These surgery questions have been compiled by me from various entrance exams. Answers and explanations for the questions have been given. This front page has 9 questions. After the 1st three questions, for the next 6 answers and detailed explanations have been provided.
I have been working on this site since 2005. Earlier it used to be on geocities and other free servers. Initially I planned to publish a surgery mcq book, but that could not materialize, then I planned a surgery pdf file but that too did not work out. Finally I settled on this format and your support and messages have kept me going.
This site has three kinds of viewers. Visitors have access to 5 pages (25 questions). If you become a basic member, you can see up to 50 questions and our premium members (for a nominal fee of 1$/month) have access to the entire site (250 questions) and updates. To access the entire question bank click this button
If you like my site and questions, please use the FB and twitter button on left to spread the word around. You can mail me at adam(at)mcqsurgery.com for criticism, suggestions and comments or better like my facebook page
a. Zollinger Ellsion syndrome
b. Primary hyperthyroidism
d. Pernicious Anemia
Peptic ulcer is associated with a host of conditions.
|Other rare infections: TB, syphilis, mucormycosis, etc
|Hormonal or mediator-induced, including acid hypersecretory states
|Gastrinoma (Zollinger-Ellison syndrome)
|Basophilia in myeloproliferative disease
|Antral G cell hyperfunction (existence independent of H. pylori is debatable)
|NSAIDs and aspirin including low dose aspirin
|Bisphosphonates (probably when combined with NSAIDs)
|Clopidogrel (when combined with NSAIDs or in high risk subjects)
|Corticosteroids (when combined with NSAIDs)
|Spironolactone (probable, no data with NSAID cotherapy)
|Chemotherapy (eg, hepatic infusion with 5-fluorouracil)
|Vascular insufficiency including crack cocaine use
|Mechanical: Duodenal obstruction (eg, annular pancreas)
|Comorbid ulcers associated with decompensated chronic disease or acute multisystem failure
|Stress intensive care unit ulcers
|Chronic obstructive pulmonary disease (secondary to smoking)
Most frequent digestive manifestations of Primary Hyperthyroidism are constipation, heartburn, nausea and appetite loss that occur in 33%, 30%, 24% and 15% of cases, respectively.
EUS is better than CT or any other diagnostic modality for diagnosis of carcinoma esophagus. C T scan only shows thickened esophagus wall in cases of carcinoma esophagus which is not specific for malignancy and also can not truly describe the extent of local disease.
The greatest inaccuracy of EUS in reporting the local extent for Ca esophagus is for T2 tumors. This is because for clinical assessment the fourth ultrasound layer is interpreted as the muscularis propria. This layer, however, does not include the interface between the submucosa and muscularis propria; it is contained in the third ultrasound layer. Thus, the border necessary to completely differentiate T1 from T2 tumors is contained in the third ultrasound layer. As two boundaries must be assessed for determination of T2 and errors might occur at each, the inaccuracy is potentially twice that of T1 and T4 tumors.
Ref Shakelford 6th edition , Chapter Endoscopic Esophageal Ultrasonography
Q Not a true statement regarding double contrast barium enema
a) Bowel preparation is not required
b) Patient has to be rolled in various positions
c) It is inferior to colonoscopy in detection of colon cancer and polyps
d) Sensitivity in detecting polyps depend on the size of polyp
Which of the following radiation injuries require immediate laparotomy?
a) Rectovaginal fistula
b) Colon Obstruction
c) Colon perforation
d) Rectal stenosis
a. CA19.9 and CEA should be done in all patients
b. Imaging will show intra hepatic duct dilatation with normal extra hepatic ducts
c. Contrast enhanced MRCP is the imaging of choice
d. ERCP should be done in most cases to get the brush cytology
a) CBD diameter 6 mm
b) Multiple large stones in CBD
c) Unsuccessful transcystic exploration
d) Small cystic duct diameter
A suspected case of cholangiocarcinoma should undergo evaluation to rule out benign biliary diseases and staging workup in cases of malignancy. Contrast MRI and MRCP are the initial investigations of choice. Hilar cholangiocarcinoma or Klatskin tumor is at the biliary confluence and causes dilatation of both intrahepatic ducts.
ERCP is not preferred for diagnostic purposes because
- It is invasive
- It fails to drain/stent some times leading to ascending cholangitis
- Brush cytology has a very low sensitivity (25-30%)
In laparoscopic CBD exploration there are two ways. One with less morbidity is the transcystic approach in which cystic duct is dilated and stones are removed through the cystic duct. After the procedure the cystic duct is clipped as in laparoscopic cholecystectomy. This procedure has the least morbidity as CBD is not opened. Indications of Choledochotmy are
- Unsuccessful transcystic exploration
- CBD diameter more than 8 mm
- Multiple large stones
- Ampullary diverticulum on IOC
- ERCP unavailable or contraindication of ERCP
- Previous Billroth II gastrectomy
- See more at: http://www.mcqsurgery.com/index11.html#sthash.IAz9zeJ2.dpuf
a) It is a very rare cause of GI bleeding (less than 1% incidence)
b) The bleeding artery in Dieulafoy's lesion lies in the submucosa
c) The lesion is seen in the distal stomach near the antrum
d) Surgery is required in all cases to stop the bleeding.
Dieulafoy's lesion of the stomach is not an uncommon cause of upper GI bleeding. Its incidence in all patients with upper GI bleed range from 0.3 to 7%. The cause of such bleeding is a large tortuous vessel in submucosa which leads to ulceration of the over lying mucosa. The lesions occur at 6-10 cm from the cardia near the GE junction. Endoscopy is the diagnostic modality of choice and lesion is controlled by electrocoagulation, heatre probes or photo coagulation
Ref Sabiston 19th edition page 1222
a) 20% bile salt which reaches liver is lost in the stools per day
b) Bile salt are stored and diluted in Gall bladder
c) 0.2to 0.6g of bile salts are secreted by the liver each day
d) Gall Bladder fills by antegrade mechanism from the liver
0.2-0.6 g of bile salts are secreted by liver each day in the form of cholic acid and dexoy cholic acid. Only 5% of bile salt is excreted per day and 95% is absorbed by the portal vein Bile is stored and concentrated in the gall bladder Gall bladder fills by retrograde mechanism by contraction of sphincter of oddi. - See more at: http://www.mcqsurgery.com/index11.html#sthash.IAz9zeJ2.dpuf