Surgery MCQS for MCH

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NEET SS Surgery

Surgery MCQS for NEET SS Surgery and INI GI Surgery with explanations & references.

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With an experience of 18 years we know high yield topics and mcqs built around them. This site is a supplement to your standard surgery text books and helps you understand the important topics and parts in books from where mcqs are asked.

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TIPS

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Q) A 60-year-old man with cirrhosis presents with refractory ascites requiring frequent large-volume paracentesis. He is evaluated for TIPS placement. Which of the following findings would be the strongest contraindication to proceeding with the procedure?

A) Serum bilirubin of 3.5 mg/dL
B) MELD score of 18
C) Right heart catheterization showing mean pulmonary artery pressure of 55 mmHg
D) History of prior hepatic encephalopathy controlled on lactulose

#Theme from INI CET GI Mock test Liver

Correct Answer:

C) Right heart catheterization showing mean pulmonary artery pressure of 55 mmHg

Explanation:

  • A mean pulmonary artery pressure >45 mmHg is a contraindication to TIPS due to the risk of worsening right heart failure.

  • Bilirubin up to 3.5 and a MELD score <25 are relative risks but not absolute contraindications.

  • Prior controlled hepatic encephalopathy is not a strict contraindication, though the risk of recurrence post-TIPS is higher.

  • TIPS is often used in patients with refractory ascites when medical management fails.

Suturing Techniques

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Q) During a surgical skills assessment, you are asked to perform a hand-sewn intestinal anastomosis using a continuous, inverting suture that enters the bowel lumen. Which of the following suture techniques best fits this description?

#Theme from INI CET GI Mock test

A. Lembert suture
B. Cushing suture
C. Gambee suture
D. Connell suture

Correct Answer: D. Connell suture

The Connell suture is a continuous, inverting, full-thickness suture technique. It is unique because:

  • The needle enters the bowel lumen, passing through the mucosa.

  • It is run parallel to the incision line.

  • It achieves inversion of the bowel edge, which promotes serosal healing but intraluminal suture exposure is a drawback.

  • Historically used for the inner layer of two-layer bowel anastomoses.

Comparison with Other Options:

A. Lembert suture

  • Seromuscular only, avoids the mucosa

  • Interrupted or continuous

  • Inverting, but does not enter lumen

B. Cushing suture

  • Continuous, inverting

  • Parallel to incision

  • Penetrates submucosa but not mucosa (no lumen entry)

C. Gambee suture

  • Interrupted, inverting

  • Passes through a small portion of mucosa

  • Designed to minimize mucosal eversion and reduce luminal exposure

Malignancy risk in Stem cells

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Q) Risk of malignancy is highest with which stem cells. # Bailey Chapter 4 

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a) Somatic cells

b) SSc

c) Fetal cells

d) All

 

Secondary hemorrhage after necrosectomy

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Q) A patient develops a delayed hemorrhage 3 weeks after an open necrosectomy. Which of the following best describes the pathophysiology of this complication?

# Pancreas INI CET MCQs

A) Coagulopathy from systemic inflammatory response
B) Arterial pseudoaneurysm formation and rupture
C) Disseminated intravascular coagulation (DIC)
D) Portal hypertension due to splenic vein thrombosis

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NEET SS 26 Online Course

Gall bladder stone with obstruction

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A 65-year-old male presents with abdominal pain, vomiting, and a history of multiple episodes of cholecystitis. X ray image is given below.What is the most likely diagnosis?

Gall stone and intesinal obstruction

A. Acute cholecystitis
B. Gallstone ileus
C. Small bowel volvulus
D. Duodenal perforation

Answer: B. Gallstone ileus

Explanation:
Rigler's Triad consists of pneumobilia, small bowel obstruction, and an ectopic gallstone, which is diagnostic of gallstone ileus. This condition occurs when a gallstone enters the bowel through a biliary-enteric fistula, leading to mechanical obstruction.

A large gallstone (>2.5 cm) erodes through the gallbladder wall, creating a cholecysto-enteric fistula (most commonly into the duodenum).

The stone enters the bowel and may cause obstruction, most often at the ileocecal valve due to its narrow lumen.

The presence of air in the biliary tree (pneumobilia) results from communication between the biliary and intestinal tracts.

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