Surgery MCQ I

Question 1 of 95

1. Question

Which of the following is correct of extracellular fluid loss in a pre-operative patient?

Bradycardia.
Elevated blood pressure in a known normotensive.
Loss of 7% of body weight.
Increased urinary output.

Question 2 of 95

2. Question

Which of the following statements about intestinal obstruction is correct?

The quiet intervals between burst of peristalsis are longer in upper intestinal than lower intestinal obstruction.
Markedly reduced fluid absorption is the primary cause of distension above the level of obstruction.
Fluid and electrolytes are not lost into bowel wall.
Free peritoneal fluid is expected in a patient with unrelieved lower ileal obstruction.

Question 3 of 95

3. Question

Clinical features of internal hemorrhoids include which of the following?

Defecation with painful bright red rectal bleeding.
Prolapse.
Identification by palpation.
Calcification.

Question 4 of 95

4. Question

Which of the following statements about carcinoma of the prostate is correct?

Lower back pain is an uncommon symptom.
Treatment of choice for advanced cases is radical prostatoseminalvesiculectomy.
Histologically most of them are adenocarcinomas.
Orchiectomy should not be considered when there is metastasis.

Question 5 of 95

5. Question

Osteoarthritis: Which of the statements below is correct?

It does not affect large joints.
It may be sequel to previous joint injury.
It is a diagnosis limited to the elderly.
It is not usually encountered by general physicians.

Question 6 of 95

6. Question

Talipes calcaneo-valgus: Which of the statements below is correct?

It presents as dorsiflexion.
It affects only one foot.
It is a more serious deformity than talipes equinovarus.
It does not usually respond to conservative treatment.

Question 7 of 95

7. Question

In the immediate post-operative period which of the following findings is a pointer to extracellular fluid volume depletion?

A urinary output of 50ml/hr.
A blood pressure of 70/50mmHg.
A temperature of 37.2oC.
Equal, normally-reacting pupils.

Question 8 of 95

8. Question

Early clinical features of simple mechanical obstruction of the upper ileum do not include which of the following?

Generalized abdominal discomfort.
Constipation.
Vomiting.
Diarrhea

Question 9 of 95

9. Question

Anal fissure: Which of the statements below is correct?

It spares the portion of anal canal lined by skin.
It characteristically causes anal pain during and after defecation.
In most cases it affects the midline of the anal canal anteriorly.
It preferentially responds to lateral partial internal sphincterotomy.

Question 10 of 95

10. Question

Cryptorchidism: Which of the statements below is correct?

It is synonymous with ectopic testis.
It is commoner in full term male infants than in the premature.
It subjects the testes to reduced temperature.
It should be treated by orchidopexy.

Question 11 of 95

11. Question

Which of the following statements about osteoarthritis is correct?

The shoulder joint is more prone to osteoarthritis than the knee joint.
A mid-shaft fracture of the tibia is more likely to lead to osteoarthritis than a condylar fracture.
Uncontrolled obesity may result in osteoarthritis.
Cartilage space is increased.

Question 12 of 95

12. Question

Which of the following statements about orthopedic diseases of the lower limb is correct?

Genu valgum is bow leg.
Genu varum is synonymous with knock knee.
Osteo-arthritis of the knee region may predispose to knee deformities.
There is usually an underlying disease in genu valgum.

Question 13 of 95

13. Question

In severe hypovolemic shock the diversion of blood flow is expected to be to which of the following organs?

Kidneys.
Heart.
Skin.
Liver.

Question 14 of 95

14. Question

Which of the following statements about diarrhea is incorrect?

It may result from vagotomy.
Malabsorption is a known cause.
When severe, diarrhea may cause acidosis.
When protracted, hyperkalemia may result.

Question 15 of 95

15. Question

Fistula-in-ano: Which of the statements below is correct?

It arises from an abscess in the space between the glutei.
It has a secondary internal opening in the anal canal at the dentate line.
When superficial, it is a palpable indurated cord.
The transsphincteric variety traverses the internal anal sphincter but not the external sphincter.

Question 16 of 95

16. Question

Torsion of the testis: Which of the statements below is incorrect?

It is usually of sudden onset.
It presents as an exquisitely tender testis and edematous scrotum.
It frequently simulates epididymitis.
It rarely leads to infarction if untreated.

Question 17 of 95

17. Question

Spondylosis: Which of the statements below is correct?

It affects the thoracic region much more than the lumbar region.
It presents clinically as spurring of vertebrae.
It does not respond to non-steroidal anti-inflammatory drugs.
It may require physiotherapy as part of the treatment.

Question 18 of 95

18. Question

Prolapse of the intervertebral disk: Which of the statements below is correct?

It is commonest in the thoracic region.
It causes backache which is aggravated by coughing.
It occurs at the anterior part of the annulus forbrosus.
It commonly affects the uppermost lumbar intervertebral disk

Question 19 of 95

19. Question

Which of the following statements about treatment of hypovolemic shock is incorrect?

When due to external hemorrhage, replacement with crystalloids is adequate.
Electrolyte solutions are useful in cases of peritonitis.
Balanced salt solution infusions are a useful initial therapy in hemorrhagic shock.
The Trendelenburg position is inappropriate for the patient

Question 20 of 95

20. Question

Which of the following statements regarding achalasia is correct?

Peristaltic movement of the esophagus is normal.
The lower esophageal sphincter does not relax during deglutition.
There are constriction and tortuosity of the esophagus.
Patients are not prone to developing esophageal carcinoma.

Question 21 of 95

21. Question

Peri-rectal suppuration: Which of the statements below is correct?

An abscess forms between the longitudinal intersphincteric muscles and the internal anal sphincter.
Pilonidal abscess is an unlikely cause.
Peri-anal abscess is difficult to palpate and the patient is usually afebrile.
Antibiotic therapy is the most important form of therapy

Question 22 of 95

22. Question

Varicose veins: Which of the statements below is correct?

They are deep vein branches.
They have incompetent bicuspid valves.
They may cause lower limb swelling relieved by standing.
They may be managed non-operatively by walking.

Question 23 of 95

23. Question

Pott’s disease: Which of the statements below is incorrect?

It is synonymous with tuberculosis of the vertebral spine.
It presents as spinal pain.
It does not occur in patients who have had pulmonary tuberculosis.
It may present with gibbus.

Question 24 of 95

24. Question

With respect to predisposition to osteomalacia which of the following is incorrect?

Nutritional deficiency.
Renal disease.
Malabsorption syndrome.
Non-involvement of drugs.

Question 25 of 95

25. Question

Which of the following conditions is not expected to cause shock?

Cardiac tamponade.
Malaria in the semi-immune.
Acute gastric dilatation.
Myocardial infarction.

Question 26 of 95

26. Question

In achalasia which of the following statements is correct?

Men are four times more prone than women.
Middle-aged individuals are less likely than elderly patients.
Dysphagia in early cases is to solid and warm foods.
Esophagomyotomy is effective treatment.

Question 27 of 95

27. Question

Which of the following is a major constituent of gallstones?

Calcium.
Iron.
Potassium.
Phosphate.

Question 28 of 95

28. Question

Which of the following is a correct statement about ganglion?

Unlikely locations include the dorsum and flexor surface of the wrist.
When the distal inter-phalangeal joint is affected there is associated osteoarthritis.
Connection with the wrist joint is unusual.
A bloodless operative field is superfluous during ganglion excision.

Question 29 of 95

29. Question

Tuberculosis of the spine: Which of the statements below is incorrect?

Onset is sudden.
The cervical spine is the commonest site of involvement
Kyphosis is a known result of the disease.
It causes collapse of the vertebral body.

Question 30 of 95

30. Question

Which of the following statements about wound healing is correct?

Inflammation is detrimental to wound healing.
Epithelialization of a secondary healing wound usually lasts less than 24 hours.
Granulation tissue consists of poorly perfused proliferating capillaries.
Contraction plays an important role in filling skin wound defects.

Question 31 of 95

31. Question

Burns involving which of the following parts of an adult’s body represents the stated percentage of total body surface area?

Half of the anterior surface of the trunk, 18%.
The entire anterior surface of the head and neck, 3%.
The front of the two upper extremities, 9%.
The posterior surfaces of the two lower limbs, 36%.

Question 32 of 95

32. Question

Which of the following statements about gastroesophageal reflux is correct?

Patients rarely have associated sliding esophageal hiatal hernia.
Scleroderma predisposes to gastroesophageal reflux.
Heartburn is an uncommon symptom.
Antacids are contraindicated.

Question 33 of 95

33. Question

Which of the following is expected in patients with common bile duct stones?

Left shoulder tip pain.
Dull right upper abdominal quadrant pain.
Dark urine and pale stools.
Gall bladder distension as an operative finding.

Question 34 of 95

34. Question

Goiter: Which of the statements below is correct?

The term refers to thyroid enlargement whether benign or malignant.
It is not a cause of dysphagia.
It frequently causes recurrent laryngeal nerve paralysis with hoarseness.
It is usually associated with a euthyroid state.

Question 35 of 95

35. Question

Tuberculosis of the spine: Which of the statements below is correct?

The usual site of infection is the vertebral spinous process.
There may be paraspinal abscess.
The intervertebral disk is unaffected.
There is evidence of bone sclerosis.

Question 36 of 95

36. Question

Which of the following factors negatively affects healing of a wound?

Re-trauma.
Globular protein aggregation.
Collagen synthesis.
Collagen remodeling.

Question 37 of 95

37. Question

Which of the following statements about burns is correct?

Burns involving the head and neck may result in pharyngeal and laryngeal edema.
Hoarseness of the voice and tachypnea contraindicate laryngoscopy or endotracheal intubation.
Partial thickness burn is synonymous with first degree burn.
Third-degree burns do not involve sebaceous glands and hair follicles

Question 38 of 95

38. Question

Complications of gastroesophageal reflux do not include which of the following?

Esophageal stenosis.
Esophagitis.
Lower esophageal constriction ring.
Lower gastro-intestinal hemorrhage.

Question 39 of 95

39. Question

Acute cholecystitis: Which of the statements below is incorrect?

It is usually caused by impacted stones in Hartmann’s pouch.
It presents as ulceration of the gall bladder muscle.
It may result from septicemia.
It is dissimilar to intercostal nerve herpes zoster.

Question 40 of 95

40. Question

Fibroadenoma: Which of the statements below is correct?

It is commonest in the fifth decade.
It is firm and rubbery in consistency.
It presents mostly as multiple lumps.
It is usually fixed to the skin of the affected breast.

Question 41 of 95

41. Question

Which of the following statements about tuberculosis of the spine is correct?

The intervertebral disk space is widened.
It may present as an old compression fracture.
Erythrocyte sedimentation rate is usually normal.
Conservative management is not relevant and so not advised.

Question 42 of 95

42. Question

Proper wound care does not involve which of the following?

Application of concentrated antiseptic solution to the surface of a wound before suturing.
Taking a history of the wound before doing something definitive to it.
Thorough inspection to decide whether the wound is infected or contaminated.
Closing a deep wound in layers.

Question 43 of 95

43. Question

Which of the following statements about an adult with 45% burns is correct?

They may have first-degree burns.
Crystalloid solutions may be used in the first 48 hours post-burn but not colloid solutions.
Intravenous fluid therapy should aim at ensuring a urinary output of not less than 30ml/hr.
Pain is a significant feature in the areas with third-degree burns.

Question 44 of 95

44. Question

Carcinoma of the esophagus: Which of the statements below is correct?

It is usually of squamous cells in the esophago-gastric junction.
It affects females more than males
It commonly affects the upper esophagus.
It commonly presents as progressive dysphagia.

Question 45 of 95

45. Question

Chronic cholecystitis: Which of the statements below is correct?

It presents with left upper abdominal quadrant pain which radiates to the scapular tip.
It is not associated with Rokitansky-Aschoff sinuses.
It may be complicated by gall bladder perforation.
It presents as intolerance of carbohydrates.

Question 46 of 95

46. Question

Carcinoma of the breast: Which of the statements below is correct?

It is usual in an 18-year-old female.
It is rarely a scirrhous adenocarcinoma.
It presents as an ulcer early in the course of the disease.
It metastasizes to the vertebral column and the lungs.

Question 47 of 95

47. Question

Which of the following statements about psoas abscess is correct?

It is not an acute pyogenic infection.
It is a known presentation of tuberculosis of the spine.
The patient is comfortable in a position of hip extension.
Psoas sign is negative.

Question 48 of 95

48. Question

Which of the following suture materials is absorbable?

Silk.
Dexon.
Nylon.
Cotton.

Question 49 of 95

49. Question

Which of the following is not a cause of upper abdominal pain?

Pancreatitis.
Cholecystitis.
Pneumonia.
Prostatitis.

Question 50 of 95

50. Question

Features of duodenal ulcer perforation include which of the following?

Gradually developing symptoms.
Normal skin turgor.
Bradycardia.
Sub-diaphragmatic air in an upright chest radiograph.

Question 51 of 95

51. Question

Which of the following statements about abdominal wall hernias is correct?

An inguinal hernia is a ventral hernia.
In a strangulated hernia the contained organ is incarcerated.
A sliding hernia is one in which the blood supply is compromised.
A hernia at the junction between the linea semilunaris and linea semicircularis is called Petit’s triangle hernia.

Question 52 of 95

52. Question

Symptoms and signs of early breast carcinoma include which of the following?

Breast skin dimpling.
Edema of the skin.
Backache.
A small, hard, irregular-shaped breast mass.

Question 53 of 95

53. Question

Ganglion: Which of the statements below is correct?

It has a thick capsule.
It contains viscid material.
It usually undergoes malignant transformation.
It should be treated by excision irrespective of size and location.

Question 54 of 95

54. Question

With regards to wound care, which of the following statements is incorrect?

Sucuticular sutures tend to make the scar wider than it would have been following suture removal.
Dry sterile gauze is desirable for dressing wounds.
Wet dressing may cause maceration of surrounding normal skin
Dressing and sutures should be removed after inspection shows that the wound edges are held together properly.

Question 55 of 95

55. Question

Likely causes of pain in the left lower quadrant of the abdomen do not include which of the following?

Appendicitis.
Abdominal wall hematoma.
Ureteric calculi.
Pancreatitis.

Question 56 of 95

56. Question

Complications of long-standing duodenal ulcer do not include which of the following?

Massive upper gastrointestinal hemorrhage.
Gastric outlet obstruction.
Gastric ulcer.
Intractable abdominal pain.

Question 57 of 95

57. Question

Which of the following statements about inguinal hernias is correct?

A left-sided hernia which reduces with difficulty in an elderly patient is unlikely to be a sliding hernia.
An indirect hernia protrudes through Hesselbach’s triangle.
A scrotal hernia is commonly a direct hernia.
Incarceration is unlikely in a direct inguinal hernia.

Question 58 of 95

58. Question

Post-operative complications: Which of the statements below is correct?

Atelectasis usually occurs after a minimum of 48 hours following a major surgery.
An elderly patient with a pre-existing heart disease is prone to arrhythmias.
Serosanguineous wound discharge 48 hours post-operatively is a good sign of wound dehiscence.
Pain at the operation site and intermittent fever five days after surgery is a pointer to wound infection.

Question 59 of 95

59. Question

Which of the following is an unlikely site for ganglion?

The dorsum of the hand.
The anterior abdominal wall.
The wrist.
The ankle

Question 60 of 95

60. Question

Which of the following statements about suture materials is correct?

Chromic catgut is tanned with chromium salts.
Plain and chromic catgut are solubilized by tissue collagenase within two weeks of applying them to human tissue.
Nylon and silk should be left in-situ when there is evidence of wound infection.
Uninfected tissue is expected to react to non-absorbable materials more than absorbable ones.

Question 61 of 95

61. Question

Dysphagia is unlikely to be a presentation of which of the following?

Lower gastrointestinal bleeding.
Esophageal carcinoma
Retropharyngeal abscess.
Poliomyelitis.

Question 62 of 95

62. Question

Which of the following statements about long-standing gastric ulcer is correct?

It is usually located in the greater curvature of the stomach.
It is a differential diagnosis of gastric cancer.
Weight loss is an expected feature, not anorexia.
Delayed gastric emptying is less likely than gastric outlet obstruction

Question 63 of 95

63. Question

Which of the following statements about abdominal wall hernias is correct?

The defect in a congenital umbilical hernia rarely closes before age four years.
Parturition is a known predisposing factor to umbilical hernia.
Femoral hernias are found mainly in males.
Inguinal hernias are commoner in females.

Question 64 of 95

64. Question

Which of the following statements is correct of post-operative psychiatric complications?

They are rare in the aged.
Anxiety is an unusual presentation.
Effective communication between the surgeon and the patient prevents or reduces the complications.
They are more likely in a patient who has developed a relationship of trust with the surgeon.

Question 65 of 95

65. Question

Callosities: Which of the statements below is incorrect?

They are areas of skin atrophy.
They result from abnormal pressure.
They are commonly associated with anterior flat foot.
They are synonymous with corns.

Question 66 of 95

66. Question

Which of the following is an acceptable mechanical method of closing a bleeding point?

Digital pressure.
Simple ligature for transected large arteries.
Distant pressure by tourniquet application.
Pressure by application of warm wet pack for diffuse bleeding.

Question 67 of 95

67. Question

Which of the following statements about vomiting is correct?

Reverse peristalsis in the stomach explains vomiting of gastro-intestinal origin.
Vomiting is not a feature of migraine.
Vomiting is usually preceded by anorexia and nausea in carcinoma of the stomach.
Nausea is expected to precede vomiting in cases of raised intracranial pressure.

Question 68 of 95

68. Question

Gastric cancer: Which of the statements below is correct?

It is usually squamous cell carcinoma.
It may present as a palpable upper abdominal mass.
When associated with Virchow’s node, it indicates early disease.
It may be associated with Krukenberg tumor in adult males.

Question 69 of 95

69. Question

Which of the following on management of abdominal wall hernias is incorrect?

The sac of a wide hernia may be returned into the peritoneal cavity.
A narrow-necked hernial sac should be excised and the neck closed.
Herniotomy is the operation of choice in congenital indirect inguinal hernia.
All strangulated hernias have gangrenous contents.

Question 70 of 95

70. Question

Which of the following statements about acute osteomyelitis is correct?

It affects adults more than children.
Swelling of bone is a common feature.
There is ischemia of a portion of bone.
The diaphysis is the usual site of onset of hematogenous infection.

Question 71 of 95

71. Question

Ainhum: Which of the statements below is correct?

It usually affects the big toe.
It is painless.
It may lead to auto-amputation.
It predisposes to typhoid.

Question 72 of 95

72. Question

Electrocautery: Which of the statements below is correct?

It causes vasoconstriction.
It is time-consuming.
More tissue than is desired may be necrosed.
The patient does not suffer burns.

Question 73 of 95

73. Question

Which of the following is not an extramural bowel wall disease responsible for intestinal obstruction?

Volvulus.
Intussusception.
Carcinoma of the colon.
Constrictive adhesive bands.

Question 74 of 95

74. Question

Which of the following statements about Meckel’s diverticulum is incorrect?

Its location is the antimesenteric border of the ileum, about 100cm. from the ileo-cecal valve.
It may be involved in intestinal obstruction.
Appendicitis is a differential diagnosis.
When symptomatic, surgical intervention is the treatment of choice.

Question 75 of 95

75. Question

Amebic liver abscess: Which of the statements below is correct?

It is usually multiple.
It has amebas in the necrotic zone of the abscess.
It is usually located in the left lobe of the liver.
It usually presents as fever and chills associated with right upper quadrant or epigastric pain.

Question 76 of 95

76. Question

Features of acute osteomyelitis do not include which of the following?

Reduced movement of a nearby joint.
Formation of sequestrum.
Formation of involucrum.
Depression of the periosteum.

Question 77 of 95

77. Question

Which of the following statements about achondroplasia is correct?

There is impairment in growth of the trunk.
There is shortening of the lower extremities with normal upper extremities.
There is mental retardation.
Trident hand is a feature.

Question 78 of 95

78. Question

Which of the following is true of blood banked for transfusion

ACD- and CPD-solutions are inefficient blood preservatives.
Storage of whole blood is usually done at a temperature of 10oC. Banked whole blood should not be transfused if older than 28 days.
It is still rich in platelets if older than one day.
Oxygen transportation is reduced as blood gets older in the blood bank.

Question 79 of 95

79. Question

Which of the following is an appropriate step in the management of patients with intestinal obstruction?

Delay in surgical intervention in the presence of a markedly tender localized area of the abdomen with a mass.
Establishing an intravenous line just to keep the vein open.
Nasogastric intubation
Prompt surgical intervention to relieve intestinal obstruction which has lasted for 36 hours.

Question 80 of 95

80. Question

Diseases of the appendix do not include which of the following?

Tuberculosis.
Carcinoid.
Diverticulitis
Adenocarcinoma.

Question 81 of 95

81. Question

When amebic liver abscess ruptures, its contents may not enter which of the following?

Pleural cavity.
Pericardial cavity.
Peritoneal cavity.
Endometrial cavity.

Question 82 of 95

82. Question

Complications of acute osteomyelitis do not include which of the following?

Chronic osteomyelitis.
Acute septic arthritis.
Pulmonary embolism.
Destruction of epiphyseal plate.

Question 83 of 95

83. Question

Osteomalacia: Which of the statements below is correct?

There is resorption of calcium from bone.
Osteoid tissue is abnormal.
The radiological finding is generalized bone rarefaction.
Fractures may occur spontaneously.

Question 84 of 95

84. Question

Which of the following statements about intravenous fluids is correct?

Normal saline contains same concentration of sodium and chloride ions.
The lactate in sodium lactate is converted into lactic acid.
One-sixth molar sodium lactate solution may be used to correct metabolic alkalosis.
Isotonic saline solution should not be used in cases of hypochloremia and hyponatremia.

Question 85 of 95

85. Question

Which of the following statements about intestinal obstruction is correct?

Essentially high levels of chloride, sodium and potassium in early cases.
Progressive fall in hematocrit in the early phase.
Polyuria causing dehydration in early cases.
Multiple gas-fluid levels on plain erect abdominal radiographs.

Question 86 of 95

86. Question

Features of acute appendicitis include which of the following?

Abdominal pain which usually starts from the right lower quadrant.
Severe protracted vomiting initially.
Fecalith in the lumen of the appendix.
Marked derangement in vital signs even in uncomplicated cases.

Question 87 of 95

87. Question

Cystic hygroma: Which of the statements below is incorrect?

It results from obstruction of developing lymph vessels.
It is usually found anterior to the sternocleidomastoid.
It is usually multiple.
It may affect the tongue and floor of the mouth.

Question 88 of 95

88. Question

Which of the following statements about septic arthritis is correct?

Staphylococci are common causes.
Joint fluid is clear-colored.
Complete resolution of the inflammatory process does not occur.
Joint pain is an insignificant symptom.

Question 89 of 95

89. Question

Talipes equinovarus: Which of the statements below is correct

There is dorsiflexion.
There is shortening and underdevelopment of the soft tissue of the foot laterally.
There is abduction at the subtalar joint.
The sole of the foot faces medially.

Question 90 of 95

90. Question

Which of these does not represent extracellular fluid loss with redistribution?

Ascites
Crush injuries.
Mild epistaxis.
Intestinal secretions in intestinal obstruction.

Question 91 of 95

91. Question

Findings in patients with intestinal obstruction include which of the following?

Gaseous distension principally caused by carbon dioxide.
Occlusion of blood supply to a portion of intestine in cases of strangulation.
Absent bowel sounds in simple mechanical obstruction lasting 24 hours.
Loss of large volumes of hypotonic extracellular fluid in simple mechanical obstruction of small bowel.

Question 92 of 95

92. Question

Which of the following statements about colorectal carcinomas is correct?

A patient with early ascending colon carcinoma is likely to be cachexic
Left-sided colonic carcinomas are not expected to cause obstructive symptoms.
Severe anemia is an unreliable sign, prognostically.
A palpable right-sided abdominal mass may be due to cecal or ascending colonic carcinoma.

Question 93 of 95

93. Question

Benign prostatic hyperplasia: Which of the statements below is correct?

It rarely manifests as nocturia.
It predisposes to development of inguinal hernias.
It does not cause vesical calculi.
It should be treated by prostatectomy in patients with renal impairment.

Question 94 of 95

94. Question

In suppurative septic arthritis which of the following is not expected as an etiological agent?

Brucella.
Borrelia burgdorferi
Histoplasma species.
Streptococcus viridans.

Question 95 of 95

95. Question

Which of the following statements about talipes equinovarus is correct?

Bilateral involvement is unusual.
Eversion of the foot is easy.
Chances of satisfactory result are increased with early therapy.
It is uncommon in early childhood.