surgery mcqs

56. The following is true about a direct hernia, except: 1) It is due to the weakening of the posterior wall of the inguinal canal 2) It is always acquired and is due to strain¬ing 3) It is usually occurs in multiparous females 4) It arises out from the triangle of Hasselbach ​

4

59. If a patient has severe pain at the McBurney's point, what is the least likely working differential diagnosis? a. Lobar pneumonia b. Duodenal ulcer c. Myocardial infarction d. Merckel's diverticulitis ​

C

67. Complications of PUD include, except: a. Curling's ulceration b. Teapot deformity c. Hour glass deformity d. Gastric outlet obstruction ​

a

2. Cricothyroidotomy: a. Is done just above the thyroid cartilage b. Takes about 3.5 minutes to complete c. Is an emergency procedure d. Can be done when there is no access to medical equipment ​

can be done when there's no access to medical equipments

11. Methods of management of maxillary sinusitis include the following, except: a. Caldwell-Luc procedure b. Ballooning of the affected antrum c. Antral wash-outs and repair of the septum d. Prolonged use of nasal decongestant ​

d

81. Which one is the commonest condition that mimics acute cholecystitis in young women? a. Acute appendicitis b. Acute pancreatitis c. Perforated PUD d. Ectopic pregnancy ​

b

82. The following medical conditions mimic acute cholecystitis, except: a. Acute pyelonephritis b. Gallstone ileus c. Myocardial infarction d. Right lobar pneumonia ​

d

46. A complication less commonly seen in burns is: 1) Deep vein thrombosis 2) Pulmonary embolism 3) Mechanical intestinal obstruction 4) Decubitus ulcers (Bed sores) ​

3

22. Signs of injury to the left facial nerve include all the following, except: 1) Left pupillary dilation & loss of reflex 2) Deviation of angle mouth to the left 3) Weakness of the left masseter muscle 4) Altered taste on posterior 2/3 of tongue ​

2

40. A prostate abscess is least likely to present with: 1) Rectal pain and tenesmus 2) A nodular prostate 3) High fever and rigors 4) Night sweats ​

2

50. The following is NOT true about gastric ulcer 1) It can be due to pancreatic tumours 2) The patient is a usually weighty 3) It is readily prone to malignant change 4) It is associated with low-economic status ​

2

57. The following is the truth about anatomy of inguinal canal, except: 1) It is a triangular canal 4 cm long almost horizontal, parallel to inguinal ligament and above it 2) Medially, it starts from internal inguinal ring and laterally goes up to external abdominal ring 3) The internal ring is triangular, while the external ring is U-shaped 4) The deep inguinal ring is in the transversalis fascia ½ " above inguinal ligament. ​

2

71. The following is true about a funicular hernia, except: 1) It is usually a reducible indirect inguinal hernia. 2) It is always acquired if is a direct inguinal hernia 3) It frequently presents as bilateral Malgaigne's bulging 4) It is represents a ratio male to female ratio of 2:1 ​

2

72. The following is the truth about anatomy of inguinal canal, except: 1) It is a triangular canal 4 cm long almost horizontal, parallel to inguinal ligament and above it 2) Medially, it starts from internal inguinal ring and laterally goes up to external abdominal ring 3) The internal ring is triangular, while the external ring is U-shaped 4) The deep inguinal ring is in the transversalis fascia ½ " above inguinal ligament. ​

2

73. What is the surface marking of external ring and its clinical significance? 1) It is ½ " above and lateral to pubic tubercle 2) It is used in invagination test 3) It is subcutaneous the finger can be passed i.e. invaginated in the ring through the skin 4) A coughing impulse is felt to the tip of the finger it is indirect hernia and if it is felt to the pulp of the finger it is direct hernia 5) A coughing impulse is felt to the pulp of the finger it is direct hernia ​

2

74. Features of tension pneumothorax include all, EXCEPT: 1) Late cyanosis 2) Rapid pulse (tachycardia) 3) Systemic hypertension 4) Raised JVP ​

2

80. The following is true about right-sided epidural hematomas, except: 1) May present with a lucid period immediately following the trauma 2) After trauma the epidural hematoma begins collecting slowly 3) The right eye will be positioned up and in (superomedially) 4) The CT scan shows a whitish biconvex lesion on the right side ​

2

8. The onset of supraglottitis is acute, often in as little as 2 to 6 hour. Child sits upright with stridor (air hunger position). Which one of the symptoms are listed below is NOT true? 1) Severer sore throat 2) Dribbling of saliva 3) High rise of temperature 4) Greater expiratory stridor ​

4

9. The following is true about acute tonsillitis, except: 1) The surface of the tonsil may be bright red and with visible white areas 2) The tonsillar surface may have streaks of pus 3) Tonsillectomy can be performed when the swallowing is impaired 4) STonsillectomy is advised in case of three concurrent attacks that year ​

4

3. The following is true concerning acute epiglottitis , except: 1) It is a condition that occurs mainly in children 2) It is a common cause of severe sore throat and feeding difficulty in children 3) It occurs mostly in in children between 2-6 years of age 4) It is an acute inflammation and edema of the supraglottitis mainly the epiglottitis 5) It is an infection that is confined to supraglottic structure, such as aryepiglottic folds ​

5) its an infection that is confined by the supruglotic structure, such as aryepiglottic folds

5. Herpes Simplex Keratitis 1) Most common infectious cause of corneal blindness in Zambia. 2) Dendritic ulcer is the hallmark of epithelial Keratitis. 3) The virus laden cells at the centre of the Dendritic ulcer stain with Rose Bengal. 4) Corneal sensation is reduced. 5) Mild subepithelial scarring may develop after healing. ​

Dendritic ulcer is the Hallmark of epithelial keratitis

24. All the following is true about gallstones is the biliary tree, EXCEPT: a. A plain X-ray is usually diagnostic b. There are seen as a filling defect in ERCP c. Small ones are treatable with olive oil d. Mixed stones contain 30-60% cholesterol ​

a

58. What is the commonest position of the appendix? a. Retrocecal b. Pelvic and subcecal combined c. Pre-ileal and post-ileal combined d. Subcecal, and paracecal combined ​

a

e. Which one is a feature of raised intracranial pressure due to space-occupying lesion? a. Occasional convulsions b. Systemic hypotension c. Synchronous tachycardia d. Presence of constricted pupil ​

a

f. Suspect brain injury if any of the following are evident, EXCEPT: a. Hyperpyrexia b. Convulsions c. Hypertonia d. Temporal scalp hematoma ​

a

13. Management of acute epiglottitis include all the following, except: a. Emergency tracheostomy b. Examination of the throat with a spatula c. Laryngoscopy in readiness to intubate d. Needle cricothyroidotomy ​

b

48. A Bartholin's abscess is preferably a. Treated by incision and suturing of edges b. Surgically incised and drained c. Managed by marsupialization d. Is an infection of the greater vestibular glands ​

c

61. They following is least likely to be true in diagnosing using plain abdominal X-rays: a. They are helpful in diagnosing sigmoid volvulus b. They diagnose most cases of pneumoperitoneum c. They diagnose right lower lobe pneumonia on chest x-ray d. They diagnose most cases perforated appendix ​

c

84. The following is most unlikely to be true about cancer of the prostate: a. Prognosis is generally good b. It is common between 50-65 years c. Treatment includes castration d. Acid phosphatase levels increase ​

c

8. A 75 year old man comes to you screening room complaining of smoky vision, glare or dazzling, gradual loss of vision and haloes. What is the most likely diagnosis? 1) Glaucoma 2) Diabetes Retinopathy 3) Cataracts 4) Ocular trauma. ​

cataracts

65. In a patient with a suspected perforated peptic ulcer disease (PUD), the following will be most likely, except: a. A chest X-ray will show gas under the diaphragm b. There will be free pneumoperitoneum c. There will be board-like rigidity d. There will be stony dullness ​

d

68. Iliopsoas test is elicited a. When a patient lying on his side with knees extended b. By asking the patient to actively flex his thigh at the hip c. If abdominal pain results in the opposite iliac fossa d. By hyperextension at the hip ​

d

86. The following is true about phimosis a. It is failure to cover the prepuce over the glans b. It is usually treated as an emergency c. It is usually associated with paraphimosis d. It is can be treated by doing a dorsal slit ​

d

g. The following is NOT true regarding Brown-Séquard Syndrome a. This is typically seen in cord hemisection b. It results in ipsilateral loss of power and proprioception c. There is a contralateral loss of pain and temperature sensation d. This type of spinal cord injury carries a bad prognosis ​

d

1. Astigmatism 1) is defined as refractive condition in which variation of power does not exist in the different meridians of the eye 2) the power meridian is always perpendicular to its axis 3) the scissors retinal reflex during retinoscopy indicates presence of irregular astigmatism 4) is corrected using cylindrical and toric lenses 5) is usually irregular in keratoconus ​

is corrected using cylindrical and toric lenses

2. Blepharitis 1) Is often due to a staphylococcal infection. 2) Is more common on atopic subjects. 3) Is associated with marginal corneal ulceration. 4) Should be treated with long-term topical steroids. 5) Is a common cause of red eye ​

is often caused by staphylococcal infection

3. Cataract 1) Immature cataract is one in which the lens is less than 30 Years old. 2) Hypermature cataract has a shrunken cortex and posterior capsule. 3) Is a major cause of blindness in Zambia. 4) Diabetes mellitus may cause Cataract. 5) Diabetic Cataract occurs in elderly Diabetic patients and takes long to mature. ​

is the major cause of blindness in Zambia

4. The following is true concerning acute epiglottitis , except: 1) It is an acute inflammation and edema of the epiglottitis, supraglottic structure and aryepiglottic folds and arytenoid region 2) It is an acute inflammation and edema of the supraglottitis mainly the epiglottitis, confined to supraglottic structure, Epiglottis, Aryepiglottic folds and Arytenoid region 3) It may also can occur in adult 4) It is a laryngeal infections 5) Its incidence has decreased dramatically because of Vaccine 6) It is sometimes termed as supraglottitis ​

it is a laryngeal infection

7. As a newly qualified clinical officer you have just been posted to Levy Mwanawasa general hospital. During your routine screening, a mother presents to you a 10 days old infant with a purulent profuse discharge from both eyes. What is your likely diagnosis? 1) Congenital glaucoma 2) Ophthalmia neonatorum 3) Congenital cataracts 4) Retinopathy of prematurity ​

opthalmia neunatorum

a. Highly selective vagotomy b. Omental patching c. Use of omeprazole d. Eradication of H. pylori ​

B

16. The commonest agent for otomycosis is 1) Aspergillus niger 2) Candida albicans 3) Bacteroides fragilis 4) Varicella Zoster ​

1

20. The approximate % TBSA of the burnt neck and face in a five year old is _______________ 1) 14% 2) 11% 3) 9% 4) 7% ​

1

21. In tension pneumothorax there accumulation of air in the pleural space with each inspiration. Which of the following will be absent in right-sided tension pneumothorax? 1) Reduced jugular pressure 2) Reduced tactile fremitus 3) Reduced vocal resonance 4) Tracheal shift to the left ​

1

28. The following is correct about left sided massive haemothorax: 1) There is severe pallor 2) There is central cyanosis in late stage 3) The jugular veins are distended 4) The tactile fremitus is increased ​

1

29. Which one of the following in correctly paired? 1) Fractured femur → Kirchner nail 2) Biconvex configuration on CT scan → subdural hematoma 3) Concavo-convex configuration on CT scan → epidural hematoma 4) Gallow's traction → fractured femur in children < 3 years 5) Fractured femur in children → percutaneous Kapandji nail insertion ​

1

30. Blockage of cystic duct will least likely cause 1) Yellowness of conjunctiva 2) Gall bladder distention 3) A painless Mucocele 4) Courvoisier's sign ​

1

38. Complications of circumcision include all the following, EXCEPT: 1) Amputation of prepuce 2) Amputation of glans 3) False phimosis 4) Penile deviation ​

1

39. A circumcision is contra-indicated in the following condition: 1) Hypospadias 2) Phimosis 3) Paraphimosis 4) Priapism ​

1

44. The aetiology of Marlolin's ulcer is include of the following, EXCEPT: 1) A discharging fistula 2) A discharging sinus 3) An itchy rodent ulcer 4) A full-thickness burn ​

1

45. A facial burn does NOT lead to 1) Ectropion 2) Entropion 3) Microstomia 4) Proptosis ​

1

47. Complications of burns like: 1) Systemic inflammatory syndrome (SIRS) is caused by Staphylococcus aureus toxin 2) Globally sun burn is the commonest type of burn 3) Frostbite requires urgent amputation of the extremities 4) Fourth degree burn may require guillotine amputation ​

1

49. Which one of the following is NOT true about a duodenal ulcer? 1) The umbilical pain is burning and gnawing nature 2) It is associated with remissions and relapses 3) The pain is relieved by food and is more on empty stomach 4) It is associated with a family history ​

1

6. The following is true about the Larynx, except: 1) Cricoid cartilage is that thing that we can feel in touching the throat, it is actually a prominence in your front of throat 2) The main part of the laryngeal framework is formed by the thyroid cartilages. The epiglottitis is attached to the thyroid prominence at the level of vocal cords 3) The Total larynx is divided into three part for the purpose of laryngeal cancer treatment 4) Epiglottis is one of them, unpaired cartilages placed at the above ​

1

7. Others are beta hemolytic streptococci, pneumococci and staphylococcus which may be the reason of acute epiglottitis 1) Streptococcus pneumoniae 2) Streptococcus agalactiae 3) Staphylococcus aureus 4) Streptococcus pyogenes 5) Moraxella catarrhalis ​

1

70. Surgery is a must when a patient with peptic ulcers develops the following: 1) Perforation 2) Haematemesis 3) Pyloric obstruction 4) Troublesome relapse 5) Cancer of the stomach ​

1

76. Factors that increase wound infection postoperatively include all, EXCEPT: 1) Copious wound irrigation 2) Extensive tissue damage 3) Haematoma formation 4) Keeping clean incised wounds dressed for 48hours ​

1

78. True about epidural hematomas are the following, except: 1) CT scans reveal hematomas in 20% of unconscious patients 2) Spontaneous hemorrhage is known to occur 3) The majority of bleeds occur in the temporal region 4) Most bleeds originate from posterior meningeal arteries ​

1

15. The following is true about the structure of external auditory canal: 1) It is 3.5 cm long in a man 2) The outer 1/3 is cartilagenous 3) The inner 2/3 is bony and hairy 4) It is a very curved tube in infants ​

2

17. BPH 1) Occurs in 50% of men at 50 years 2) Is commoner in men > 65 years 3) Usually affects the median lobe 4) Readily migrates to the lungs ​

2

10. Treatments to reduce the discomfort from tonsillitis symptoms include: 1) Oral acetaminophen and/or ibuprofen 2) Dissolved aspirin warm water gargles 3) Dissolved brufen or indocid gargles 4) Intake of iced/cold liquids ​

2

9. Which of the following statements best defines VISUAL ACUITY 1) Ability to see at near distance 2) Ability to see fine objects at a distance of 6metres 3) Ability for the eye to accommodate 4) Eyes which are emmetropic ​

2) ability to see fine objects at a distance of 6 metters

23. Staphylococcus aureus is the least likely cause of: 1) Carbuncles 2) Toxic shock syndrome 3) Erysepela 4) Abscesses ​

3

26. Which one is the following is least likely true about hematomas? 1) Epidural hematoma is usually as a result of arterial 2) Subdural hematoma is mainly due to venous bleeding 3) There is low pressure bleeding in epidural hematoma 4) There is a lucid interval in epidural hematoma ​

3

33. All the following refer to true phimosis, EXCEPT: 1) Ballooning of prepuce on voiding 2) Presence of a soft prepuce 3) Absence of scarring of prepuce 4) Presence of a penile frenulum ​

3

35. One of the following is incorrectly matched: 1) Bag of worms → varicocele 2) Transillumination → hydrocele 3) Pitched bowel sounds → omental hernia 4) Cough impulse → hernia ​

3

36. Uric acid stones are 1) Typically radiolucent 2) Hard and less friable 3) Referred to as staghorn 4) Inapparent on IVU ​

3

37. The epithelium of the urinary bladder is made up of __________________________ 1) Cuboidal cells 2) Columnar cells 3) Transitional cells 4) Pseudostratified cells ​

3

42. Which one of the following is least likely to be associated with an undescended testis: 1) Malignant change 2) Hydrocele 3) Hypospadias 4) Torsion of testis ​

3

43. Which one of the following is most likely to be true about stages of cancer of the prostate: 1) T4: tumor beyond the pelvic walls 2) T3: tumor now involves pelvic walls 3) T2: tumor is confined to the capsule 4) T1: tumor is can be diagnosed only by biopsy ​

3

5. The following is true about the Larynx, except: 1) It guards the entrance to the lower tract airway 2) It houses the vocal cords 3) It is comprises of cartilage, ligaments, muscles and mucous membrane 4) There are 3 paired and 3 unpaired cartilages. ​

3

51. The management of peptic ulcers the following are well paired, except: 1) H2 receptor blocker → Ranitidine 2) Protein pump blocker → Omeprazole 3) Antibiotic agent → Sucraflate 4) Eradication of H. pylori → colloidal bismuth ​

3

54. The following is true about indirect inguinal hernia, except: 1) It is the failure of processus vaginalis to close 2) It is more common on the right side 3) It transilluminates light in neonates and children 4) There is extreme bulging when it is obstructed ​

3

77. Staphylococcus aureus causes the following infections, EXCEPT: 1) Carbuncles 2) Toxic shock syndrome 3) Erysepela 4) Abscesses ​

3

79. Subdural hematoma is associated with all the following, except; 1) Occurs mainly in the elderly casualties 2) Victims include patients on anticoagulants 3) Major contre coup head trauma 4) Good or complete recovery ​

3

Decoy prostate" refers to _________________________ 1) Failure to rule out a stricture 2) Stone-induced renal hematuria 3) Not performing cystoscopy 4) Disregarding rectal findings ​

3

right sided tension pneumothorax least likely to be true is the following: There is 1) Reduced tactile fremitus 2) Reduced vocal resonance 3) Reduced jugular pressure 4) Tracheal shift to the left ​

3

75. The following are features of raised intracranial pressure, EXCEPT: 1) Nausea and vomiting 2) Grand mal seizures 3) Bradycardia 4) Hypotension ​

4

8. The onset of supraglottitis is acute, often in as little as 2 to 6 hour. Child sits upright with stridor (air hunger position). Which one of the symptoms are listed below is NOT true? 1) Severer sore throat 2) Dribbling of saliva 3) High rise of temperature 4) Greater expiratory stridor ​

4

12. Which one of the following is least likely to be a painful condition of the pinna? 1) Aural seroma 2) St. Anthony's fire 3) Facial nerve palsy 4) Rumsey-Hunt syndrome ​

4

18. Which one of the following is a storage issue? 1) Hesitancy 2) Poor urinary stream 3) Intermittent stream 4) Nocturnal incontinence 5) Dribbling ​

4

19. The risk of bleeding following paracentesis may be increased if: 1) International normalize ratio > 1.6 2) Platelet count < 50,000 per cubic millimeter 3) In case of mild hematologic abnormalities 4) Prothrombin time > 21 seconds ​

4

31. Which one of the following is unlikely to be true about residual urine? 1) It is the most valuable sign of BPH 2) Ultrasound scan shows the presence of urine 3) Despite voiding some urine remains in the bladder 4) An enlarged median lobe blocks the urethra ​

4

34. It is unlikely for chronic retention of urine to present as or with 1) Nocturia 2) Bedwetting 3) Urgency 4) Suprapubic pain ​

4

41. Congenital abnormalities of the urethra include the following, EXCEPT: 1) Meatal stenosis 2) Epispadias 3) Urethral stricture 4) Paraphimosis ​

4

52. The following is true about a Richter's hernia, except: 1) It is a protrusion of part of viscus through an abdominal opening 2) It is represents a ratio female to male ratio of 20:1 3) It frequently presents with absolute constipation 4) It is the commonest hernia to strangulate ​

4

53. The frequency of hernias is a follows, except: 1) Inguinal (73%) 2) Femoral (17%) 3) Umbilical (08%) 4) Incisional hernias (15%) ​

4

55. The following is true about a congenital hernia, except: 1) The processus vaginalis remains unobliterated 2) It contains peritoneal fluid and other viscera 3) Bowel sounds can be heard over the scrotum 4) It gives rise a cystic direct inguinal hernia ​

4

14. Which one is NOT a symptom of an earwax impaction? 1) Decreased bony hearing 2) Dizziness or giddiness 3) Ear pain / otalgia 4) Plugged or fullness sensation 5) Ringing in the ear (tinnitus) 6) Itching or drainage from the ear canal ​

6

63. True is about duodenal ulcers (DU), except: a. It is less common than gastric ulcer b. It affects male 8 times more than women c. It affects mainly the 35-45 years group d. Anterior perforation occurs in 80% of patients ​

A

64. Eating often exacerbates or worsens the pain of the following, except: a. Duodenal ulcers b. Bowel obstruction c. Biliary colic d. Bowel perforation ​

A

89. Which one of the descriptions of fractures below is least likely to be true? a) It is a Salter-Harris type IV injury if the growth plate is crushed b) A # may be an incomplete disruption of the normal bony architecture c) Ii is difficult to see a cartilage fracture on an X-ray (radiograph) d) An acute fracture has fragments with sharp, well-defined edges ​

A

Congenital Glaucoma presents with which of the following signs and symptoms 1) Bulphthalmos 2) Megalocornea 3) Corneal clouding and epiphora 4) All of the above ​

All of the above

62. Which one is the commonest surgical condition in young women? a. Acute pancreatitis b. Perforated peptic ulcer c. Acute appendicitis d. Ectopic pregnancy ​

C

83. Investigations that are done in acute abdomen include all the following, except: a. Sigmoidoscopy and barium enema b. Endoscopic retrograde cholangiopancretography c. History and gentle rectal digital examination d. Estimation of serum amylase levels ​

C

85. Intra- and post-circumcision complications include all the following, EXCEPT: a. Amputation of glans b. False phimosis c. Amputation of prepuce d. Penile deviation ​

C

25. All the following is true about pain of biliary colic, EXCEPT: a. It responds better to pethidine b. It responds better to meperidine c. It is relieved by sitting and leaning forward d. It radiates to the infraclavicular area e. Which one is a feature of raised intracranial ​

d

60. Physical examination in acute abdomen is always in this sequence, except: a. General inspection precedes abdominal inspection b. Palpation follows percussion & is the last examination c. Percussion precedes auscultation d. Auscultation is the last examination ​

d

4. Herpes Zoster Ophthalmicus 1) Prodromal phase precedes the appearance of the skin rash. 2) The skin rash respects the vertical midline. 3) Post herpetic neuralgia is defined as pain that persists for more than one year after the rash has healed. 4) Mucous plaque keratitis is a feature. 5) Cicatricial Entropion and Ectropion are known complications. ​

prodromal phase precedes the appearance of skin rush