MOCK TEST SURGERY—FINAL YEAR MBBS NOVEMBER 12, 2024
1. Which of the following is correct treatment option for 7. A 30-years old man is brought to the emergency
thyroglossal cyst? department following a high-speed car accident. He was
A. Total thyroidectomy the driver and the windshield of the car was broken. On
B. Sistrunk's operation examination he is alert, awake, oriented and in no
C. Lobectomy respiratory distress. He is unable to move any of his four
D. Near total thyroidectomy extremities however, his extremities are warm and pink.
E. Subtotal thyroidectomy His vital signs on admission are; HR 54 bpm, BP 70/40
mmHg. What is the diagnosis?
2. How long should you check for breathing in CPR? A. Irreversible shock
A. 05 seconds B. Septic shock
B. 10 seconds C. Neurogenic shock
C. 15 seconds D. Cardiogenic shock
D. 20 seconds E. Hemorrhagic shock
E. 30 seconds
8. Of the common complications of thyroidectomy, the one
3. A 27-years old man is involved in a car crash while that may be avoided through prophylaxis is
traveling in excess of 150km/hour. He sustains an intra- A. Symptomatic hypocalcemia
abdominal injury and a fracture of the femur. The BP is B. Postoperative hemorrhage and wound hematoma
60/40 mm Hg, and the hematocrit is 16%. Initial C. Thyroid storm
resuscitation is best done by administration of which of D. Injury to the superior laryngeal nerve
the following? E. Injury to the recurrent laryngeal nerve
A. 5% hydroxyethyl starch solution
B. Ringer’s lactate solution 9. A 22-year-old boy came to causality department with
C. 5% dextrose water two-day history of pain at umbilical region. Patient also
D. 5% Plasma protein solution complains of vomiting and fever. On examination, patient
found to have temperature of 101F, and pulse 100 bpm.
E. 5% dextrose water and 0.45% normal saline
He is having rebound tenderness at right iliac fossa. His
past history is insignificant. What is most likely
4. Which of the following physical findings differentiates diagnosis?
cardiogenic shock from hypovolemic shock? A. Ileocecal tuberculosis
A. Cold, clammy skin B. Diverticulitis
B. Oliguria C. Appendicitis
C. Tachycardia D. Psoas abscess
D. Distended neck veins E. Right ureteric colic
E. Nail bed pallor
10. A 70-years old patient is found to have anterior
5. Which one is commonest malignant tumor of thyroid? perforation of a duodenal ulcer, dung Laparotomy. He
A. Lymphoma has a recent history of nonsteroidal anti-inflammatory
B. Papillary drug (NSAIDs) use and no previous history of peptic
C. Follicular ulcer disease. A large amount of bilious fluid is found in
D. Medullary the abdomen. What is the appropriate treatment?
E. Anaplastic A. Total gastrectomy
B. Laser of the ulcer
6. A 67-years old male presents with complain of itching, C. Lavage of the peritoneal cavity alone
dark urine and epigastric pain. Physical examination D. Lavage, vagotomy and gastroenterostomy
reveals jaundice. Initial laboratory tests show total E. Lavage and omental patch closure of the ulcer
bilirubin of 6.5mg/dl, ALP elevated at 3 upper limit of
normal and mild elevation serum transaminases. 11. Which of the following will cause intestinal obstruction?
Appropriate management includes which diagnostic test A. Hypokalemia
next? B. Hyponatremia
A. Magnetic resonance imaging (MRI) of the abdomen C. Hyperkalemia
B. Percutaneous transhepatic cholangiogram D. Hypernatremia
C. Abdominal ultrasound E. Hypercalcemia
D. Computed tomography (CT-scan) of the abdomen
E. Endoscopic retrograde cholangiopancreatography
(ERCP)
MOCK TEST SURGERY—FINAL YEAR MBBS NOVEMBER 12, 2024
12. A first-year resident is receiving a 30 years old female 17. A 32-years old man is seen in OPD with history of pain
presented with pain in right iliac fossa for 24 hours. He is at anal region for two weeks, associated with defecation
suspecting acute appendicitis. Which one of the and bleeding off & on. Pain, relieves spontaneously 20-30
minutes after defecation. His pain is so severe that he
following is most specific to support his diagnosis?
could not pass stool for two days. On examination
A. Pain increasing on movement
temperature 99F, pulse 88 bpm, BP 130/90 mmHg.
B. Fever Digital rectal examination reveals severe tenderness
C. Commencement as Central colicky abdominal resulting in inadequate examination at clinic. The most
pain appropriate next step for this patient will be;
D. Anorexia A. Immediate examination under anesthesia
E. Last menstruation three weeks ago B. Anal dilatation
C. Conservative treatment including GTN
13. A 35-year-old male trapped under the collapsed building. D. Conservative treatment without GTN
He got closed lower limb injuries and are characterized E. Re-examination after one week
by severe pain, pain on passive movement, distal sensory
disturbance and, finally, absent pulses. What is your most 18. A patient brought to emergency department with
likely diagnosis? crushed injury of face. The priority in management
A. Compartment syndrome would be:
B. Untidy wound A. Control of external bleeding
C. Pressure sore B. Immediate transfer the patient to well-equipped
D. Tidy wound hospital
E. De-gloving injury C. Maintain intravenous line
D. Exposure of patient for thorough examination
14. On 3rd post-operative day of exploratory laparotomy for E. Air way control and cervical spine
typhoid perforation, a 24-year male becomes immobilization
hemodynamically unstable with pulse 110 b/min, BP
70/40mmHg. Clinically he found to have 102°F fever 19. A young male sustained blunt chest trauma. On
with decrease urinary output. Patient is suffering from examination he was tachypneic, hypotensive, engorged
which type of shock? neck veins and absent breath sounds on right
A. Obstructive hemithorax. What could be the 1st step of your
B. Endocrine management?
C. Hypovolemic A. Wide bore needle insertion at 2nd intercostal
D. Cardiogenic space
E. Distributive B. Thoracotomy
C. Maintain I/V line
15. A 30-year-old man presented with pain in abdomen and D. Chest Intubation
vomiting. He also gives history of absolute constipation. E. X-Ray chest
On examination his vitals are normal. Abdomen
distended with absent bowel sounds. The appropriate 20. A 40-year-old male patient brought in emergency after
investigation to reach the diagnosis will be; sustaining head injury during RTA. O/E patient is vitally
A. Ultrasound abdomen stable. The most appropriate investigation will be:
B. Chest X-ray A. CT scan of Skull
C. Upper GI endoscopy B. X-Ray Skull
D. CT abdomen C. Cerebral angiography
E. Supine and erect X-ray of abdomen D. Nuclear scintigraphy
E. MRI
16. A-40-year-old man has a long history of Gastro-
esophageal reflux disease. His barium study shows an 21. Major cause of death following trauma is;
irregular, ulcerated area in the lower third of his A. Fascial injury
esophagus. There is marked mucosal disruption and B. Neck injury
overhanging edges. What is the most likely diagnosis? C. Chest trauma
A. Sliding hiatal hernia with GERD D. Abdominal injury
B. Squamous carcinoma of esophagus E. Brain injury
C. Para-esophageal hernia
D. Benign esophageal stricture
E. Adenocarcinoma arising in Barret esophagus
MOCK TEST SURGERY—FINAL YEAR MBBS NOVEMBER 12, 2024
22. A 33-year-old man presents with a perianal abscess at 28. A 50-year-old woman known case of cholelithiasis
the 6 o'clock position. Which of the following is the most presents in emergency department with a one-day
appropriate management? history of constant upper abdominal pain. The pain is
A. Flexible sigmoidoscopy central, radiates to back and associated with intermittent
B. MRI of the pelvis bouts of vomiting. Patient feels some relief of pain on
C. Intravenous antibiotics leaning forward. On examination her temperature is 38°C
D. Examination under anesthesia and drainage of and pulse rate 116/min. which one of the following, sign
sepsis you may find on examination of the abdomen?
E. CT scan of the abdomen A. Blumer shelf sign
B. Kehr's sign
23. A 9-year-old boy complains of a swelling on the left side C. Murphy's sign
of his neck in the supraclavicular region. The swelling is D. Trousseau sign
translucent, a diagnosis of cystic hygroma is established. E. Grey Turner sign
What is true of cystic hygroma?
A. It is premalignant 29. A 74-year-old woman has weight loss and increasing
B. Its lesions are usually easy to enucleate jaundice over the last three-four weeks. She has a
C. It never fluctuates palpable gallbladder. Which investigation from the list
D. It usually arises in posterior triangle of neck below is of most value in achieving a diagnosis?
E. It arises from sweat glands in the neck. A. Abdominal X-ray
B. Barium meal and follow through
24. The treatment of choice for a 20-year-old girl with C. CT abdomen
familial polyposis is: D. Fine needle aspiration biopsy of gallbladder
A. Fulguration of all polyps E. Abdominal ultrasound
B. Biannual sigmoidoscopy
C. Laxatives and fat-free diet 30. A-30-year-old female presented in outpatient department
D. Biannual sigmoidoscopy and barium enema with severe abdominal pain, vomiting, loss of weight with
E. Subtotal colectomy evening rise of temperature. On Examination patient is
anemic. What is the most likely diagnosis?
25. A 17-year-old female model presents to the emergency A. Lymphoma of intestine
room with a 1-day history of lower abdominal pain. On B. Crohn's disease
examination she is most tender in the right lower C. Carcinoma of intestine
quadrant (RLQ) and also has pelvic tenderness. White
D. Mesenteric adenitis
blood cell of (WBC) count is 13000 and temperature
E. Tuberculosis of abdomen
100.6F. A provisional diagnosis of uncomplicated
appendicitis is made, best surgical treatment option is;
A. Exploratory laparotomy 31. A 17-year-old female presents with lump in left Breast for
B. Laparoscopic appendectomy 6 months. Examination of breast suggestive of benign
C. Ochsner-Sherren regimen lump. Which following investigation will you perform
D. Wait and watch first?
E. Open appendectomy A. MRI Breast
B. PET Scan
26. Meckel's diverticulitis most commonly occurs in the; C. Ultrasound Breast
A. Proximal ileum D. CT Scan Breast
B. Distal ileum E. Mammogram
C. Proximal colon
D. Proximal jejunum 32. Patient present with dysphagia more for liquid than solid.
E. Distal jejunum X-ray shows bird beak appearance. Diagnosis?
A. Barret esophagus
27. Most common malignant small bowel tumor: B. GERD
A. Adenocarcinoma C. Ca. esophagus
B. Lymphoma D. Achalasia Cardia
C. Mesenchymal tumors E. Nut cracker esophagus
D. Villous adenoma
Carcinoid tumor
MOCK TEST SURGERY—FINAL YEAR MBBS NOVEMBER 12, 2024
33. A 40 years old female presented with swelling in front of 38. On barium enema, skip areas are seen on X-ray in:
neck. On examination there is solitary swelling at right A. Amoebic colitis
side of neck which moves on deglutition. It is 3x3 cm in B. Diverticulitis
size, firm in consistency, not tender, normo-thermic, C. Crohn's disease
having smooth surface and well-defined edges. D. Ulcerative colitis
Ultrasound neck also shows solitary solid swelling in E. Carcinoma of colon
right lobe. T3 and T4 are raised while TSH is decreased.
What next investigation will you order. 39. Most common extra-intestinal manifestation of Crohn's
A. Repeat ultrasound neck disease of small intestine is:
B. IDL A. Oral ulcers
C. FNAC B. Erythema Nodosum
D. Thyroid Scan C. Ankylosing Spondylitis
E. CT scan neck D. Iritis
E. Ureteral Obstruction
34. A 45-year-old man complains of burning epigastric pain
that wakes him up at night. The pain is relieved by using 40. A 34-year-old female was brought to A& D with 24-hour
over-the counter antacids and H2-blockers. Diagnosis is history of absolute constipation, distension of abdomen
best confirmed by which of the following? and vomiting. Her abdominal x-ray shows dilated
A. Upper GI Endoscopy ‘inverted U-loop’ of bowel. What is the most likely
B. Barium meal examination diagnosis of this patient?
C. Serum gastrin levels A. Pyloric stenosis
D. Upper endoscopy with biopsy B. Acute pancreatitis
E. Urea breath test C. Small bowel obstruction
D. Intussusception
35. A 39-year-old female has complaints of bloody nipple E. Sigmoid volvulus
discharge from left breast. Small nodule is present deep
to the areola. X-Ray mammogram is unremarkable. What 41. Patient scenario—diagnosed with GERD. Most sensitive
is most likely diagnosis? diagnostic test;
A. Carcinoma in situ A. Endoscopy
B. Intraductal papilloma B. Barium enema
C. Intraductal carcinoma C. 24-hour pH monitoring
D. Breast cyst D. Ultrasound
E. Fat necrosis. E. Manometry
36. What is the long-standing complication of ileostomy? 42. Most common site for carcinoid tumor;
A. Stenosis A. Liver
B. Infection B. Stomach
C. Bleeding C. Appendix
D. Renal stones D. Colon
E. Dehydration E. Ilium
37. A 28-year-old lady complains of painful defecation 43. Patient present with thyroid swelling and history of
associated with fresh per-rectal bleeding. Possible episodic diarrhea. Lab investigation show increase
diagnosis to consider will be: calcitonin level. Diagnosis?
A. Hidradenitis suppurativa A. Multinodular goiter
B. Pruritis ani B. Hyperparathyroidism
C. Anal fistula C. Follicular thyroid cancer
D. Anal fissure D. Medullary thyroid cancer
E. Pilonidal sinus E. Papillary thyroid cancer
MOCK TEST SURGERY—FINAL YEAR MBBS NOVEMBER 12, 2024
44. A 27-year-old female patient having mobile discrete
nodule in upper right quadrant of breast. Most likely
diagnosis in this patient is?
A. Fibroadenoma
B. Cyst
C. Phyllodes tumor
D. Fat necrosis
45. Patient present in E/D with coffee ground vomiting. Past
history of NSAID use, appropriate diagnosis is?
A. Perforated peptic ulcer
B. Duodenal ulcer
C. Mallory Wiess Syndrome
D. Barret esophagus
46. 29 Patient scenario—metaplasia of glandular epithelium
in lower esophagus. Diagnosis?
A. Barret esophagus
B. GERD
C. Achalasia cardia
D. Adenocarcinoma
47. Common causative agent for gastric and duodenal ulcer
is
A. Clostridium
B. Mycoplasma
C. Helicobacter Pylori
D. Streptococcus
48. Patient present epigastric burning pain, past history is
ulcer refractory to PPI use. On Secretin injection given
gastrin level become above 1000. Most likely diagnosis?
A. Gastric ulcer
B. GERD
C. Duodenal ulcer
D. Zollinger Ellison syndrome
49. A 70-year-old patient present with loose stool, tenesmus.
On rectal examination—mucus and blood. Diagnosis?
A. Diverticulitis
B. Ca. rectum
C. Rectal prolapse
D. Ca. sigmoid
50. A 70-year patient scenario—left sided scrotal swelling,
presence of sigmoid colon in scrotum. Diagnosis?
A. Sliding hernia
B. Direct inguinal hernia
C. Femoral hernia
D. Richter hernia
