Bailey Chapter 4 Based MCQs

Basic surgical skill and anastomoses

1	Which of the following is true statement regarding elliptical incisions ? Two times as long as it is wide Five times as long as it is wide Four times as long as it is wide Three times as long as it is wide	Answer: A Rule of thumb for elliptical incisions: ‘an elliptical incision must be at least three times as long as it is wide’ for the wound to heal without tension.
2	Consider following statements regarding abdominal incisions :  Transverse incisions tend to be associated with fewer respiratory complications Transverse incisions tend to be associated with better cosmetic outcome Midline incisions tend to be associated with fewer respiratory complications Midline incisions tend to be associated with better cosmetic outcome Identify true statements from the following ? Both 1 and 3 are true Both 1 and 2 are true Both 2 and 4 are true Both 3 and 4 are true	Answer: B Transverse incisions tend to be associated with fewer respiratory complications and a better cosmetic outcome. In the past, traditionally vertical midline or paramedian incisions were used for the majority of abdominal procedures, but there is a current trend to utilise transverse incisions wherever possible as this minimises postoperative complications

5/07/2020 03:17:00 PM

Q1. The “Nissl substance” represents which organelle of neuron?
A. Golgi complex
B. Nucleolus
C. Rough endoplasmic reticulum
D. Mitochondria

Ans: The cytoplasm of a neuron shows the presence of a granular material that stains intensely with basic dyes called Nissl substance (also called Nissl bodies or granules) . These bodies are rough endoplasmic reticulum

Q2. Which of the following provides myelin sheath to the axons of the CNS?
A. Astrocytes
B. Oligodendrocytes
C. Microglia
D. Ependymocytes

Ans: Oligodendrocytes form myelin sheath in CNS. Schwann cells form myelin sheath in PNS

Q3. The perivascular foot of the “blood–brain barrier” is an extension from the:
A. Oligodendrocyte
B. Ependymocyte
C. Astrocyte
D. Microglia

Ans: Astrocytes form the perivascular feet around a capillary. Astrocytes act as insulators, nourish the neurons, help form blood-brain barrier.

Q4. Sensation of pain is detected by:A. Mechanoreceptor
B. Chemoreceptor
C. Nociceptor
D. Thermoreceptor

Ans: Nociceptor

Q5. The cerebral aqueduct is developed from the cavity of:A. Rhombencephalon
B. Mesencephalon
C. Telencephalon
D. Diencephalon

Ans: The cavity of each telencephalic vesicle becomes the lateral ventricle. The cavity of  iencephalon (along with the central part of the telencephalon) becomes the third ventricle. The cavity of the mesencephalon remains narrow, and forms the cerebral aqueduct (aqueduct of Sylvius). The cavity of the rhombencephalon forms the fourth ventricle. Its continuation in the spinal cord is the
central canal

Q6. The failure of closure of the cranial end of neural tube gives rise to:A. Anencephaly
B. Hydrocephalus
C. Microcephaly
D. Meningomyelocoele

Ans: The neural tube remains open in the region of the brain because of nonclosure of the anterior neuropore. This results in anencephaly. Brain tissue, which is exposed, degenerates

Q7. By which week of intrauterine life does the neural tube close?

A. Fourth
B. Fifth
C. Sixth
D. Seventh

Ans: At 4 weeks the neural tube is normally completely closed (Ref: https://embryology.med.unsw.edu.au/embryology/index.php/Timeline_human_development#Neural)

Q8. The cervical flexure of the neural tube occurs:A. Between the forebrain and midbrain
B. In the midbrain
C. Between hindbrain and spinal cord
D. In the hindbrain 

Ans: The cervical flexure lies at the junction of the rhombencephalon and the spinal cord  

Q9:Rabies virus, from the site of bite, travels along nerves by 

A. Forward Axoplasmic Flow

B: Reverse Axoplasmic flow

C: Dendritic Flow

D: Along the Endoneurium of nerve fibres

Ans: Rabies virus, from the site of bite, travels along nerves by reverse axoplasmic flow.

Q10:Polio virus is also transported from the gastrointestinal tract through :

A. Forward Axoplasmic Flow

B: Reverse Axoplasmic flow

C: Dendritic Flow

D: Along the Endoneurium of nerve fibres

Ans: Polio virus is also transported from the gastrointestinal tract through reverse axoplasmic flow.

Q11:Tetanus bacteria, in contrast, travels from the site of infection to the brain by:

A. Forward Axoplasmic Flow

B: Reverse Axoplasmic flow

C: Dendritic Flow

D: Along the Endoneurium of nerve fibres

Ans: Tetanus bacteria travels from the site of infection to the brain along the endoneurium of nerve fibres

  

Reference:

Inderbir Singh's Textbook of Human Neuroanatomy (Fundamental and Clinical)  

4/11/2020 07:30:00 AM

Introducing surgery MCQs in cram sheet format to get the most out of your limited time online. Will be adding more MCQs patterned for MRCS Part A, NEET SS, DNB CET SS exams.

1.	In blast injury, which of the following organ is least vulnerable to blast wave? a) GIT b) Lungs c) Ear drum d) Liver	b: Liver Primary injuries are caused by blast shockwaves. The ear drums are most often affected by the blast wave, followed by the lungs and the hollow organs of the gastrointestinal tract.
2.	On mammogram all of the following are the features of a malignant tumor except: a) Spiculation b) Micro-calcification c) Macro-calcification d) Irregular mass	c. Macro-Calcification Micro-calcifications may be associated with cancer. Macro calcification may be caused by aging or by a benign condition such as fibro-adenoma, a common noncancerous tumor of the breast. Distorted areas suggest tumors that may have invaded neighbouring tissues
3.	A 40 year old patient is suffering from carotid body tumor. Which of the following is the best choice of treatment for him? a) Excision of tumor b) Radiotherapy c) Chemotherapy d) Carotid artery ligation both proximal and distal to the tumor	a. Excision of tumor Surgical excision is the treatment of choice. The larger the tumor the higher is the risk of operative complication
4.	The diagnosis of congenital mega-colon is confirmed by a) Clinical features b) Barium enema c) Rectal biopsy d) Recto-sigmoidoscopy	c. Rectal biopsy In Hirschsprug’s disease, the migration is not complete and part of the colon lacks these nerve bodies that regulate the activity of the colon. The suction rectal biopsy is considered the current international gold standard
5.	Which of the following renal calculi are most difficult to treat with lithotripsy? a) Uric acid stones b) Cystine stones c) Calcium oxalate stones d) Triple phosphate stones	b. Cystine stones ESWL does not successfully treat Cystine kidney stones
6.	Most common site of spinal cord tumour is: a) Intra-dural extra-medullary b) Extra-dural c) Intra-medullary d) Equally distributed	b. Extra-dural Spinal tumors are neoplasms located in the spinal cord. Extra-dural tumors are more common than intra-dural neoplasms. Extra-dural tumors are mostly metastases from primary cancers elsewhere (commonly breast, prostate and lung cancer).
7.	Most common cause of liver abscess in chronic granulomatous disease: a. Klebsiella b. Staph. aureus c. Peptostreptococcus d. E. coli	b. Staph. Aureus Staphylococcus is most common. Occurs in the setting of chronic granulomatous diseaseQ, disorder of granulocyte function and hematologic malignancies.
8.	Choledochocoele is which type as per Todani classification: a. Type 2 b. Type 3 c. Type 4 d. Type 5	b. Type 3 Type 1: Solitary Extrahepatic fusiform in shape Type 2: Extrahepatic supraduodenal diverticulum Type 3: Choledochocoele Type 4: Extra and Intrahepatic/ Multiple Extrahepatic Type 5: Multiple Intrahepatic
9.	A patient with obstructive jaundice bilirubin level of 40 mg/dl, the possible explanation is a) Malignancy of gall bladder b) Concomitant renal failure c) Chronic cholecystitis d) Complete obstruction of common bile duct	b) Concomitant renal failure In presence of complete biliary obstruction, serum bilirubin levels generally plateau at 25 to 30 mg/dl. At this level, daily bilirubin load equals that excreted by kidneys, Situation in which even higher bilirubin levels can be found include renal insufficiency, hemolysis and hepato-biliary disease.
10.	TRUE about neurogenic shock a) Cold and moist extremity b) Tachycardia c) Due to parasympathetic cut-off d) Diagnosis of exclusion	d) Diagnosis of exclusion Following are features of neurogenic shock which you should remember: · Due to sudden loss of autonomic tone · Disruption of descending sympathetic pathway · Patient has bradycardia · Extremities are warm

12/22/2019 09:36:00 AM

Introducing surgery MCQs in cram sheet format to get the most out of your limited time online. Will be adding more MCQs patterned for NEET SS, DNB CET SS and MRCS Part A exams.

S.NO	Question	Answer and Explanation
1.	Liver abscess ruptures most commonly in a. Pleural cavity b. Peritoneal cavity c. Pericardial cavity d. Bronchus	b. Peritoneal cavity High risk of rupture · size >5 cm · left lobe abscess
2.	True about amoebic liver abscess: a. Male: female >10:1 b. Not predisposed by alcohol c. More common in diabetics d. E. histolytica is isolated in >50% from blood culture	a. Male: female >10:1 Majority of patients are young men (may be due to heavy alcohol consumption)
3.	Not an indication for percutaneous aspiration in amoebic liver abscess) a. Radiographically unresolved lesion afer 6 months b. Suspected diagnosis c. Lef lobe liver abscess d. Compression or outflow obstruction of hepatic or portal vein	a. Radiographically unresolved lesion afer 6 months Radiologic resolution of the abscess cavity is usually delayed. The average time to radiologic resolution is 3 to 9 months and can take as long as years in some patients. Clinical improvement after adequate treatment with antiamoebic agents is a rule.
4.	Liver biopsy is done through 8th ICS midaxillary line to avoid: a. Lung b. Pleural cavity c. Subdiaphragmatic space d. Gall bladder	a. Lung Liver biopsy is done through 8th ICS in midaxillary line to avoid Lung
5.	“Crumbled egg appearance” in liver is seen in a. Hepatic adenoma b. Chronic amoebic liver abscess c. Hydatid liver disease d. Hemangioma	c. Hydatid liver disease Crumbled egg appearance in liver is seen in hydatid disease
6.	Honey-comb liver is seen in a. Micronodular cirrhosis b. Dubin Johnson’s syndrome c. Actinomycosis d. Hydatidosis	c. Actinomycosis Most commonly, Actinomyces reaches liver through portal vein. Liver is gradually replaced by multiple abscesses, typical honey comb liver
7.	Primary sinusoidal dilatation of liver is also known as: a. Hepar lobatum b. Peliosis hepatis c. Von-Meyerburg complex d. Caroli’s disease	b. Peliosis hepatis It is an uncommon disorder characterized by multiple, small, blood-filled sinuses. It occurs in immunocompromised postransplant patients, AIDS patients, and patients taking long term steroids.
8.	Not a contraindication of lap cholecystectomy: a. Acute Cholecystitis b. Ca Gallbladder c. Portal Hypertension d. Bleeding Diathesis	a. Acute Cholecystitis In Acute cholecystitis, Lap cholecystectomy IS NOT CONTRAINDICATED. In other conditions surgery should be done by open method.
9.	A patient presented with RIF pain with dyspepsia. USG showed edematous GB wall. What will be the most sensitive investigation to confirm the suspected diagnosis? a. CECT b. MRI c. HIDA d. ERCP	c. HIDA Hydroxy-iminodiacetic acid (HIDA) is taken by liver and excreted into bile. Failure to fill gallbladder in a time of 2 hours is indicative of Acute cholecystitis
10.	True statement regarding choledochal cyst is all except: a. Type 2 is most common b. Type 1 needs excision and biliary anastomosis c. Surgical excision is the treatment of choice d. Associated with anomalous union of pancreatic and bile duct	a. Type 2 is most common As per Todani classification of Choledocal cysts: · Most common choledochal cyst – Type 1 · APBDJ is seen in 90% of choledochal cyst cases

1/11/2018 09:51:00 PM

[A] Duodenal  Injury
[B] Diffuse Axonal Injury
[C] Splenic Injury
[D] Perineal Injury 

Answer- B

Axons are normally elastic, but when rapidly stretched they become brittle, and the axonal cytoskeleton can be broken. Misalignment of cytoskeletal elements after stretch injury can lead to tearing of the axon and death of the neuron. Axonal transport continues up to the point of the break in the cytoskeleton, but no further, leading to a buildup of transport products and local swelling at that point. When it becomes large enough, swelling can tear the axon at the site of the break in the cytoskeleton, causing it to draw back toward the cell body and form a bulb. This bulb is called a retraction ball, the hallmark of diffuse axonal injury

6/21/2017 06:07:00 PM

1. Most common neuroendocrine tumor seen in MEN-1

Nonfunctioning or that secrete pancreatic polypeptide (PPoma)

2. Xanthogranulomatous cholecystitis is caused by 

Inflammatory response to extravasated bile, possibly from ruptured Rokitansky-Aschoff sinuses

3. Most common organism responsible for Xanthgranulomatous pyelonephritis

Proteus

4. Most common organism responsible for Emphysematous pyelonephritis

E. coli

5. Most common organism responsible for Emphysematous cholecystitis

Clostridium welchii

6. Trauma and injury severity score (ISS) includes

Injury Severity Score + Revised trauma score + Age + Mechanism

7. University of Wisconsin solution used for preserving Liver, Pancreas and Kidney before transplant: Relative Cationic composition (potassium and sodium) ?

mimics intracellular levels : High Potassium and Low Sodium

8. Duodenal switch operation includes

Sleeve gastrectomy, Duodenoileostomy, Jejunoileal bypass, Cholecystectomy, Appendectomy

9. MC endocrine abnormality in MEN-1 is

multiglandular parathyroid tumors

10. First biochemical abnormality in MEN 1 (It precedes the clinical onset of a pancreatic NET or pituitary neoplasm by several years)

Hypercalcemia

6/04/2017 03:53:00 PM