Mcq Salad 027

Front 1

Interesting things to know about Tamoxifen

Back 1

T-Thrombotic complicationsA-agonist and antagonist of estrogenM-modulator of estrogen receptor (SERM)O-obesity X-xeroderma of vagina skin/areola (vaginal dryness,areolar hyperpigmentation)I-itching of the vulva (pruritus vulvae)F-Flushes (hot),fluid retention,first line hormonal therapy for breast caE-endometrial carcinoma riskN-nausea and vomiting

Front 2

What is responsible for peau d'orange in ca breast?

Back 2

Blockage of dermal lymphatics

Front 3

DVT prophylaxis

Back 3

Little preop timeTed stockingsEarly ambulationDeep breathing and limb exercises Prophylactoc anticoagulant Sc heparin 5000iu 2hr preop x and b.d pstop for 7/7

Front 4

What is the estimatef maximum proyein and enerhy requirement per day?

Back 4

Protein 1.5g/kg/dEnergy 40kcal/kg/day

Front 5

What are the benefits of using essential aa in renal failure?

Back 5

▪essential aa + huperyonic glucose prevents a rise in BUN▪also prevemts hyperkalemia thereny obviaying dialysis in such patients.

Front 6

What is lid retraction?

Back 6

Raised upper eyelids witj widening of palpebral fissure exposing the whiye sclera above the superior limbus. (Dalry,ple's sign) due to spasm of involuntary part of levator palpebrae superioris is seen in patients witj huperthyroidism.

Front 7

Classify hyponatremia

Back 7

Mild 130-135Moderate 120-130Severe <120

Normal range 135-145mmol/l

Front 8

How long does it take for CRP to go up and to fall in osteomyelitis?

Back 8

Goes up in 4 hours .Falls in 48 hours

Front 9

Unhappy triad of O'donoghue

Back 9

ACL-rupture of the anterior cruciate ligamentMM-damage to the medial meniscusMCL-injury to the medial collateral lihament

A.k.a terrible triad or blown knee

Front 10

The most common benign primary bone tumour

Back 10

Osteochondroma

Also called cartolage capped exostosis

Front 11

What is tesponsible for the contravtion of the internal anal sphincter? Sympatheti pr parasympathetic?

Back 11

Sumpathetic

Parasympathetic stimulation causes relaxation

Front 12

The olecramon arises from which bone?

Back 12

Ulna

Front 13

Things to look for when inspecting the breast

Back 13

S - sizeS- symetryS-scar - biopsy,surgery3F- fullness-supra/infraclavicular,quadrants,axillaP-puckeringE-erythema-mastitis,abscess,inflammatory caN-Nipple-discharge,deviation,displacement,destruction,retractionUP-upper limb lymphoedema

SSS 3F PENS UP!

Front 14

Active treatment of DVT

Back 14

▪check naseline PT (2-3times),PTT (1.5-2)▪start sc LMWH 200iu daolu x 5/7▪72hrs prior to stopping LMWH,stary wargarin 5-10mg/d and continue it for 3months▪INR must be 2-3

Front 15

Why is CO2 the gas of cjoice for pneumoperitoneum in laparoscopy?

Back 15

Find out

Front 16

How will you prevent stasis in a polycythaemia rubra vera patient?

Back 16

Phlebotomy

Front 17

What are the risk factors for DVT?

Back 17

Age>40ObesityOral contraceptivesSurgeries esp ortjopedic surgCamcer e.g ca lung,stomach,leukaemia

Front 18

How do you diagnose DVT on ultrasound?

Back 18

Failure of the lumen of a vein to collapse and the walls to coapt indicates the presence of a thrombus.

Front 19

Where do the following deformities occur? House maid knee,clergy man's knee

Back 19

House maid knee -prepatellarClergy man's knee - infrapatellar

Front 20

Effect of mannitol use in management of head injury

Back 20

●decreases ICP●Increases CBF through modulation of viscocity

Front 21

ECOG performance status

Back 21

0-Fully active and is able to carry out normal activities without any restrictions1-symptoms restrict strenous activity but is able to carry out light sedentary activities 2-Ambulatory but unable to carry out normal activities.up and about >50% waking hours3-only li,ited self care.Confined to bed,disabled,needs assistance4-Completely confined to bed,disabled,needs assistance.

Front 22

What are the signs of brain herniation?

Back 22

●Unilateral or bilateral pupillary dilatation●Asymetrical pupillary activities●Motor posturing

Front 23

What investigations will u do to confirm DVT?

Back 23

USG- reproducible, iliac veins are too deep to compress (doppler helps with this)Xray + urograffinImpedance plethysmography

Front 24

What investigations willbu do to conform DVT?

Back 24

USG- reproducible, iliac veins are too deep to compress (doppler helps with this)Xray + urograffinImpedance plethysmography

Front 25

What is responsible for peau d'orange in ca breast?

Back 25

Blockage of Dermal lymphatics

Front 26

Surgical complications of sockle cell disease

Back 26

Painfil crisisAcute chest syndromeCerebrovascilar accident

Front 27

What is the commonest operation performed in patienys with SCD?

Back 27

Cholecystectomy

Front 28

What should be the composition of your maintainance fluid?

Back 28

-3L of fluid-150mmol Na+-60 mmol k+(giben when the urine output is adequate)

Front 29

Osteomyelitis has pregerence for which pary of the bone?

Back 29

Metaphysis

Front 30

Complications of the colostomy

Back 30

H-HerniationE-escoriation of the skinP-prolapseI-Impacted with faecesN-NecroticS-stenosed C-candidiasisA-abscessR-retractD-diarrhoea,dermatitis,depression

Front 31

There is a high risk of renal dysplasia in ?

A) Posterior urethral valves

B) Bladder extrophy

C) Anorectal malformation

D) Neonatal sepsis

Back 31

C

Explanation: [About 50% of children with anorectal anomalies have a urological problem. The more serious and complex the anorectal defect, the more frequently it is associated with a urological anomaly. Ref: Nelson Textbook of Pediatrics; 16th edition; page 1146] [Contributed by "Dr. Sharad Chandra" at forum & "Dr. Rohit Tekriwal" via email, thanks...!!!]

Front 32

Cells from the neural crest are involved in all except ?

A) Hirschprung's disease

B) Neuroblastoma

C) Primitive neuroectodermal tumor

D) Wilm's tumor

Back 32

D

Explanation: [Wilms�?? tumor (nephroblastoma) is a mixed tumor containing epithelial and connective tissue elements arising from embryonic nephrogenic tissue. Ref: Bailey & Love�??s Short Practice of Surgery; 23rd edition; page 1196 �?? 1197 - "Dr. Sharad Chandra"] [Neuroblastoma is an embryonal tumor of neural crest origin that may arise anywhere in the sympathetic nervous system, including the neck (3%), posterior mediastinum (20%), pelvis (3%), para-aortic paraspinal ganglia (24%), and adrenal medulla (50%). 52 This is the most common solid malignant tumor of infancy and occurs in 1 per 7000 to 10,000 live births. Aganglionic megacolon is a neurogenic form of intestinal obstruction in which there is an absence of ganglion cells in the myenteric (Auerbach's) and submucosal (Meissner's) plexuses. Hypertrophic nerve fibers are often observed. The absence of parasympathetic innervation causes a failure of relaxation of the internal anal sphincter. Abnormalities in purinergic and peptidergic fibers and nitric oxide synthase deficiency have also been observed. - "Dr. Bruno"]

Front 33

A 'Malignant pustule' is a term used for ?

A) An infected malignant melanoma

B) A carbuncle

C) A rapidly spreading rodent ulcer

D) Anthrax of the skin

Back 33

D

Explanation: [Anthrax is found in cattle and is likely to be seen in people who handle carcasses, wool, hides, hair and bone meal. The cutaneous variety is the most common human variety; incubation period is 3 �?? 4 days. The lesion usually starts on an exposed portion of the body such as hands, forearms, or face. An itching papule occurs, around which a patch of induration soon becomes evident. The papule suppurates and is replaced by a black slough with a ring of vesicles appearing on the surrounding indurated area. This stage is typically known as malignant pustule. Bailey & Love�??s Short Practice of Surgery; 23rd edition; page 110] [Contributed by "Dr. Sharad Chandra" at fourm & "Dr. Rohit Tekriwal" via email, thanks...!!!]

Front 34

A Warthin's tumor is ?

A) An adenolymphoma of parotid gland

B) A pleomorphic adenoma of parotid gland

C) A carcinoma of the parotid

D) A carcinoma of the submandibular salivary gland

Back 34

A

Explanation: [Warthin�??s tumor or adenolymphoma is a benign neoplasm composed of a double-layered epithelium which lines spaces, which are frequently cystic. ng: Bailey & Love�??s Short Practice of Surgery; 23rd edition; page 659] [Contributed by "Dr. Sharad Chandra" at forum & "Dr. Rohit Tekriwal" via email, thanks...!!!]

Front 35

A newborn baby had normal APGAR score at birth and developed excessive frothing and choking on attempted feeds. The investigation of choice is ?

A) Esophagoscopy

B) Bronchoscopy

C) MRI chest

D) Xray chest and abdomen wiht the red rubber catheter passed per orally into oesophagus

Back 35

A

Explanation: [This is a case of -esophageal atresia with tracheo-esophagal fistula. Ideal investigation is: X-ray with -INFANT FEEDING TUBE - in infant's pharynx shows curling up of tube.. Here-RED RUBBER CATHETER.. THE CRUX-- infant feeding tube has a radio-opaque line that is visible on x-ray while red rubber catheter doesnt have any so it will not be visible in the xray so the next best out of the options given is esophagoscopy.. Here the examiner wants to know whether you know whythe things are done rather than what is done.] [Contributed by " Dr. Prashant Nageshwar" & "Dr. Rohit Tekriwal" via email, thanks...!!!]

Front 36

A newborn baby has been referred to the casualty as a case of congenital diaphragmatic hernia. The first clinical intervention is of ?

A) Insert a central venous pressure line

B) Bag and mask ventilation

C) Insert a nasogastric tube

D) Ventilate with high frequency ventilator

Back 36

C

Front 37

One year old male child is presented with poor urinary stream since birth. The investigation of choice for evaluation is ?

A) Voiding cystourethrography (VCUG)

B) USG bladder

C) Intravenous urography

D) Uroflometry

Back 37

A

Front 38

Which of the following statements about peptic ulcer disease is true ?

A) Helicobacter pylori eradication increases likelihood of occurrence of complications

B) The incidence of complications has remain unchanged

C) The incidence of Helicobacter pylori reinfection in India is very low

D) Helicobacter pylori eradication does not alter the recurrence ratio

Back 38

D

Front 39

Which of the following is not a contraindication for extracorporeal shockwave lithotripsy (ESWL) for renal calculi ?

A) Uncorrected bleeding diathesis

B) Pregnancy

C) Ureteric stricture

D) Stone in a calyceal diverticulum

Back 39

D

Front 40

Which of the following is not an appropriate investigation for anterior urethral stricture ?

A) Magnetic Resonance Imaging

B) Retrograde Urethrogram

C) Micturating Cystourethrogram

D) High frequency Ultrasound

Back 40

A

Front 41

The recommended treatment for preputial adhesions producing ballooning of prepuce during micturition in a 2 year old boy is ?

A) Wait and watch policy

B) Circumcision

C) Doral slit

D) Preputial adhesions release and dilatation

Back 41

D

Front 42

Regarding neonatal circumcision, which one of the following is true ?

A) It should be done without anaesthesia as it is hazardous to give anaesthesia

B) It should be done without anaesthesia as neonate do not perceive pain as adult

C) It should be done under local anasthesia

D) General anaesthesia should be given to neonate for circumcision as they also feel pain as adult

Back 42

D

Front 43

Which of the following imaging modality is most sensitive to detect early renal tuberculosis ?

A) Intravenous urography

B) Ultrasound

C) Computed tomography

D) Magnetic resonance imaging

Back 43

A

Front 44

Regarding testicular tumors, the following are false except ?

A) They are the commonest malignancy in older men

B) Seminomas are radiosensitive

C) Only 25% of Stage I teratomas are cured by surgery alone

D) Chemotherapy rarely produces a cure in those with metastatic disease

Back 44

B

Front 45

Hypochloremia, hypokalemia and alkalosis are seen in ?

A) Congenital hypertrophic pyloric stenosis

B) Hirschprung's disease

C) Oesophagal atresia

D) Jejunal atresia

Back 45

A

Explanation:[Protracted and extensive vomiting in congenital hypertrophic pyloric stenosis leads to critical deficits of K+ and Na+; but much more striking are decrease in Cl - and H+ and increase in CO2 contents of blood (hypochloremic alkalosis). Correction of these chemical changes requires both Na+ and K+. Intravenous administration of 5% dextrose in isotonic NaCl solution (5% DNS) to which KCl is added in a concentration of 3 �?? 5 mEq / dL will gradually correct the calculated deficits of Na+, K+ and Cl -. may be studied at - Bailey & Love's Short Practice of Surgery;23rd edition] [Contributed by "Dr. Sharad Chandra" at forum & "Dr. Rohit Tekriwal" via email, thanks...!!!]

Front 46

Use of tamoxifen in carcinoma of breast patients does not lead to the following side effects ?

A) Thromboembolic events

B) Endometrial Carcinoma

C) Cataract

D) Cancer in opposite breast

Back 46

D

Explanation: [Tamoxifen is the most widely used hormonal treatment in breast cancer. The beneficial effects of tamoxifen in reducing the risk of tumors in the contralateral breast have also been observed. Bailey & Love�??s Short Practice of Surgery; 23rd edition; page 767] [Contributed by "Dr. Sharad Chandra" at forum, thanks...!!!]

Front 47

An adult old man gets a burn injury to his hands. Over few weeks , the burned skin heals without the need for skin grafting. The most critical factor responsible for the rapid healing in this case is ?

A) Remnant skin appendages

B) Underlying connective tissue

C) Minimal edema and erythema

D) Granulation tissue

Back 47

A

Front 48

Investigation of choice to diagnose Hirschprung's disease is ?

A) Rectal manometry

B) Barium enema

C) Rectal biopsy

D) Laparotomy

Back 48

C

Front 49

All of the following are the classical presentation of Craniovertebral anomalies except ?

A) Pyramidal signs

B) Low hair line

C) Short neck

D) Pupillary asymmetry

Back 49

D

Front 50

Portal hypertension in children in India is commonly due to ?

A) Indian Childhood Cirrhosis

B) Extrahepatic portal venous obstruction

C) Idiopathic portal hypertension

D) Hepatic outflow tract obstruction

Back 50

B

Explanation:[B) as this is the most common cause in India causing non-cirrhotic portal hypertension which is the most common cause in india - by "Dr. Ved Prakash", thanks...!!!] C) Idiopathic portal hypertension [By - " Dr. Debsanjay", thanks...!!!]