50-Fmge-Repeat-Questions-Discussion-.docx

FMGE QUESTIONS

1. ARISE Academy 50
Repeat Questions
Discussion
DR. RAJAMAHENDRAN MS, MRCS, MCH
AUTHOR SURGERY SIXER

2. Section A : GENERAL

3. Question 1
Correct position of inserting a Nasogastric Tube is
a. Supine with Neck flexed
b. Supine with Neck extended
c. Sitting with Neck flexed
d. Sitting with Neck Extended


Ans. C. Sitting with Neck flexed

4. Nasogastric tube

5. NEX and NEMU rules

6. Method to insert Ryles tube

7. Identification of Tip in Stomach

8. Question 2
Which of the following is not scanned by e-FAST?
a. Pericardium
b. Liver
c. Bowel
d. Spleen


Ans. C. Bowel

9. Focussed Assessment with Sonography for Trauma.
To assess presence of blood in peritoneum or pericardium.
Focuses on four areas only: Epigastric (pericardial), splenic, hepatic, pelvic

FAST

10. Two more places are also examined- Left and right thoracic cavities.
Helps to detect Pneumothorax and Collection in Thoracic cavity.

e-FAST

11. Question 3
Prophylactic antibiotics to minimise the SSI are given
a. 60 minutes before skin incision
b. 1-3 hours before skin incision
c. At time of surgical incision
d. Night before surgery


Ans. a. 60 minutes before skin incision

13. Question 4
Calculate the GCS of a patient exhibiting eye opening on painful stimulus, Conscious but
confused and unable to tell time and exhibits flexion on painful noxious stimuli to the arm
a. 8
b. 9
c. 10
d. 11


Ans. C 10

14. Glassgow coma scale
(EVM-456)

15. Question 5
Amount of Blood lost in Class III Hemorrhagic Shock
a. 15-30%
b. 30-40%
c. 40- 45%
d. 45-50%


Ans. B 30-40%

17. Question 6
50 kg patient has 40% Burns on his body surface area. Calculate the Ringer lactate fluid to be
given in 1
st
8 hours.
a. 1 L
b. 2 L
c. 4 L
d. 8 L


Ans. C

18. PARKLAND FORMULA

19. Question 7
Which of the following needle is used to suture skin?
a. Cutting needle
b. Reverse cutting needle
c. Round Body needle
d. Straight body needle


Ans. A

21. Question 8
Which of the following is the best parameter to monitor the response to shock
management?
a. Urine output
b. Respiratory rate
c. BP
d. CVP


Ans. a. urine output

22. Question 9
What is the investigation of choice in hemodynamically stable blunt injury abdomen
patient?
a. USG
b. CECT abdomen
c. MRI
d. Diagnostic Peritoneal Lavage


Ans. B

24. Question 10
Identify the procedure shown here for
providing nutrition
a. Feeding Jejunostomy
b. Percutaneous endoscopic gastrostomy
c. Central vein insertion
d. Hickman lines


Ans. B Percutaenous endoscopic gastrostomy

25. Techniques
Direct Stab
Push Through

26. Section B- Head and
Neck, Thyroid and
Breast

27. Question 11
What is the location of Kilian’s dehiscence?
a. Below Superior Constrictor
b. Below Inferior Constrictor
c. Below Cricopharyngeal muscle
d. Below upper third of Smooth musces in esophagus


Ans. B Below Inferior Constrictor

29. Question 12
Which procedure is done for Ranula Management?
a. Incision and drainage
b. Aspiration
c. Excision of Sublingual gland
d. Marsupialization


Ans. C. Excision of Sublingual gland

31. Question 13
Which cancer in thyroid arises from Parafollicular C cells?
a. Anaplastic cancer
b. Medullary cancer
c. Follicular cancer
d. Papillary cancer


Ans. B. Medullary cancer

32. Question 14
FNAC can diagnose all the following lesions except
a. Follicular cancer
b. Papillary cancer
c. Medullary cancer
d. Hashimotos thyroiditis


Ans. A

33. Question 15
Warthin’s Tumor is seen arising from
a. Submandibular gland
b. Parotid gland
c. Sublingual gland
d. Minor salivary glands


Ans. B Parotid Gland

34. Warthin Tumor

35. Question 16
Most common nerve injured in Thyroid Surgery
a. RLN
b. ELN
c. ILN
d. Vagus nerve


Ans. B. ELN

36. Course of Recurrent Laryngeal Nerve
 The nerve runs posteriorly and enters at the level of cricothyroid joint where the BERRY
Ligament is attached.
 Please remember Berry Ligament is the posterior attachment of Pretracheal fascia that
binds Trachea and Thyroid ( One important reason for Gland moving with deglutition.
 This is the point where nerve is at highest risk of injury**
 This point is known as BEAHR’S Triangle

37. Beahr’s triangle
Boundaries :
• Tracheo Oesophageal Groove
• Common Carotid artery
• Inferior Thyroid Artery

38. Question 17
Stage the Breast cancer – Size 3cm and 4 axillary nodes in Axilla
a. Stage I
b. Stage II
c. Stage III
d. Stage IV


Ans. B Stage II

40. Question 18
Which is correct regarding paeu de orange in breast cancer?
a. Infiltration of Cooper’s ligament
b. Infiltration of subdermal lymphatics
c. Associated with Lobular cancer
d. Good prognosis



Ans. B. Infiltration of Subdermal lymphatics

41. Question 19
For Sentinel Node Biopsy in Breast cancer , where is the Dye injected ideally.
a. Subareolar
b. Axilla
c. Tail of Spence
d. Peritumoral


Ans. D Peritumoral

44. Question 20
What is the diagnosis of this mammography
picture shown here :
a. Fibroadenoma
b. Fibroadenosis
c. Cancer breast
d. Paget disease


Ans. A. Fibroadenoma

45. Section C
GIT

46. Question 21
Which of the following is not done in Cancer esophagus evaluation?
a. Biopsy
b. pH metry
c. CT Chest
d. PET Scan


Ans. B pH Metry

47. Identify this investigation

































SURGERY SIXER BY RRM

48. SURGERY SIXER BY RRM

49. SURGERY SIXER BY RRM





Rat tail appearance in ca esophagus

50. Question 22
Gastric outlet obstruction leads to
a. Hypochloremic metabolic alkalosis
b. Hypochloremic metabolic acidosis
c. Hypernatremic metabolic alkalosis
d. Hyponatremic metabolic acidosis


Ans. A. Hypochloremic Metabolic Alkalosis

51. Question 23
Congenital Hypertrophic Pyloric stenosis presents at
a. 3 days
b. 4 weeks
c. 3 months
d. 4 years


Ans. B. 4 weeks

52. CHPS

53. Ramstaed’s Pyloromyotomy

54. Question 24
Achalasia Cardia presents with all except
a. Increased LES tone
b. Normal Peristalsis
c. Proximal Dilatation
d. Malignant risk


Ans. B Normal Peristalsis

55. SURGERY SIXER BY RRM

Identify this investigation?

56. SURGERY SIXER BY RRM

57. Question 25
Boerhaave syndrome is
a. Spontaneous rupture of esophagus
b. Traumatic rupture of esophagus
c. Tear at GE junction
d. Foreign Body esophagus


Ans. a. Spontaneous Rupture of esophagus

58. SURGERY SIXER BY RRM

59. Question 26
What is the diagnosis of this Barium enema?
a. Diverticulum
b. Intussusception
c. Volvulus
d. Fistula


Ans. B Intussusception

60. Question 27
A 26 year old male patient presented with
RIF pain and Fever. USG image is shown
below:
a. Acute diverticulitis
b. Crohns disease
c. Acute appendicitis
d. Perforation


Ans. C. Acute Appendicitis

61. Question 28
Which is false about Crohn’s Disease?
a. No occurrence after surgery
b. Apthous ulcers
c. Skip lesions
d. Fistula formation


Ans. A No occurrence after surgery

62. Fistula

63. Cobble stoning

64. Serpiginous ulcers

65. Terminal Ileitis

66. Strictures

67. Question 29
Best treatment for Anal Cancer Squamous cell cancer
a. Chemoradiation
b. Radiation only
c. Surgery
d. Chemo only


Ans. A Chemoradiation

68. Question 30
Which is true about Carcinoid Tumor?
a. Always Benign
b. Kulchisky cells origin
c. Present with Paroxysmal hypertension
d. Punch biopsy is done


Ans. B. Kulchisky cell origin

69. Question 31
Which of the following polyp is least likely to turn malignant?
a. Inflammatory polyp
b. Hamartomatous polyp
c. Hyperplastic polyp
d. FAP polyps


Ans.C Hyperplastic polyps

70. Question 32
Most common location of Lymphoma in GIT?
a. Ileum
b. Stomach
c. Colon
d. Rectum


Ans. B Stomach

71. Question 33
All are true about Femoral hernia except:
a. Common in Nulliparous women
b. Lockwood infrainguinal approach is done
c. Cough impulse is seen
d. High incidence of strangulation



Ans. A. Common in Nulliparous women

73. Obstructed Femoral hernia

74. Question 34
The content of Littre’s hernia is
a. Omentum
b. Bladder
c. Meckel’s diverticulum
d. Appendix


Ans. C. Meckel’s Diverticulum

76. Question 35
In Nyhus Classification Type 3A stands for which hernia?
a. Femoral
b. Direct
c. Pantaloon
d. Indirect


Ans. B Direct hernia

78. Section D HBP and
Spleen

79. Question 36
MC immediate complication of splenectomy:
a. Fistula
b. Bleeding from Gastric mucosa
c. Pancreatitis
d. Hemorrhage


Ans. D. Hemorrhage

80. Question 37
A 6 year old girl brought with high fever with rigors for 5 days with pain in right
hypochondrium. On examination patient is anicteric and tenderness is noted in right upper
quadrant. What is the best investigation in this case?
a. USG
b. Serology
c. SGOT/LFT
d. Contrast CT scan
Ans. D. Contrast CT scan

81. CT scan- Irregular margins

82. CT scan- Rim enhancement
smooth edges: Amoebic liver abscess

83. Question 38
What is the name of the investigation shown
here?
a. MRCP
b. ERCP
c. PTC
d. T tube cholangiogram


Ans. B ERCP

84. Question 39
A patient with RUQ pain – USG done shows
this image:
Diagnosis is
a. GB malignancy
b. GB stones
c. GB polyps
d. Porcelain GB


Ans. B GB Stones

85. Question 40
Pringle’s manuever is used to control bleeding from
a. IVC
b. Cystic artery
c. Hepatic artery
d. Hepatic vein


Ans. C

87. Question 41
Severity of Acute pancreatitis is assessed by
a. Serum Amylase
b. Stool Trypsin
c. RANSON score
d. ARDS development


Ans. C RANSON Score

89. Ranson’s Score


On Admission At 48 Hours
L- LDH > 350 Units/L B- Base deficit > 4 mmol/L
A- AST>250 Units/L U-Urea Nitrogen > 5mg/dl
G- Glucose>1.1mmol/L ( >200 mg/dl) C- Calcium < 2 mmol/L
A- Age > 55 years H- Hematocrit fall > 10%
W- WBC count > 16X10^9/L O- PaO2 < 60 mmHg ( 8 Kpa)
W- Water Fluid Sequestration >6 L

90. Question 42
In case of Annular Pancreas, what is the surgery of Choice
a. Duodeno-duodenostomy
b. Duodeno-Jejunostomy
c. Pancreatico jejunostomy
d. Porto enterostomy


Ans. A. Duodeno Duodenostomy

92. Section E Specialty
topics

93. Question 43
Which of these is the best for management of a 3cm stone in renal pelvis without evidence
of hydronephrosis?
a. ESWL
b. PCNL
c. Antegrade pyeloplasty
d. Retrograde pyeloplasty


Ans. PCNL

94. Surgery Sixer UNDER THE KNIFE 94

95. Surgery Sixer UNDER THE KNIFE 95

PCNL

96. Question 44
A 40 year old man after TURP for BPH develops seizures in post operative state. What is the
diagnosis?
a. Water intoxication
b. Anaesthetic Over dosage
c. Mismatched Blood Transfusion
d. Malignant Hyperthermia


Ans. a. water intoxication

97. Surgery Sixer UNDER THE KNIFE 97

99. Surgery Sixer UNDER THE KNIFE 99

100. Surgery Sixer UNDER THE KNIFE 100

102. Post op irrigation
Remember that normal saline is used after the operation it is used for post operative
irrigation
( but not for resection)










Surgery Sixer UNDER THE KNIFE 102

103. Question 45
Bell Clapper testis predisposes to
a. Torsion
b. Varicocele
c. Cancer
d. Hydrocele


Ans. A torsion

104. Predisposing factors:
- Undescended testis
- Testicular Inversion
- Bell Clapper deformity ( MC anomaly) in
which the tunica vaginalis is highly invested


Torsion testis

Surgery Sixer UNDER THE KNIFE 104

105. Bell clapper

106. ▫ In the 1
st
hour the torsion can be treated by
manipulation (but later on surgery has to be
done to fix the testis )

▫ If not correctable by manipulation or more
than one hour has passed then surgery has
to be done.

▫ Surgery must be done within 4 hours.
Otherwise the testis will be dead
Surgery Sixer UNDER THE KNIFE 106

107. Question 46
Chordee is associated with
a. Hypospadias
b. Phimosis
c. Paraphimosis
d. Posterior urethral valve


Ans. a. Hypospadias

108. Hypospadias

Surgery Sixer UNDER THE KNIFE 108

109. Clinical features
 MC anomaly of Lower Urinary System
 1 in 250
 No treatment needed for Glandular type ( MC type)
 Cryptorchidism may be associated- 8%
 Indirect hernia may be associated
 Best time to operate 6 months- 12 months
 Circumcision is Contraindicated.

110. Question 47
Most common complication of stripping varicose veins below knee is
a. Hemorrhage
b. Neuralgia
c. Thromboembolism
d. Infection


Ans. B Neuralgia

111. GSV stripping

112. Question 48
All are true about Buerger’s disease except
a. Ulnar and peroneal vessels involved
b. Nerve involvement can occur
c. Superficial thrombophlebitis seen
d. Small acral vessels of limb involvement causes Hypohidrosis


Ans. D

114. Question 49
What is xenograft?
a. Transplant from one relative to other
b. Transplant between identical twins
c. Transplant of tissues self
d. Transplant from one other species to human



Ans. D

115. Question 50
Craniopharyngioma is a brain tumor arising from
a. Posterior Pituitary
b. Median eminence
c. Neurohypophysis
d. Rathke pouch


Ans. D

116. Thank you