Q12) a 50 year old man with road side accident and injuries on right chest and femoral fracture, He is conscious, BP is 80/60 , Pulse 104/min, and chest expansion is reduced. JVP is not visible and heart sounds are normal. Respiratory rate is 22/min
What does he have
a) Left heart failure
b) Fat Embolism
d) Fluid loss
Q) A 35 year old lady has severe vomiting accompanied with headache and becomes unconscious. She has no similar history in the past and is not on any medicines.
She has a GCS of 11/15, BP 140/90, Pulse of 86/min. No cardiac or respiratory cause is noted for the symptoms.She has mild nuchal rigidity and b/l extensor plantar response.
CT scan of the brain is equivocal .Lumbar puncture studies show high RBcs in the aspirate? What is the next step in management?
a) MRI brain
b) Cerebral Angiogram
c) MR angiogram
d) IV broad spectrum antibiotic and anti virals
Q) A 68 year old man undergoes repair of infra renal aortic aneurysm. On 2nd POD he has abdominal pain, bloody diarrhea and tachycardia. BP is 120/70. Abdomen is mildly distended and tender especially in the left lower quadrant.
How will you proceed
a) Send stool for clostridium and spores
b) CT Abdomen
c) Exploratory laparotomy
d) Higher antibiotics
Answer for premium - Discuss the complications of Surgery for aortic aneurysm
Q14. A 6 months old baby is brought to the emergency with continuous crying and drawing his legs up for 1 day. He has vomiting and passage of bloody stools. On examination a lump is found in right hypochondrium. What is the best clinical diagnoses?
c) Hirshprung disease
d) Intestinal atresia
Q) A 24 year old male suffers low velocity gun shot wound in lower abdomen. On exploration there is a 1 cm segment loss of left ureter above the pelvic brim. Best management is :
b) Uretero ureterostomy
d) Ligation of ureter
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Q) A 45 year old man who has been drinking regularly for the past 15 years vomits after a large meal and complains of severe chest pain. Cardiac cause is ruled out and boerhavve's syndrome is suspected. Which of the following is not true about this condition
a) Gastrograffin tests will confirm the diagnosis
b) Perforation is most common in the left lower end
c) Exploration and full thickness suturing of perforation should be done
d) This condition has a high morbidity and mortality if not diagnosed at time
Answer for premium members - Discussion on Boerhaave's syndrome
Q) A 45 year old male with carcinoma head of pancreas, complains of stickiness of stools and difficulty in digestion. Which of the following enzyme deficiency does he have?
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Q) Which of the following is true about reno vascular hypertension
a) Seen in young age group
b) Both kidneys are of same size
c) It is familial
d) Diuretics will control the hypertension
Answer for free
Renal artery occlusion creates ischemia of the kidney which releases renin. Hypereninemia leads to secondary hypertension. This further leads to conversion of angiotensin I to angiotensin II and vasocontriction and eventually release of aldosterone.
It is a disease of young adults and children
Size of the kidneys vary and diuretics do not control hypertension because the mechanism is high renin secretion which is unresponsive to diuretics.
Q) True statement regarding peritonitis is
a) Raised serum amylase is only seen in pancreatitis
b) Rectal examination is better diagnostic of appendicitis than per abdominal examination
c) Ultrasound has diagnostic accuracy of 90% for diagnosing acute appendictis
d) Catarrhal appendicitis mostly leads to gangrene of appendix and perforation
Answer for premium members http://www.mcqsurgery.com/appendix
Q)Splenic artery aneurysm is seen in
a) Proximal 1/3rd of splenic artery
b) Proximal 2/3 of splenic artery
c) Middle 1/3 of splenic artery
d) Distal 1/3 of splenic artery
Answer for Premium members
Q) A 50 year old male undergoes pancreatectomy for Carcinoma head of pancreas. His pre op Hb was 9.2g% and during surgery he received 5 units of PRBC. In the post op period on the 2nd day he develops ECG changes. Work up is done for Myocardial Ischemia which is negative. What is the most common cause of ECG changes here
Free Answer b, Hyperkalemia
Transfusion of high volume of PRBC especially stored blood leads to hyperkalemia. In the setting of pancreatectomy in an already anemic patient, if massive blood transfusion is given, chances of hyperkalemia are there.
The ECG changes of Hyperkalemia are tall T waves, shortened QT interval and ST segment depression