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91. Which jaw cyst is pre-malignant?

a) Radicular Cyst

b) Dental Cyst

c) Odntgenic !eratcyst

d) Dentigerus Cyst

"nswer# Odntgenic !eratcyst

$%planatin#

Odntgenic !eratcyst is de&elpmental dntgenic cyst ' epithelial rigin.

 (he dntgenic !eratcyst is !nwn 'r its high recurrence rate aggressi&e

beha&ir and its ccasinal assciatin with the ne&id basal cell carcinma

syndrme.

9*. " tddler has 'ew drps ' bld cming ut ' rectum. +rbable diagnsis is

a) ,u&enile rectal plyp

b) "denid plypsis cli

c) Rectal cancer

d) +iles

"nswer# ,u&enile rectal plyp

$%planatin#

 ,u&enile plyps are mst cmmn type ' childhd plyps ccurring in up t 1 ' 

preschl children.

 (hey are slitary plyps 'und in the rectum which mst cmmnly present with

rectal bleeding.

9. /arrett0s esphagus is diagnsed bya) 2uamus metaplasia

b) 3ntestinal metaplasia

c) 2uamus dysplasia

d) 3ntestinal dysplasia

"nswer# 3ntestinal metaplasia

$%planatin#

/arrett0s esphagus is a serius cmplicatin ' 4$RD 54astr-esphageal re6u%

disease). 3n /arrett0s esphagus nrmal tissue lining the esphagus changes t

tissue that resembles the lining ' the intestine./arrett esphagus is mar!ed by the presence ' clumnar epithelia in the lwer

esphagus replacing the nrmal s2uamus cell epithelium7an e%ample '

metaplasia. (his metaplasia cn'ers an increased ris! ' aden-carcinma.

 (he presence ' gblet cells called intestinal metaplasia is necessary t ma!e a

diagnsis ' /arrett esphagus.

98. st cmmn mechanism ' 4$RD

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prbable cause ' his bleeding is

a) +rtal ;ypertensin

b) 4astric ulcer

c) Dudenal ulcer

d) Drug-induced 43 injury

"nswer# +rtal ;ypertensin

$%planatin#

Cmplicatins ' prtal hypertensin#

$sphageal and gastric &arices and assciated li'e threatening bleeding

"scites

plenmegaly r enlargement ' the spleen

Decreased white bld cell cunts and mild pan-cytpenia

;epat-renal syndrme

pntaneus bacterial peritnitis

;epatic encephalpathy

9E. "'ter rem&al ' the +artid gland patient is ha&ing sweating n chee!s while

eating. "uricul-tempral ner&e which cntains parasympathetic secret-mtr

=bers t partid gland is 'used with

a) 4reater petrsal ner&e

b) Facial ner&e

c) 4reater auricular ner&e

d) /uccal ner&e

"nswer# 4reater auricular ner&e

$%planatin#Frey0s syndrme 'ten results as a side eGect ' surgeries ' r near the partid

gland r due t injury t the "uricul-tempral ner&e which passes thrugh the

partid gland in the early part ' its curse.

 (he "uricul-tempral branch ' the (rigeminal ner&e carries parasympathetic =bers

t the sweat glands ' the scalp and the partid gland.

"s a result ' se&erance and inapprpriate regeneratin the parasympathetic ner&e

=bers may switch curse and is 'used with smatic sensry greater auricular ner&e

resulting in Hgustatry weatingI r sweating in the anticipatin ' eating instead

' the nrmal sali&atry respnse.

9J. " patient ' Crhn0s disease underwent resectin anastmsis. w presents n

Eth pst-p day with anastmtic site lea! 'rm a =stula. $&eryday lea!age &lume

adds up t 1>@-*@@ml. (here is n intra-abdminal cllectin and the patient is

stable withut any cmplains. What will be the ne%t line ' management?

a) D cnser&ati&e treatment and lea&e him and hpe 'r the spntaneus

reslutin

b) +er'rm lapartmy and chec! 'r lea!age site and healthy margins

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c) +er'rm lapartmy and cmpletely e%teriri

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c) Decreased bld supply t lwer limbs

d) Discntinuatin ' "rteria Radicularis agna

"nswer# Discntinuatin ' "rteria Radicularis agna

$%planatin#

 (hree spinal arteries ne anterir and a pair ' psterir spinal arteries 'rm the&ertebral arteries supply the crd.

 (he anterir spinal artery is the principal artery ' the three supplying the anterir

tw-thirds ' the crd including the critical mtr area.

egmental arteries 'rm subcla&ian inter-cstal upper lumbar and branches 'rm

the internal iliac and middle sacral arteries regularly 'eed the anterir spinal artery.

 (he great radicular artery ' "dam!iewic< r "rteria Radicularis agna riginates as

a branch 'rm a le't inter-cstal artery between (9 and (1* in E> ' patients.

Operati&e inter'erence with this artery is implicated as ne ' the causes '

paraplegia in thrac-abdminal aneurysmal repair.

1@1. (rue abut epigastric ;ernia is

a) :cated belw the umbilicus and always in the midline

b) :cated ab&e the umbilicus and always in the midline

c) :cated ab&e the midline and n either side

d) Can be seen anywhere n abdmen

"nswer# :cated ab&e the umbilicus and always in the midline

$%planatin#

"n epigastric hernia is an pening r wea!ness in the =brus tissue ' the abdmen

between the breast bne and the belly buttn.

3t is caused by incmplete clsure ' the =brus tissue ' the abdmen duringde&elpment.

3n adults t much abdminal pressure can cause an epigastric hernia.

1@*. $%ternal ;emrrhids belw the dentate line is-

a) +ain'ul

b) !in (ag is nt seen in these cases

c) ay turn malignant

d) ligatin is dne as management

"nswer# +ain'ul$%planatin#

;emrrhids present ab&e the dentate line are classi=ed as internal hemrrhids.

;emrrhids ccurring belw the dentate line are classi=ed as e%ternal

hemrrhids.

$%ternal hemrrhids are in sensiti&e anal canal s!in and are pain'ul while internal

hemrrhids are in insensiti&e anal canal mucsa and are painless.

+rlapse ' internal hemrrhids is highly characteristic ' mre ad&anced and

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chrnic hemrrhidal disease.

1@. $arly cmplicatin ' ilestmy in the pst-perati&e perid

a) Diarrhea

b) Obstructin

c) ecrsisd) +rlapse

"nswer# ecrsis 5?)

$%planatin#

any studies 'cusing n stmy-related cmplicatins measured their incidence

&er the =rst 1 t * pstperati&e years.

Duchesne and c-in&estigatrs reprted results ' a retrspecti&e re&iew ' *@8

stmy patients during a -year perid.

$arly pstperati&e cmplicatins included prlapse 5**) necrsis 5**) stensis

51E) irritatin 51E) in'ectin 51>) bleeding 5>) and retractin 5>).

tmal necrsis is de=ned as the death ' stmal tissue resulting 'rm impaired

bld 6w.

3schemia typically ccurs within *8 hurs ' the stmy surgery resulting in a dar!

necrtic stma that appears marn t blac! and is typically s't and 6abby t

palpatin.

Causes ' stmal necrsis include cnstricting sutures mesenteric tensin

disprprtinate clipping ' the mesentery embli pressure assciated with barrier

wa'er cnstrictin and abdminal edema r distensin.

1@8. Ca /reast tage (8b in&l&es all $LC$+(

a) ipple retractinb) !in ulcer &er the swelling

c) Dermal $dema

d) atellite dule

"nswer# ipple retractin

$%planatin#

 (@# clinical e&idence ' primary tumr

 (is# Carcinma in situ

 (1# (umr * cm r less in greatest dimensin

 (*# (umr mre than * cm but nt mre than > cm (# (umr mre than > cm in greatest dimensin

 (8# (umr ' any si

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1@>. Which ' the 'llwing anti-estrgen drug is used in estrgen receptr psiti&e

breast cancer?

a) (am%i'en

b) Clmiphene Citrate

c) $strgend) "driamycin

"nswer# (am%i'en

$%planatin#

 (am%i'en is nly eGecti&e in treating estrgen receptr psiti&e breast cancers.

 (am%i'en belngs t class ' drugs !nwn as selecti&e estrgen receptr

mdulatrs.

 (am%i'en is used t treat patients with early stage breast cancer as well as thse

with metastatic breast cancer.

1@. "calculus chlecystitis are caused by

a) D

b) (+

c) :eptspirsis

d) $strgen therapy

"nswer# a b and c

$%planatin#

"calculus chlecystitis is a se&ere illness that is a cmplicatin ' &arius ther

medical r surgical cnditins.

Causes ' "calculus chlecystitise&ere trauma

/urn

+stpartum perid

 (tal parental hyper-alimentatin

/iliary sludge

D

:eptspira almnella r M. cli

1@E. Right sided cln Ca is assciated with

a) "nemiab) /leeding +R

c) ass +"

d) "lternate cnstipatin and diarrhea

e) 3nternal bstructin

"nswer# a and c

$%planatin#

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Right sided cln Ca#

;yp-chrmic micrcytic anemia

Fatigue

+alpitatin

 (rans&erse and ascending cln Ca#

"bdminal crampOccasinal bstructin and apple cre r nap!in ring in radigraphs

Rect-sigmid Ca#

;ematche

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d) +resents with abdminal mass

e) Old age presentatin implies gd prgnsis

"nswer# a b and d

$%planatin#

3n childhd abut 8@ ' neurblastma arises in adrenal medulla and presentswith abdminal mass 'e&er and weight lss.

ecnd mst slid malignancy ' childhd

etastasi years usually ha&e e%tremely pr utcme irrespecti&e '

stage

111. urgical indicatin in the R% ' hemptysis

a) +r'use uncntrlled bleeding

b) /rnchiectasis

c) /rnchial adenma

d) /rnchial =stula

"nswer# a c and d

$%planatin#

"bslute indicatins ' pulmnary resectin in management ' hemptysis#

assi&e hemptysis

/rnch-pleural =stula

uspicius ' carcinma

Destryed lung and psiti&e sputum

11*. Cntra-indicatin 'r radical mastectmy in Ca breast

a) Distant metastasis

b) Fi%ity t chest wall

c) "%illary :. in&l&ement

d) upra-cla&icular :. in&l&ement

"nswer# a and d

$%planatin#

Cntra-indicatin 'r radical mastectmy in Ca breast#mall tumr

n palpable lesin

Distance metastasis

+atients wh wants recnstructi&e surgery

C-e%istence ' se&ere systemic disease

11. plenectmy is indicated in

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a) ;ypersplenism

b) ;ereditary sphercytsis

c) 3.(.+

d) 4. +D de=ciency

e) +rtal hypertensin

"nswer# "ll

$%planatin#

118. (rue abut /arrett0s esphagus

a) etaplasia

b) +eptic stricture

c) +araesphageal hernia

d) 2uamus carcinma

"nswer# a b and c

$%planatin#

Cmplicatin ' /arrett0s esphagus#

+eptic ulcer in lwer end ' esphagus

tricture

Dysplasia 5"dencarcinma)

+er'ratin

3mprtant pints#

3ntestinal metaplasia with gblet cells in the esphagus is diagnstic ' /arrette

esphagus.

11>. 3n Crhn0s disease all are seen e%cepta) ;yper-plastic plyps

b) Di&erticulsis

c) Fissuring ulcer

d) $pithelid granulma

e) Crypt abscess

"nswer# a and b

$%planatin#

+athlgical 'eatures ' Crhn0s disease#

"phthus ulcerCrypt abscess

n caseating type ' $pithelid granulma

11. /: breast Ca

a) :bular Ca

b) Ductal Ca

c) Cmed Ca

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d) Cyst-sarcma phylldes

e) cirrhus carcinma

"nswer# :bular Ca

$%planatin#

3n&asi&e lbular Ca is 're2uently multi'cal multi-centric and bilateral.

11E. Cntraindicatin ' enteral nutritin

a) 3ntestinal bstructin

b) "cute pancreatitis

c) e&ere diarrhea

d) 3/D

e) 3ntestinal =stula

"nswer# a b c and e

$%planatin#

Cntraindicatin ' enteral nutritin#

mall bwel bstructin r ileus

e&ere diarrhea

+r%imal small intestinal =stula

e&ere pancreatitis

11J. (rue abut $ 33-b 5ipple syndrme)

a) +hechrmcytma

b) ;yperparathyridism

c) uc-cutaneus neurmas

d) edullary Ca ' thyrid

"nswer# a c and d

$%planatin#

$ 33-b 5ipple syndrme)#

edullary Ca ' thyrid

uc-cutaneus neurmas

+hechrmcytma

ar'anid 'eatures

119. 3ndicatins ' surgery in pulmnary (/a) uspicin ' malignancy

b) Ca&itary lesin with "spergillma

c) assi&e hemptysis

d) "ll

"nswer# "ll

$%planatin#

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"bslute indicatins ' pulmnary resectin in management ' hemptysis#

assi&e hemptysis

/rnch-pleural =stula

uspicius ' carcinma

Destryed lung and psiti&e sputum

1*@. :w ris! in Ca thyrid

a) enQ8@ year

b) Wmen Q>@ year

c) +apillary Ca Q8 cm

d) etastasis

e) Fllicular Ca A >cm

"nswer# a b and c

$%planatin#

:w ris! in Ca thyrid#

"ge Q8@ year

etastasis ne

i

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c) Familial plypsis cli

d) ,u&enile plypsis

e) +eut

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a) Flush ligatin

b) tripping ' great saphenus &ein

c) 3ncmpetent per'ratr ligatin

d) hrt saphenus ligatin

"nswer# a c and d$%planatin#

 (rendelenburg peratin#

Flush ligatin

3ncmpetent per'ratr ligatin

hrt saphenus ligatin

3mprtant pint#

 (rendelenburg peratin is dne 'r &aricse &ein which in&l&e ligatin '

saphenus &ein.

1*. "ccidental =nding ' incidentalma 5"drenal mass) is detected n B4.

Fllwing isare t be ruled ut

a) Cushing0s disease

b) etastasis

c) "drenal adenma

d) Carcinma

e) "drenal hyperplasia

"nswer# "ll

$%planatin#

"drenal incidentalma#

"ldsterne prducing adenma- 1 etastatic carcinma- *

"dren-crtical carcinma- >

+hechrmcytma- >

+re-clinical Cushing0s- >

+resumed nn-'unctinal adenma- J*

1*E. " patient was presented with strangulated hernia ne%t line ' management

a) Operate immediately

b) 3.M. 6uids

c) C( cand) B4

e) L- ray abdmen

"nswer# a and b

$%planatin#

 (he diagnsis ' strangulated hernia is made n clinical grund.

Migrus resuscitatin with intra-&enus 6uids nasgastric aspiratin and antibitic

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administratin

$mergency r immediate peratin

1*J. "$ used t detect Ca prstate

a) +"

b) R3c) C( scan

d) D"

e) (RB

"nswer# b c and d

$%planatin#

3n&estigatin ' Ca prstrate#

Digital rectal e%aminatin

 (RB 5(rans-rectal B4)

+rstatic bipsy by (RB r (BR+

+"

3mprtant pints#

C( scan is rarely accurate 'r staging and nt rutinely recmmended.

:i!e C( R3 is incapable ' accurately diGerentiating intra-prstatic lesins.

D" 5Digital subtractin angigraphy)

1*9. Child0s criteria includes

a) $ncephalpathy

b) 4O(4+(

c) "scites

d) Creatininee) "lbumin

"nswer# a c and e

$%planatin#

Re&ised Child0s classi=catin ' clinical se&erity ' cirrhsis# Criteria

utritinal status

"scites

erum albumin

erum bilirubin

+rthrmbin time;epatic encephalpathy

1@. Catheteri

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e) Rupture

"nswer# a and b

$%planatin#

Catheteri

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"nswer# d and e

$%planatin#

litary thyrid ndule is abut 'ur times mre cmmn in wmen than men.

litary thyrid ndule is rem&ed surgically t e%clude malignancy.

1. 4d prgnstic mar!ers in breast Ca

a) $R 5receptrs) S&e

b) +rgesterne 5receptrs) S&e

c) ;$R -* neu 5receptrs) S&e

d) CD88 receptr S&e

e) +> gene S&e

"nswer# a and b

$%planatin#

4d prgnstic mar!ers in breast Ca#

$R 5receptrs) S&e

+rgesterne 5receptrs) S&e

Wrst prgnstic mar!ers in breast Ca#

;$R -* neu 5receptrs) S&e

utated +> gene

+resence ' mre micr-&essels

n-diplid tumrs

 (umr with pr nuclear grade

Cell cycle antigen +C"!iE

18. 3n the R% ' hydatid cyst +"3R is cntraindicated ina) :ungbne cyst

b) icm

c) t amenable t R% with "lbenda cmCyst with daughter cysts

ultiple cysts i' accessible t puncture

3n'ected cyst

Cntra-indicatins ' +"3R 5+uncture aspiratin injectin re-aspiratin)#

3naccessible lcatin

ultiple cysts nt accessible t puncture

Cyst in spine brain bne lung heart

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3nacti&e and calci=ed lesins

Cyst cmmunicating r pen t ther rgans r ca&ity

1>. (he caudate lbe ' li&er crrespnds t with segment ' Cuinaud

classi=catin

a) egment 3b) egment 33

c) egment 333

d) egment 3M

e) egment M

"nswer# a

$%planatin#

Cuinaud classi=catin#

egment 3# Caudate lbe

egment 33 and 333# :ateral segment ' le't lbe

egment 3M# edial segment ' le't lbe

egment M t M333# Right lbe

1. +apillary ca thyrid

a) st cmmn thyrid cancer

b) +sammma bdies seen

c) $ncapsulated

d) /ld brne metastasis is cmmn

"nswer# a and b

$%planatin#+apillary ca thyrid#

3t is mst cmmn primary malignant tumr ' the thyrid gland.

3t has a prpensity t spread &ia the lymphatic system but can metastasi

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"nastr

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4ases used 'r +neum-peritneum#

 (he abdmen is in6ated with abut 1 t 8 : carbn di%ide.

/ut diagnstic purpse nitrus %ide rm air r %ygen can be used.

181. Charct0s triad includes

a) +ainb) Fe&er

c) ,aundice

d) "nemia

"nswer# a b and c

$%planatin#

Charct0s triad is an epnym re'erring t tw sets ' clinical 'eatures# ne 'r acute

chlangitis r less cmmnly a secnd set 'r multiple sclersis.

Charct0s triad#

+ain

Fe&er

 ,aundice

Charct0s neurlgic triad#

ystagmus

3ntentin tremr

canning r staccat speech

Charct0s neurlgic triad is assciated with multiple sclersis hwe&er it is nt

cnsidered pathgnmnic 'r it.

18*. +ygenic granulma true statements isare

a) Mascular pathlgyb) /leeds rarely

c) 3ncreased in pregnancy

d) :cal e%cisin

e) Recurrent N malignant

"nswer# a c and d

$%planatin#

+ygenic granulma 5lbular capillary hemangima) is a relati&ely cmmn benign

&ascular lesin ' the s!in and mucsa.

+ygenic granulmas are misnamedU they are neither in'ectius nr granulmatus. (he lesin usually ccurs in children and yung adults as a slitary glistening red

papule r ndule that is prne t bleeding and ulceratin.

+ygenic granulmas typically e&l&e rapidly &er a perid ' a 'ew wee!s mst

'ten n the head nec! e%tremities and upper trun!.

+ygenic granulma 'ten arises in pregnancy 5r rarely with ral cntracepti&e

usage and then is termed the Hpregnancy tumr.I

Recurrence ccurs in're2uently.

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 (reatment#

Curettage and Cauteri

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"nswer# "ll

$%planatin#

Cmplicatin ' (+ 5:ate mnths nward)#

$ssential 'atty acid de=ciency

Mitamin de=ciency

Vn 3rn Cpper chrmium and selenium de=ciency

18. (rue abut branchial cyst

a) een deep t lwer 1 ' stern-cleidmastid

b) Wall cnsists ' lymphid tissue

c) Filled with straw clred 6uid with chlesterl crystals

d) ne

"nswer# b and c

$%planatin#

/rachial cyst#

/rachial cysts are characteristically 'und anterir and deep t upper third '

stern-cleidmastid.

ecnd brachial remnants are the mst cmmn

Bsually lined by s2uamus epithelium and shws layer ' lymphid tissue

Cntain thic! turbid 'ull ' chlesterl crystals

 (reatment- urgical e%cisin

18E. tructures nt rem&ed in radical nec! dissectin

a) L ner&e

b) L3 ner&e

c) (ail ' partidd) +artid and pst- auricular ner&e

"nswer# a and d 5?)

$%planatin#

tructures nt rem&ed in radical nec! dissectin#

Cartid artery

/rachial ple%us

+hrenic ner&e

Magus ner&e

arginal mandibular branch ' 'acial lingual and glss-pharyngeal ner&esCer&ical sympathetic chain

tructures rem&ed in classical radical nec! dissectin#

Cer&ical lymphatics and lymph ndes

3nternal jugular &ein

"ccessry ner&e

tern-cleidmastid

Omhyid

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 (ail ' partid

ubmandibular gland

18J. Mariant ' papillary carcinma thyrid

a) edullary

b) Warthin0sc) Clumnar

d) 3nsular

e) DiGuse sclersing

"nswer# c d and e

$%planatin#

Mariants ' papillary carcinma thyrid#

+ure papillary

Fllicular &ariant

DiGuse sclersing

 (all cell &ariant

Clumnar cells &ariant

3nsular

Mariants ' 'llicular carcinma thyrid#

inimally in&asi&e

Widely in&asi&e

;rthle cell carcinma

3nsular

189. Diagnsis ' traumatic rupture ' diaphragm is made by

a) :aparscpyb) Chest L ray

c) Diagnstic peritneal la&age

d) ne

"nswer# a and b

$%planatin#

Diagnsis ' traumatic rupture ' diaphragm#

Chest L-ray a'ter placement ' nasgastric tube

 (he mst accurate e&aluatin is by M"( 5Mide assisted thracscpy) and

laparscpy.Cntrast study ' 43 C( scan and diagnstic peritneal la&age all lac!s psiti&e r

negati&e predictable &alue.

1>@. (rue abut breast carcinma in men

a) $strgen receptr psiti&e

b) "ssciated with gynecmastia

c) Raditherapy cntraindicated due t clse pr%imity t chest wall

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d) ne

"nswer# a and b

$%planatin#

/reast carcinma in men#

"ppr%imately 9@ ' male breast cancers cntain estrgen receptrs."ssciated with gynecmastia and ris! ' cancer is much greater in men with

gynecmastia

3rradiatin is the =rst step in treating lcali