Free Questions

Free MCQs in Surgery

THE vs TTE

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Q) THE vs TTE which is not true? ( Question asked in all AIIMS and INI exams since 2017) 

a) Leak rates are more with TTE 

b) Pulmonary complication is more with TTE

c) Side to side stapler anastomosis has less leaks than open two layer suturing

d) THE can be done through minimally invasive surgery

Ans c

Pulmonary complications 57% with TTE 27% with  THE  ( SKF 409)

Anastomotic leak 16% TTE and 14% THE ( not significant) subclinical leak slightly more in THE

Option D is correct

Cardiac complications, Vocal cord paralysis , wound infection, chyle leak are all more with TTE

Blackmon et al. published a propensity-matched analysis comparing outcomes between side-to-side stapled anastomosis, end-to-end circular stapled anastomosis, and handsewn,
with no significant difference in leak rate noted.  ( SKF page 475)

SKF page 409

Medullary thyroid cancer – Management

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Q) Male patient with 1 cm nodule in Right side of Thyroid. Biopsy shows medullary carcinoma. No neck nodes are seen on USG. What is the management

a) Total thyroidectomy

b) Total thyroidectomy with central node dissection

c) Total thyroidectomy with lateral and central neck dissection

d) Right hemithyroidectomy

Thyroid MCQs 

NEET SS 22

Ans b 

For patients with disease confned to the thyroid, total thyroidectomy is recommended to remove all C cells with elective dissection of the central neck nodes. If there is evidence of nodal metastases, gross
disease should be remove

Bailey 28th page 831

 

Carcinoma Breast and Pregnancy

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Q) 30 year old female in 2nd trimester of pregnancy has a 2 cm Ca breast with no axillary lymph node What should be the management?

a) Terminate Pregnancy and MRM

b) Wait till completion of pregnancy and MRM

c) Lumpectomy plus chemo

d) Lumpectomy + axillary dissection + chemo

Breast

Neet SS 22 paper

Ans d

Lumpectomy plus axillary dissection + chemo

Axillary dissection is ideally after SLNB

Radiotherapy can be given after termination of pregnancy

Hormonal therapy is also given after pregnancy if required

No need to terminate pregnancy

Bailey 28th page 942

Anal malformation

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Q) Newborn with abdominal distension on day 2, not passed meconium. There is absent anal orifice. WHat is the next step? # NEET SS 22 

a) Cross table X ray

b) Invertogram

c) Anoplasty

d) Sigmoid colostomy

Ans a) Cross table X ray

1st step in such cases Rule out congenital abnormalities of spine, sacrum , kidney heart etc

2nd step Cross table x ray  If it shows Perineal fistula do ANoplasty, If x ray shows rectal gas below coccyx do PSA RP with or without colostomy, If it shows gas above coccyx with associated defects do colostomy

Table 67.14 Sabiston 

 

Fuel for colonocytes

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Q) Primary fuel for colonocytes is 

a) Glucose

b) Lactate

c) Butyrate

d) Fats

Ans c ) Butyrate

Butyrate For the fermentable complex carbohydrates available, colonic flora produce short-chain fatty acids (SCFAs).

Butyrate, an SCFA, is the principal source of nutrition for the colonocyte.
Mammalian cells do not produce butyrate, the colonic epithelium and luminal bacteria form an essential and elegant symbiotic relationship.

Antibiotics disrupt this cohabitation—decreased bacteria leads to less butyrate, which, in turn, negatively affects colonocyte function leading to diarrhea.

Lymphatic Spread carcinoma Prostate

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Q) Most common lymph node involved in carcinoma prostate is
a. Obturator
b. Iliac
c. Periprostatic
d. Perivesical

a ✅

Lymphatic spread may occur (1) via lymphatic vessels passing to the obturator fossa or along the sides of the rectum to the lymph nodes beside the internal iliac vein and in the hollow
of the sacrum

Also lymphatics that pass over the seminal vesicles and follow the vas deferens for a short distance to
drain into the external iliac lymph nodes.

From retroperitoneal lymph nodes, the mediastinal nodes and occasionally the supraclavicular nodes may become implicated.

Bailey page 1468

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