INI SS December 2021 General Surgery Questions

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Q) Steroids inhibit which state of Wound healing

a) Collagen synthesis

b) Remodeling phase

c) Maturation phase

d)


Q2 Intention to treat analysis used in 

a) Randomized control trial

b) Cohort study

c) Case control

d) Case series


Q3. Case control study, level of evidence

a) Level I

b) Level II

c) Level III

Ans Level III

Case control study weakness -

Selection bias
– Recall bias
– Limited potential to establish causal effects
– Can only study one outcome


Q4. 1st Noble prize in Surgery was for 

Kocher in 1909



Q5. 35 yr Male following RTA presented with pain abdomen tachycardia and hypotension.
CXR shows loss of aortic knob and widened mediastinal shadow.
Next step -
A. Transesophageal echo
B. CT angio chest
C. eFAST
D. Emergency  Thoracotomy

Ans c) efast

This is a case of Aortic injury . As patient has tachycardia and hypotension, CT studies are ruled out.

The following are the indicative of aortic injury

  • Widening of the mediastinum (this may not be evident)
  • If it is greater than 8 cm at the level of the aortic arch, it requires further evaluation and imaging studies.
  • Loss of the normal shadow of the aortic knob
  • Left apical pleural cap of fluid, or blood
  • Left pleural effusion
  • Deviation/Displacement of the trachea, or esophagus to the right

Breast General Surgery 

Q5. For cyclical mastalgia which of the following was found to have placebo effect from multiple systematic studies?
A) Evening  primrose oil
B) Diclofenac gel
C) Tamoxifen
D) Danazole

Ans a Evening primrose oil


Uro General Surgery 

Q) Living renal donor , detected to have renal stone further  investigation of choice

A) Ct with and without contrast
B) Selective angiography
C) MR tomography


Endocrinology 

Q) All of the the following are correct except about imaging of para thyroids ?
a) 4d CT is less sensitive than USG  neck
b) 4d  CT  gives both anatomical and functional information
c) 4 th dimensions in 4 D CT  is time
d) 4D CT  is less effective in locating recurrent / ectopic location of parathyroids

Ans ) a  

Sensitivity of 4D CT and USG is almost same . 81-89% for 4DCT and 76% for USG . PPV for both is 93%

4th dimension is time.

4DCT gives both anatomical and functional informtaion ( Ref Bailey)

For recurrent / ectopic location of parathyroids, best is sestamibi scan

Ref Sabiston  21 Table 38.5


Q) Thyroid nodule 9 mm in size is detected incidentally. What should be done next 

a) TSH

b) only Follow up

c) USG guided FNAC

d) Plan for Surgery

Ans a) TSH 

TSH is the first step in every thyroid nodule to know if it is hypo, hyper or normal functioning gland. Further management then depends as per Fi 37.14 on page 892 of Sabiston 21

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