Koncpt GB Pant
Koncpt GB Pant
And Explanations
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Question 1:
Recombinant human activated protein C(drotecogrin alpha) is
indicated in all of the following except:
a) APACHE II score 18.
b) Evidence of multiorgan failure.
c) APACHE II score 28.
d) Adult patient with sepsis induced organ dysfunction.
Explanation
Correct Answer is
Question 2:
All of the following statements are true except:
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Correct Answer is
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Question 3:
Most common vasculitis affecting the hepatic arterial network is:
a) Kawasakis disease
b) Cogans disease.
c) Non specific medium vessel vasculitis.
d) Polyarteritis nodosa.
Explanation
Correct Answer is
Question 4:
Not an indication of retrievable IVC filter?:
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Correct Answer is
Question 5:
Lyres sign on DSA scan is a feature seen in:
a) Branchial cyst.
b) Potato tumor of neck.
c) Thyroglossal cyst.
d) Vertebral artery aneurysm.
Explanation
Correct Answer is
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Question 6:
The first successful coronary artery bypass grafting is credited to:
a) Cooley.
b) De bakey.
c) Gibbon.
d) Vineberg.
Explanation
Correct Answer is
Option 2 b) De bakey.
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Question 7:
Which of the following vessels shows maximum variation in size?
a) Superior mesenteric artery
b) Celiac artery.
c) Middle rectal artery.
d) Inferior rectal artery.
Explanation
Correct Answer is
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Question 8:
Catchpole regimen is used in the management of which of the
following conditions?
a) Appendiceal carcinoid.
b) Mesenteric abscess.
c) Appendicular mass.
d) Ogilvies syndrome.
Explanation
Correct Answer is
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Question 9:
Which of the following anti microbial agent has the propensity to
alter the acid base balance?
a) 0.5% silver nitrate.
b) Polymyxin B
c) Mafenide acetate 5%.
d) Dakins solution.
Explanation
Correct Answer is
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Question 10:
All of the following statements about burn injuries are true except?
Correct Answer is
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Question 11:
Which of the following variants of melanoma exhibits neurotropism?
a) Lentigo maligna melanoma.
b) Desmoplastic melanoma.
c) Acral lentiginous melanoma.
d) Nodular melanoma.
Explanation
Correct Answer is
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Question 12:
Pseudolymphoma or Lymphoma like benign picture is seen in all
except:
a) Monoclonal gammopathy.
b) Phenobarbitone therapy.
c) Sjogrens syndrome.
d) Dysgammaglobulinemia.
Explanation
Correct Answer is
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Question 13:
The most well vascularised zone of a TRAM pedicled flap is?
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a) Zone I
b) Zone II
c) Zone III
d) All are equally well perfused
Explanation
Correct Answer is
Option 1 a) Zone I
Question 14:
Not a component of the Bishop and Cairo criteria?
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a) Cardiac arrhythmia.
b) Seizure.
c) Serum potassium > 6meq/l.
d) Serum calcium > 8mg/dl.
Explanation
Correct Answer is
Ref: Bishop and cairo criteria for tumor lysis syndrome: devita textbook of
oncology.
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Question 15:
A 50 year patient with CKD right side has been put on
immunosuppressive therapy. He is being planned up for renal
transplant. On 3rd day of starting the therapy, the patient develops
sudden onset high grade fever, with SBP falling to 70 mm Hg and
breathlessness. The TLC was recorded to be 25000. The 24 hour urine
output was 400 ml. What could be culprit agent?
a) Azathioprine.
b) OKT3.
c) Mycophenolate mofetil.
d) Basiliximab.
Explanation
Correct Answer is
Option 2 b) OKT3.
Question 16:
Not a pro inflammatory cytokine?
a) IL-7.
b) IL-10.
c) IL-5.
d) TNF alpha.
Explanation
Correct Answer is
Option 2 b) IL-10.
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Question 17:
As per the hospital safety codes issued by the NABH, which of the
following is not a correct match?
a) Code Blue: cardiorespiratory critical care.
b) Code Red: Fire.
c) Code pink: stable.
d) Code grey: Internal disaster.
Explanation
Correct Answer is
Question 18:
Which part of the gut is maximal affected in blast injuries?
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a) Duodenum.
b) Proximal jejunum.
c) Terminal ileum.
d) Ascending colon.
Explanation
Correct Answer is
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Question 19:
A 45 year man presented to surgery OPD with vague aching pain in
Right flank for the past 3 months. He has no other systemic
complaints. On USG, a mass was noted in right renal area with mixed
echogenecity. A CECT was done which revealed a mass involving the
lower pole of right kidney; about 8 cm in greatest dimension,
involving the right wall of IVC with evidence of involvement of the
right adrenal gland. There is involvement of the right paracaval
nodal group as well. No evidence of any systemic involvement. The
TNM staging would be?
a) T3N1M0
b) T4N1M0
c) T3cN2M0
d) T4N2M0
Explanation
Correct Answer is
Option 2 b) T4N1M0
Question 20:
Not a component of the TRISS scoring for trauma?
a) Mechanism of injury (blunt/penetrating)
b) Systolic BP.
c) Heart rate.
d) Age.
Explanation
Correct Answer is
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Question 21:
All of the following statements are true except?
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Correct Answer is
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Question 22:
All of the following statements about meconium ileus are true
except?
Correct Answer is
Question 23:
The most common site affected by lumbar disk herniation is?
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a) L4-L5
b) L5-S1.
a) L2-L3.
d) L3-L4
Explanation
Correct Answer is
Option 2 b) L5-S1.
Question 24:
Which of the following is not a correct match?
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Correct Answer is
Question 25:
Clinodactyly refers to?
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Correct Answer is
Question 26:
Not true about hand infections?
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Correct Answer is
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Question 27:
Which of the following does not merit replantation of the amputated
digit?
a) Multiple injured digits.
b) Single digit amputation in children.
c) Thumb amputation.
d) Single digit amputation in an 18 year old proximal to FDS insertion.
Explanation
Correct Answer is
Question 28:
Allens classification is used in which of the following?
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Correct Answer is
Question 29:
Most common variant of mesenteric cyst?
a) Chylolymphatic.
b) Enterogenous.
c) Urachal.
d) Dermoid.
Explanation
Correct Answer is
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Option 1 a) Chylolymphatic.
ref: bailey and love.
Question 30:
Thyroglossal cyst is a type of?
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a) Implantation dermoid.
b) Mucous retention cyst.
c) Cartilaginous remnant.
d) Tubulodermoid.
Explanation
Correct Answer is
Option 4 d) Tubulodermoid.
ref: bailey and love.
Question 31:
All of the following are correct match except?
a) Adamantinoma- metaphysic.
b) Ewings sarcoma- diaphysis.
c) Osteosarcoma- metaphysis.
d) Chondroblastoma- epiphysis.
Explanation
Correct Answer is
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Question 32:
The Total surface area of the peritoneum is approx:
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a) 3 m2.
b) 4 m2.
c) 2 m2
d) 5 m2.
Explanation
Correct Answer is
Option 3 c) 2 m2
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Question 33:
A middle aged perimenopausal woman presents to surgical OPD with
complaints of a dragging sensation in lower abdomen. It apparently
increases on exertion. It developed suddenly about 2 mths back
following a bout of heavy sprinting exercise. On examination, an ill
defined fullness was noted in right lumbar region. On carnets test, it
showed no change in its size. Which of the following statements
about this condition is incorrect?
a) Most of the cases respond with analgesics and rest.
b) The condition is more common in athletic males than females.
c) There may be associated signs like grey turner/ cullens.
d) It is important to take history of OCP or warfarin intake in these cases.
Explanation
Correct Answer is
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Question 34:
Consider the following statements about congenital umbilical hernia.
Which of the following statements is not correct?
Correct Answer is
Question 35:
Which of the following statements is true?
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Correct Answer is
Option 1 a) Levator scapulae is the most common flap used to cover the
exposed carotid artery post RND.
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Question 36:
Which of the following histological variants of RCC has the leafy
pattern on histology?
a) Clear cell.
b) Papillary.
c) Chromophobe.
d) Bellini duct.
Explanation
Correct Answer is
Option 3 c) Chromophobe.
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Question 37:
Which of the following mandates surgical intervention in a patient
with hyperparathyroidism?
a) BMD at lumbar spine, hip or distal radius showing a T score of >-2.5.
b) Patient aged 25 years with primary hyperparathyroidism.
c) Patient aged 65 years with secondary hyperparathyroidism.
d) Serum calcium level of 10.5 mg/dl.
Explanation
Correct Answer is
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Question 38:
A patient aged 24 years presents with a malignant appearing thyroid
mass about 5 cms in greatest dimension, with involvement of
contralateral level 4,5,6 cervical nodes and multiple cutaneous
nodules on anterior part of left leg with histological evidence of
malignant cells. AJCC 7th edn stage?
a) Stage I
b) Stage II
c) Stage III
d) Stage IV.
Explanation
Correct Answer is
Option 2 b) Stage II
Question 39:
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Correct Answer is
Option 4 d)Hypercalcemia.
Ref: campbells urology
Question 40:
Middle adrenal artery is a branch of?
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a) Abdominal aorta.
b) Renal artery.
c) Gonadal artery.
d) Inferior phrenic artery.
Explanation
Correct Answer is
Question 41:
Not true about MEN syndrome?
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Correct Answer is
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Question 42:
DTIC (Dacarbazine) has been used in the management of which of the
following pancreatic NET?
a) GRFoma.
b) Neurotensinoma.
c) Glucagonoma.
d) Somatostatinoma.
Explanation
Correct Answer is
Option 3 c) Glucagonoma.
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Question 43:
Which of the following conditions of hypergastrinemia is not
associated with increased acid output?
a) Pernicious anemia
b) Retained gastric antrum
c) ZES.
d) GOO.
Explanation
Correct Answer is
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Question 44:
Which of the following statements about thyroid anatomy is not
true?
a) Non recurrent laryngeal nerve may occur in 0.5% cases and is
more common on the left side.
b) Jolls triangle has inferior thyroid artery as one of its branches.
c) The parafollicular cells are concentrated along the upper part of the
thyroid gland.
d) The organ of Zuckerkandl is an important landmark in near total
thyroidectomy
Explanation
Correct Answer is
Option 1 a) Non recurrent laryngeal nerve may occur in 0.5% cases and is
more common on the left side.
more common on right side; ref: stell and marans head and neck.
Question 45:
Leaderhose disease is?
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a) Plantar fibromatosis.
b) Dermatofibrosarcoma protuberans
c) Fibrosarcoma of thigh.
d) Massive DVT of upper extremity.
Explanation
Correct Answer is
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Question 46:
Which of the following statements about benign breast diseases is
not true?
Correct Answer is
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Question 47:
Most common adverse effect seen in chronic therapy with aromatase
inhibitors in patients with carcinoma breast is?
a) DVT.
b) Osteoporosis.
c) Dyslipidemia.
d) Hypertrophic cardiomyopathy.
Explanation
Correct Answer is
Option 2 b) Osteoporosis.
Question 48:
Not a component of the definition of metabolic syndrome?
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Correct Answer is
Question 49:
Not true about enteral nutrition?
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Correct Answer is
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Question 50:
Calculate the serum osmolality in a patient with serum sodium 130
meq/L, Serum BUN of 40 mg/l and serum glucose of 300 mg/dl.
a) 380 mosm/l.
b) 290 mosm/l
c) 260 mosm/l.
d) 330 mosm/l.
Explanation
Correct Answer is
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Question 51:
Which of the following serum parameters is the best indicator of
oxygen debt?
a) Serum lactate.
b) pH.
c) sPO2.
d) Serum bicarbonate.
Explanation
Correct Answer is
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Question 52:
Which of the following anesthetic agents causes redistribution
hypothermia?
a) Ketamine.
b) Propofol.
c) Meperidine.
d) Thiopentone.
Explanation
Correct Answer is
Option 2 b) Propofol.
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Question 53:
Which of the following statements about surgical wounds is correct?
Correct Answer is
Question 54:
False about wound healing is:
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Correct Answer is
Question 55:
QUORUM guidelines ensure the quality of:
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Correct Answer is
Option 4 d) Meta-analyses.
Question 56:
Which of the following statements is false?
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a) The ANOVA test is used when comparing more than 2 groups with
continuous outcome variable.
b) Kaplan meier analyses is a measurement of time to event such as
survival analyses in cancer patients.
c) The power of a statistical study is determined by the number of false
negative or the beta error.
d) A wide confidence interval in a statistical study is indicative of
minimal uncertainity or high precision.
Explanation
Correct Answer is
Question 57:
Monocryl suture is a polymer of?
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Correct Answer is
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Question 58:
Most common fungal infection in recipients of renal transplant is?
a) Candida.
b) Cryptococcus.
c) Histoplasma.
d) Blastomyces.
Explanation
Correct Answer is
Option 1 a) Candida.
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Question 59:
Bisgaards regimen is used in the management of which of the
following conditions?
a) Chronic venous ulcer.
b) Lymphedema.
c) Varicose veins.
d) Arterial ulcer.
Explanation
Correct Answer is
Question 60:
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Correct Answer is
ref: sabiston.
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Question 61:
Which of the following statements about splenic anatomy is not
true?
a) The splenic milleu is usually acidotic
b) The distributed vascular pattern is the most common pattern in spleen.
c) Spleen develops from the ventral mesogastrium at around 5 weeks
of life.
d) The lienorenal ligament contains the tail of pancreas.
Explanation
Correct Answer is
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Question 62:
Barley water fluid on aspirate is a feature of which of the following
pathologies of scrotum?
a) Spermatocele.
b) Lymphocele.
c) Pyocele.
d) Chylocele.
Explanation
Correct Answer is
Option 1 a) Spermatocele.
spermatocele.
Question 63:
Which of the following is a mismatch about intravenous fluids?
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Correct Answer is
Option 3 c) 0.9% normal saline: contains 154 meq/l of sodium in one vac.
contains 154 meq in 1 liter not 1 vac.
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Question 64:
Trigeminal neuralgia is most commonly associated with abnormality
in which vessel?
a) Anterior cerebral artery.
b) Superior cerebellar artery.
c) Inferior cerebellar artery.
d) Lenticulostriate artery.
Explanation
Correct Answer is
Question 65:
Supraduodenal artery of Wilkie is most commonly a branch of?
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Correct Answer is
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Question 66:
Which of the following agents has been implicated in causing a
picture similar to gallstones (pseudolithiasis)?
a) Ciprofloxacin.
b) Ceftriaxone.
c) Penicillin.
d) Aspirin.
Explanation
Correct Answer is
Option 2 b) Ceftriaxone.
Question 67:
Peritoneal mice are?
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Explanation
Correct Answer is
Question 68:
Not true about internal hernias?
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Correct Answer is
Question 69:
False statement about laparoscopic inguinal hernia repair
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Explanation
Correct Answer is
Question 70:
False statement about dieulafoys lesion?
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Correct Answer is
Question 71:
AMBU stands for:
Correct Answer is
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Question 72:
False about mediastinal masses:
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Correct Answer is
Option 4 d) The primary mediastinal goiter derives its main blood supply
from the superior thyroid artery.
it derives supply from thoracic aorta; ref; sabiston pages 1603-1606.
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Question 73:
The thoracic incision providing maximum exposure of operative field
is?
a) Posterolaterlal thoracotomy.
b) Anterolateral thoracotomy.
c) Median sternotomy.
d) Clamshell thoracotomy.
Explanation
Correct Answer is
Question 74:
False statement about neuroblastoma:
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Correct Answer is
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Question 75:
Which of the following perforators does not fall in the Short
saphenous vein territory?
a) Bassis perforator.
b) Leonardos vein.
c) Soleal point perforator.
d) Gastrocnemius point perforator.
Explanation
Correct Answer is
Question 76:
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Correct Answer is
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Question 77:
Pain in acute appendicitis caused by gentle traction on the right
testicle is called?
a) Ronsohoff sign.
b) Tenhorn sign.
c) Danforth sign.
d) Aaron sign.
Explanation
Correct Answer is
Question 78:
Not a component of the Blatchford scoring:
a) Melena.
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Correct Answer is
Question 79:
Not true about GI hormone:
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Correct Answer is
GRP stimulates release of all hormones except secretin; ref: sabiston page
1235, table 50-3.
Question 80:
True about short chain fatty acids:
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a) The primary SCFAs are acetate, propionate and butyrate in 5:1:1 ratio.
b) Acetate mediates cholesterol synthesis.
c) Butyrate is the least important SCFA.
d) About 90% SCFAs are lost in the feces.
Explanation
Correct Answer is
Question 81:
The following statements about LGI bleed are true except:
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Correct Answer is
Question 82:
Criminal nerve of grassi is a branch of:
a) Posterior vagus nerve.
b) Anterior vagus nerve.
c) Common vagal trunk.
d) Celiac branch of vagus.
Explanation
Correct Answer is
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Question 83:
False statement about GI hormonal mediator:
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Correct Answer is
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Question 84:
The most common neoplasm arising in a meckels diverticulum is:
a) Adenocarcinoma.
b) Carcinoid.
c) Lymphoma.
d) Sarcoma
Explanation
Correct Answer is
Option 2 b) Carcinoid.
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Question 85:
A 23 year old man presents with frequent bouts of pain abdomen and
symptoms of irritable bowel. On ileocolonoscopy there were multiple
areas of narrowing noted affecting the terminal ileum with colon. A
diagnosis of CD was made. As per the Vienna classification it will be
labeled as:
a) A1B1L2.
b) A1B2L4
c) A1B2L3
d) A2B2L3
Explanation
Correct Answer is
Option 3 c) A1B2L3
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Question 86:
Which of the following is not a pathogenic mediator in amoebic
colitis?
a) Cryptidins.
b) Lectin.
c) Cysteine protease.
d) Amoebapore.
Explanation
Correct Answer is
Option 1 a) Cryptidins.
Question 87:
Not true about duodenal diverticula:
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Correct Answer is
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Question 88:
Which of the following statements about pneumatosis intestinalis is
true?
a) Most commonly affects the subserosa of ileocolic junction.
b) Males and females have an equal incidence.
c) Usually spares the rectum.
d) Rupture leads to a sterile pneumoperitoneum.
Explanation
Correct Answer is
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Question 89:
All of the following are implicated as predisposing factors for Wilkies
syndrome except:
a) Young asthenic female.
b) Spinal surgery.
c) J pouch ileoanal anastomosis.
d) Angiodysplasia.
Explanation
Correct Answer is
Option 4 d) Angiodysplasia.
ref: sabiston page 1276.
Question 90:
All are true about the vascular anatomy of the gut except:
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Correct Answer is
it connects the proximal parts; arc of riolan connects the distal parts. 9ref;
shackelford).
Question 91:
All are true about the physiology of colonic absorption except:
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Correct Answer is
Question 92:
All are true about large gut volvulus except:
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Correct Answer is
recurrences are high, 70% requiring surgery. (ref: sabiston page 1315-6;
shackelford.)
Question 93:
All are true about esophageal anastomosis except
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Correct Answer is
Question 94:
False statement about the esophageal anatomy:
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Correct Answer is
Question 95:
False statement about the embryology of foregut:
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a) The fetus takes its first swallow by the 14th week of gestation.
b) The development of esophagus begins in the 3rd week of gestation.
c) The endodermal and mesodermal development of the gut tube are
under the control of homeobox genes.
d) The primitive esophagus at around 5th week of gestation is lined
by ciliated columnar epithelium.
Explanation
Correct Answer is
Question 96:
False statement about the rectal pain syndromes
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Explanation
Correct Answer is
Question 97:
False statement about management of hemorrhoids:
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Correct Answer is
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Question 98:
The best flap technique for covering the defect after excision of
perianal bowens disease is:
a) Pearl anoplasty.
b) Christensens flap.
a) S-plasty.
d) Martin anoplasty
Explanation
Correct Answer is
Option 3 a) S-plasty.
Question 99:
False statement about Endo anal ultrasound:
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a) The perineal body thickness is assessed at the level of mid anal canal.
b) The internal anal sphincter is most prominently seen in the distal
anal canal.
c) The external anal sphincter usually appears hyperechoic.
d) In patients with SRUS, the submucosa appears hyperechoic because of
fibrosis
Explanation
Correct Answer is
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Question 100:
The pickrell procedure of anal encirclage uses which of the following?
a) Silver wire.
b) Bulbocavernosus.
c) Gracilis.
d) Silicone elastomer.
Explanation
Correct Answer is
Option 3 c) Gracilis.
Question 101:
Hyperpigmented macules on glans penis are a feature of:
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Correct Answer is
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Question 102:
Rebeccamycin is a novel therapeutic agent used in the management
of:
a) Cholangiocarcinoma.
b) Carcinoma pancreas.
c) HCC.
d) Anal canal carcinoma.
Explanation
Correct Answer is
Option 1 a) Cholangiocarcinoma.
ref: wikipedia.
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Question 103:
Which pharmacological agent has been implicated in the prevention
of sinusoidal obstruction syndrome caused by oxaliplatin?
a) Aspirin.
b) Clopidogrel.
c) Dipyridamole.
d) Inchinkoto herb
Explanation
Correct Answer is
Option 1 a) Aspirin.
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Question 104:
Tunnel of love is an important landmark in which surgical procedure?
a) Miles procedure.
b) LAR
c) Kausch whipples procedure.
d) Freys procedure
Explanation
Correct Answer is
Question 105:
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Correct Answer is
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Question 106:
The upper limit of pressure while creating pneumoperitoneum for
lap cholecystectomy is:
a) 10-12 mmHg
b) 12-15 mmHg.
c) 8-10 mmHg.
d) 18-20 mmHg.
Explanation
Correct Answer is
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Question 107:
All of the following statements about intrahepatic calculi are false
except:
Correct Answer is
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Question 108:
Consider the following statements about IgG4 associated
cholangitis:I. More common in the 25-45 years age group. II. Females
are affected twice as commonly as males. III. Seldom affects any
other organ. IV. Obliterative phlebitis is a characteristic picture in
most of the cases. Which of the above statements is/are true?
a) I and IV.
b) I, II and IV.
c) Only IV.
d) None of the above is true
Explanation
Correct Answer is
Question 109:
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Correct Answer is
Question 110:
Creeping resection strategy is employed in surgical resection of:
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a) IPMN.
b) MCN
c) Intrahepatic cholangiocarcinoma.
d) Klatskin tumor
Explanation
Correct Answer is
Option 1 a) IPMN.
Question 111:
Choose the incorrect statement about pancreatic embryology:
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Correct Answer is
Option 4 d) The B celss form 70% of the core of the pancreatic endocrine
cells are are distributed peripherally in the gland.
ref: shackelford pages 1111-1119, sabiston page 944.
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Question 112:
On ERCP in a patient with a 3 weeks old pseudocyst presenting with
severe pain abdomen and features of obstructive jaundice the
following picture was reported: A 6*5 cms pseudocyst in the tail of
pancreas with a single stricture in the pancreatic duct
communicating with the apex of the cyst; rest of the duct and the
gland normal. Based on the above report which Nealons category
does it fall under?
a) Nealon type II.
b) Nealon type IV.
c) Nealon type III.
d) Nealon type VI.
Explanation
Correct Answer is
Question 113:
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Explanation
Correct Answer is
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Question 114:
All of the following statements about colorectal NETs are true
except:
a) Colonic NETS are usually more proximal in location and are often large
at the time of diagnosis.
b) Most rectal NETS arise in the mid rectum.
c) Rectal NETs are mostly subserosal in location.
d) Segmental resection forms the mainstay of management in cases of
colonic NETs.
Explanation
Correct Answer is
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Question 115:
All of the following statements about pancreatic lymphoma are
true except:
Correct Answer is
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Question 116:
The most common primary source for isolated pancreatic metastases
is;
a) Ca lung.
b) Ca GB.
c) RCC.
d) Ca breast.
Explanation
Correct Answer is
Option 3 c) RCC.
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Question 117:
Which of the following toxins does not cause centrilobular hepatic
necrosis?
a) Yellow phosphorus.
b) Amanita mushroom.
c) Carbon tetrachloride.
d) Valproate.
Explanation
Correct Answer is
Question 118:
The
most
common
chemoembolisation is:
sole
agent
used
in
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transarterial
a) FUDR.
b) Doxorubicin.
c) Methotrexate.
d) 5-FU.
Explanation
Correct Answer is
Option 2 b) Doxorubicin.
ref: blumgart page 1345.
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Question 119:
The PRETEXT staging is used in which of the following malignancies?
a) HCC.
b) HCC in children.
c) Hepatoblastoma.
d) Hepatic lymphoma.
Explanation
Correct Answer is
Option 3 c) Hepatoblastoma.
ref: blumgart page 1332.
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Question 120:
Which of the following statements most correctly describes Von
Myenburg complexes?
a) The incidence is about 30% in autopsied specimen.
b) They are commonly precursors of cholangiocarcinoma and hence need
special attention.
c) They represent hamartomas and are not connected with the
biliary tree
d) They represent aberrant remodeling of the hepatocytes and sinusoids.
Explanation
Correct Answer is
Option 3 c) They represent hamartomas and are not connected with the
biliary tree
ref: blumgart pages 1243-4.
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Question 121:
The least common genetic variant of hepatocellular adenoma is:
a)Beta catenin mutated.
b) HNF 1 alpha mutated.
c) MODY 3 associated
d) Telangiectatic variant.
Explanation
Correct Answer is
Question 122:
Choose the correct statement about HCC:
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Correct Answer is
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Question 123:
The ablation modality for HCC least susceptible to heat and curret
sinking effects is:
a) Laser interstitial thermotherapy.
b) Irreversible electroporation.
c) HIFU.
d) Microwave ablation.
Explanation
Correct Answer is
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Question 124:
The following statements about desmoid tumor are true except:
Correct Answer is
Option 3 c) The tumor stains positive for vimentin and negative for beta
catenin.
positive for both vimentin and beta catenin; ref: sabiston page 1095.
Question 125:
Tillauxs triad is mentioned in reference to:
a) Omental cyst.
b) Slerosing mesenteritis.
c) Rectus sheath hematoma.
d) Mesenteric cyst.
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Explanation
Correct Answer is
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Question 126:
All of the following form boundaries of the grynfelts triangle except:
a) Serratus posterior inferior.
b) Quadrates lumborum.
c) Latissimus dorsi.
d) Internal oblique.
Explanation
Correct Answer is
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Question 127:
Ghrelin shows structural homology with which of the following
hormones?
a) Motilin.
b) Leptin.
c) Cholecystokinin.
d) Secretin.
Explanation
Correct Answer is
Option 1 a) Motilin.
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Question 128:
A 25 year old male presents to the casualty with a history of being
stabbed in an altercation 2 hrs back. On examination his BP was
recorded to be 90 mm Hg systolic with pulse rate of 123/min. The
abdomen was tense and showed active signs of peritonitis. On
exploratory laparotomy, there was a laceration noted in the cardia of
the stomach, about 4 cm in size. Rest of the stomach and the gut was
healthy. As per the AAST grading what is the grade of injury?
a) Garde II
b) Grade IV.
c) Grade III.
d) Grade I.
Explanation
Correct Answer is
Option 1 a) Garde II
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Question 129:
Which of the following is a method of managing a difficult duodenal
stump?
a) Csendes repair.
b) Polyas repair.
c) Hill-baker repai.
d) Bancrofts repair.
Explanation
Correct Answer is
Question 130:
Gambee suture is:
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Correct Answer is
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Question 131:
Valtrac sutureless anastomosis ring has been devised as a
biofragmentable device for sutureless intestinal anastomosis. The
device has 2 rings composed of:
a) Dexon and barium sulphate.
b) Prolene and dexon.
c) Fibrinogen and prolene.
d) Dexon and polyglactin.
Explanation
Correct Answer is
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Question 132:
A 30 year olf man presented to the casualty with a history of blunt
trauma abdomen by impact against the seatbelt on a RTA. On
exploratory laparotomy, the bowel showed evidence of gangrene
affecting the whole of jejunum and ileum with patches of gangrene
extending upto the proximal 2-3 cm of ascending colon. The rest of
the large bowel and duodenum was normal. There were pulsations
palpable in the root of mesentery. True statement is:
a) SMA trauma Fullen zone I.
b) SMA trauma Fullen zone III.
c) SMA trauma fullen zone II.
d) SMA trauma fullen zone IV.
Explanation
Correct Answer is
Question 133:
Taylor repair for peptic ulcer disease is:
a) Posterior TV alone.
b) Posterior TV with anterior HSV.
c) Posterior TV with anterior lesser curve seromyotomy.
d) Supradiaphragmatic TV.
Explanation
Correct Answer is
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Question 134:
Aprepitant is a novel antiemetic drug used mainly in chemotherapy
induced vomiting. It acts by:
a) Substance P agonist.
b) Kallikrein receptor inhibition
c) Neurokinin-1 receptor antagonist.
d) 5-HT4 agonist.
Explanation
Correct Answer is
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Question 135:
All of the following statements about enteric duplications are true
except:
a) Mostly are found along the antimesenteric side of ileum.
b) May be saccular or tubular in morphology.
c) Most of the patients are diagnosed in the first year of life.
d) They may be located in subserosal or intermuscular layers of the
Explanation
Correct Answer is
Question 136:
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Correct Answer is
Question 137:
True statements about hepatic artery aneurysm are all except:
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Correct Answer is
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Question 138:
Investigation of choice for diagnosis of Mesenteric venous
thrombosis is:
a) CECT scan
b) MRI.
c) Duplex scan.d) Angiography.
Explanation
Correct Answer is
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Question 139:
On a bowel contrast study done in view of suspected small bowel
atresia, it was found that there was atresia of the mid jejunum with
proximal dilatation and the distal atretic segment was separated
from the proximal segment by a large V shaped gap in the
mesentery. What type of atresia it is as per the Louw classification?
a) Type IIIa.
b) Type IV.
c) Type IIIb.
d) Type II.
Explanation
Correct Answer is
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Question 140:
SOX 11 is a new immunohistochemical marker used in the diagnosis
of:
a) Enteropathy T cell lymphoma
b) Burkitt lymphoma
Correct Answer is
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Question 141:
The following esophageal pathology presents with severe chest pain
and dysphagia with multiple peaks on esophageal motility study and
a distal contractile integral to the tune of 8000-9000 mm Hg-s-cm:
a) Nutcracker esophagus.
b) Jackhammer esophagus
c) Type III achalasia.
d) Diffuse esophageal spasm.
Explanation
Correct Answer is
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Question 142:
The type of achalasia cardia showing best response to therapy is:
a) Type I.
b) Type II.
a) Type III.
d) All show equal response
Explanation
Correct Answer is
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Question 143:
According to the Gross classification of TEF, the type that has to be
approached by the cervical incision is:
a) Type A
b) Type B.
c) Type D
d) Type E.
Explanation
Correct Answer is
Option 4 d) Type E.
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Question 144:
The shoe shine maneuver is an intraoperative maneuver used in:
a) Laparoscopic sleeve gastrectomy.
b) Laparoscopic Nissens fundoplication.
c) Laparoscopic Roux en Y gastric bypass.
d) Laparoscopic hellers myotomy.
Explanation
Correct Answer is
Question 145:
False statement about esophageal carcinogenesis is:
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Correct Answer is
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Question 146:
All of the following are eligible candidates for EMR for esophageal
cancer, except:
a) Lesion 1 cm in size.
b) No lymph nodal involvement
c) Polypoid lesion with evidence of ulceration on the apex.
d) Well differentiated histology.
Explanation
Correct Answer is
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Question 147:
The local ablative therapy used for barrets esophagus that carries
the maximum risk of metaplastic changes hidden beneath the
normal appearing epithelium is:
a) Ps-PDT.
b) ALA-PDT
c) SRER.
d) EMR.
Explanation
Correct Answer is
Option 1 a) Ps-PDT.
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Question 148:
Following statements are true about myogenic dysphagia except:
Correct Answer is
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Question 149:
The most common genomic event in esophageal carcinogenesis is:
a) Chromosome 8q amplification
b) KRAS mutation.
c) P16INK4A inactivation.
d) PTEN activation.
Explanation
Correct Answer is
Question 150:
False statement about esophageal diverticula:
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Correct Answer is
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Question 151:
Consider the following risk factorsI. High carbohydrate diet. II.
NSAIDs. III. Obesity. IV. Scleroderma. V. H. pylori.
a) I and V are protective against adenocarcinoma of esophagus
b) I and III are protective against SCC esophagus.
c) III, IV and V are high risk factors for adenocarcinoma esophagus.
d) All are high risk factors for SCC esophagus.
Explanation
Correct Answer is
Question 152:
Endoscopic study results are normal in case of:
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a) Vigorous achalasia.
b) DES.
c) Achalasia type I.
d)Nutcracker esophagus.
Explanation
Correct Answer is
Question 153:
The most common location of congenital esophageal cysts is:
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a) Upper 1/3rd
b) Lower 2/3rd.
c) Middle 1/3rd.
d) Equally distributed.
Explanation
Correct Answer is
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Question 154:
All of the following statements about liver fibrosis are true except:
Correct Answer is
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Question 155:
The ability of hepatic artery to respond acutely to changes in portal
flow is called the hepatic arterial buffer response. What is the
proposed mediator of this response?
a) Accumulation of substance P.
b) Accumulation of adenosine.
c)Decrease in pH.
d) Calcium accumulation in sinusoids.
Explanation
Correct Answer is
Question 156:
All of the following are scoring systems for liver fibrosis except:
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a) Ishak-Knodell.
b) APRI.
c) SHASTA.
d) Littles scoring
Explanation
Correct Answer is
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Question 157:
What is the preferred site of placement of HAI pump in a patient with
HCC in the Right lobe with an aberrant right hepatic artery?
a) Gastroduodenal artery.
b) Common hepatic artery.
c) Left hepatic artery.
d) Superior mesenteric artery.
Explanation
Correct Answer is
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Question 158:
All of the following are correct about the Belghitis maneuver except:
a) The most pivotal step in this maneuver is defining the anterior plane of
the IVC.
b) The upper surface of the liver is exposed up to the anterior surface of
suprahepatic IVC.
c) The maneuver has been proposed for left and extended left
hepatectomies.
d) The veins draining the caudate process are also ligated while
mobilization.
Explanation
Correct Answer is
Option 3 c) The maneuver has been proposed for left and extended left
hepatectomies.
ref: blumgart page 1487.
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Question 159:
Laparoscopic hepatic resection can be undertaken in the following
cases except:
Correct Answer is
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Question 160:
The following hemodynamic changes are observed in a patient with
hepatic vascular exclusion except:
a) Severe decrease in cardiac preload.
b) 10% decrease in MAP.
c) Decrease in systemic vascular resistance.
d) 25% decrease in pulmonary artery pressure.
Explanation
Correct Answer is
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Question 161:
Not included in the Kings College hospital criteria for nonacetaminophen induced FHF:
a) Serum bilirubin >300 micromol/L.
b) Age <10 years.
c) Halothane induced FHF.
d) Jaundice to encephalopathy time <7 days.
Explanation
Correct Answer is
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Question 162:
Which of the following condition shows recurrence following liver
transplantation:
a) Galactosemia.
b) Byler disease.
c) Niemann-pick disease.
d) Erythropoietic protoporphyria.
Explanation
Correct Answer is
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Question 163:
All of the following statements about vascular complications post
liver transplant are true except:
a) Doppler US is the best screening method for HAT and may be used
liberally after 2 weeks of transplant.
b) Sirolimus therapy has a positive association with development of HAT in
the pediatric liver transplants
c) PVT observed several years post transplant usually results in formation
of cavernomatous collaterals.
d) HAT very rarely presents with biliary complications
Explanation
Correct Answer is
Question 164:
Which of the following is not a component of the PELD score?
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a) Serum creatinine
b) Serum bilirubin.
c) INR.
d) Serum albumin.
Explanation
Correct Answer is
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Question 165:
The most predictive finding on endoscopic ultrasound done for
chronic pancreatitis is:
a) Honeycombing lobularity.
b) Irregular main pancreatic duct contour
c) Main pancreatic duct calculi.
d) Pancreatic duct dilation> 3.5 mm in the body.
Explanation
Correct Answer is
Question 166:
The correct sequence
carcinogenesis is:
of
molecular
pathway
of
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pancreatic
a) K ras->DPC4-->CDKN2A.
b) Kras->CDKN2A-->p53.
c) P53-->Kras-->CDKN2A.
d) Kras->MYC-->PTEN.
Explanation
Correct Answer is
Option 2 b) Kras->CDKN2A-->p53.
Question 167:
The first laparoscopic pancreatoduodenectomy is credited to:
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a) Lortat-Jacob.
b) Kendrick- Cusati.
c) Gagney-Pomp.
d) Palanivelu.
Explanation
Correct Answer is
Option 3 c) Gagney-Pomp.
ref: sabiston page 1542.
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Question 168:
Following are the metabolic risk factors for development of acute
pancreatitis except:
a) Hypercalcemia.
b) Hyperparathyroidism.
c) Type III hyperlipidemia.
d) Type II hyperlipidemia.
Explanation
Correct Answer is
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Question 169:
Accessory Gall bladder appearance on cholangiography is a feature
of:
a) Type III choledochal cyst.
b) Forme fruste type choledochal cyst.
c)Type VI choledochal cyst.
d) Type II choledochal cyst.
Explanation
Correct Answer is
Question 170:
The middle hepatic artery in adults is usually a branch of:
a) Celiac trunk.
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Correct Answer is
Question 171:
Goodsalls ligature surgery is done for:
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a) Fistula in ano.
b) Hemorrhoids.
c) Rectal prolapse.
d) Fissure in ano.
Explanation
Correct Answer is
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Question 172:
The most common cause of mortality in recipients of pancreas
transplant is:
a) Cardiovascular disease.
b) Graft leak.
c) Infection.
d) Graft vein thrombosis.
Explanation
Correct Answer is
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Question 173:
Which of the following biochemical markers has been studied on
experimental basis as a potential marker of intestinal function in
short gut syndrome?
a) Serum ornithine.
b) Serum arginine.
c) Serum calprotectin.
d) Serum conitine
Explanation
Correct Answer is
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Question 174:
The most common indication for undergoing small bowel transplant
in pediatric age group based on the epidemiological data is:
a) Gastroschisis.
b) Necrotizing eneterocolitis.
c) Midgut volvulus.
d) Jejunoileal atresia.
Explanation
Correct Answer is
Option 1 a) Gastroschisis.
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Question 175:
All of the following statements are true about Transplant of human
organs act except:
Correct Answer is
Option 4 d) The treating medical staff and ICU care staff are not entitled
to request the relatives of the dead for the provision of organ donation.
ref: transplant of human organs act (amended) online.
Question 176:
Not true about HNPCC is:
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Correct Answer is
not meet the Amsterdam criteria are labeled as familial cancer type X.
shackelford pages 2041-2.
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Question 177:
All of the following statements about juvenile polyposis syndrome
are correct except:
Correct Answer is
Option 1 a) The polyps in JPS appear at an earlier age than in cases with
solitary juvenile polyp alone.
ref: shackelford page 2045.
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Question 178:
All of the following statements about cowden syndrome are true
except:
Explanation
Correct Answer is
Question 179:
The most common extraintestinal manifestation of FAP is:
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a) Desmoid tumor.
b) Thyroid cancer.
c) CHRPE.
d) CNS tumor.
Explanation
Correct Answer is
Option 3 c) CHRPE.
Question 180:
Reverse 3 sign on Barium enema is a feature seen in:
a) Acute appendicitis.
b) Ileocaecal TB.
c) Caecal diverticula.
d) Carcinoma head of the pancreas.
Explanation
Correct Answer is
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Question 181:
A patient who presented with history of pain abdomen and altered
stools for last 3 mths was found to have multiple strictures all >5 cm
length spanning over a length of 150-200 cm distal to DJ flexure on
exploratory laparotomy done in view of acute intestinal obstruction.
The surgeon took the decision of preserving the bowel since the
contamination was minimal and hence thought of stricturoplasty.
Which of the following would be the best method in this case?
a) Judd stricturoplasty.
b) Moskel- Neumayer stricturoplasty.
c) Michelassi stricturoplasty.
d) Jaboulays stricturoplasty.
Explanation
Correct Answer is
Question 182:
All of the following statements about IPAA are true except:
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Explanation
Correct Answer is
Question 183:
All are true about Post IPAA pouchitis except:
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Correct Answer is
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Question 184:
Which of the following scenarios would not be a contraindication to
resection of locally recurrent rectal cancer?
a) Patient giving a history of sciatica.
b) Presenting with bilateral hydronephrosis
c) ASA grade III.
Correct Answer is
Question 185:
All are true about colorectal lymphoma except:
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Correct Answer is
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Question 186:
As per the RTOG garding of radiation enteritis, small bowel
perforation secondary to radiation necrosis falls under which grade?
a) Grade 4
b) Grade 5
c) Grade 2
d) Grade 3.
Explanation
Correct Answer is
Option 1 a) Grade 4
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Question 187:
All of the following have been clinically accepted as agents for
radioprotection except:
a) Glutamine.
b) Pentoxifylline.
c) Sucralfate.
d) WR-2771.
Explanation
Correct Answer is
Option 1 a) Glutamine.
Question 188:
All of the following statements about GIST are true except:
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Correct Answer is
Option 3 c) Type III tumors are located in the antropyloric region and are
best approached by laparoscopic distal gastrectomy.
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Question 189:
Following points are true about the anatomy of small gut except:
Correct Answer is
Option 4 d) There are approximately 4-6 jejunal and 12-14 ileal branches
originating from the right side of the SMA to supply the jejunum and the
ileum respectively.
left side not right sideref: shackelford pages 1067-71; figure 84-8.
Question 190:
All are true about chronic mesenteric ischemia except:
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Correct Answer is
Question 191:
All of the following statements about CHPS are true except:
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a) Pyloric stenosis typically occurs between 2nd and 8th week of life
affecting the male child more than the female.
b) No genetic association or abnormality has been noted with CHPS.
c) Association with H.pylori infection has been noted.
d) On clinical examination, peristaltic waves may be seen passing from left
to right side of the abdomen.
Explanation
Correct Answer is
Question 192:
Sugarbaker operation is done for:
a) Sciatic hernia.
b) Lumbar hernia.
c) Parastomal hernia.
d) Obturator hernia.
Explanation
Correct Answer is
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Question 193:
Camerons ulcers are seen in:
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a) Antropyloric region.
b) Greater curvature.
c) Lesser curvature.
d) Cardia.
Explanation
Correct Answer is
Question 194:
All are true about pancreatic transplantation except:
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Correct Answer is
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Question 195:
Which of the following prognostic modalities has a value if done
within 24 hours of admission in a case of acute pancreatitis?
a) BISAP.
b) CRP.
c)Imrie.
d) Ranson.
Explanation
Correct Answer is
Option 1 a) BISAP.
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Question 196:
Not a component of the Sugiura procedure for portal hypertension:
a) Splenectomy.
b) Pyloroplasty.
c) Vagotomy.
d) Proximal gastrectomy.
Explanation
Correct Answer is
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Question 197:
In all of the following conditions the normal relationship of portal
triad to the central hepatic venule is disrupted except:
a) Primary biliary cirrhosis.
b) Alcoholic cirrhosis.
c)Wilsons disease.
d) Hereditary hemochromatosis.
Explanation
Correct Answer is
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Question 198:
Plasminogen activator inhibitor levels have found usefulness as a
diagnostic marker in cases of:
a) Budd-Chiari syndrome.
b) Veno-occlusive disease.
c) Membranous obstruction of IVC.
d) Myeloproliferative disease.
Explanation
Correct Answer is
Question 199:
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FNH like lesions are seen in all of the following conditions except:
a) Budd- Chiari syndrome.
b) Hereditary hemorrhagic telangiectasia.
c) Congenital hepatic fibrosis.
d) Nodular regenerative hyperplasia.
Explanation
Correct Answer is
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Question 200:
As per the Japanese classification of gastric carcinoma,
retropancreatic group of lymph nodes correspond to which LN
station?
a) 10.
b) 11.
c) 13.
d) 15.
Explanation
Correct Answer is
Option 3 c) 13.
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