Final MBBS Surgery MCQs 1.

In mesh repair for inguinal hernia, which type of suture can be used for suturing mesh to muscle? a) b) c) d) e) silk propylene stainless steel polylactic acid catgut

2. Necrotising fasciitis is associated with a) b) c) d) e) swelling of the calf redness high fever high ESR high CRP

4. In a patient with hypovolaemic shock, which cannular size would you ideally choose for infusion? a) b) c) d) e) 19G 21G 14G 26G 30G

6. Adequate minimum urine output in a 70kg man during resuscitation is a) b) c) d) e) 35 ml/hr 20 ml/hr 50 ml/hr 45 ml /hr 60 ml/hr

7. Copper IUCD prevent pregnancy by the following way: a) b) c) d) e) spermicidal action preventing ovulation prevent implantation of embryo all of the above non of the above

9. Which is important in the antenatal history? a) b) c) d) e) menstrual history medical history family history previous contraceptive methods all of the above

11. Which of the statement about a perforated duodenal ulcer is false: a) b) c) d) ? patch repair ? 20% show free air under diaphragm on CXR

13. Several studies have followed up patients with asymptomatic gallstones. What percentage of patients develop symptoms after 5 20 years? a) b) c) d) e) < 2% 10 20 % 30 40 % 50 60 % 60%

14. Salbutamol a) b) c) d) e) may cause hypokalaemia not used with steroid for PTL in DM improve outcome when used alone by prolonging pregnancy negative chronotrophic effect on heart more effective in PROM

15. Which of the following give complications in 1st H&L injection? a) b) c) d) e) trigger finger DeQuervains tenovaginitis Achilles tendinitis ? Tennis elbow

16. Acute retention of urine, which is FALSE: a) imperforate hymen does not commonly present as ARU b) herpes simplex genitalis often presents with voiding difficulties and urinary retention c) can be treated by indwelling catheter for 48 hours

d) retention is often accompanied by overflow incontinence e) often occurs post vaginal delivery, post-instrumental vaginal delivery, post surgical instrumentation 17. Which of the following is true for basal cell carcinoma? a) b) c) d) e) metastases to lymph node is rare common at non-sun exposed area UV light is not a cause morpheous type is easily treated treatment of choice is radiotherapy

18. Inhalation burn injury 20 mins earlier, now carbonaceous sputum, respiratory rate 24 breaths per minute. TRUE: a) b) c) d) e) if stridor and cyanosis not present, then not severe X-rays, chest signs should be positive ABG normal, then watch/treat conservatively bronchoscopy is of no value intubation and oxygen indicated

19. Varus injury to the knee results in a) b) c) d) medial meniscus injury medial condyle fracture tear of fibulo?? ligament ?inability to use extensor hallucis longus

20. Which is the least likely to be present in ?acute cholecystitis a) b) c) d) e) nausea right hypocondrial tenderness right hypochondrial guarding elevated conjugated bilirubin jaundice

21. Following are features of Conns EXCEPT a) b) c) d) e) hypertension low serum potassium low plasma rennin activity raised serum sodium muscle weakness

23. Workman fell on a bar, hit perineum. Scrotal haematoma and per-uretral bleeding. Which is TRUE?

a) catheterise b) surgery to repair urethra c) suprapubic catheter if patient cannot pass urine 24. Which of the following is NOT a risk factor for bladder cancer a) b) c) d) e) smoking cyclophosphamide schisostomiasis pelvic irradiation adriamycin

26. Treatment of dysfunctional uterine bleeding except a) b) c) d) e) prostaglandin E bromocriptine danazol tranexamic acid OCP

27. 40 year old male with ulcerative colitis now with exacerbation of GI symptoms. Assess severity with a) b) c) d) e) erythema nodosum anaemia dose of salazopyrine ankylosing spondylitis dysplasia on colonoscopy

28. Cause of thirst and oliguria in ileostomy a) b) c) d) hypokalaemia metabolic alkalosis renal calculi high output from ileostomy

29. Man went for anterior resection, post-op histo shows Duke C. Advise: a) adjuvant chemo-RT b) neoadjuvant RT c) liver resection 30. Termination of mid-trimester pregnancy can be by applying prostaglandin via

a) b) c) d) e)

intra-amniotic extra-amniotic vaginally none of the above all of the above

31. A 28 year old lady complains of painful defecation associated with fresh per-rectal bleed. Possible diagnosis to consider: a) b) c) d) e) hiradenitis suppurativa dermoid cyst pilonidal sinus anal fissure pruritis ani

32. Which is FALSE for colorectal cancer? a) father with colorectal cancer predisposes one to higher risk than general population b) familial adenomatous polypopsis coli is inherited as autosomal dominant c) cancer localized to mucosa can be cured d) DNA mismatch repair gene mutation predisposes you to 100% lifetime risk of colorectal cancer 33. ? Submandibular stones associated with a) b) c) d) e) swelling radiolucent stones Freys syndrome pain after eating 2 hours excision of the whole gland

34. Not a cause of large bowel intestinal obstruction a) b) c) d) e) Crohns volvulus radiotherapy adhsions recurrent ischaemic colitis

35. Haemorrhoids a) b) c) d) are commonly believed to be venous malformation require surgical excision if small and symptomatic commonly present with painful bleeding and perianal swelling may undergo malignant metaplasia in those with chronic prolapse

e) pruritis ani 39. What is true about malrotation and volvulus? a) b) c) d) e) commonly presents with bilious vomiting presents in late childhood barium meal excludes it may lead to acute ischaemic colitis is not an emergency and may be treated conservatively

40. Which statement with regards to burns is TRUE? a) the commonest cause of deaths is overwhelming infection b) in electrical burns, extent of surface injury is a good reflection of underlying injury c) flame burns worse than scalds d) ? e) Partial thickness burns are sensate 41. Maternal mortality rate is calculated as the number of maternal deaths per: a) b) c) d) e) 100 1000 10 000 100 000 1 000 000

42. Which is false for squamous cell carcinoma a) can be caused by repeated exposure to chronic skin irritation b) can arise from chronic conditions like Marjolins ulcer c) Bowens and Pagets are known risk factors d) seborrhoiec keratosis is a pre-malignant lesion e) can present as cutaneous horn 44. Which of the following is commonly used to screen for osteoporosis/osteopenia in a menopausal lady? a) b) c) d) e) MRI of hip lumbar X-ray DEXA mammogram CT scan

46. The osmolality of plasma and interstitial fluid is determined by:

a) b) c) d) e)

bicarbonate potassium chloride protein sodium

50. In the 2nd stage of labour a) b) c) d) e) immediate delivery is indicated in early decelerations pushing is encouraged once cervis is fully dilated urinary catheter is routinely done to help foetal head engage persistent late decelerations is suggestive of foetal hypoxia it is never allowed to go beyond 1 hour

52. Grade III open fracture of tibia best treated with: external fixation 53. The following signs & symptoms are consistent with acute unruptured appendicitis EXCEPT: a) b) c) d) e) patient writhing in pain pain initially paraumbilical, then moves to right iliac fossa Rovsings sign positive Rectal temperature 38.1C ?

54. A young lady presents with 3cm thyroid nodule. FNAC shows papillary cells. The next appropriate management is a) b) c) d) e) thyroxine radioactive iodine ? Excise nodule Hemithyroidectomy

56. Menopause is associated with the following except: a) b) c) d) e) hot flushes urinary problems Colles fracture Increase risk of acute myocardial infarct Dysmenorrhoea

58. Hyperprolactinaemia is associated with the following EXCEPT: a) b) c) d) e) Hypothyroid Bitemporal hemianopia Ovarian cyst Breast discharge Oligomenorrhoea

59. Man with 3cm adrenal mass found on CT scan. Which of the following is NOT true: a) b) c) d) e) do CXR FNAC Do rennin level Surgery observe

61. Which of the following is not associated with increased maternal mortality? a) b) c) d) e) antepartum haemorrhage postpartum haemorrhage infection ectopic pregnancy pre-existing diabetes mellitus

63. 70 year old man fell in bathroom and fractured left hip (displaced NOF #). Treatment: a) b) c) d) e) total hip replacement hemiarthroplasty excisional arthroplasty internal fixation and screw dynamic hip screw

64. Which of the following is found in diabetes insipidus? a) b) c) d) e) increase serum urea decrease serum urea increase serum potassium decrease serum potassium decrease creatinine

65. Chronic pelvic pain associated with the following EXCEPT: a) b) c) d) chronic pelvic inflammatory disease previous abdominal operation adenomyosis endometrioma

e) retroverted uterus 66. Most common cause of sub-arachnoid haemorrhage is a) b) c) d) e) hypertension coagulopathy arteriovenous malformation aneurysm tumour

67. SIADH is associated with a) b) c) d) e) hypernatraemia hyponatraemia hyperkalaemia hypokalaemia raised serum urea

68. Which of the following is not a sign of upper motor neurone lesion? a) b) c) d) e) sustained clonus hyper reflexia Hoffmans sign Upgoing plantar Flaccid paralysis

70. The following affect perinatal mortality rate except a) b) c) d) e) low birth weight asphyxia vacuum aspiration congenital abnormalities prematurity

71. Following a road traffic accident, a motorcyclist presents with a cold pulseless foot. Injuries that may be associated include: a) b) c) d) e) posterior knee dislocation closed fracture of the tibia and fibula penetrating injury to the popliteal fossa a&b a, b & c

72. Contraindications to breast conservation a) multicentric on mammogram

b) c) d) e)

central > 60 year old diabetes mellitus Jehovahs Witness

76. Perthes disease: which of the following is TRUE? a) b) c) d) e) present > 10 years old poorer prognosis always bilateral has congenital deformities age range up to 20 years old early surgery improves prognosis

77. Wide local excision + axillary clearance + radiotherapy compared with simple mastectomy + axillary clearance: a) b) c) d) e) ? inprove survival, increase local recurrence same survival and recurrence inprove survival, reduced local recurrence studies inconclusive

78. Patient going for right hemicolectomy. Consultant asks you to prescribe ampicillinsulbactam. After checking no drug allergy, you would administer: a) b) c) d) e) oral route 24hr before surgery oral route 10 30 min before surgery IV route 6 hr before skin incision IV 10 30 min before skin incision IV 0 30 min before surgery and continue for 3 days after

79. Which is not a cause of pancreatitis? a) b) c) d) e) hypercalcaemia hypokalaemia hyperlipidaemia obstruction at ampulla of Vater thiazide

81. 60 year old man, 70kg with oesophageal carcinoma. Poor feeding for 2 wks because of dysphagia, lost 12kg in 4 wks. What would you do for him? a) b) c) d) do not need nutritional correction IV parenteral nutrition 1 day before operation IV parenteral nutrition 1 wk before operation IV parenteral nutrition after surgery

e) ? 82. Monteggia fracture-dislocation. Which is TRUE? a) b) c) d) e) fracture of proximal ulnar + radial head ulnar nerve palsy weak finger extension cross-union treat conservatively with above-elbow cast

83. Patient with colorectal Ca 5cm metastasis to liver. T2N1M1. Primary is treated. What to do with liver mets? a) b) c) d) e) liver resection TACE (transarterial chemo-embolisation) Radiotherapy Chemoradiotherapy Wait and see

84. In which of the following tumours does radiotherapy (offered as a 1st line treatment) have the same results as surgical resection? a) b) c) d) e) renal cell carcinoma adenocarcinoma of stomach malignant melanoma squamous cell carcinoma of oesophagus carcinoma of rectum

85. Closed fracture of the shaft of humerus may be associated with inability to: a) b) c) d) e) extend distal interphalangeal joint of little finger oppose thumb flex wrist flex proximal metacarpophalangeal joint of thumb extend the interphalangeal joint of thumb

86. Normal menstrual cycle, true EXCEPT: a) LMP taken as final day of last menstrual period b) FSH, LH change continuously throughout cycle c) mid-cycle pain and bleeding is physiological 87. 11 year old male cyclist had an accident, sustained laceration over left thigh extending over left inguinal area into left iliac fossa. On further history taking he is estranged from his parents and staying alone. Choose the most appropriate statement.

a) b) c) d) e)

patient is a minor and his consent for any operation is not needed patient and 2 senior doctors can sign the consent form toilet & suture is minor procedure so consent is not required if patient refuses treatment, it is not necessary to trace the parents to inform them no consent is needed if procedure performed in emergency room

89. You are a HO clerking a patient for elective laparoscopic cholecystectomy for cholelithiasis. He complained of dark urine of 1 day duration the day before. Had abdominal pain 3 weeks ago, after fatty food. LFT shows: - conjugated bilirubin - unconjugated bilirubin - ALP - ALT - AST - PT Your plan of management: a) b) c) d) e) continue with cholecystectomy, becourse the stones will be taken out anyway ultrasound, if dilated bile ducts refer for ERCP Hep B, Hep C screen Recheck LFT in 2 weeks CT liver 25 20 180 25 26 13.3 s

90. True of slipped capital femoral epiphysis EXCEPT: a) common in children < 6 years old b) associated with endocrine abnormalities c) present with limp d) associated with obesity e) ? 92. Most effective parameter in the ultrasound diagnosis of IUGR is: a) b) c) d) e) biparietal diameter head circumference abdominal circumference femur length to biparietal diameter ratio umbilical artery Doppler

93. Teenager with painful flat foot. Which can cause it? a) juvenile chronic arthritis b) tarsal coalition

c) accessory navicular bone d) all of the above e) none of the above 94. Periosteal bone formation seen in a) b) c) d) e) chronic osteomyelitis osteogenic sarcoma post-phlebitic leg a&c all of the above

96. Indications for vaginal examination in theatre a) b) c) d) e) diagnose placenta praevia ? Ultrasound finding of placenta praevia Revealed PV bleeding Concealed PV bleeding

97. 34 year old lady, 3cm hard mass in left breast, what is the investigation which is least helpful? a) b) c) d) e) FNAC of lump Ultrasound both breast for DCIS Mammogram both breast for DCIS LFT for mets CXR for mets

98. In variceal bleeding, FALSE: a) b) c) d) e) IV somatostatin early Correct PT of 22 with FFP Encephalopathy may be treated by lactulose Sengstaken-Blackmore tube once diagnosis made Band ligation in 1st endoscope

99. 45 year old motorcyclist, has a road traffic accident. A&E findings revealed patient groaning, speaking unintelligibly, chest wall abrasions. RR 20/min, BP 90/70 mmHg, pulse 125/min, small pulse volume. Cold and clammy. Reduced air entry and tympanic percussion note on right chest. Distended neck veins. Next appropriate thing to do? a) b) c) d) enquire RTA circumstances 2 large bore IV lines Intubate Needle in 2nd intercostals space

e) Pericardiocentesis 100. Fat embolism is commonly associated with a) ? b) ? c) mental alteration and restlessness 101. Face presentation in labour, most commonly associated with a) b) c) d) e) post term anencephaly ? Oligohydramnios Downs syndrome

102. In a bleeding patient, which is the most important parameter to assess successful fluid replacement? a) b) c) d) e) pulse rate pulse pressure urine output cutaneous perfusion pallor

103. A young man at A&E after road traffic accident. Unconscious, systolic BP 60mmHg by palpation. No obvious open wounds or fractures. Most likely cause of shock: a) b) c) d) e) sub-dural haemorrhage cervical transection bleeding into abdomen and chest cavity cardiac tamponade tension pneumothorax

104. Regarding mammographies, which is inappropriate: a) b) c) d) e) increase false negative in younger females compared to older females mammograms have not affected mortality outcome false negative rate is about 10-15% women about 40 years should go for one women under 40 should go if they have positive family history

109. Enterocutaneous fistula. Which is false a) skin irritation is a major problem b) barium meal should be done by 1st wk

c) ? d) Can try oral elemental feeding if fistula is at distal small intestine e) Fistulogram can help in diagnosis 111. 25 year old smoker, 32 wks pregnant, noticed to have IUGR on ultrasound only, what is associated with this feature? a) b) c) d) e) polyhydramnios gestational diabetes mellitus decreased fetal plasma viscosity drinking alcohol of > 120mg daily ? increased proction of thromboxane A2 & prostacyclin

112. A 70 year old man presents with painless cholestatic jaundice and vomiting. CT scan shows a bulky tumour in the pancreas and tumour thrombosis in the superior mesenteric and splenic veins. An appropriate treatment plan is a) b) c) d) e) pancreaticoduodenectomy fibrinolysis treatment followed by Whipples operation gastrojejunostomy and choledochojejunostomy total pancreatectomy and splenectomy fraxiparin (LMW heparin) and pain relief

114. Symptoms of endometriosis include the following EXCEPT: a) b) c) d) e) dysmenorrhoea irregular bleeding sudden lower abdominal pain infertility abdominal mass

116. Regarding traumatic diaphragmatic rupture, which statement is FALSE: a) b) c) d) e) laparotomy is indicated mainly on right side Ryles tube can assist in making diagnosis respiratory distress is common blunt is more common than penetrating trauma

118. Incidence of post-term pregnancies a) b) c) d) e) 1% 20% 6% 80% 0.01%

120. In renal trauma the diagnostic investigation that best demonstrates parenchymal laceration, urine extravasation, extent of retroperitoneal haemorrhage is: a) b) c) d) e) intra-venous urogram CT abdomen Nephrotomography Arteriogram MRI

124. Most appropriate investigation for an obstructed upper urinary tract which is dilated a) b) c) d) e) IVU CT scan MRI Ultrasound Renogram

126. Which is not a proven benefit of combined HRT? a) b) c) d) e) decrease risk of osteoporosis decrease risk of ovarian Ca decrease risk of endometrial cancer decrease risk of colon cancer reduction of vasomotor symptoms

127. The best way to evaluate the testicle and epididymis in the presence of a tense hydrocoele is: a) b) c) d) e) manual compression transillumination Doppler flow studies scrotal ultrasound DTPA scan

128. 40 year old Chinese man, 2 days history of right knee swelling. ESR 90 mm/hr, CRP raised. Afebrile a) b) c) d) e) diagnostic aspiration arthrotomy and washout intravenous antibiotics NSAIDs None of the above

129. Anterior dislocation of shoulder is associated with loss of sensation a) of medial arm

b) c) d) e)

of lateral forearm of medial forearm of 1st dorsal interossei of hand none of the above

131. Scoliosis a) b) c) d) e) kyphotic deformity of the spine poor back posture lateral curvature of spine exaggerated lordosis congenital high scapula

132. Management of 4mm mid-ureteric stone include: a) b) c) d) e) ?push stone up & PCNL Conservative Retrograde ureteroscopy & laser ?Open surgery ?ESWL alone

133. In the blood supply of the long bone, which of the following is true? a) b) c) d) e) nutrient artery supplies 2/3 of the inner cortex periosteal arterioles supply 2/3 of outer cortex nutrient artery supplies 1/3 of inner cortex the blood supply is centripetal nutrient artery supplies of the inner cortex

134. The following is true of GnRH agonist EXCEPT: a) b) c) d) e) symptoms of endometriosis may worsen can be given in intravenous pulses can be given as depots ? Increase bone density

135. Which of the following is true about epidural analgesia? a) b) c) d) e) cardiorespiratory collapse is a recognized complication it cause increased pelvic floor tone previous Caesarean section is a contraindication current pregnancy-induced hypertension is a contraindication post-dural puncture headache occurs immediately

136. Most common symptom of testicular tumour

a) b) c) d) e)

testicular pain scrotal swelling sensation of heaviness in scrotum haematocoele bilateral gynaecomastia

137. The following are risk factors for senile osteoporosis, EXCEPT: a) b) c) d) e) chronic smoking regular aspirin intake Asian women with small build Chronic steroid intake NSAIDs ingestion

138. In uterine rupture, all are found EXCEPT: a) b) c) d) e) hypotension increased uterine contractions haematuria per-vaginal bleeding fetal distress

139. GMP-mediated relaxation of penile corporeal smooth muscle is mediated by a) b) c) d) e) norepinephrine dopamine serotonin NO endothelin

141. Bladder cancer, true EXCEPT: a) b) c) d) e) smoking is a risk factor superficial variant is most common transitional cell carcinoma is commonest histology lifelong follow-up following ablation for superficial transitional cell carcinoma immunotherapy is not useful

142. Side-effect of use of prostagladins for mid-trimester termination of pregnancy include all EXCEPT: a) b) c) d) shivering nausea & vomiting pyrexia diarrhea

e) post-partum haemorrhage 144. With respect to compartment syndrome, which of the following is FALSE: a) b) c) d) e) pale & pulseless limb is an early sign it can occur in open fractures indication for urgent fasciotomy can occur in the foot pain is always present

145. Abruption placentae a) b) c) d) e) more common in primigravida than multiparous women associated with ? coulevaire uterus always lead to per-vaginal bleeding does not result in fetal death associated with cardiac disease

146. Occipital posterior presentation in labour a) b) c) d) e) occipital frontal is presenting diameter rupture of membrane occurs late in pregnancy 50% rotate to occipital anterior during labour Persistent occipital posterior means vaginal delivery contraindicated Accounts for 50% of vertex presentation in early labour

147. Commonest cause of haematospermia a) b) c) d) e) non-specific inflammation of prostate or seminal vesicles TB prostate Adenocarcinoma prostate Transitional cell carcinoma of prostate Epididymo-orchitis

148. The following antibiotics are used for prophylaxis of UTI EXCEPT a) b) c) d) e) trimethoprim-sulphamethazole amoxicillin nitrofurantoin cephalexin fluroquinolones

149. Management of 3cm stone in renal pelvis: a) PCNL b) ESWL

c) conservative management d) open pyelolitomy e) double J-stenting 151. Which of the following is not used in HRT administration? a) b) c) d) e) tablets patch subdermal implantation vaginal pessaries IUCD

152. Which is not a feature of degenerative spine diease a) b) c) d) e) decreased joint space sclerosis of vertebral body grade 1 spondylolisthesis of L4/5 vertebrae decrease joint space of facet joints syndesmophytic lipping

154. Chronic complication of radiotherapy for cancer of cervix. Which is FALSE: a) b) c) d) e) urinary continence will not be compromised blood transfusion may be indicated for haemorrhagic cystitis ?it is caused by endarteritis, fibrosis Includes pelvic pain, tenesmus, diarrhea, rectal bleeding Occurs 6 36 months after cessation

155. 70 year old lady, fit, presents with lower 1/3 ureter transitional cell carcinoma, no lymph node involvement. Treatment: a) b) c) d) e) radiotherapy intravesical chemotherapy radical nephrectomy radical cystectomy nephro-uretectomy

157. 62 year old man presents with recurrent lower urinary tract infection. Which of the following investigations is most unlikely to be useful? a) b) c) d) e) uroflow urine culture intravenous urogram micturating cystourogram cystoscopy

158. Polycystic ovarian syndrome may be treated by the following, EXCEPT: a) b) c) d) e) ovarian cystectomy norethisterone clomiphene ovarian drilling metformin

159. After motorcycle accident, 33 year old man with fixed internal rotation of upper arm. Diagnosis to exclude is: a) b) c) d) e) fracture of surgical neck of humerus anterior dislocation of shoulder posterior dislocation of shoulder rotator cuff tear none of the above

160. A 40 year old man presented to the A&E department with ureteric colic. Which of the following investigation is not relevant? a) b) c) d) e) abdominal ultrasound non-contrast CT scan intravenous urogram urine dipstick urine culture

161. Which of the following drugs should not be used in pregnancy? a) b) c) d) e) amoxicillin tetracycline erythromycin acyclovir zidovudine

163. Endometrioma is associated with a) b) c) d) e) cervical cancer vulva cancer clear cell cancer of ovary cancer of fallopian tube germ cell tumour of ovary

166. The single largest factor determining long term survival in breast cancer is: a) tumour size b) tumour grade

c) tumour subtype d) nodal positivity e) adjuvant chemotherapy 169. What is not true about nephroblastoma? a) b) c) d) e) also known as Wilms tumour occurs in 10% of children presents as an abdominal mass more common in children before 3 years of age composed purely of epithelial elements

170. What is true of phaeochromocytoma a) b) c) d) e) neuroendocrine tumour of adrenal cortex associated with MEN I malignant in 90% of cases ? scan Only -blocker required pre-op

171. True about cephalo-pelvic disproportion: a) b) c) d) e) a high head at 36 wk is diagnostic prolong latent phase is a good sign of CPD diagnosis usually not made without trial of labour diagnosis made accurately by X-ray pelvimetry fetal abnormalities such as microcephaly is associated with increased risk of CPD

172. Procedure of choice to define anatomic details of calyces, pelvis and ureter is: a) b) c) d) e) intravenous urogram ultrasound CT scan nuclear renogram retrograde pyelography

173. False statement about placental localization & antepartum haemorrhage management: a) b) c) d) e) ultrasound at 22 wks is unreliable absence of retro-placental haematoma effectively excludes abruption placentae posterior placenta gives false negative report of placenta praevia transvaginal scan can be done for suspected placenta praevia placenta accrete can be diagnosed antenatally on ultrasound

174. Effectiveness of breast cancer screening has been shown to be most useful in the following age group a) b) c) d) e) < 35 40 49 50 64 > 70 All age groups

175. The following is associated with increased risk of breast cancer: a) b) c) d) e) fibroadenoma fibrocystic disease atypical duct hyperplasia ductal papilloma increase breast size

178. 16 year old boy presents with a gradually enlarging left knee. X-ray shows a lytic lesion in the metaphysic of proximal tibia. Which of the following need to be excluded? a) b) c) d) e) chondrosarcoma osteogenic sarcoma osteochondroma giant cell tumour chondroblastoma

179. Pagets diease of the breast a) b) c) d) e) present anywhere on breast skin usually bilateral rare in-situ carcinoma bad prognosis usually require mastectomy with axillary clearance

- Min. urine output in 70kg person per day: a) b) c) d) 35ml 25ml 40ml 60ml

- Following can cause gout, EXCEPT: a) deficiency of homo?? oxidase b) loop diuretics c) chemotherapy

d) myeloproliferative disease - 70 year old man has a chest drain inserted for pneumothorax. He is listed for surgery because of a persistant large air leak. Nurses call you to the ward because during transfer, he became acutely dyspnoeic and oxygen saturation is 70%. Your first course of action is: a) b) c) d) e) check chest tube since it may have become inadvertently clamped during transfer exclude anxiety as a cause exclude reaction to anaesthetic premedication check if pulse oximetry machine is working none of the above

- About inguinal hernia, which is FALSE? a) b) c) d) e) deep ring is a defect in fascia transversalis cannot get above it cough impulse may be absent in large hernia mesh repair is contraindicated unless recurrence repair can be done under local anaesthesia

- Which dont improve claudication distance in peripheral vascular disease? a) b) c) d) e) bypass angioplasty exercise stop smoking aspirin

- Which is not contributory to Glasgow Coma Scale? a) b) c) d) e) obey commands localizes painful stimuli open eyes to calling incomprehensible sounds 5mm pupils

- The following are features of Conns syndrome EXCEPT: a) b) c) d) e) hypertension hypernatraemia low plasma rennin activity hypokalaemia muscular weakness