Question: A patient undergone emergency laparotomy and Ileostomy closure done after 3 months then he developed swelling in the ileostomy region with Cough impulse. This is known as

Ans. (b) Incisional herniaRef: Practical Question* Question is very clear - Ileostomy is reversed in 3 months - so this cannot be a parastomal hernia.* Parastomal hernia is one which develops via a defect in the opening made for Ileostomy or Colostomy, and the hernia is present in the presence of stoma.* Now here it is clear the stoma is reversed and hence this is a Incisional hernia via the incision made for creating stoma


Question: High T3, high T4, low TSH and low radioiodine uptake is seen in

Ans) c ( Subacute thyroiditis) Ref Bailey 25th ed pg 800Subacute thyroiditisAlso called Granulomatous or Dequervines thyroiditisCaused by viral infections. Presents with pain in the neck, fever, malaise, firm irregular enlargement of one or both thyroid lobes.ESR raised, absent thyroid auto antibodies, serum T4 high.Iodine 133 uptake low. It is self limiting.There may be a period of hypothyroidism before recovery.Specific treatment - Prednisolone 10- 20mg for 7 days.Grave's disease & toxic noduleHyperthyroidism with increased radioiodine uptakeHashimoto's thyroiditisMild hyperthyroidism initially but hypothyroidism inevitable. Decreased T3 & T4.


Question: Best diagnostic modality for parotid swelling is

Best diagnostic modality - FNAC Best imaging investigation - MRI (MRI is the most sensitive study to determine soft-tissue extension and involvement of adjacent structures but it lacks the specificity for differentiating benign from malignant neoplasms.)


Question: Fuctional GI disorders can be differentiated from organic GI disorders by

Common causes of Bleeding per rectum hemorrhoids anal fissures (tears in the rectal tissue), diveicula (diveiculitis, including Meckel's diveiculum), infections (bacterial and other pathogens) inflammatory bowel diseases (Crohn's disease and ulcerative colitis), angiodysplasia (fragile blood vessels), tumors,polyps, and bowel trauma. Less common causes include upper GI tract problems like ulcers and Mallory-Weiss tears in the esophagus or a dilated vein or varix. Ref:


Question: Early stage of carcinoma esophagus is diagnosed by

.investigations for carcinoma oesophagus includes 1)barium swallow -shouldering sign and irregular filling defect.RAT TAIL defect in fluoroscopy is typical. 2)oesophagoscopy -to know lesion, extent and types. 3)biopsy -histological evaluation 4)X-ray /CT/MRI/ bronchoscopy/chromoendoscopy/oesophageal endosonography ref: SRB&;s manual of surgery,5th ed, pg no 806


Question: Cause of congestive splenomegaly is

Answer- B. Budd Chiari SyndromeCauses of congestive splenomegalyBudd Chiari SyndromeHepatic vein obstructionPoal vein obstruction


Question: Abbey estlander flap is used for


Question: The tensile strength of wound after laparoscopic cholecystectomy in a 30 years old Woman depends upon

"Covalent cross-linking of the lysine residues provides tensile strength. The extent and type of crosslinking vary from tissue to tissue. In tissues such as tendons, in which tensile strength is crucial, collagen cross-linking is extremely high."Sabiston 20th edition Pg: 139


Question: Plexiform neurofibromatosis commonly affects...


Question: In Pediatric age group, the most common feature of polytrauma is

As the surface area to body volume ratio of children is high, thermal energy loss is higher and hypothermia is a higher risk. Due to the greater physiological capacity and ability of children to compensate for the fluid loss, hypotension is a very late and ominous sign of hypovolaemic shock.


Question: Capillary refill is present in


Question: Initial treatment in the management of trauma is

.primary management Airway management(blocked by food,vomiting,clot,fallen tongue) Breathing Circulation Disability and level of consciousness assessment by Glasgow coma scale Exposure of patient from head to toe for final assessment Fingers and tubes: Finger evaluation, Foley&;s catheterisation (Ref: SRB&;s Manual of Surgery, 5th edition, pg no.140)


Question: Most Commonly done screening test for diagnosing Acute Pancreatitis

Ans. (a) Serum AmylaseRef: Bailey and Love 27th ed. pg. 1214* Most common used to diagnose Acute pancreatitis - Serum amylase (will be elevated for first 3 days and declines in 4-8 days)* Serum Lipase though more sensitive is not widely available.


Question: The operation that precipitates poosystemic encephalopathy is

Poosystemic encephalopathy is a neuropsychiatric syndrome, It most often results from high gut protein or acute metabolic stress (eg, GI bleeding, infection, electrolyte abnormality) in a patient with poosystemic shunting. In poosystemic shunting, absorbed products that would otherwise be detoxified by the liver enter the systemic circulation and reach the brain, causing toxicity, paicularly to the cerebral coex.


Question: The treatment of choice for the management of carcinoma of the anal canal is

Nowadays, primary treatment is by chemoradiotherapy , the chemotherapy sually including a combination of 5-fluorouracil (5-FU) with mitomycin C or cisplatin. The surgeon, however, has an impoant role in management: initial diagnosis is surgical; small marginal tumours are still best treated by local excision; radical surgery is indicated in those with persistent or recurrent disease following CMT; and a defunctioning stoma may be indicated for those in whom treatment and disease regression is associated with radionecrosis, incontinence or fistula. Other anal malignancies Adenocarcinomata within the anal canal are usually extensions of distal rectal cancers. Rarely, adenocarcinoma may arise from anal glandular epithelium or develop within a longstanding (usually complex) anal fistula; treatment is as for low rectal cancers but prognosis is less good. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1269

Neoadjuvant chemotherapy and local excision


Question: Epispadias is associated with

Epispadias Epispadias is very rare. In penile epispadias, the urethral opening is on the dorsum of the penis and is associated with an upward curvature of the erect penis . Epispadias often coexists with bladder exstrophy and other severe developmental defects. Associated anomalies Extrophy of bladder (ectopiae vesicae) with pubic diastasis and waddling gait Dorsal chordee VUR in 40 % cases Ref: Smith's 18th edition Pgno : 639 Bailey and love 27th edition Pgno : 1478


Question: Psudomyxoma peonei is

.PSEUDOMYXOMA PERITONEI * Jelly like mucoid yellowish-brown substance accumulates in peritoneal cavity * Due to ruptured adenocarcinoma appendix/ mucocele or mucinous carcinoma of ovary * Common in females * Painless progressive distension of abdomen with intestinal obstruction occurs eventually * Shifting dullness is absent * Surgical debulking, oophorectomy, appendicectomy, omentectomy are often done * Chemotherapy is useful--Cisplatin * Carries poor prognosis ref:SRB&;s manual of surgery ,ed 3,pg no 884


Question: Most common cause of secondary tumors affecting spinal cord is from

(C) Secondaries from lungs # Secondary spinal cord tumors, which are more common, are metastases of cancer originating in another part of the body and thus are always cancerous. Metastases most commonly spread to the vertebrae from cancers that originate in the lungs, breasts, prostate gland, kidneys, or thyroid gland. Metastases compress the spinal cord or nerve roots from the outside. Lymphomas may also spread to the spine and compress the spinal cord.> Advanced prostate cancer can spread to other parts of the body, possibly causing additional symptoms. The most common symptom is bone pain, often in the vertebrae (bones of the spine), pelvis, or ribs. Spread of cancer into other bones such as the femur is usually to the proximal part of the bone. Prostate cancer in the spine can also compress the spinal cord, causing leg weakness and urinary and fecal incontinence. Spread to the lymph nodes can cause a swelling or lump, either under your arm or in another part of the body. If the lymph nodes in your armpit are affected, your hand and arm may swell. Secondary breast cancer in the bone can cause aching or pain in the affected bone. If the breast cancer has spread to your liver you may feel ill and tired. Women with secondary breast cancer in their lungs usually first notice a cough, or find that they get short of breath easily. If a secondary breast cancer develops in the brain, you may have headaches and feel sick. Secondary spinal cord tumors, which are more common, are metastases of cancer originating in another part of the body and thus are always cancerous. Metastases most commonly spread to the vertebrae from cancers that originate in the lungs, breasts, prostate gland, kidneys, or thyroid gland. Metastases compress the spinal cord or nerve roots from the outside. Lymphomas may also spread to the spine and compress the spinal cord. The liver is a common site for other gastrointestinal cancers to spread to, particularly colorectal cancer, resulting in so-called secondary deposits or metastatic cancer


Question: Primary closure of incised wounds must be done within

• Primary suture:
−− Clean wounds
−− Selected contaminated wounds after thorough wound toileting and debridement
• Delayed primary suture:
−− Heavily contaminated wounds
−− Wounds in which wound toileting has been delayed for 6–8 hours
• Left open to heal by secondary closure


Question: BRCA 1positive woman hav ..........% increased risk of breast carcinoma

Mutation of tumour suppressor genes BRCA1/BRCA2 is thought to be involved with high-risk of breast carcinoma. BRCA1 mutation is having more risk (35-45%) than BRCA2 mutation It is located in long arm of chromosome 17, whereas BRCA2 is located in long arm of chromosome 13. BRCA1 more commonly shows ER negative status, high grade, aneuploid with raised S fraction than BRCA2 which shows ER positive status. BRCA1 is associated with increased risk in males. Lifelong risk of breast cancer in BRCA1 and BRCA2 mutations is 50-70%. Both are associated with high-risk for ovarian cancer. Ref; (page no;530 ) 5th edition of SRB&;S manual of Surgery


Question: Fogarty's catheter is used for

Fogarty's catheter is used for removal of embolus from the blood vessels.


Question:
A displaced mandibular fracture in a child should
be managed by


Question: The screening test for neonatal hypothyroidism

Ans. (c) TSH and T4 assaysRef Harrison 17th edition Chapter 335* Neonatal hypothyroidism is due to thyroid gland dysgenesis in 80-85%, to inborn errors of thyroid hormone synthesis in 10-15%, and is TSH-R antibody-mediated in 5% of affected newborns.* Because of the severe neurologic consequences of untreated congenital hypothyroidism, neonatal screening programs have been established.* These are generally based on measurement of TSH or T4 levels in heel-prick blood specimens* When the diagnosis is confirmed, T4 is instituted at a dose of 10-15g/Kgper day, and the dose is adjusted by close monitoring of TSH levels.* T4 requirements are relatively great during the first year of life, and a high circulating T4 level is usually needed to normalize TSH.* Early treatment with T4 results in normal IQ levels, but subtle neurodevelopmental abnormalities may occur in those with the most severe hypothyroidism at diagnosis or when treatment is suboptimal

TSH and T4 assays on heel prick blood sample


Question: Tardy Ulnar nerve palsy is caused by

A i.e. Fracture lateral epicondyle of humerus Tardy Ulnar Nerve Palsy Tardy ulnar nerve palsy as a late complication of fractures of the lateral condyle physisQ is well known, especially after the development of cubitus valgusQ from malunion or nonunion of fractures. The symptoms are usually gradual in onset and may appear years after injuryQ (upto 22 years also). Motor loss occur first, with sensory changes developing somewhat later. Anterior transposition of ulnar nerve is most commonly used procedure. With development of cubitus valgus there is outward detion of forearm 1/ t stretching of medial structures (including ulnar nerve) and causing tardy ulnar nerve palsy.


Question: Period of onset in tetanus refers to the time between

The interval between first symptom(dysphagia and stiffiness of jaw) to a reflex spasm is called period of onset. If this is less than 48hours,the prognosis is poor and if more than 48hours,prognosis is better. Ref:Manipal manual of surgery,4th edition,pg


Question: Jeeps disease is known as

Pilonidal sinus is seen in drivers mainly hairy jeep drivers in military.


Question: Most common site for squamous cell carcinoma of esophagus is

Ans. is 'b' i.e., Middle 1/3* Esophageal Carcinoma is of two common histological typesi) Squamous cell Ca - the MC type in world (-95% according to Sabiston)ii) Adenocarcinoma - where incidence is increasing at a rapid rate and is now the MC type in USA (Ref: Harrison, Schwartz)* Distribution of Squamous Cell Ca.# Upper 1/3 - 10%# Middle 1/3 - 60%# Lower 1/3 - 30% * Adenocarcinoma is mainly located in lower 1/3.


Question: Pringle's Maneuver is used to stop the bleeding from

Pringle maneuver is soft clamping hepatic artery and portal
vein at the point of entry. It is done for liver trauma patients.


Question: Acute onset of anuria in elderly men


Question: &;FAST&; can detect free blood if it is a minimum of

Focused abdominal sonar for trauma (FAST) is a technique whereby ultrasound (sonar) imaging is used to assess the torso for the presence of free blood, either in the abdominal cavity or in the pericardium. The technique, therefore, focuses on six areas: the pericardium, the areas around the liver and the spleen, the left and right pericolic gutters, and the peritoneal space in the pelvis. FAST is accurate at detecting >100 mL of free blood;Bailey and Love 26e pg: 359


Question: Causes for primary hyperparathyroidism


Question: History of lucid interval is present in

.extradural haematoma is the collection of blood in the extradural space between the dura and skull. most common site is temporoparietal region . usually , it is associated with fracture of temporoparietal region. immediately after injury, there is transient loss of consciousness and the patient soon becomes normal. later after 6-12 hours, he again falls ill and condition deteriorates. this is the time taken to develop raising intracranial pressure , coning and its effects. this crucial time gap is caleed lucid interval. (Ref : SRB&;s Manual of Surgery, 5th editin , pg no. 1095)


Question: Congenital hydrocele is best treated by

Congenital hydrocele is best treated with herniotomy if they do not resolve spontaneously. Established acquired hydrocele often have thick walls. They are treated by subtotal excision of the sac. If the sac is small, thin walled and contains clear fluid, Lord's operation is done. Jaboulay's operation where the sac is eveed with placement of testis in a pouch created by dissection in the fascial planes of the scrotum, is an alternative. Reference : page 1328 Bailey and Love's sho practice of surgery 25th edition and page 1072 SRB's manual of surgery 5th edition


Question: The treatment of choice for squamous cell anal cancer is

Anal cancer # Uncommon tumour, which is usually a squamous cell carcinoma # Treatment is by chemoradiotherapy in the first instance # More prevalent in patients with HIV infection # May affect the anal verge or anal canal # Lymphatic spread is to the inguinal lymph nodes #Associated with HPV # Major ablative surgery is required if the above fails Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1269


Question: Fine needle aspiration cytology is not suitable for diagnosing

Aneurysmal bone cyst, abbreted ABC, is an osteolytic bone neoplasm characterized by several sponge-like blood or serum filled, generally non-endothelialized spaces of various diameters. On a radiograph, well-defined, expansile, lytic lesion is observed. Expansion of coex gives the lesion a balloon-like appearance. Larger lesions may appear septated The afflicted may have relatively small amounts of pain that will quickly increase in severity over a time period of 6-12 weeks. The skin temperature around the bone may increase, a bony swelling may be evident, and movement may be restricted in adjacent joints. Spinal lesions may cause quadriplegia and patients with skull lesions may have headaches. Commonly affected sites are metaphyses of veebra, flat bones, femur and tibia. Approximate percentages by sites are as shown: Skull and mandible (4%) Spine (16%) Clavicle and ribs (5%) Upper extremity (21%) Pelvis and sacrum (12%) Femur (13%) Lower leg (24%) Foot (3%) Ref: Internet sources (Wiki)


Question: The concept of One Stage Full Mouth Disinfection has been put forth to prevent


Question: Wolfe grafts is

.wolfe graft is a ful thickness graft consisiting of epidermis and full layer of dermis thiersch graft is a paial thickness graft consisiting of epidermis and variable layers of dermis


Question: "Peritoneal mice" is


Question: Melanoma of anal canal

Malignant melanoma of the anus is very rare and usually presents as a bluish-black soft mass that may mimic a thrombosed external pile, although it may be amelanotic.The prognosis, irrespective of treatment, is extremely poor. Ref: Bailey & Love&;s Sho Practice of Surgery,E25,Page-1269

AP resection gives better result then local excision


Question: A young man gets into a fight after taking beer and is kicked by the lower abdomen. There was pelvic fracture. Blood at meatus. Most likely cause is

Rupture of membranous urethra is usually associated with pelvic fractures. It is characterised by blood in external meatus, failure or difficulty in passing urine, extravasation of urine to scrotum, perineum and abdominal wall, shock .
Bulbar urethral injury is usually d/t a fall astride a projecting object leading to blood at meatus, perineal hematoma, retention of urine.
In case of kidney laceration- features of shock, hematuria, clot colic, bruising,swelling and tenderness in the loin.


Question: Most common type of melanoma

Superficial spreading melanoma (SSM) This is the most common presentation (70%), usually arising in a pre-existent naevus after several years of slow change, followed by rapid growth in the preceding months before presentation.Ref: Bailey and Love, 27e, page: 609


Question: Burns with vesiculation of the epidermis and upper dermis is

Second degree burns Paial thickness burn Involve epidermis and some pa of dermis Divided into : Superficial and deep second degree Superficial second degree Involve upper layer of dermis (papillary dermis) Erythematous Blisters are seen Blanch to touch Painful Heals without scarring in 7-14 days Deep second degree burns Also known as deep paial thickness burn Injury extends to reticular layer of dermis Dont blanch Mottled pink and white colour of wound surface Capillary refilling is absent or occurs slowly Pain is absent Pin-prick sensation is absent or occurs slowly Heals in 3-9 weeks with scar formation Ref: Sabiston 20th edition Pgno : 506-507


Question: The least common type of intussuception is


Question: Ormand's disease is

Ans. b (Idiopathic retroperitoneal fibrosis) (Ref. Bailey and Love surgery 25th/pg. 1007)RETROPERITONEAL FIBROSIS (RPF) / ORMAND'S DISEASE# This is one of a group of fibromatoses (others being Dupuytren's contracture and Peyronie's disease).# This process was first identified in 1905 by Albarran who encountered a patient with an extensive fibrotic retroperitoneal process at surgery.# Causes of retroperitoneal fibrosis: Idiopathic (Ormond's disease), Chronic inflammation, Extravasation of urine, Retroperitoneal irritation by leakage of blood or intestinal Content, Aortic aneurysm ('inflammatory type'), Trauma, Drugs: Chemotherapeutic agents Methysergide Beta-Adrenoceptor antagonists, Lymphoma, Carcinoid tumours, Secondary deposits (especially from carcinoma of stomach, colon, breast and prostate)# Most cases are idiopathic.# It is most commonly observed in middle-aged to elderly men between the ages of 40 and 70.# Familial cases are known, involving mediastinal fibrosis, sclerosing cholangitis, Riedel's thyroiditis and orbital pseudotumour. Extensive collagen deposition surrounds the ureters, mostly at the level of the pelvic brim or below. Most patients present with ureteric obstruction, often with renal failure.# The hallmark IVU feature of RPF is deviation of both ureters medial to the lumbar vertebral pedicles.0# Multislice CT remains the standard imaging employed to evaluate patients in whom RPF is suspected.# Ureteric stenting and steroid therapy are often effective.


Question: Hamman's sign is most characteristic of

(D) Pneumomediastinum # Subcutaneous emphysema is a frequently found in pneumothorax (air outside of the lung in the chest cavity) and may also result from air in the mediastinum, pneumo- pericardium (air in the pericardial cavity around the heart). Pneumothorax (plural pneumothoraces) is a collection of air or gas in the pleural cavity of the chest between the lung and the chest wall. It may occur spontaneously in people without chronic lung conditions ("primary") as well as in those with lung disease ("secondary"), and many pneumothoraces occur after physical trauma to the chest, blast injury, or as a complication of medical treatment. Pneumopericardium is a medical condition where air enters the pericardial cavity.lt can be congenital, or introducec by a wound Hamman's crunch is caused by pneumomediastinum , and is associated with tracheobronchial injury due to trauma, medical procedures (e.g., bronchoscopy) or proximal pulmonary bleb rupture


Question: Curling&;s ulcer is seen in

.Acute ulcers after cerebral trauma or neurosurgeries are called as Cushing's ulcers. Acute ulcers after major burns are called as Curling ulcers. Diagnosis is by gastroscopy presenting as pain in the epigastric region, vomiting or haematemesis. Treatment is conservative- IV ranitidine. IV pantoprazole 80 mg in 100 ml DNS--slow, later 40 mg IV maintenance. Note: Curling's ulcer occurs when burn injury is more 35%. It is observed in the body and fundus, not in antrum and duodenum. Ref: SRB&;s manual of surgery,3 rd ed, pg no 770


Question: Heller's cardiomyotomy done for

Ans. (b) AchalasiaRef: Bailey and Love 27th Edition, Page 1098Treatment for Achalasia:There are various modes of treatment for achalasia cardia:Medical Treatment:* Calcium channel blockers like sublingual Nifedipine* Sildenafil citrate* NitratesEndoscopic Treatment:* Pneumatic balloon dilatation: 30mm - 40mm plastic balloon are used. Most common complication is perforation around 0.5%. Results are good for age above 40 years* Botulinum toxin: injected in the LOS which destroys the excitatory effect of cholinergic neurons. Effect is temporary and we have to repeat after few months. Hence used only for Unfit elderly patients.* Endoscopic myotomy known as peroral endoscopic myotomy (POEM)Heller's Myotomy:* Gold standard of all procedures. Myotomy done from 1-2 cm on stomach side extending up to 6-8 cm on esophagus side anteriorly* Most common complication is GERD* Hence nowadays Dor anterior fundoplication is done along with myotomy.* Successful in 90% cases.


Question: Wolffian duct give rise to

(Vas deference) (1403-LB) (1377-B &L 25,h)* The testis develops from the genital fold medial to the mesonephros (Wolffian body)* The Wolffian duct becomes the epididymis and vas deferensDevelopment of genitourinary System:Embryonic structureStructure developing in MALEStructure developing in FEMALEGenital tuberclePenis (C. cavernosa)ClitorisUrethral foldsPenile urethra (C. spongiosa)Labia minoraGenital swellingScrotumLabia majoraGubemaculumGubemaculums testisLigament of ovaryRound ligament of uterus Genital glandsTestisOvary (genital ridge)Germinal cordsSeminiferous tubulesPfluger's tubeMesonephric duct (Wolffian duct)Epididymis, Vas deferens and seminal vesicles Ejaculatory ductsAppendix epididymidisDuct of epoophoron Gartner's duct vesicular appendageUreter, renal pelvis etc Trigonal structure**Ureter, renal pelvis, et^ Trigonal structuresMullerian duct (Paramesonephric duct)Appendix testisProstatic utricleUterine tubes, Uterus, Vagina (upper four- fifths)Muller's tubercleVeromontanumSite of hymenSinovaginal bulb from urogenital sinusPart of prostatic utricleLower one-fifth of vaginaJunction of sinovaginal bulb and urogenital sinusDisappears normally (remnants probably from posterior urethral valves)HymenUrogenital sinusVentral and pelvic partUrinary bladder (except the trigone)Supramontanel part of prostatic urethraUrinary bladder (except the trigone) whole urethraPhallic or urethral portionInframontanal part of prostatic urethra Membranous urethraVaginal vestibules


Question: In classic Barret's, the length of columnar epithelium in distal oesophagus is

Classic Barrett's (>= 3cm columnar epithelium);Sho-segment Barrett's (<3 cm of columnar epithelium);Cardia metaplasia (intestinal metaplasia at the oesophagogastric junction without any macroscopic change at endoscopy).The relative risk of cancer rises with increasing length of abnormal mucosa.


Question: Maximum dose of xylocaine with out adrenaline that can be given in 60kg adults is


Question: Paget's disease of breast is a manifestation of

Ans. (a) Ductal carcinoma(Ref Bailey and Love 27th edition Page 873)* Paget's disease of nipple is the manifestation of underlying Ductal carcinoma, Nipple gets eroded completely and disappears.* Large ovoid cells with abundant Pale staining cytoplasm in malphigian layer of skin is Paget's cells


Question: Conscious sedation in dentoalveolar surgery is best done by


Question: Infection draining the ring finger goes to

Mid palmar space Infection from thumb and index finger --- thenar space Middle and ring finger--mid palmar space Little finger-- fore arm space of Parona


Question: Trismus associated with infection of Lateral pharyngeal space is related to irritation of the


Question: The treatment of choice for perforation of the cervical esophagus is

Surgical exploration of the neck conr with drainage of the retro visceral space is the preferred treatment of persons who have a cervical esopre perforation. Drainage can be performed under G. anesthesia and improvement is prompt. Suture may be required for major lacerations. All persons having an esophageal injury should receive parenteral administered antibiotics and appropriate fluid electrolyte solutions; however, relying on these measures alone-without surgery-is dangerous and may be fatal.

Nasogastric intubation and use of antibiotics

Cervical exploration and drainage of superior mediastinum and use of antibiotics


Question: Tinnels sign indicates


Question: Tietz syndrome is

It causes breast pain which is non cyclical.


Question: Investigation of choice in discrete thyroid swelling is

Fine-needle aspiration cytology is the investigation of choice in discrete thyroid swellings. FNAC has excellent patient compliance, is simple and quick to perform in the outpatient depament and is readily repeated Comment : This question is based on above lines from bailey and love. In workup of solitary nodule of thyroid , thyroid profile is done after history and physical eamination. In normal or elevated TSH patients , USG neck is done. following which FNAC is done Previously thyroid scan used to be very impoant investigation in solitary nodule workup. Now its limited to toxic nodules. May be question is framed to highlight this point. Source : Sabiston 20th edition Pg : 890 Bailey and Love 26th edition Pg : 750


Question: Contraindication of major thoracic surgery is

(A) Myocardial infarction in recent 3 months# CARDIOVASCULAR FITNESS:1. All patients for lung resection should have a preoperative ECG.2. All patients with an audible cardiac murmur should have an echocardiogram.3. Patients who have had a myocardial infarction should normally not be operated on for lung resection within 6 weeks.4. Any patient who has had a myocardial infarction within 6 months and is being assessed for thoracic surgery should have a cardiology opinion.5. Patients who have had coronary artery bypass surgery should not be precluded from having lung resection. They should be assessed as for other patients with possible cardiac risk factors.6. The guidelines from the American College of Cardiology and the American Heart Association should be used as a basis for assessing the perioperative cardiovascular risk of patients undergoing lung resection.# Major risk:(a) These patients should have a formal cardiological assessment and their management discussed at a multidisciplinary meeting.(b) Patients found to have significant lesions on coronary angiography should be considered for coronary artery bypass surgery before lung resection.# Intermediate Risk:(a) Patients in this group with reasonable functional capacity (able comfortably to walk up one flight of stairs) should not normally be regarded as at greater than average risk for postoperative complications. They do not need further cardiac testing.(b) Patients with poor functional capacity and those in whom there is doubt about the degree of severity of their angina pectoris or who report breathlessness which may be due to cardiac disease should have an ECG monitored exercise test and echocardiogram and the results should be discussed with a cardiologist.# Minor Risk:> Patients in this group with one risk factor should not normally be considered to be at greater than average risk for postoperative complications.

Myocardial infarction is recent 3 months

Myocardial infarction in recent 9 months

Myocardial infarction in recent 12 months


Question: Split skin grafts in young children should be harvested from

.* Once the area granulates well, in 3 weeks usually, split skin grafting is done (SSG, Thiersch graft). * For wider area MESH split skin graft is used. * If there is eschar, escharotomy is required to prevent compression of vessels. * In ceain areas like face and ear, full thickness graft (Wolfe graft) or flap is required. ref:SRB;s manual of surgery,ed 3,pg no 112


Question: Elective cholecystectomy is

Clean no viscus opened EX: thyroid, breast surgeries Clean-contaminated viscus opened, minimal spillage) Cholecystectomy, Gastric surgery Contaminated open viscus with spillage or inflammatory disease Inflamed appendix, rectal surgeries Diy pus or perforation, or incision through an abscess I&d wound debridement


Question: Hyperbaric oxygen is indicated for


Question: The most common underlying aetiology of primary hyperparathyroidism is

The underlying aetiology of PHPT is usually a solitary parathyroid adenoma, however, in a small number of patient (2-4%), there are double adenomas. It may occur in a sporadic fashion or it can be familial (MEN type 1 or type 2A, hyperparathyroidism-jaw tumour syndrome (HPT-JT)Ref: Bailey and Love 27e pg: 826


Question: Treatment of contaminated wound in Gas Gangrene isa) Debridement of woundb) Systemic penicillinc) Metronidazole Administrationd) Peroxide dressings


Question: Bakers cyst is a type of

Answer- A. Pulsion diveiculum of knee jointIt is the pulsion diveiculum of the knee joint, caused by chronic disease in the joint.Bulging of the posterior capsule and synol herniation may produce a swelling in the popliteal fossa.


Question: Pulp space infection is known as

A felon is an abscess between the specialised fibrous septae in the fingeip pulp. It causes intense pain and may lead to terminal phalangeal osteomyelitis. Reference : Bailey & Love, 27th Edition, page no = 503.


Question: In cholecystectomy, fresh plasma should be given

.Indications for cholecystectomy, * Gallstones--symptomatic. * Cholecystitis--acute, chronic. * Acalculous cholecystitis. * Empyema gallbladder. * Mucocele gallbladder. Approaches employed are * Open - Right subcostal incision (Kocher's). - Right paramedian. - Horizontal incision. - Mayo-Robson incision. * Laparoscopic approach. Technique After opening the abdomen, colon is pushed downwards and stomach medially. Duct--first method: Here Calot's triangle is dissected. Cystic aery is identified and ligated. Cystic duct is ligated close to the gallbladder. Gallbladder is separated from gallbladder fossa and removed. Haemostasis is maintained. Fundus--first method: It is done in difficult gallbladder due to dense adhesions. Fundus is separated from themliver bed. Dissection is carried proximally until cystic duct and cystic aery are identified, which are then ligated. Drain is placed, which is removed after 72 hours. On table cholangiogram is a must after cholecystectomy. ref : SRB&;s manual of surgery,3 rd ed,pg no 595


Question: Most common complication of end colostomy is


Question: Risk factors of pulmonary embolisma) 30 yrs female on OCP' sb) Pregnancyc) Leg paralysisd) 50 yrs person with uncomplicated cholecystectomye) Bechet's disease


Question: Hormonal therapy is useful if Cancer breast expresses ...

Ans. (a) Estrogen receptor(Ref. Sabiston 20th edition Page 853)* ER positive cases are provided Hormone therapy* HER-2/neu Positive cases are provided Trastuzumab HERCEPTIN (VEGF inhibitor)


Question: Lymphnode metastasis commonest in .... Carcinoma thyriod


Question: The typical appearance of "spider leg" on excretory urography is seen in

REPEAT QUESTION polycystic kidney, an autosomal dominant disease, common in females; excretory urogram shows 'spider leg' pattern - elongated and compressed renal pelvis with narrowed and stretched calyces over the cysts. ( Reference: emedicine.medscape.com/aicle/983281-workup )


Question: Testicular tumor in man aged 70 years is most likely to be


Question: Treatment for pagets disease of breast is

Simple mastectomy along with lymph node assessment is usually treatment of choice.