performed in emergency room
D'. ou are a =< clerking a patient for elective laparoscopic cholecystectomy for cholelithiasis. =e complained of dark urine of 1 day duration the day before. =ad abdominal pain * weeks ago, after fatty food. :B9 shows3 E conugated bilirubin E unconugated bilirubin E :$ E :9 E !9 E $9
2/ 2+ 1D+ 2/ 2 1*.* s
our plan of management3 a) b) c) d) e)
continue with cholecystectomy, becourse the stones will be taken out anyway ultrasound, if dilated bile ducts refer for "#$ =ep G, =ep # screen "echeck :B9 in 2 weeks #9 liver
'+. 9rue of slipped capital femoral epiphysis 6#$93 a) common in children 8 years old b) associated with endocrine abnormalities c) present with limp d) associated with obesity e) ? '2. ;ost effective parameter in the ultrasound diagnosis of I(" is3 a) b) c) d) e)
biparietal diameter head circumference abdominal circumference femur length to biparietal diameter ratio umbilical artery oppler
'*. 9eenager with painful flat foot. 4hich can cause it? a) uvenile chronic arthritis b) tarsal coalition
c) accessory navicular bone d) all of the above e) none of the above '%. $eriosteal bone formation seen in a) b) c) d) e)
chronic osteomyelitis osteogenic sarcoma postEphlebitic leg a>c all of the above
'. Indications for vaginal eCamination in theatre a) b) c) d) e)
diagnose placenta praevia ? ltrasound finding of placenta praevia "evealed $F bleeding #oncealed $F bleeding
'. *% year old lady, *cm hard mass in left breast, what is the investigation which is least helpful? a) b) c) d) e)
BN# of lump ltrasound both breast for #I! ;ammogram both breast for #I! :B9 for mets #6" for mets
'D. In variceal bleeding, B:!3 a) b) c) d) e)
IF somatostatin early #orrect $9 of 22 with BB$ ncephalopathy may be treated by lactulose !engstakenEGlackmore tube once diagnosis made Gand ligation in 1st endoscope
''. %/ year old motorcyclist, has a road traffic accident. > findings revealed patient groaning, speaking unintelligibly, chest wall abrasions. "" 2+0min, G$ '+0+ mm=g, pulse 12/0min, small pulse volume. #old and clammy. "educed air entry and tympanic percussion note on right chest. istended neck veins. NeCt appropriate thing to do? a) b) c) d)
en-uire "9 circumstances 2 large bore IF lines Intubate Needle in 2nd intercostals space
e) $ericardiocentesis 1++. Bat embolism is commonly associated with a) ? b) ? c) mental alteration and restlessness 1+1. Bace presentation in labour, most commonly associated with a) b) c) d) e)
post term anencephaly ?
1+2. In a bleeding patient, which is the most important parameter to assess successful fluid replacement? a) b) c) d) e)
pulse rate pulse pressure urine output cutaneous perfusion pallor
1+*. young man at > after road traffic accident. nconscious, systolic G$ +mm=g by palpation. No obvious open wounds or fractures. ;ost likely cause of shock3 a) b) c) d) e)
subEdural haemorrhage cervical transection bleeding into abdomen and chest cavity cardiac tamponade tension pneumothoraC
1+%. "egarding mammographies, which is inappropriate3 a) b) c) d) e)
increase false negative in younger females compared to older females mammograms have not affected mortality outcome false negative rate is about 1+E1/5 women about %+ years should go for one women under %+ should go if they have positive family history
1+'. nterocutaneous fistula. 4hich is false a) skin irritation is a maor problem b) barium meal should be done by 1st wk
c) ? d) #an try oral elemental feeding if fistula is at distal small intestine e) Bistulogram can help in diagnosis 111. 2/ year old smoker, *2 wks pregnant, noticed to have I(" on ultrasound only, what is associated with this feature? a) b) c) d) e)
polyhydramnios gestational diabetes mellitus decreased fetal plasma viscosity drinking alcohol of K 12+mg daily ? increased proction of thromboCane 2 > prostacyclin
112. + year old man presents with painless cholestatic aundice and vomiting. #9 scan shows a bulky tumour in the pancreas and tumour thrombosis in the superior mesenteric and splenic veins. n appropriate treatment plan is a) b) c) d) e)
pancreaticoduodenectomy fibrinolysis treatment followed by 4hippleAs operation gastroeunostomy and choledochoeunostomy total pancreatectomy and splenectomy fraCiparin :;4 heparin) and pain relief
11%. !ymptoms of endometriosis include the following 6#$93 a) b) c) d) e)
dysmenorrhoea irregular bleeding sudden lower abdominal pain infertility abdominal mass
11. "egarding traumatic diaphragmatic rupture, which statement is B:!3 a) b) c) d) e)
laparotomy is indicated mainly on right side "yleAs tube can assist in making diagnosis respiratory distress is common blunt is more common than penetrating trauma
11D. Incidence of postEterm pregnancies a) b) c) d) e)
15 2+5 5 D+5 +.+15
12+. In renal trauma the diagnostic investigation that best demonstrates parenchymal laceration, urine eCtravasation, eCtent of retroperitoneal haemorrhage is3 a) b) c) d) e)
intraEvenous urogram #9 abdomen Nephrotomography rteriogram ;"I
12%. ;ost appropriate investigation for an obstructed upper urinary tract which is dilated a) b) c) d) e)
IF #9 scan ;"I ltrasound "enogram
12. 4hich is not a proven benefit of combined ="9? a) b) c) d) e)
decrease risk of osteoporosis decrease risk of ovarian #a decrease risk of endometrial cancer decrease risk of colon cancer reduction of vasomotor symptoms
12. 9he best way to evaluate the testicle and epididymis in the presence of a tense hydrocoele is3 a) b) c) d) e)
manual compression transillumination oppler flow studies scrotal ultrasound 9$ scan
12D. %+ year old #hinese man, 2 days history of right knee swelling. !" '+ mm0hr, #"$ raised. febrile a) b) c) d) e)
diagnostic aspiration arthrotomy and washout intravenous antibiotics N!Is None of the above
12'. nterior dislocation of shoulder is associated with loss of sensation a) of medial arm
b) c) d) e)
of lateral forearm of medial forearm of 1st dorsal interossei of hand none of the above
1*1. !coliosis a) b) c) d) e)
kyphotic deformity of the spine poor back posture lateral curvature of spine eCaggerated lordosis congenital high scapula
1*2. ;anagement of %mm midEureteric stone include3 a) b) c) d) e)
?push stone up > $#N: #onservative "etrograde ureteroscopy > laser ?
1**. In the blood supply of the long bone, which of the following is true? a) b) c) d) e)
nutrient artery supplies 20* of the inner corteC periosteal arterioles supply 20* of outer corteC nutrient artery supplies 10* of inner corteC the blood supply is centripetal nutrient artery supplies O of the inner corteC
1*%. 9he following is true of (n"= agonist 6#$93 a) b) c) d) e)
symptoms of endometriosis may worsen can be given in intravenous pulses can be given as depots ? Increase bone density
1*/. 4hich of the following is true about epidural analgesia? a) b) c) d) e)
cardiorespiratory collapse is a recogni&ed complication it cause increased pelvic floor tone previous #aesarean section is a contraindication current pregnancyEinduced hypertension is a contraindication postEdural puncture headache occurs immediately
1*. ;ost common symptom of testicular tumour
a) b) c) d) e)
testicular pain scrotal swelling sensation of heaviness in scrotum haematocoele bilateral gynaecomastia
1*. 9he following are risk factors for senile osteoporosis, 6#$93 a) b) c) d) e)
chronic smoking regular aspirin intake sian women with small build #hronic steroid intake N!Is ingestion
1*D. In uterine rupture, all are found 6#$93 a) b) c) d) e)
hypotension increased uterine contractions haematuria perEvaginal bleeding fetal distress
1*'. (;$Emediated relaCation of penile corporeal smooth muscle is mediated by a) b) c) d) e)
norepinephrine dopamine serotonin N< endothelin
1%1. Gladder cancer, true 6#$93 a) b) c) d) e)
smoking is a risk factor superficial variant is most common transitional cell carcinoma is commonest histology lifelong followEup following ablation for superficial transitional cell carcinoma immunotherapy is not useful
1%2. !ideEeffect of use of prostagladins for midEtrimester termination of pregnancy include all 6#$93 a) b) c) d)
shivering nausea > vomiting pyreCia diarrhea
e) postEpartum haemorrhage 1%%. 4ith respect to compartment syndrome, which of the following is B:!3 a) b) c) d) e)
pale > pulseless limb is an early sign it can occur in open fractures indication for urgent fasciotomy can occur in the foot pain is always present
1%/. bruption placentae a) b) c) d) e)
more common in primigravida than multiparous women associated with ? coulevaire uterus always lead to perEvaginal bleeding does not result in fetal death associated with cardiac disease
1%.
occipital frontal is presenting diameter rupture of membrane occurs late in pregnancy /+5 rotate to occipital anterior during labour $ersistent occipital posterior means vaginal delivery contraindicated ccounts for /+5 of verteC presentation in early labour
1%. #ommonest cause of haematospermia a) b) c) d) e)
nonEspecific inflammation of prostate or seminal vesicles 9G prostate denocarcinoma prostate 9ransitional cell carcinoma of prostate pididymoEorchitis
1%D. 9he following antibiotics are used for prophylaCis of 9I 6#$9 a) b) c) d) e)
trimethoprimEsulphametha&ole amoCicillin nitrofurantoin cephaleCin fluro-uinolones
1%'. ;anagement of *cm stone in renal pelvis3 a) $#N: b) !4:
c) conservative management d) open pyelolitomy e) double LEstenting 1/1. 4hich of the following is not used in ="9 administration? a) b) c) d) e)
tablets patch subdermal implantation vaginal pessaries I#
1/2. 4hich is not a feature of degenerative spine diease a) b) c) d) e)
decreased oint space sclerosis of vertebral body grade 1 spondylolisthesis of :%0/ vertebrae decrease oint space of facet oints syndesmophytic lipping
1/%. #hronic complication of radiotherapy for cancer of cerviC. 4hich is B:!3 a) b) c) d) e)
urinary continence will not be compromised blood transfusion may be indicated for haemorrhagic cystitis ?it is caused by endarteritis, fibrosis Includes pelvic pain, tenesmus, diarrhea, rectal bleeding
1//. + year old lady, fit, presents with lower 10* ureter transitional cell carcinoma, no lymph node involvement. 9reatment3 a) b) c) d) e)
radiotherapy intravesical chemotherapy radical nephrectomy radical cystectomy nephroEuretectomy
1/. 2 year old man presents with recurrent lower urinary tract infection. 4hich of the following investigations is most unlikely to be useful? a) b) c) d) e)
uroflow urine culture intravenous urogram micturating cystourogram cystoscopy
1/D. $olycystic ovarian syndrome may be treated by the following, 6#$93 a) b) c) d) e)
ovarian cystectomy norethisterone clomiphene ovarian drilling metformin
1/'. fter motorcycle accident, ** year old man with fiCed internal rotation of u pper arm. iagnosis to eCclude is3 a) b) c) d) e)
fracture of surgical neck of humerus anterior dislocation of shoulder posterior dislocation of shoulder rotator cuff tear none of the above
1+. %+ year old man presented to the > department with ureteric colic. 4hich of the following investigation is not relevant? a) b) c) d) e)
abdominal ultrasound nonEcontrast #9 scan intravenous urogram urine dipstick urine culture
11. 4hich of the following drugs should not be used in pregnancy? a) b) c) d) e)
amoCicillin tetracycline erythromycin acyclovir &idovudine
1*. ndometrioma is associated with a) b) c) d) e)
cervical cancer vulva cancer clear cell cancer of ovary cancer of fallopian tube germ cell tumour of ovary
1. 9he single largest factor determining long term survival in breast cancer is3 a) tumour si&e b) tumour grade
c) tumour subtype d) nodal positivity e) aduvant chemotherapy 1'. 4hat is not true about nephroblastoma? a) b) c) d) e)
also known as 4ilmAs tumour occurs in 1+5 of children presents as an abdominal mass more common in children before * years of age composed purely of epithelial elements
1+. 4hat is true of phaeochromocytoma a) b) c) d) e)
neuroendocrine tumour of adrenal corteC associated with ;N I malignant in '+5 of cases ? scan
11. 9rue about cephaloEpelvic disproportion3 a) b) c) d) e)
a high head at * wk is diagnostic prolong latent phase is a good sign of #$ diagnosis usually not made without trial of labour diagnosis made accurately by 6Eray pelvimetry fetal abnormalities such as microcephaly is associated with increased risk of #$
12. $rocedure of choice to define anatomic details of calyces, pelvis and ureter is3 a) b) c) d) e)
intravenous urogram ultrasound #9 scan nuclear renogram retrograde pyelography
1*. Balse statement about placental locali&ation > antepartum haemorrhage management3 a) b) c) d) e)
ultrasound at 22 wks is unreliable absence of retroEplacental haematoma effectively eCcludes abruption placentae posterior placenta gives false negative report of placenta praevia transvaginal scan can be done for suspected placenta praevia placenta accrete can be diagnosed antenatally on ultrasound
1%. ffectiveness of breast cancer screening h as been shown to be most useful in the following age group a) b) c) d) e)
8 */ %+ 7 %' /+ 7 % K + ll age groups
1/. 9he following is associated with increased risk of breast cancer3 a) b) c) d) e)
fibroadenoma fibrocystic disease atypical duct hyperplasia ductal papilloma increase breast si&e
1D. 1 year old boy presents with a gradually enlarging left knee . 6Eray shows a lytic lesion in the metaphysic of proCimal tibia. 4hich of the following need to be eCcluded? a) b) c) d) e)
chondrosarcoma osteogenic sarcoma osteochondroma giant cell tumour chondroblastoma
1'. $agetAs diease of the breast a) b) c) d) e)
present anywhere on breast skin usually bilateral rare inEsitu carcinoma bad prognosis usually re-uire mastectomy with aCillary clearance
E ;in. urine output in +kg person per day3 a) b) c) d)
*/ml 2/ml %+ml +ml
E Bollowing can cause gout, 6#$93 a) deficiency of homo?? oCidase b) loop diuretics c) chemotherapy
d) myeloproliferative disease E + year old man has a chest drain inserted for pneumothoraC. =e is listed for surgery because of a persistant large air leak. Nurses call you to the ward because during transfer, he became acutely dyspnoeic and oCygen saturation is +5. our first course of action is3 a) b) c) d) e)
check chest tube since it may have become inadvertently clamped during transfer eCclude anCiety as a cause eCclude reaction to anaesthetic premedication check if pulse oCimetry machine is working none of the above
E bout inguinal hernia, which is B:!? a) b) c) d) e)
deep ring is a defect in fascia transversalis cannot get above it cough impulse may be absent in large hernia mesh repair is contraindicated unless recurrence repair can be done under local anaesthesia
E 4hich donAt improve claudication distance in peripheral vascular disease? a) b) c) d) e)
bypass angioplasty eCercise stop smoking aspirin
E 4hich is not contributory to (lasgow #oma !cale? a) b) c) d) e)
obey commands locali&es painful stimuli open eyes to calling incomprehensible sounds /mm pupils
E 9he following are features of #onnAs syndrome 6#$93 a) b) c) d) e)
hypertension hypernatraemia low plasma rennin activity hypokalaemia muscular weakness
