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1|Page ps

AMC RECALL PAPERS: SURGERY

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2005

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Snake bite:
A middle-aged man is brought to your surgery with a history of being bitten by a black

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snake. On examination there are scratch marks on the lower leg and no other symptoms.
What is your management?

ad
a) Reassure and send him home
b) Excise wound
nlo
c) Administer antivenin immediately
d) Apply Tourniquet
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e) Observation and antivenom if necessary

Ans: e.
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Apply bandage immediately on the bite site firmly but not very firmly, extend 15 cm above
(JM p.1345).
cq

Trauma:
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Photograph 3: X-ray showing an open fracture of the fibula & tibia. A young man, after an
accident on his motorcycle, presented with 3 cm of bone protruding through the skin of
his leg. What is your next line of management?
dic

a) Internal fixation of the fracture immediately


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b) Skin closure of the wound immediately to prevent infection


c) Reduce the fracture and apply plaster of paris
d) Give tetanus toxoid IM & antibiotics iv
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e) Debridement is only indicated when the wound is severely contaminated

Ans: D.
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But debridement is to be done.


2|Page ps

Guide for tetanus prophylaxis: JM p.1385

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Endocrinology:

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Photograph 5: Shows the head & neck of a female. There is a large swelling at the center

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of the neck and no exophthalmos of the eyes. What is the most likely diagnosis? ***

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a) Multinodular goiter
b) Ca thyroid
c) Sub acute thyroiditis

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d) Thyroid cyst
e) Graves disease

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Ans: Large diffuse non tender swelling:

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1. Graves disease
2. Hashimotos thyroiditis (Dj p.133).
nlo
Graves ds and Sud acute thyroiditis (transient phase) can present with hyperthyroidism.

Multinodualr Goitre: Benign Thyroid nodules (Tjendra p.294).


ow

Skin:
sd

Photograph 6: Shows a red hemispherical lesion on the back of a hand. Some


cq

brownish/necrotic tissue present at the border of the lesion, no visible punctum. What is
the diagnosis?
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a) Malignant Skin Lesion


b) Inflamed keratoacanthoma
dic

c) Infected lipoma
d) Lichen planus
e) Solar Keratosis
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Ans: E.

Solar keratosis has potential has malignant change (JM p.1206).


w.

Ortho:
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Photograph 7: X-ray showing Colles fracture.


An elderly person sustained a fall on an outstretched hand. What is true?

a) Median nerve function should be assessed


3|Page ps

b) The plaster cast is not suitable to correct the fracture in the elderly

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c) Immediate internal fixation
d) Plaster cast from below elbow to MCP joint, for at least 10 weeks

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Ans: E.

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JM p.1399.

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Rh:

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Photograph 8: showing a deformed hand (swan neck deformity).
Which of the following is true?

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a) It is due to erosion & rupture of the flexor tendons
b) It is more common in rheumatoid arthritis than oseoarthritis

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c) It is due to Ulner nerve compression

Ans: B nlo
Skin:
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Photograph 9: A young child with a patch of hair loss on the scalp. Some small flakes of
skin are present. What is your diagnosis?
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a) Tinea
b) Psoriasis
cq

c) Alopecia areata
d) Trichotillomania
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e) SLE

Ans: Tinea capitis


dic

JM p.1231, look 1230 for Trichotillomania.

Skin:
me

Photograph 10: A man came with his wife. A slow growing soft large lump on his back in
between the scapulae remains in that position for last 10 years. WOF is your MX -
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a) Observation and reassurance


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b) Opinion from specialist


c) Radiotherapy

Ans: A.
4|Page ps

Lipoma/dermoid / sebaceous cyst.

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Ortho:

A man is suffering from back pain, so he is sleeping on a hard wooden bed for last three

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weeks. Now he complains of pain in his right elbow. WOF is the cause of the pain in
elbow-

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a) Olecranon bursitis

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b) Injury to the insertion of flexor muscles
c) Injury to the insertion of extensor muscles

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Ans: Olecranon Bursistis (JM p.685).

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Ethics:
During an operation spleen was accidentally injured and splenectomy was done to
nlo
minimize the complications. Next morning the patient asked you about the success &
progress of that operation. As an intern you will tell him----
ow

a) Everything has gone smoothly


b) Your spleen has been removed
c) During the operation procedure complication aroused and to minimize further
sd

complication it was necessary to remove your spleen.


d) Only the surgeon could tell you about your operation.
cq

Ans: D.
alm

Trauma:

A young man injured in a road traffic accident (RTA) has fractures of three ribs anteriorly
dic

on the left and a minimal left pneumothorax. Peritoneal lavage is positive for blood, and
laparotomy is planned for intraperitoeal hemorrhage. The most important step prior to
laparotomy is -
me

a) Insertion of a naso-gastric tube.


b) Insertion of intercostals drainage tube
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c) Determination of PaO2 and PaCO2


d) Insertion of a central venous pressure line on the right side.
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e) Delay surgery until BP comes to normal

Ans: D. Abdominal bleeding may cause hemorrhagic shock thus CVP


5|Page ps

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CVS:

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After an operation for aortic aneurysm/aortography, there is uncontrollable bleeding
from the site of the grafting. WOF is best to transfuse-

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a) Fresh blood

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b) Desmopressin
c) Fresh frozen plasma
d) Cryosipitate

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e) Factor VIII

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Ans: A. Fresh blood.

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CVS:
nlo
A man came to you complaining of pain in the leg. O/E you could not find pulse in his leg.
You clinically become sure that there is atherosclerasis or atheroma in the peripheral
ow
artery. This is due to -

a) Stenosis of femoral artery


sd

b) Thrombosis of Femoral artery


c) Polyarteritis nodosa(PAN)
cq

d) Rupture aneurysm
alm

Ans: b.

CVS:
dic

A 42-years old man complaint of pain in his right hand. He tells you that the previous day
he used a chainsaw for long hours to cut trees. O/E you found his right arm is slightly
me

swollen than other arm, and there is pain too. WOF is most appropriate investigation--***

a) Venogram
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b) Lymphanogram (Dx: Raynauds phenomenon; due to use of vibratory tools)


c) CT Scan
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d) MRI
e) Arteriogram

Ans: Arteriogram is only indicated in before surgery.


6|Page ps

AA p.445

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GUT:

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Regarding unilateral undescended testis, which of the following is most commonly
associated? ***

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a) Malignancy

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b) Varicocele
c) Ingiunal hernia(Indirect)

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d) Hydrocele
e) Torsion of the testis
f) Direct Ingunal hernia

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Ans:

Indirect inguinal hernia 80 to 90%


nlo
Sterility
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Pain
Torsion
Epididymo orchitis
sd

Malignancy 5times risk increased.


cq

GIT:
alm

A 64-years old man presents with profuse bright red bleeding per rectum. What is the
most likely cause? ***
dic

a) Ca colon
b) Polyp
c) Diverticulosis
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d) Duodenal ulcer
e) Haemorrhoids
w.

Ans: C.

JM p.362
ww

A 50-year old man presents with sudden onset of severe abdominal pain. Which of the
following is least likely to be the cause?
7|Page ps

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a) Acute appendicitis
b) Perforated peptic ulcer

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c) Acute pancreatitis
d) Ruptured abdominal aortic aneurysm

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e) Renal colic

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Ans: A.

JM p.321

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Malignancy:

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Which of the following disseminated malignancies has the worst prognosis? ***

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a) Metastatic breast cancer
b) Metastatic choriocarcinoma nlo
c) Metastatic seminoma
d) Hodgkins lymphoma
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e) Non-Hodgkins lymphoma

Ans: E. No reference
sd
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Breast:

Which of the following is the most common cause of bloody discharge from the nipple?
alm

a) Intraductal carcinoma
b) Intraductal papilloma
dic

c) Pagets disease of the braest


d) Fibroadenoma
e) Duct ectasia
me

Ans: A.
w.

12. Hutchinsons melanotic freckle. Which of the following is not correct?


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a) Mostly occurs in the elderly


b) Mainly occurs in covered parts of the body
c) Malignant
8|Page ps

d) Irregular border

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e) Irregular colour (from black to brown)

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Ans: B.

JM p.1220.

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Ulcer:

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A diabetic patient with an ulcer at the head of the 2nd metatarsal on the sole of the foot,
which of the following would be the most likely cause?

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a) Macrovasclar disease

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b) Diabetic neuropathy
c) Infection
d) Varicose venis nlo
e) Hyperglycaemia

Ans: B.
ow

Harrison p.2168
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GIT:
A 60-year old man presents with 3 days vomiting and loss of weight (3 kg.). Six years ago
cq

he was treated with Cimetidine. Over the last 3 months he has had epigastric pain
intermittently, for which he takes aspirin. Vomitus is clear in colour with identifiable food
alm

particles. The likely diagnosis is?

a) Drug induced gastritis


b) Chronic duodenal ulcer disease
dic

c) Ca pancreas
d) Cancer of the cardia of the stomach
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e) Pyloric stenosis

Ans: E.
w.

GOO: Bailey p.1048.


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GIT:
The most common cause of diarrhoea in bedridden elderly patients is?
9|Page ps

a) Ca colon

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b) Crohns disease
c) Ulserative colitis

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d) Diverticulosis
e) Faecal impaction

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Ans: E.

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Spurious diarrhoea (JM p.)

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Breast:

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A female had mastalgia for the last 1 year. Conservative treatment has not worked. How
would you manage this patient?

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a) Bromocriptine
b) Danazole
nlo
c) Clomiphene
d) OCP
ow

e) NSAIDs

Ans: Danazol
sd

JM p.969
cq

CVS:
alm

With fat embolism, petechiae are most to be seen where?

a) All over the body


dic

b) Pressure dependent areas


c) Subungual
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d) Upper part of the body


e) Lower body

Ans: D.
w.

Maheshwari p.34
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GIT:
A 65-year old woman develops acute abdominal pain with distension. There is a history of
12 hours of vomiting and cramping pain. On examination, irregular pulse 120/min, BP-
10 | P a g e ps

100/60 mmHg, abdomen is tender with guarding and bowel sounds are absent. Rectal

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examination reveals a dark bloodstone on the finger. Which of the following is most
likely?

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a) Perforated peptic ulcer

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b) Messenteric arterial occlusion
c) Diverticulosis

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d) Perforated appendicitis
e) Ca colon

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Ans: B.

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Atrial fibrillation.

Trauma:

ad
A 21-year old man presents with increasing dysponea, tachypnoea a hyperinflated left
nlo
hemithorax with evidence of a mediastinal shift. Your immediate management would be?

a) Insert a water sealed chest drain


ow

b) Intubate
c) Insert a venflon into 4th intercostals space midaxillary line
d) Insert a wide bore needle into the 2nd intercostals space, midclavicular line
sd

Ans: D.
cq

ENT:
alm

Which of the following is most likely to be associated with otosclerosis?

a) Normal tympanic membrane


dic

b) Red & inflamed tympanic membrane


c) Tense & transparent tympanic membrane with fluid level behind
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d) Blue gray sclera


e) Obstruction of the Eustachian tube

Ans: A.
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ww

ENT:

Which of the following is true regarding carcinoma of the nasopharynx?


11 | P a g e ps

a) Arises from the lymphatics

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b) Not sensitive to radiotherapy
c) Responds well to chemotherapy

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d) Caused by EBV
e) Locally destructive lesion

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Ans: D.

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All are seen in ischaemia of the leg, except?

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a) Claudication

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b) Pallor
c) Pain on walking

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d) Shooting pain down the posterior aspect of the thigh

Ans: D. nlo
Malignancy:
ow

Which of the following is least likely to cause metastasis to the brain?


sd

a) Prostate cancer
b) Melanoma
cq

c) Small cell carcinoma of the lung


d) Breast cancer
alm

e) Renal carcinoma

Ans: prostate.
dic

GIT:
me

Which of the following is not a feature of uncomplicated haemorrhoids?

a) Bright red bleeding


w.

b) Prolapse of mucosa
c) Purities
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d) Pain
e) Mucous
12 | P a g e ps

Ans: Pain

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Ortho:

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Which of the following nerves would be damaged in a mid-humerus fracture?

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a) Axillary nerve
b) Radial nerve

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c) Musculocutaneous nerve
d) Ulner nerve
e) Median nerve

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Ans: radial nerve.

.bl
ad
GIT:
A female complaints of bloating & belching. She is found to have gallstones, which is
nlo
subsequently treated by cholecystectomy. Cholangiogram was done during the operation
and was clear (nothing was found). She was symptom free for 1 week, but then the same
symptoms returned. What is the most likely? ***
ow

a) Pancreatities
sd

b) Cystic duct stump syndrome


c) Stone left in the common bile duct
cq

d) Symptoms are not related to the gallstones


e) Post cholecystectomy syndrome
alm

Ans:
dic

All are true about gallstones, except?

a) Usually asymptomatic
me

b) Stone in the bile duct presents with clinical sepsis


c) Ususally radiolucent
d)
w.

Ans: http://emedicine.medscape.com/article/175667-overview
ww

Bailey p.1109.

Breast:
13 | P a g e ps

Which of the following is true regarding mammography?

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a) More sensitive in premenoposal than postmanuposal women

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b) Painless
c) Most useful in woman with a palpable breast lump

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d) It has a better pick up rate than self examination
e) Can differentiate between a solid & cystic tumour

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Ans:

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GIT:
All of the following would be expected after splenectomy for spherocytosis, except? ***

.bl
a) Transient leucocytis

ad
b) Persistence of anaemia
c) Same osmotic fragility
d) Persistence of spherocytosis nlo
e) Normal life span of the erythrocytes

Ans: E.
ow
sd

Ortho:

What is the most important aspect in managemant of an open fracture?


cq

a) Antibiotics
b) Intenal fixation
alm

c) Debridement
d) Tetanus toxoid
e) Immobilisation
dic

Ans: Debridement.
me

GIT:
A 35-years-old woman having severe sudden abdominal pain throughout the night wakes
w.

up and passes dark urine in the bathroom. She immediately goes to see the doctor.
Investigations showed:
ww

- bilirubin 5 times normal


- Alkaline phosphatase 3 times normal
- AST & ALT 4 times normal
- S.amylase 2 times normal
What is the most likely diagnosis?
14 | P a g e ps

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a) Acute cholelithiasis
b) Acute cholecystitis

co
c) Ca gallbladder
d) Acute choledocholithiasis

ot.
e)

sp
Ans: D.

GIT:

og
What is true about fistulas?

.bl
a) It is a communicating track between 2 epithelial surfaces
b) It is lined by granulation tissue

ad
c) It is a blind track leading from the surface down to the tissue
d) A kind of ulcer
e) ? nlo
Ans: a.
ow

Pain:
sd

What is true regarding pain management?


cq

a) Pethidine is best given by calculating mg/kg body weight


b) Pethdine is better than morphine
alm

c) Pethidine should not be repeated within 4 hours


d) Older patients require less, because they tolerate pain better
e) ?
dic

Ans: C. Potential accumulation of norpethidine limits its utility for repeated dosing (KDT
p.459).
me
w.

Trauma:
ww

You are performing external cardiac massage on a patient who has just suffered a cardiac.
Which of the following provides best indication that resuscitation is effective?

a) ECG
15 | P a g e ps

b) Palpation of the radial pulse

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c) Color of skin & mucous membranes
d) Size & reaction of the pupils

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e) Response to stimuli

ot.
Ans: D. Radial: 80mmHg, Femoral: 70mmHg, Carotid: 60mmHg.

JMp.1352

sp
og
Breast:

All of the following are risk factors for breast cancer, except?

.bl
a) Early artificial menopause

ad
b) First pregnancy after 35 years of age
c) Early menarche nlo
d) No breast feeding
e) Cancer of the other breast
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f) age - peak incidence 45-75 years but any age postmenarche >> 4x
g) country of residence - high in West > 4x e.g. UK, low in East e.g. Japan
sd

h) previous breast cancer > 4x


i) irradiation of chest - shows a linear dose-response relationship 2-4x
j) social class (I vs. V) 2-4x
cq

k) race - more common in Caucasians < 2x


l) previous ovarian or endometrial cancer < 2x
alm

m) early menarche or late menopause < 2x


n) nulliparity or older than 30 years before first child < 2x
o) hormonal supplementation < 2x
dic

p) obesity - oestrogen synthesis in adipose tissue


q) alcohol consumption
In the male, Klinefelter's syndrome is a risk factor for breast cancer.
me

Ans: a.
w.

CNS:

A 32-years old man felt pain in the maxillary area at night, which radiates to the side of his
ww

head. There was water inside his nostrils during the attack. WOF is your diagnosis-

a) Migraine
16 | P a g e ps

b) Cluster headache for female Hemicrnia....

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c) Maxillary sinusitis

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Ans: b.

ot.
Ortho:

A 35-years old female came with complaints of wake up during the night with pain in her

sp
right hand & a shooting pain up the arm. She has difficulty using her right hand when
carrying a shopping bag. Examination shows slight thenar wasting. What is your

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diagnosis?

.bl
a) Brachial neuritis
b) Thoracic outlet obstruction
c) Cervical spondylosis

ad
d) Carpal tunnel syndrome
e) Cervical rib nlo
Ans: CTS JMp. 678, p.685.
ow

GIT:
sd

A man presents with history of an inguino-scrotal swelling, which disappears on lying


down. What is the most probable diagnosis?
cq

a) Hydrocele
b) Saphena varix
alm

c) Femoral hernia
d) Varicocele
e) Direct inguinal hernia
dic

Ans: B.

A saphena varix is a dilatation at the top of the long saphenous vein due to valvular
me

incompetence. It may reach the size of a golf ball or larger.

The varix is:


w.
ww

* soft and compressible

* disappears immediately on lying down

* exhibits an expansile cough impulse


17 | P a g e ps

* demonstrates a fluid thrill

m
co
GUT:

ot.
A 25 years old man is awakened during night very severe pain in his right loin. He notices
bright blood in his urine. Next morning he comes to you- you found him a febrile and plain

sp
X ray shows calcium oxalate stone in his bladder. WOF you will advice --

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a) Not to take calcium containing food
b) Avoid red meat

.bl
c) Avoid all kind of drinks, tea, coffee

Ans: c. Bailey 1321

ad
Burns:
nlo
Most common cause of death in severe burns, in Australia is?
ow
a) Irreversible shock
b) Septicaemia
c) Respiratory failure due to respiratory tract burns
sd

d) Unable to maintain positive nitrogen balance

Ans: b.
cq
alm

GIT:
All of the following cause acute pancreatitis, except--

a) Alcohol ( Note: Dr. SusanGET SMASHED)


dic

b) Mumps virus infection 1. gall stones


c) Diabetes Mellitus 2.ethanol
me

d) Gall stone 3.trauma


e) Pancreatic islet cell tumour 4.steroids 5.mumps
7.autoimmune 8.scorpion venom
w.

9.hyperlipidaemia 10.ERCP 11.DM/drugs: azathioprine,pentamdine

Ans: e.
ww

Preop:
18 | P a g e ps

When is the best time to administer prophylactic antibiotics?

m
a) 1 day before operation

co
b) 1 hour before operation
c) At the time of incision

ot.
d) After the infection

sp
Ans: b.

GIT:

og
A female pt. Complaints of fullness fat indigestion after fatly meals. In an ultrasound

.bl
stones seen in gallbladder, but there is no sepsis. After surgery no stone left in the gall
bladder and free of symptoms for few weeks, then symptoms recur. What is the
explanation-***

ad
a) Pancreatitis after cholecystitis nlo
b) Stone was left in CBD
c) It is a result of removal of gall bladder-Fat indigestion
d) Gall stones were not her symptoms
ow

e) Cystic duct stump syndrome


f) Recurrence of stone formation after cholecyctectomy
sd

Ans: D.
cq

There is no sepsis: No choledocholithiasis.


alm

GIT:
A middle aged female complaints of morning diarrhoea and cramps. On examination
there are no remarkable findings. Which is the most likely diagnosis?
dic

a) Irritable bowel disease


b) Ca Colon
me

c) Crohns disease
d) Ulcerative colitis
w.

Ans: A.
ww

45.A patient came with weakness in extension of hand and pronation. On examination there
is no wasting of hand muscles. Flexion normal, Biceps & Triceps reflexes also normal. No
Brachioradialis jerk. Where is the lesion?
19 | P a g e ps

a) Median nerve

m
b) Radial nerve
c) Ulner nerve

co
d) Nerve to Posterior interoseus
e) Nerve to Anterior interoseus

ot.
Ans: d. Maheshwari p.53

sp
1. A couple came to your GP surgery to know about the mode of inheritance/number of

og
incidence of cystic fibrosis in the population. Your answer will be

.bl
a) 1 in 2
b) 1 in 4- mode of inheritance

ad
c) 1 in 25
d) 1 in 100
e) 1 in 2500- number of incidence nlo
Ans: e.
ow
sd
cq
alm
dic
me
w.
ww
20 | P a g e ps

m
2006

co
ot.
Picture: Dark discolouration on the side of the nose. After excision report shows it as a

sp
Nodular malignant malanoma.WOF is next Mx- (Antho-397 picture on the Sole)
a.Observe

og
b.Do nothing
c. Wider local excision
d. Radiotherapy

.bl
e. Excision

ad
Picture: A child with rash on the buttocks and legs .Both ankles swollen and tender, also
abdominal pain, but no fever. No neck stiffness.WOF is most common major complication-
nlo
(Dx:HS purpura ;AMC-286)
a.Nephritis
ow

Picture: One X-ray and one Mammogram of Breast (Anthology-104). Dx:


a.Breast Cyst
sd

4.Photo:Lipoma on the neck of a man.H/O soft swelling present for last 3 yrs, never had any
cq

trouble for that swelling.But now he came to you for your opinion.WOF you will do-
a.Reassure, nothing need to do ( Anthology-399)
alm

b.Refer for specialist opinion


c.FNAC

Picture: X-ray chest of a 8 months old infant with opacity in Rt lower zone and
dic

pneumatoceles(Staph. Pneumonia). Rx- (AMC: Fig-119)


I/V Flucloxacillin
me

Picture: Eye and dilated pupil.Man came to you with h/o pain in the eye, also has
headache and vomiting. Mx-
w.

a.Tropical Acetazolamide
b.Patch the eye to look for FB
ww

cAtropine eye drops


d. Topical Pilocarpine

Picture: A growth in the palm;developed over 2 weeks in a manual labour.Dx-


21 | P a g e ps

Pyogenic granuloma (Anthology-398)

m
Picture: A man came with a soft swelling in groin for last 2 years.It is soft, slowly growing

co
over inguinal ligament & lateral to pubic tubercle.WOF is your Dx-
a. Lipoma

ot.
b. Inguinal Hernia (May-2005)
c. Femoral Hernia

sp
Picture: X-ray chest of a 9 months old infant as shown in AMC book(page-119). What is the

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Dx? Staph. Pneumonia( But most common in this age group is Streptococcus pneumonia)

11.Photo: CT Scan. A lady complains that she feels her left side of body she feels heavy. She

.bl
also has paralysis & weakness of left side. WOF is your Dx-
a. Cerebral Tumour

ad
b. Cerebral Haemorrhage
c. Cerebral Infarction nlo
d. SAH
ow

A pt. present with ptosis of left eye, left side sensory loss of face. Left side gag reflex was
absent, Rt. Sided hemiparesis and incoordination of Rt. Upper and lower limb.Where is
the lesion?
sd

a.Middle Cerebral Artery


b.Internal Carotid Artery
cq

c. Vertebral Artery
d. Multiple Sclerosis
alm

e.Post. Cerebral Artery

Apparent shortening due to severe osteoarthritis of the hip is due to:


a.Fixed adduction
dic

b.Fixed flexion
c.Degeneration of head of femur
me

Median nerve injury above the wrist.WOF is true-


paralysis of abductor pollicis brevis with inability to abduct the thumb
w.

(LOAF)
ww

In pt. with pancreatitis for purpose of statistical studies ,AOF are useful EXCEPT-
a.Case control
b.Cohort
c.Case report/case study(one study)
22 | P a g e ps

d.Double blind study

m
e.Systemic review

co
WOF is a feature of Parkinsonism-

ot.
a..Loss of postural reflex
b.Hyperreflexia

sp
c.Hypotonia
d Wide based gait.

og
WOF is not a feature of Lacunar Infarct?
a.Fascicultion

.bl
b.Spasticity
c.Face weakness(sensory loss of face)

ad
d.Difficulty in walking
e.Increase Reflexes
nlo
Tennis elbow,cause is-
ow

Overstretch of the common extensor tendons origin at elbow

A pt. complains of severe pain on pressing on nail of thumb.WOF is most likely the cause-
sd

a.Fibrosarcoma
b.Osteosarcoma
cq

c.Glomus tumour
alm

GIT:

On 10th day after appendectomy apatient presents with diarrhoea with fever and
difficulty in passing urine, what is the most likely cause?
dic

Pelvic abscess
me

GIT:
After screening with faecal blood test WOF is the correct percentage of detection of Duke
A1 colonic carcinoma: Scott-323
w.

a.<3%
b.15% ( Duke A-tumour confined to bowel wall-survival 90%)
ww

c.25%
d.50%
e.75%
23 | P a g e ps

40.WOF is a feature of Thyrotoxicosis?

m
a.Fine tremor
b. Distal myopathy

co
c.Small muscle weakness.

ot.
GIT:

sp
After screening with faecal blood test WOF is the correct percentage of detection of Duke
A1 colonic carcinoma: Scott-323
a.<3%

og
b.15% ( Duke A-tumour confined to bowel wall-survival 90%)
c.25%

.bl
d.50%
e.75%

ad
WOF is a feature of Thyrotoxicosis? nlo
a.Fine tremor
b. Distal myopathy
c.Small muscle weakness.
ow

A 62 yr old man presents with tiredness ,weight loss,anemia and fatigability. What is the
Ix you will do first?
sd

a.Barium meal Oct.92


b.Sigmoidoscopy
cq

c.Colonoscopy
d.Fecal occult blood test
alm

A patient has hammered his nail and came to you with Subungual haematoma under his
nail.WOF is your Mx-
dic

a.Oral Trebinafine
b.Oral Griseoflvin OHCS-738
me

c.Remove the nail


d.Expressing the blood through a hole trephined in the nail
w.

A 43 yr old man came to your surgery as he is worried about his chances of getting of
colon cancer.He told you that his father and elder brother had died of colon cancer. What
ww

you will advice him?


a.Sigmoidoscopy
b.Colonoscopy
24 | P a g e ps

m
Supra condylar fracture of Humerus:structure most likely to be damaged-
a.Radial nerve

co
b.Brachial artery
c.Median nerve

ot.
GIT:

sp
A 33 yr old man came in ER with H/O 3 days vomiting followed by mid abdominal pain.O/E
abdomen is rigid, distended absent bowel sound on auscultation.Plain X-ray shows
multiple air fluid level.WOF is the appropriate fluid therapy for the patient:

og
a.2000ml of dextrose in 4.5% NaCl preoperatively
b.2000 ml of Hartmanns solution preoperatively

.bl
c.2000ml of Hartmanns solution during the operation

ad
What is true about SCOLIOSIS ?
Congenital and more common among girls than boys .
nlo
A 22 yr old football player during a game fell down in awkward position, and developed
ow

pain and rapidly increasing swelling of the knee. Anterior, posterior and lateral X-rays are
normal.WOF injuries you expect to find-
sd

a.Tear of Medial Meniscus


b.Rupture of Anterior Cruciate Ligament
cq

Leg ulcer due to peripheral neuropathy commonly located in-


a.Medial malleolus
alm

b.Sole of the foot

A patient came with weakness in extension of hand and of pronation.O/E there is no


dic

wasting of hand muscles. Flexion normal, Biceps and Triceps reflexes also normal,No
Brachioradialis jerk.Where is the lesion?
a.Median nerve July-2005
me

b.Radial nerve
c.Ulner nerve
w.

d.Nerve to Postrior Interoseus


e.Nerve to Anterior Interoseus
ww

What is the priority in a Motor Vehicle Accident(MVA):


a.Stop bleeding
b. Clear the airway @ A-B-C
25 | P a g e ps

c.Shine a torch in the pupils

m
co
Function of Adductor Pollicis is lost.Which nerve is affected?
a. Median nerve

ot.
b. Radial nerve
c. Ulner nerve

sp
Patient with ileal resection causing increased INR.WOF is correct-

og
a.Non absorption of Vit. K (Normal INR 0.9-1.2)
b.Bleeding disorder

.bl
A patient with INR 2.1: An old man is on Warfarin and now he is discovered with a

ad
resectable colon cancer.Management:
Stop Warfarin and start low dose Heparin; operate when INR is normal
nlo
WOF doesnt produce keratotic scale?
ow

a. Basal cell carcinoma


b.Squamous cell carcinoma
sd

c.Pityriasis versicolor
d.Keratoacanthoma
e.Psoriasis
cq
alm

Hutchisons Melanotic Freckle,WOF is not correct?


a.Mainly occurs in the covered parts of body
b.Irregular border
c.Malignant
dic

d.Mostly occurs in the elderly


me

Q. on Submandibular Gland:Still to be recalled


w.

A man presents with sudden onset of Horners syndrome, 9 & 10 nerves palsy and loss of
touch and temperarure sensation on the opposite side of the body.Where is the site of
ww

lesion?
a.Vertebrobasilar artery
b.Basilar artery
c.middle cerebral artery
26 | P a g e ps

d.Vertebral artery

m
e.Carotid artery

co
GIT:
A lady undergone surgery for gallstones.She developed fever and tachycardia after 6

ot.
hrs.Oral Cholangiogram was done; findindings were normal.Dx-
a.Atelectesis

sp
b.Wound infection
c.Allergy to dye

og
A 63 yr old man presents with 3 days vomiting and has lost 3 kilos.Five years ago he was

.bl
treated with cimetidine.Over the last two months he has epigastric pain and has been
treated with aspirin.Vomitus is clear in colour with identifiable food paticles.The Dx is:

ad
a.Drug induced gastritis
b.Chronic duodenal ulcer
c.Cancer of duodenum nlo
d.Pyloric stenosis
e.Cancer of cardia
ow

A 45 yr old lady complains of irregular menstrual bleeding.She has been treated for CIN-II
previously and a Pap smear done 6 months ago was fond normal.WOF is the most
sd

appropriate investigation for her?


a.Colposcopy Repeat: March06
cq

b.USG to detect endometrial thickness


c.Cone biopsy (see the difference: Q-40/oct04)
alm

d.Endometrial curettage
e.Repeat Papsmear
dic

A labourer who is a heavy smoker find difficult to perform his duties and worried about
his physical conditions.On examination there is ankle oedema, raised JVP, huge hepato-
splenomegaly and ascitisWOF is likely- (May05)
me

a.Cirrhosis
b.Costrictive pericarditis due to previous tuberculosis
w.

c.SVC obstruction
d.Budd Chiari Syndrome
ww

A foot ball player while playing got injury in his Rt.Knee.The knee is locked.Dx: [Outline of
fractures-224:Locking is common & important
Tear of Medial Meniscus feature of torn medial meniscus.Knee suddenly gives way]
27 | P a g e ps

m
A 57 yr old lady develops sudden onset of left sided weakness and right eye blindness.This
is most likely due to-

co
a.Vertebro-basilar insufficy
b.Pituitary tumour

ot.
c.Carotid artery stenosis
d.Cerebellar lesion

sp
e.Retinal detachment

og
Pleural Effusion: Typical presention.Stony dull on percussions,bronchial breath sound

.bl
above the area, restricted movements on the affected side.

A patient presents with impaired sensation on medial aspect of the hand, 4th and 5th

ad
fingers of the hand are flexed.Where is the lesion?
Ulner nerve at elbow nlo
GIT:
ow

A pt. was on warfarin, he developed haematemesis and melena.His INR is 10 times


normal.WOF should be the management? (Sept.05)
sd

a.Fresh plasma infusion


b.I/V Fluids
cq

c. Oral Vit-K
d.Transfuse blood
alm

e.Intra muscular Vit-K

GIT:
dic

Pain in epigastrium which does not releifs by eating or any effort.Has no relation with
food.Dx-
me

Hiatus hernia

Question on Basal cell carcinoma


w.
ww

Rx of ADHD: Dexa amphetamine

Management of Supracodyler # of Humerus(Anthology book)


28 | P a g e ps

A boxer comes to the ED after a fight in which he was knocked out.His left pupil is dilated,

m
but otherwise he is normal and he feels ok.WOF would you do-
a.Give Manitol

co
b.CT Scan of head

ot.
A man presents with pain over the L4 region.His X-ray shows multiple metastatic lesions in
the spine.WOF investigations is most appropriate:

sp
a. Prostate specific antigen
b. CT Scan

og
c. MRI

.bl
A 12 yr old boy presented with painless lump in the scrotum for the last 6 months.He is
otherwise healthy grown up.What is the most likely Dx?

ad
a.Hernia
b.Seminoma
c.Encysted hydrocelc of the cord nlo
d.Saphena varix
e.Haematocele
ow

A mother of a 4 yr old child noticed that there is a solid mass in the Rt. Loin area of her
sd

child which she noticed for the first time with occasional blood in urine.WOF is your initial
Dx: OHCS-220
cq

a.Neuroblastoma Wilms tumour:Commonest intraabdominal tumour of


b.Wilms tumour childhood.Haematuria not common,but fever,flank pain c c.Hydronephrosis
abdominal mass found. US-pelvicdisortion,hydronephrosis
alm

d.Plycystic kidney disease .


dic

Two months old childs mother noticed a firm lump in her baby in the left side of upper
abdomen while bathing.Child has bilateral periorbital ecchymosis.what is the most likely
cause?
me

a.Neuroblastoma May-2000
b.Wilms tumour
w.

Mother of a 3 year old child noticed a mass in the abdomen on the left side.AOF could be
the cause,except-
ww

a.Hydronephrosis October96
b.Neuroblastoma
c.Nephroblastoma(Wilms tumour)
d.Poly cystic kidneys(Die before 1 year of age )
29 | P a g e ps

e.Chr. constipation

m
co
An 8 yr old girl presents with abdominal protusion,anaemia and tenderness.O/E there is a
big irregular and mobile mass crossing the midline.Dx-

ot.
Neuroblastoma
Derived from sympathetic neuroblasts,most common solid tumour in children<5yr.Likely to

sp
present with abdominal swelling and urinary catecholamines (vanillylmandelic&
homovanillic acids) raised in 92% cases.

og
Hypospadias: incidence of 1:350 male birth.

.bl
All are autosomal recessive , Except-

ad
a.Neurofibroblastoma
b.Phenylketonuria
c.Galactossemia
nlo
d.Cystic fibrosis
e.Sickle cell anaemia
ow

A 23 yr old man limped into ED and stated that he was kicked in the post. Aspect of the leg
sd

during a game of foot ball.He experienced immediate sharp pain which subsided.O/E
there is decreased planter flexion.What is the Dx-
cq

Rupture of achillis tendon


alm

Peritonsilar abscess(Quinsy): Caused by Streptococcus& Trismus seen.

Zygomatic bone (maxillo facial) fractures characterized by-


dic

a. Involvement of infraorbital nerve


b. Subconjuctival hge. with no definitive posterior limit
me

c. Loss of senstion over canine & first premolars


d. Partial trismus
e. All of the above
w.

WOF is most likely to be damaged during carotid endarterectomy:


ww

a .Vagus nerve
b.Hypoglossal nerve NMS-132
c.Facial nerve ( 1.vagus 2.hypoglossal 3.Recurrent laryngeal 4.Marginal mandibular)
d.Laryngeal nerv
30 | P a g e ps

m
co
2007

ot.
sp
Ortho:

og
A piicture of Dupuytren contracture. Cause:

.bl
A. Use of chronic vibrating tools
B. Chronic alcoholism

ad
ans: B. Maheshwari p.255 nlo
Hereditary predisposition

Cirrhosis
ow

Anti epileptic drugs: Phenytoin and phenobarbitone.


sd

Picture of Bowen disease from Anthology. Dx?


cq

GIT:
alm

Picture of perianal haematoma. Mn?


dic

Ans: Incision and drainage.

Ortho:
me

A boy came with fever and pain in the right leg. He hardly moves the leg and does not
allow you to move it either. He refuses to carry weight on that leg. What could be the dx?
w.

A. Septic arthritis of hip


ww

B. OM of femur
C. D. E. could be excluded easily
31 | P a g e ps

Ans: A

m
co
What will be the first S/S when a plaster is too tight?

ot.
A. Pain
B. Change of colour

sp
C. Swelling
D. Stiffness

og
Ans: Pain

.bl
Ortho:

Which nerve regenerates most after taumatic laceration?

ad
A. ulnar n.
B. Median n.
nlo
C. Digital n.
D. sciatic n
ow

E. Common peroneal n.
sd

Ans: Ulner.
cq
alm
dic

GIT:

A patient came with 12 hr H/O severe vomiting. Pain in upper abdomen which is now
me

constant in the epigastrium. There is rigity and guarding in the abdomen. Dx?

A. ac. pancreatitis
w.

B. Perforated DU
C. perforated GU
ww

Ans: Anterior duodenal ulcer more likely to perforate.

GIT:
32 | P a g e ps

A pt came with an ill defined mass in the RIF and loose watery stools. He has fever and has

m
lost 6 kgs of weight recently. Dx?

co
A. Crohn disease
B. Meckel diverticulitis

ot.
C. UC
D. Ca large gut

sp
Ans: A.

og
Dj p.41

.bl
Git:

Most common S/S assoc. with ca rectum?

ad
Rectal bleeding (Bailey p.1233).
nlo
GIT:
ow
A patient came with a pus discharging bead at 5 o'clock position at the anal verge. on
probing there was a track discovered which extended in the rectum for 15 cm. (these were
the exact words). DX?
sd

A. Crohn dis
cq

B. Ankylostomiasis
C. Ca rectum
alm

D. Haemorrhoids

Ans: a.
dic

GCS:

A patient opens his eyes to pain, withdraws to painful stimulus ans is unable to answer
me

any questions. What is his GCS?

A. 7-9
w.

B. 10-12
C. 3-5
ww

C. 13-15

Ortho:
33 | P a g e ps

Pic of anterior dislocation of shoulder. Where will be the cutaneous anaesthesia?

m
On the lateral aspect of deltoid

co
(I think the one who was the least serious about the exam, could even manage to get this

ot.
one pinned.)

sp
GIT:
What is the lymphatic drainage of anal canal below dentate line?

og
A. Sup. ing. nodes

.bl
B. deep ing. nodes

Ans: A.

ad
A typical CXR of lobar consolidation. What is the org?
nlo
A. strep pneumoniae
ow

Burns:
sd

Another old authentic typical ques.: A burn patient with soot in the throat and singening
of nasal hair etc etc. Mn?
cq

Ans: intubate
alm

CNS:

A man came with ipsilateral horner's syn., cerebellar S/S, dissociated sensory loss. (I could
dic

diagnose the case as having lateral medullary syndrome). which artery is involved?

A. Ant communicating artery


me

B. Post. cerebral artery


C. Post inf. cerebellar artery
d. ant. spinal artery
w.

Ans: PICA
ww

CNS:

What is the mechanism of TIA when there is carotid stenosis?


34 | P a g e ps

A. Embolim from the artery

m
B, transient spasmodic occlusion of the artery
C. Transient hge following increase in carotid artery pressure

co
ans: A.

ot.
sp
CHEST:

Another repeated ques. (and confusing as well!!): Which org does not cause lung abscess"

og
A. Staph aureus

.bl
B. P. carinii
C. M. pneuminiae
D. M. TB

ad
Ans: C
nlo
Ortho:
ow
A man fell from height and was complaining low back pain. No other abnormality. What is
the inv you do?
sd

A. X ray spine
B. MRI spine
cq

C. CT spine
D. Nothing needed
alm

Ans: A.

GIT:
dic

Most commomn cause of intestinal obstruction in Australian community? (I think this was
the only ques I found from the AMCQ book that everybody reads so intently!!)
me

Ans: Adhesion

GIT:
w.

A child came with pain and redness and swelling of one eye. He had fever and was
ww

(probably) vomiting. i could diagnosis it as orbital cellulitis. Mn?

A. Ceftriaxon IV
35 | P a g e ps

B. Ampi + Genta IV

m
C. Cefurixime + metro

co
Ans: A.

RHP p.264

ot.
Endo:

sp
An incidentaloma was found on one of the adrenals which measured 5 mm. What do you

og
do?

A. ignore

.bl
B. ask to come 6 wk later
c. ask to come 6 months later

ad
Ans: Tjendra p.306

CNS:
nlo
A picture of a man protruding his tongue. It showed wasting on the right side. What will
ow

be correct for this.


sd

A. Left sided lesion and tongue veers to left


B. left lesion-tongue veers to right
C. right lesion and tongue veers to right
cq

D. right lesion and tongue veers to left


alm

Ans: C. Hypoglossal nerve palsy.


dic
me
w.
ww
36 | P a g e ps

m
co
ot.
sp
og
.bl
ad
nlo
ow

GIT:
An x-ray of large gut showing obstruction. Cause?
sd

Trauma:
cq

When two rescuers available, what is true regarding CPR?


A. 15:2 should be the compression rate
alm

B. response should be checked evey 2 min


C. chest compression should be on mid chest
D. There should be 2.5 cm chest compression each time.
dic

Ans:
me

GIT:

An infant was brought who was vomiting from birth. He was pale, dehydrated and not
w.

gainig weight. What is most likely to find?


ww

A. Lump
B. Distension
C. Anuria
37 | P a g e ps

Ans: b.

m
Duodenal atresia is a disease of newborn infants. Cases of duodenal stenosis or perforated duodenal

co
web (diaphragm) rarely remain undiagnosed until childhood or adulthood; these cases represent the
exception rather than the rule. Duodenal atresia appears to be equally distributed between infants of
both sexes, with no reported predilection for one race.

ot.
The use of modern ultrasonography has allowed many infants with duodenal obstruction to be
identified prenatally. In a large cohort study of 18 different congenital malformation registries from 11

sp
European countries, 52% of infants with duodenal obstruction were identified in utero.5 Duodenal
obstruction is characterized by a double-bubble sign on prenatal ultrasonography. The first bubble

og
corresponds to the stomach and the second to the postpyloric and prestenotic dilated duodenal loop.
Prenatal diagnosis allows the mother the opportunity to receive prenatal counseling and to consider
delivery at or near a tertiary care facility that is able to care for infants with GI anomalies. 5,6

.bl
Presenting symptoms and signs are the result of high intestinal obstruction. Duodenal atresia is
typically characterized by onset of vomiting within hours of birth. While vomitus is most often bilious, it

ad
may be nonbilious because 15% of defects occur proximal to the ampulla of Vater. Occasionally,
infants with duodenal stenosis escape detection of an abnormality and proceed into childhood or,
rarely, into adulthood before a partial obstruction is noted. Nevertheless, one should assume any child
nlo
with bilious vomiting has a proximal GI obstruction until proven otherwise, and further workup should
be begun expeditiously.

Once delivered, an infant with duodenal atresia typically has a scaphoid abdomen. One may
ow

occasionally note epigastric fullness from dilation of the stomach and proximal duodenum. Passing
meconium within the first 24 hours of life is not usually altered. Dehydration, weight loss, and
electrolyte imbalance soon follow unless fluid and electrolyte losses are adequately replaced. If
sd

intravenous (IV) hydration is not begun, a hypokalemic/hypochloremic metabolic alkalosis with


paradoxical aciduria develops, as with other high GI obstruction. An orogastric (OG) tube in an infant
with suspected duodenal obstruction typically yields a significant amount of bile-stained fluid.
cq
alm

HEAD and Neck:

A patient with parotid carcinoma will have which of the following


a.drooping of lower eyelid b.drooping of the angle of mouth
dic

c ? d?

Ans: b.
me

CNS:
w.

A picture of a man with the tongue deviated to right. The question was which side is the
ww

lesion and to which side is the tongue deviated.

Ans: Rt side.
38 | P a g e ps

m
CNS:

co
A man with difficulty in extending the wrist and fingers. All other movement and
sensations are normal. Reflexes normal. What is the lesion?

ot.
1. radial n

sp
2. ulnar n

3. median n

og
4. posterior interroseous nerve

.bl
Ans: 4.

ad
GIT:
nlo
Condition which typically produce profuse watery discharge per rectum to the level to
produce electrolyte imbalance.
a.colonic polyp b. pelvic abscess c.carcinoma.
ow

Ans: Villous Adenoma ( colonic Polyp).


sd

CNS:

Coma scale
cq
alm

Ortho:

A lady with history of pain and stiffness of joints for a few weeks. While playing golf she
had sudden onset of pain and swelling in calf. What is the diagnosis
dic

a.ruptured popliteal bursa

b.spontaneous haematoma
me

c.achilles tendonitis

Ans:
w.

Maheshwari p.275
ww

RH:
39 | P a g e ps

which is not a feature of temporal arthritis.

m
a.amarosis fugax

co
b.headache

c.iritis

ot.
d.shoulder muscle pain

sp
Ans: Iritis

og
CVS:

.bl
Cause of TIA in carotid stenosis?

Ans: Embolism

ad
CNS:
nlo
Cause of amaurosis fugax
ow
a.temporal arteritis

b.carotid stenosis
sd

c.infarct
cq

Ans: Carotid Stenosis. JM p.842


alm

Ophthal:

Picture. fundoscopy .which is the likely lesion


dic

GUT:
me

A child presented with undescended testis at 6 weeks. What will you do


a.do an immediate orchidopexy
b. wait till 4 years and then do orchidopexy
w.

c. encourage the mother to massage the inguinal region to milk down the testis and review
after 2 months
ww

d. review after 6 months

Ans: D.
40 | P a g e ps

Wait till one year, if not descended by one year surgery.

m
co
GUT:

Undescended testis is most frequently associated with

ot.
a.neoplasm b.inguinal hernia c.tortion

sp
Ans: 80% cases associated with inguinal hernia.

Malignancy chances increase by 5 times.

og
[10:28:28 PM] dr_gauravsuneja: An ectopic testis has deviated from the normal path of
descent after it has emerged through the external inguinal ring.

.bl
ad
In order of frequency, it may be found:
nlo
* in the superficial inguinal pouch which lies anterior to the external oblique aponeurosis
ow

* in the perineum

* at the root of the penis


sd

* in the femoral canal


cq
alm

The ectopic testis cannot be pushed down into the scrotum. Unlike an incompletely
descended testis, the ectopic one is usually well developed and histologically normal.
dic

The main hazard is that it is liable to injury.


me

Treatment is by orchidopexy.
w.

[10:28:45 PM] dr_gauravsuneja: The undescended testis lies along the correct path of
descent but outside the scrotum. It may be abdominal, inguinal or retractile.
ww
41 | P a g e ps

The incidence of testicular undescent is:

m
co
* 20% in premature boys (100% in male neonates of 32 weeks gestation)

ot.
* 2% in boys born at full term boys

* 1% at l year

sp
og
There is little evidence that testes descend spontaneously after the first year.

.bl
The right testis is affected alone in 50% of cases and the left alone in 30%. The condition is

ad
bilateral in 20%.

nlo
The scrotum is often underdeveloped and flattened. At operation, the testis often appears
grossly abnormal. It is small and soft, and has a dissociated epididymis. It is accompanied by
ow

a hernial sac.
sd

Absence of testicular tissue suggests intrauterine torsion or true testicular agenesis. If the
cq

latter is suspected, than an abdominal ultrasound should be performed to check for renal
agenesis.
alm

[10:29:55 PM] dr_gauravsuneja: Complications include:


dic

* infertility in bilateral undescent; no more common in unilateral cases

* associated indirect inguinal or interstitial hernia


me

* increased risk of malignancy, particularly seminomas in the late second or third decade

* increased risk of testicular torsion


w.

* increased risk of trauma to the testis


ww

* atrophy from recurrent trauma


42 | P a g e ps

Infection:

m
Picture of cellulites of leg. Treatment

co
Ans: JMp. 722

ot.
Bed rest

Elevate limb

sp
Pain control: paracetamol, aspirin,

og
Wound cleansing and dressing

.bl
Antibiotic: Flucloxaciliin 2gm 6hrly

Penicillin sens: Cephalexin

ad
nlo
Infection:
ow

A man was treated for cellulites of leg with antibiotics. After few days he presented with
hypotention and tachycardia. his leg was dusky in colour and crepitus was present.what is
the immediate management.
sd

a.continue antibiotics
b.wound debridement
cq

c.hyperbarric oxygen
d.antitoxin
alm

Ans: b.
dic

Picture of chronic venous ulcer. Management.


me

Immunization:

A 4 year old child with lacerated wound after falling on garden bed. He has taken dtpa at 2
and 4 months. After that no vaccination was given. What will you do
w.

a.give antibiotics b.give immunoglobulins cgive dtpa and Ig


d.dtpa and booster after 2 months e.give dtpa
ww

Ans: JM p.1385
43 | P a g e ps

Ortho:

m
Management of severe compound fracture of tibia and fibula.

co
Ans: Wound debridement.

ot.
RH:

sp
A woman with pain and stiffnes of metacarpophalangeal and pip joints. She has malar
rash. What is the initial management

og
a.NSAID

b.steroids

.bl
c.methotrexate

ad
Ans: Tor. Rh p.17.
nlo
RH:
ow
A patient with pain and swelling around the knee. Aspirated fluid (microscopy) contains
neutrophils. No organisms or crystal found. Diagnosis?
a. septic arthritis b. gout c.rheumatoid arthritis d? e?
sd

Ans: C.
cq

Septic arthritis: gram stain and culture positive (Tor p.Rh31, Tor p.Rh8).
alm

Skin:

Two darkish brown spots was found on the leg of a lady on examination. She did not
dic

notice any change in appearance of those spots for the past years. What is the diagnosis
a.benign junctional naevi
me

b.melanoma

c.???spots
w.

d?

Ans:
ww

Head and Neck:


44 | P a g e ps

A smoker with and indurated ulcer on the tongue. The ulcer margins are white. He has

m
caries tooth.
a.sq carcinoma of the tongue

co
b syphilitic ulcer

ot.
Ans: A.

sp
Rh:

og
Typical presentation of reiters syn.

Ans:

.bl
Drug:

ad
Which of the following drug combinations are contraindicated?
nlo
Ans: Varapamil/diltiazem and B blockers: Heart block

TCA and SSRIS


ow

NSAIDS, Diuertics, ACE inhibitors: Acute renal failure


Clozapine and lithium: malignant Hyperthermia
sd

GIT:

A patient with anal fistula. Internal opening in rectum and external opening at 5 oclock
cq

position.what is the most common underlying lesion


a.crohns disease b.anal gland infection
alm

GIT:

A patient given radiotherapy for ca cervix. Now presents with bloody diarrhea.
dic

a.proctitis b.rectovaginal fistula c.metastatic carcinoma

Ans: Proctatits
me

GIT:
w.

Lower part of the anal canal drains into which lymph nodes
ww

a.superficial inguinal b.deep inguinal c.paraaortic

Ans: Superficial
45 | P a g e ps

m
GIT:

co
A patient presents with severe epigastric pain, vomiting and hypotention.
a.pancreatitis

ot.
b.cholecystitis

sp
c.perforated duodenal ulcer

og
Ans: Pancreatitis, DU perforation: Gurding

.bl
GIT:

Ultrasonography is best used for the diagnosis of which condition in a jaundiced patient.

ad
a.gall stones b dilated bileduct c.cholecystitis d.ca liver

Ans; Gall stones


nlo
ow
Breast:

Treatment for mastalgia


sd

a.danasol

b. progesterone
cq

c.ocp
alm

Ans: B. Jmp.969

Womens health:
dic

Which if the most important factor for osteoporosis in women


a. menopause in 40 years
me

b.BMI <20 C.?

Ans: B. JM p.1015
w.

Chest:
ww

Most common site of insertion of intercostals tube in pneumothorax

Ans: 2nd intercostals place.


46 | P a g e ps

GIT:

m
Most important diagnostic feature of achalasia

co
Ans: Both solid and liquid.

ot.
GIT:

sp
The most common presenting feature of a patient with duodenal stricture secondary to
duodenal ulcer.

og
a.vomting one hour after each meal
b.vomioting of large amounts 2-3 times a day

.bl
c.? d?

Ans: A

ad
Nausea and vomiting are the cardinal symptoms of GOO. Vomiting usually is described as
nlo
nonbilious, and it characteristically contains undigested food particles. In the early stages of
obstruction, vomiting may be intermittent and usually occurs within 1 hour of a meal.
ow

CNS:

Which of the following conditions doesnot cause neck stiffness


sd

a.meningitis b.pneumonia c.tetanus d.botulism e.SAH

Neck stiffness often makes the investigator think of meningitis. However, it may also be
cq

caused by:
alm

* subarachnoid haemorrhage

* tetanus
dic

* upper lobe pneumonia

* tender posterior cervical adenopathy


me

* retropharyngeal abscess

* rheumatoid arthritis
w.
ww

Infection:

PICTURE of an adult man. Center of the umbilicus is red. Erythema of the surrounding skin.
A.omphalitis B.obstructed paraumbilical hernia c.necrotising faciitis
d.herpes zoster e.?
47 | P a g e ps

Ans: A.

m
co
Epidemiology:

A drug was introduced which decreased the fatality of the disease but doesnot bring

ot.
about complete cure of the disease. This means
a. incidence of the disease decrease. B.prevalence decrease
incidence increase prevalence increase. Both increase.

sp
Ans: prevalence increase and incidence remains same.

og
.bl
ad
nlo
ow
sd
cq
alm
dic
me
w.
ww