Paper-1 surgery 2018

1. After a swelling has been clinically defined, the most commonly

advised investigation is:
a) X-ray.
b) Ultrasound.
c) CT.
d) MRI.
e) FNAC.

2. Healing by first intention means?

a) Using catgut.
b) Obtaining union between two edges of an incision without
subsequent breakdown.
c) Immediate use of protective dressing.
d) Using staples.
e) A method whereby an ulcer heals.

3. Branchial cyst is best differentiated from cold abscess by:

a) Flactuant.
b) Trans illumination .
c) Contains cholesterol crystal
d) Contains sulphur granules
e) Contains sulphur granules
4. Which form of actinomycosin is most common:
a) Facicocervical
b) Thorax
c) Ilieocecal
d) Liver
e) Spleen

5. In surgical profession, a patient has been infected by HIV positive

doctor during which procedure:
a) Endoscopy
b) Dental extraction
c) Abdominal surgery
d) Cardiac transplant
e) Renal transplant

6. Ideal steam sterilization of 121ᵒ C with pressure of 151

Ib/inch2should have hold time:
a) 0 min
b) 15 min
c) 30 min
d) 45 min
e) 55 min
7. A punched out edge is a characteristic of which type of ulcer:
a) Tuberculosis
b) Rodent ulcer
c) Syphilitic
d) Non-specific ulcer
e) Malignant ulcer

8. “CYSTIC HYGROMA” is:

a) Lymphangiectasia
b) Cavernous haemangioma
c) Sebaceous cyst
d) Dermoid cyst
e) Haemangioma

9. Usual fluid requirement in burnt patient per kg percent burn during

first 24 hours is:
a) 3-4 ml
b) 5-6 ml
c) 7-8 ml
d) > 10 ml
e) > 20 ml

10. In a patient with pneumothorax and circulatory collapse, the first

action should be:
a) Immediate X-ray chest
b) Oxygen inhalation
 c) Insertion of chest drain/ needle
d) Tracheostomy
e) Putting the patient on ventilator

11. The major cause of death following road traffic accident is:
a) Brain damage
b) Abdominal injury
c) Facial injury
d) Chest trauma
e) Fracture with fat embolism

12. Cleft palate repair is ideal at the age of:

a) 6 months
b) 6-18 months
c) 12-24 months
d) 2 ½ years
e) 5 years

13. Cleft lip ideally repaired at:

a) Soon after birth
b) 6 weeks - 12 weeks
c) 10 weeks – 24 weeks
d) 24 weeks – 36 weeks
e) 1 year
14. In tongue cancer, the site least affected is:

a)Lateral margin

b)Ventral surface

c)Dorsal surface

d)Tip

e)Posterior portion

15. Subconjunctival bleed with no posterior border indicates fracture

of which bone?
a) Maxilla
b) Mandible
c) Zygoma
d) Nasal
e) Skull
16. The most common fracture of face is that of:
a) Mandible
b) Maxilla
c) Zygoma
d) Nasal bone
e) Orbital bone

17. The danger area of face where from infection can spread directly
to cavernous sinus includes:
a) From below the eyes upto chin
b) Area around the lips
c) Area around lips including lower part of nose
d) Whole of the face
e) From maxillary sinus

18. Perianal fistula is best demonstrated by:

a) CT scan
b) Plain X-ray
c) Tomography
d) Ultrasound
e) MRI

19. 80% of all salivary stones occur in:

a) Parotid gland
b) Sub-mandibular gland
c) Sub-maxillary gland
 d) Minor salivary glands
e) Sub-lingual gland

20. In recurrent laryngeal palsy, the position of affected side of vocal

cord is:
a) Full abduction
b) Full adduction
c) Paramedian
d) Lateral deviation
e) Medial deviation

21. Pain in the arm due to cervical rib is caused by:

a) Compression of D1 root
b) Compression of C7 root
c) Muscle ischemia
d) Compression of brachial plexus
e) Phrenic nerve

22. Tubercular cervical lymphadenitis commonly affects:

a) Posterior triangle nodes

b) Upper jugular nodes
c) Supra clavicular nodes
d) Sub maxillary nodes
e) Axillary lymphnodes
23. Synthesis and libration of thyroid hormone from thyroid is
controlled by:

a) Hypothalamus
b) Hippocampus
c) Anterior pituitary
d) Posterior pituitary
e) Basal ganglia

24. The suture that maintains strength for longest time is:

a) Dexon
b) Vicryl
c) PDS
d) Chromic catgut
e) Plain catgut

25. Neoplasia of larnyx are most common in:

a) Postcricoid region
b) Lateral wall
c) Piriform fossa
d) Aryepiglotic fold
e) Medial wall
 26. A 20 year old male presented with small swelling in front of neck
in midline, swelling moves upward on protrusion of tongue. What is
diagnosis:

a) Thyroglossal cyst
b) Branchial cyst
c) Thyroid nodule
d) Sub-mental lymph node
e) Cystic hygroma

27. A 65 year female complains regurgitation of undigested food, few

hours after meal, she also have progressive difficulty in swallowing,
weight loss and swelling in neck. What is the most likely diagnosis:

a. Achalasia
b. Ca esophagus
c. Diffuse esophageal spasm
d. Pharyngeal pouch
e. Plummer Winson’s syndrome
28. Most common primary malignant thyroid tumor is:

a) Papillary
b) Follicular
c) Anaplastic
d) Medullary
e) Lymphoma

29. Bones, stones, groans and moans relate to:

a) Hyperparathyroidism
b) Hypoparathyroidism
c) Hyperthyroidism
d) Hypothyroidism
e) Pheochromocytoma

30. Position of foramen caecum is:

a) Pharynx
b) Nasopharynx
c) Junction of posterior 1/3 with anterior 2/3 of tongue
d) Centre of tongue
e) Tip of tongue
31. What is the most common cause of lymphoedema (non-pitting
oedema) worldwide?
A) Iatrogenic – radiotherapy
B) Filariasis
C) Iatrogenic – lymph node resection surgery
D) Leptospirosis
E) Chaga’s disease

32. Which of the following statements is appropriate regarding

palpation of femoral artery in inguinal region?

a) The femoral pulse is usually felt at the midpoint of the inguinal

ligament
b) The femoral nerve is medial to the femoral pulse
c) The femoral pulse is lateral to the deep ring
d) The femoral pulse is usually felt at the mid of inguinal point
e) A radio femoral delay may be expected to aortic stenosis

33. Which of the following physical examination findings may be seen in

patients with dehydration?
a. Capillary refill of 4 sec.
b. Capillary refill of 1 sec.
c. Hypertension
d. Bradycardia
e. Increased skin turgor
34. After blood transfusion, the specific signs and symptoms of
hemolytic transfusion reactions include:
a) Hypothermia
b) Hypertension
c) Polyuria
d) Abnormal bleeding
e) Hyperesthesia at the transfusion site

35. What of the following is the most appropriate regarding signs and
symptoms of early sepsis?
a) Respiratory acidosis
b) Decreased cardiac output
c) Hypoglycemia
d) Increased arteriovenous oxygen difference
e) Cutaneous vasodilation

36. A 60-year-old woman presents to her physician with a 3-wk history

of severe headache. A contrast CT scan reveals a small, circular,
hypodense lesion with ringlike contrast enhancement. The most likely
diagnosis is

a) Brain abscess
b) High-grade astrocytoma
c) Parenchymal hemorrhage
d) Metastatic lesion
e) Toxoplasmosis
37. Which one of the following cases is considered a clean-
contaminated wound?
a. Open cholecystectomy for cholelithiasis
b. Herniorrhaphy with mesh repair
c. Lumpectomy with axillary node dissection
d. Appendectomy with walled-off abscess
e. Gunshot wound to the abdomen with injuries to the small bowel and
sigmoid colon

38. A 30-year-old man presents to the Emergency Department

following a high speed motor vehicle accident. He has marked
abdominal distension, a pulse rate of 130 and a blood pressure of 80/50
mmHg. The most appropriate initial investigation would be

A. abdominal angiogram
B. abdominal paracentesis
C. CT scan of the abdomen
D. plain X-ray of the abdomen
E. FAST (focused abdominal sonography for trauma) scan

39. Trendelenberg position is useful for management in which type of

shock?

a. hypovolumic shock
b. cardiogenic shock
c. Septic shock
d. neurogenic shock
e. Electric shock
40. 25 year old male suffered blunt trauma to the chest, in the ER he
presented with shortness of breath and cyanosis. On Examination, no
breath sounds in the right side and percussion note resonant. The most
likely diagnosis is:

a. Spontaneous pneumothorax
b. Cardiac tamponade
c. Cardiac contusion
d. Tension pneumothorax
e. Pericardial effusion

41. You were called to the emergency department to review a 30 year

old male patient who was in a major car accident. His vital signs
revealed heart rate of 140 beats/min and blood pressure of 60/40.
Physical examination and radiograph revealed open-book pelvic
fracture. There was no other major injury identified. The diagnosis of
this patient is:

a. Hypovolemic shock.
b. Septic shock.
c. Neurogenic shock.
d. Cardiogenic shock.
e. Spinal shock.
42) A 30 years old laboratory technician suffering from ulcerative colitis
develops listlessness, slurred speech, muscular hypotonia, depressed
reflexes and abdominal distension. His ECG shows prolonged QT
interval, depressed ST segment and flattering of T wave. The parenteral
fluid most appropriate for this patient would be:
a) Dextrose 5°k.
b) Normal saline O.9%.
c) Dextrose with saline.
d) Saline with KCI.
e) Ringer’s.

43) A 20 years old man receives multiple blood transfusions for

abdominal gunshot wound. He complains of numbness around his
mouth and displays carpopedal spasm and a positive Chvostek sign. The
treatment required is:
a) Intravenous bicarbonate.
b) Intravenous potassium.
c) Intravenous calcium.
d) Intravenous digoxin.
e) Intravenous parathormone.

44) A 20 years old woman is taking high doses of vitamin D to

supplement a defect in bones due to abnormalities of vitamin D
metabolism. The disease she is most likely suffering from is called:
a) Osteogenesis imperfecta.
b) Osteoporosis.
c) Osteitis fibrosa cystica.
d) Osteomalacia.
e) Osteitis deformans.
45) A 20 years old medical student falls on the outstretched hand. He
presents with mild pain and swelling of wrist. Examination reveals
tenderness over anatomical snuff box. What is the most likely
diagnosis?
a) Fracture of first metacarpal.
b) Fracture of distal radius.
c) Fracture of trapezium.
d) Fracture of scaphoid.
e) Galeazzi fracture.