SYSTEMIC SURGERY ONE: GASTROINTESTINAL SURGERY MCQS

COMPILED BY KANDY EMMA MBChB KIU-WC 2024

Oesophagus and Diaphragm

1. Following are disorders of the pharyngooesophageal junction except:
A. Stroke
B. Myasthenia
C. Cricopharyngeal achalasia
D. Nutcracker oesophagus
2. Following are true for oesophageal lymphatics except:
A. Extensive lymphatic plexus in the submucosa
B. They are classified as perioesophageal, paraoesophageal and lateral
oesophageal lymph nodes
C. Presence of coeliac nodes indicate inoperability
D. Longitudinal lymphatics are 6 times less than transverse
3. Which one of the following is highest percentage of premalignant
condition, for carcinoma oesophagus?
A. Tylosis
B. Lye strictures
C. Achalasia
D. Oesophagus
4. Factors for adenocarcinoma oesophagus are following except:
A. Barrett’s oesophagus
B. Obesity
C. Reflux oesophagitis
D. Oesophageal web

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5. Factors for development of reflux disease of oesophagus include the
following except:
A. Obesity
B. Absence of intra-abdominal length of oesophagus
C. Helicobacter pylori infection
D. Defective angle of His
6. Clinical features of reflux disease of oesophagus include the following
except:
A. Heartburn
B. Vomiting
C. Epigastric pain
D. Regurgitation
7. Gold standard for the treatment of reflux disease is:
A. Barium meal
B. Oesophagoscopy
C. 24-hour pH monitoring
D. Endosonogram
8. The most effective drugs for reflux disease are:
A. Alginates
B. Antacids
C. H2 receptor antagonists
D. Proton pump inhibitors
9. The most effective curative treatment for carcinoma oesophagus is:
A. Radiotherapy
B. Oesophagectomy

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C. Photodynamic therapy
D. Chemotherapy
10. Following are features of Barrett’s oesophagus except:
A. 3 cm or more of columnar epithelium
B. Cardiac metaplasia
C. Development of squamous cell carcinoma
D. Presence of mucus secreting goblet cells
11. Which of the following conditions predisposes to volvulus of the
stomach?
A. Sliding hernia
B. Para-oesophageal hernia
C. Following gastrojejunostomy
D. Wide hiatus
12. Following are true for PET scan except:
A. Drug used is oral fluorosodeoxycholic acid
B. Combining PET with CT is better for diagnosis
C. Can be used after chemotherapy to see the response of the tumour
D. High metabolic activity—glycolytic pathway
13. Following are true for transhiatal oesophagectomy except:
A. Thoracotomy is a must for completion of the procedure
B. Anastomosis is in the neck
C. Ideal for lower oesophageal cancers
D. Upper oesophagus mobilisation is blind
14. About achalasia cardia following are true except:

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A. It affects lower oesophageal end
B. It is due to loss of inhibitory neurons
C. Dilated oesophagus above contain normal ganglion cells
D. In vigorous achalasia normal ganglion cells are present
15. About treatment of achalasia cardia following are true except:
A. Balloon dilatation is ideal for patients above the age of 45 years
B. Botulinum toxin injection gives the permanent relief from dysphagia
C. Sublingual nifedipine can relieve symptoms
D. Myotomy with anterior fundoplication is a good surgical procedure
16. Schatzki’s ring is associated with:
A. Proximal oesophagus
B. Carcinoma oesophagus
C. Reflux oesophagitis
D. Congenital ring
17. For normal swallowing stricture should be dilated to at least:
A. 12 mm diameter
B. 14 mm diameter
C. 16 mm diameter
D. 18 mm diameter
18. Following are true for Mallory-Weiss syndrome except:
A. The vertical split occurs in the lower end of oesophagus in majority of cases
B. Surgery is rarely required
C. Endoscopic sclerotherapy is very useful treatment
D. More often it is a mucosal tear than rupture

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19. For the diagnosis of intraperitoneal metastasis, which is the ideal
investigation?
A. Ultrasound
B. CT scan
C. MRI
D. Diagnostic laparoscopy
20. Following are true about Heller’s cardiomyotomy except:
A. It is best done by laparoscopic method
B. Many surgeons add fundoplication
C. Myotomy should be more in length in the stomach side than oesophagus
D. Reflux is a major complication
21. Most accurate method for the diagnosis of T stage for oesophageal cancer
is by:
A. Upper gastroduodenal scopy
B. Barium swallow
C. CT scan
D. Endosonogram
22. The typical defect in Bochdalek hernia is:
A. Posterior
B. Posterolateral
C. Anterior
D. Anterolateral

Stomach and Duodenum

1. Regarding duodenum following are true, except:

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A. Lined by mucus-secreting columnar epithelium
B. Brunner’s glands are present
C. Duodenum can produce cholecystokinin
D. Duodenum will not secrete secretin
2. Following are true regarding blood supply of the stomach, except:
A. The fundus is supplied by left gastric artery
B. Left gastric artery is a branch of coeliac axis
C. Right gastroepiploic artery runs along greater curvature of the stomach
D. Gastroduodenal artery is a branch of hepatic artery
3. Duodenal ulcer commonly occurs in which part of duodenum?
A. First part
B. Second part
C. Third part
D. Fourth part
4. Following are true for Helicobacter pylori bacteria, except:
A. It is spiral shaped
B. It hydrolyses urea
C. It can produce cytotoxins
D. Mostly, it is associated with type A gastritis
5. Following are true for duodenal ulcer, except:
A. It occurs in the first part of the duodenum
B. It may be associated with type B gastritis
C. Smoking may precipitate development of ulcer
D. It can erode branches of left gastric artery and result in massive bleeding

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6. Following are true for malignancy in a gastric ulcer, except:
A. It occurs rarely
B. Occurs in the lesser curvature of the stomach
C. It produces a notch in barium studies
D. Converging rugosity is lost
7. Most important cause of duodenal stump leakage after Billroth II
gastrectomy is:
A. Efferent loop obstruction
B. Oedema of the stump
C. Kinking of the afferent loop
D. Fat necrosis
8. About truncal vagotomy which one of the following is not correct?
A. Decreases acid secretion
B. Decreases parasympathetic activity
C. Increases gall stones
D. Increases constipation
9. More accurate investigation for the diagnosis of the perforated duodenal
ulcer is:
A. Ultrasound of the abdomen
B. Plain X-ray abdomen erect position
C. Plain X-ray chest
D. CT imaging
10. Treatment of the perforated duodenal ulcer include following, except:
A. Suturing the ulcer in transverse direction
B. Truncal vagotomy

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C. Peritoneal toilet
D. Omental patch
11. The most common site of bleeding from peptic ulcer is:
A. Lesser curvature of the stomach
B. Greater curvature of the stomach
C. First part of the duodenum
D. Fundus of the stomach
12. Following are true with Dieulafoy’s lesion, except:
A. It is an arteriovenous malformation
B. It is one of the causes of occult bleeding
C. Local excision is the choice of treatment
D. The site is fundus of the stomach
13. Which one of the following is the complication of gastrojejunostomy?
A. Gall stones
B. Duodenal blow out
C. Intussusception
D. Diarrhoea
14. Following are complications of vagotomy, except:
A. Diarrhoea
B. Gall stones
C. Achlorhydria
D. Carcinoma stomach
15. Hypochloraemic alkalosis in pyloric stenosis is treated by:
A. Normal saline

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B. Ringer lactate
C. Isotonic saline with potassium
D. Double strength saline
16. H. pylori is an important factor for carcinoma stomach in which region?
A. Distal
B. Proximal
C. Body
D. Gastro-oesophageal junction
17. Which one of the following is not a risk factor for proximal carcinoma
stomach?
A. Chronic gastric ulcer
B. H. pylori induced gastritis
C. Pernicious anaemia
D. Obesity
18. Which one of the following is not a feature of early gastric cancer?
A. Confined to mucosa
B. Confined to mucosa and submucosa
C. Confined to mucosa with lymph nodes
D. Involving muscularis
19. Following are features of gastrointestinal stromal tumours (GISTs) of the
stomach, except:
A. Stomach is the most common site of GIST
B. More than 5 cm size tumour is considered to have malignant potential
C. Wedge excision is the treatment of choice for small lesions
D. Always do lymphadenectomy with wedge excision

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20. Which one of the following features is false for gastrointestinal stromal
tumour (GIST)?
A. It is arising from mesenchymal tissue
B. Associated with tyrosine kinase C-kit oncogene
C. They are sensitive to tyrosine kinase antagonist imatinib
D. Lymph node spread is very common
21. All are true for hormone Ghrelin, except:
A. Produced by gastric antrum
B. It is a hunger hormone
C. It stimulates growth hormone
D. It is produced by oxyntic glands
22. About Roux-en-Y gastric bypass following are true, except:
A. It is the most common procedure done now
B. It prevents bile reflux
C. It allows endoscopic examination of gastric fundus
D. Obilteration of Peterson’s space is also a part of the procedure

Liver
1. Which of the following statements is false about hepatic encephalopathy?
A. It is caused by ammonia
B. Precipitated by sedatives
C. Not precipitated by bleeding into gastrointestinal tract
D. Precipitated by diuretics
2. About hepatorenal syndrome following are true except:

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A. It can occur in sepsis
B. Most of them have advanced liver disease
C. It is associated with profuse intrarenal vasodilatation
D. Orthotopic liver transplantation can reverse hepatorenal syndrome
3. Which of the following is not the cause for overproduction of bilirubin?
A. Total parenteral nutrition
B. Haemolytic anaemias
C. Blood transfusion
D. Gilbert’s syndrome
4. Triad of Sandblom includes the following except:
A. Colicky abdominal pain
B. Obstructive jaundice
C. Haematemesis or melaena
D. Sepsis
5. The following are indications for percutaneous method for drainage of
pyogenic liver abscess except:
A. Superficial abscesses
B. Abscess with no intra-abdominal pathology
C. Abscesses of unknown aetiology
D. Multiple abscesses
6. Very tender liver is a feature of the following except:
A. Secondaries in the liver
B. Amoebic liver abscess
C. Hepatoma

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D. Congestive cardiac failure
7. A differentiating feature of amoebic liver abscess from acute cholecystitis
is:
A. Intercostal tenderness
B. Abdominal tenderness
C. Guarding
D. Fever
8. The drug of choice for the treatment of amoebic liver abscess is:
A. Penicillin
B. Gentamicin
C. Metronidazole
D. Cotrimoxazole
9. The following are scolicidal agents except:
A. Hypertonic saline
B. Chlorhexidine
C. Sodium hypochlorite
D. Hydroxyethyl starch
10. Indications for PAIR in the treatment of hydatid cyst includes:
A. Relapse following surgery
B. Multiple septal divisions
C. Communicating cysts
D. Dead or inactive cysts
11. The following feature is true about Echinococcus multilocularis except:
A. Alveolar echinococcosis

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B. Causes malignancy
C. Poorly demarcated honeycombed cystic lesion
D. Infiltrates liver and invades vascular system
12. A 65-year-old patient presents with the following: Serum bilirubin: 4
mg%, serum albumin: 1.8 mg%, INR: 2. He has gross ascites and is drowsy.
What Child-Pugh Class does he belong to?
A. A
B. B
C. C
D. D
13. The following are features of polycystic liver disease except:
A. They are usually asymptomatic
B. The cysts do not produce liver cell failure
C. They are acquired
D. Cysts also occur in kidneys and pancreas
14. Which of the following is the commonest benign tumour of the liver?
A. Haemangioma
B. Adenoma
C. Focal nodular hyperplasia
D. Hepatoma
15. For purposes of hepatic resection, the liver can be divided into ______
number of segments.
A. 2
B. 4
C. 6

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D. 8
16. The main portal fissure is also called:
A. Cantlie’s line
B. Murphy’s line
C. Spigelian line
D. Macewan’s line
17. The following conditions are associated with increased risk of
hepatocellular carcinoma except:
A. Hepatitis B carrier state
B. Cirrhosis
C. Malignant hydatid cyst
D. Aflatoxin consumption
18. Up to ______ segments of the liver can be resected safely without the
danger of hepatic failure provided rest of the liver is normal.
A. 2
B. 3
C. 4
D. 5
19. Transcatheter arterial embolisation is a good option in the treatment of
hepatocellular carcinoma in following situation:
A. Serum bilirubin >3 mg%
B. Tumour thrombus in the main portal trunk
C. Early hepatocellular carcinoma
D. Inoperable tumours
20. Which of the following is true criteria for secondaries in the liver?

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A. Single lobe enlargement
B. Rounded border
C. Soft in consistency
D. Nodular liver
21. Commonest gastrointestinal tract primary in a nodular liver secondaries is
from:
A. Stomach
B. Pancreas
C. Gall bladder
D. Duodenum
22. Portal hypertension is defined as a portal venous pressure exceeding _____
mmHg.
A. 5
B. 10
C. 15
D. 20
23. Portal vein normally carries _______ % of blood supply to liver.
A. 25
B. 50
C. 75
D. 100
24. Causes of bulky secondaries include the following except:
A. Malignant melanoma
B. Carcinoid tumours
C. Colloid carcinoma rectum

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D. Testicular tumours
25. Which of the following is true about the use of vasopressin in variceal
bleeding?
A. 20 units is diluted in 200 ml of saline and given over 20 min
B. Causes coronary vasodilatation
C. Is a powerful inotrope
D. Is a splanchnic vasodilator and reduces pressure in the splanchnic vessels
26. Gastric transection of Tanner is an operation performed for:
A. Carcinoma stomach
B. Carcinoma pancreas
C. Portal hypertension
D. Hepatocellular carcinoma
27. About sorafenib following are true except:
A. It is tyrosine kinase inhibitor
B. It has anti-angiogenesis property
C. Vascular endothelial growth factor is inhibited by sorafenib
D. It is not a drug for hepatocellular carcinoma

Gall Bladder and Pancreas

1. Which of the following statements is false for pseudocyst of pancreas?
A. It occurs in lesser sac
B. Cystogastrostomy is usually the treatment of choice
C. Better to operate after 2 weeks
D. It has no epithelial lining

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2. Which of the following is not the cause for gall stone formation?
A. Saint’s triad
B. Haemolytic anaemia
C. Infection
D. Gastrojejunostomy
3. Gall bladder carcinoma has following features, except:
A. It is squamous cell carcinoma
B. It does cause jaundice often
C. It does not respond to radiation
D. Prognosis is very poor
4. Most ideal and quick method for the diagnosis of gall stones is by:
A. Endosonogram
B. MRI scan
C. CT scan
D. Ultrasound
5. Following is not the feature of acute cholecystitis:
A. It causes pain in the right hypochondrium
B. If it perforates, gas under diaphragm is detected by percussion
C. Shoulder pain can occur
D. Acalculous cholecystitis is due to hypotension
6. Following is the most important sign of acute cholecystitis:
A. Pain in the right shoulder
B. Intercostal oedema and tenderness
C. Positive Murphy's sign

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D. Hyperaesthesia of the abdominal wall
7. Cystic duct joins supraduodenal CBD in what percentage of the cases?
A. 80%
B. 90%
C. 70%
D. 95%
8. Porcelain gall bladder has following features, except:
A. It is calcification of the gall bladder
B. Plain X-ray is not very useful to detect this
C. CT scan will detect this
D. It may be associated with carcinoma gall bladder
9. Which one of the following is true for choledochal cyst?
A. Acquired dilatation
B. Not premalignant
C. Type I cyst is the most common variety
D. Does not cause pancreatitis
10. Which one of the features is true in gall stone ileus?
A. Obstruction is in terminal ileum
B. Stone reaches ileum via ampulla of Vater
C. Obstruction and features of perforation of gall bladder are found
D. Cholecystectomy and extraction of the stones by enterotomy is done
11. Following are true for acalculous cholecystitis, except:
A. It can be seen in septic shock due to hypotension
B. Some features of cholecystoses may also be found

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C. Salmonella typhi can also give rise to acute acalculous cholecystitis
D. Rare to get chronic cholecystitis in Salmonella cholecystitis
12. Following are indications for common bile duct exploration, except:
A. Palpable stones in the CBD
B. Dilated common bile duct
C. Jaundice
D. Thickened common bile duct
13. Following are risk factors for cholangiocarcinoma, except:
A. Choledochal cyst
B. Caroli’s disease
C. Primary sclerosing cholangitis
D. Biliary stricture
14. Which one of the following is true for carcinoma gall bladder?
A. It is common in males
B. Disease occurs around 5th decade
C. Gall stone disease does not predispose to carcinoma gall bladder
D. Majority are adenocarcinoma
15. Caterpillar hump is an anomaly of what structure?
A. Cystic artery
B. Hepatic artery
C. Coeliac artery
D. Gastroduodenal artery
16. Portal veins is formed at:
A. Posterior to head of pancreas

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B. Posterior to body of pancreas
C. Anterior to neck of pancreas
D. Posterior to neck of pancreas
17. Following are true about anatomy of the pancreas, except:
A. 30% is by the head of pancreas
B. 75% of islet cells are beta-cells producing insulin
C. 80–90% pancreatic tissue is exocrine pancreatic tissue
D. 5% of islet cells are A cells producing glucagon
18. To avoid spillage of cells after FNAC of the pancreatic head mass which is
the best investigation?
A. Endoscopic biopsy
B. CT-guided biopsy
C. MRI-guided biopsy
D. Endosonographic biopsy
19. Which one of the following is true for pancreatic divisum?
A. Dorsal pancreatic duct become accessory duct
B. It does not cause pancreatitis
C. MRCP is not an ideal investigation for diagnosis
D. Endoscopic sphincterotomy has a definitive role
20. Following are true for annular pancreas, except:
A. It is more prevalent in children with Down syndrome
B. It surrounds 2nd part of duodenum
C. Duodenal obstruction causes vomiting in neonate
D. Gastrojejunostomy is the treatment of choice

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21. The use of ultrasound in the diagnosis of acute pancreatitis is mainly to:
A. Rule out perforation
B. To look for oedematous pancreatitis
C. To rule out gall stones
D. To look for pancreatic stones
22. Role of CT scan in acute pancreatitis include following, except:
A. To detect gall stones
B. Diagnostic uncertainty
C. To detect necrotizing pancreatitis
D. To find out the localized complication
23. Following are features of acute pancreatitis, except:
A. Shock
B. Cullen’s sign
C. Grey Turner’s sign
D. Kehr sign
24. Which one of the following is not routinely recommended in severe
pancreatitis?
A. Aggressive fluid resuscitation
B. Nasogastric feeding
C. ICU monitoring with oxygenation
D. Antibiotic prophylaxis
25. Which one of the following is true for pancreatic necrosectomy?
A. Usually done within 2–3 weeks of acute attack of pancreatitis
B. Gall stones, if present, should not be removed along with necrosectomy

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C. Blunt dissection is the best technique
D. Feeding jejunostomy may not be useful
26. Sudden rise in platelet counts in acute pancreatitis suggests:
A. Pancreatic fistula
B. Bleeding
C. Portal vein thrombosis
D. Pancreatic necrosis
27. Following are true about pseudocyst fluid, except:
A. Ultrasound can easily detect pseudocyst
B. CEA levels are usually above 400 ng/ml
C. High amylase levels
D. Inflammatory cells in the aspirate
28. Following are true for tropical pancreatitis, except:
A. Starts in young age
B. High incidence of stone formation
C. High incidence of diabetes mellitus
D. Does not predispose to pancreatic cancer
29. The best surgical treatment for chronic pancreatitis with dilated duct is:
A. Frey’s operation
B. Whipple’s operation
C. Longitudinal pancreaticojejunostomy
D. Distal pancreatectomy
30. Following are the risk factors for carcinoma pancreas, except:
A. Cigarette smoking

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B. Hereditary pancreatitis
C. Chronic pancreatitis
D. Female sex
31. About porcelain gall bladder following is true:
A. Requires conservative treatment
B. It cannot be detected by ultrasound
C. Prophylactic cholecystectomy is not indicated
D. It is a precancerous condition

Spleen
1. In splenic injury, Kehr's sign refers to:
A. Absence of shifting dullness on the left side of abdomen
B. Tenderness on the left side between sternocleidomastoid and scalenus
medius muscle
C. Tender left iliac fossa
D. Shoulder pain due to irritation of the under-surface of the diaphragm
2. Spontaneous rupture of the spleen is seen in the following, except:
A. Idiopathic thrombocytopenic purpura
B. Malaria
C. Infectious mononucleosis
D. Leukaemia
3. Diagnostic peritoneal lavage is said to be positive in all of the following,
except:
A. Fresh blood >20 ml is aspirated after inserting dialysis catheter
B. Gram stain is positive in the contents of the lavage

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C. RBC count >100,000 cells/cu mm
D. Amylase level of 75 units/dl
4. The following is not true about nonoperative treatment in splenic trauma,
except:
A. Hemodynamically stable patient
B. Hollow viscus injury
C. Close monitoring is available
D. Hospitalisation is required
5. Big spleen is not a feature of:
A. Malaria
B. Idiopathic thrombocytopenic purpura
C. Portal hypertension
D. Leukaemia
6. The following is true about purpura:
A. Bleeding time is prolonged
B. Clotting time is prolonged
C. Prothrombin time is prolonged
D. Activated partial thromboplastin time is prolonged
7. Which of the following vaccinations has to be given after splenectomy to
prevent overwhelming postsplenectomy infection?
A. Measles vaccine
B. Pneumococcal vaccine
C. Hepatitis vaccine
D. Varicella vaccine

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8. The following is true about splenectomy in idiopathic thrombocytopenic
purpura (ITP):
A. Is required in all cases of ITP
B. Must be done when platelet count is >100,000 cells/cu mm
C. Accessory spleens, if present must be left behind
D. Two-thirds of patients will be cured by surgery
9. The following is true about splenectomy for hereditary spherocytosis:
A. Splenectomy should be done as a last resort
B. Splenectomy must be done either before 6 years or after ten years of age
C. Accessory spleen, if present must be left behind
D. Jaundice disappears after splenectomy
10. The most common benign tumour of the spleen is:
A. Haemangioma
B. Lymphoma
C. Tuberculoma
D. Lipoma

Peritoneum, Peritoneal Cavity, Mesentery and Retroperitoneum

1. One need not close peritoneal layer after laparotomy because:
A. The peritoneum can get stuck to the bowel
B. Flattened mesothelial cells heal within a few hours
C. The peritoneum tears when closure is attempted
D. It is very painful postoperatively
2. Peritoneum can be used for dialysis because:

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A. It is close to kidney
B. It is faster than haemodialysis
C. Capillaries and lymphatics between two layers of peritoneum help in
absorption and exudation
D. It covers entire abdomen
3. Which of the following is an example of primary peritonitis?
A. Tuberculous peritonitis
B. Perforation peritonitis
C. Postoperative peritonitis
D. Parturition peritonitis
4. Which of the following organisms are most commonly involved in
secondary peritonitis?
A. Enterococci
B. Streptococci
C. Staphylococci
D. Pneumococci
5. The following are the typical features of acute generalised peritonitis
except:
A. Abdominal pain
B. Persistent vomiting
C. Bradycardia
D. High-grade fever with chills
6. Abdominal tap is done in peritonitis for all of the following roles except:
A. Aspiration of blood to indicate haemoperitoneum
B. Aspiration of pus indicating infection with gram negative bacteria

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C. Aspiration of bile indicating biliary peritonitis
D. Aspiration of urine indicating ureterocele MFH (Malignant Fibrous
Histiocytoma)
7. The following suture material is best suited for closure of bowel
perforation:
A. Silk
B. Catgut
C. Nylon
D. Thread
8. History of discharge per rectum for the first time in a patient who is
recovering from peritonitis suggests:
A. Anal prolapse
B. Pelvic abscess
C. Proctitis
D. Colitis
9. What forms the anterior relationship of Rutherford Morrison’s space?
A. Liver
B. Kidney
C. Diaphragm
D. Duodenum
10. Subphrenic abscess is common on the right side because of the following
reasons except:
A. Majority of the diseases affect right side
B. Right lung is larger
C. Left paracolic gutter is narrow and colophrenic ligament is present on the left
side

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D. Right paracolic gutter is large and colophrenic ligament is absent on the right
side
11. Indications for open drainage of subphrenic abscess include the following
except:
A. Persistent fistula discharging pus
B. Thick viscid pus
C. Abscess very close to IVC/diaphragm
D. Single loculus
12. Intra-abdominal pressure exceeds ________ cm H2O in abdominal
compartment syndrome.
A. 15
B. 25
C. 35
D. 45
13. Following are features of tuberculous peritonitis except:
A. Tubercles over peritoneal surface
B. Encysted form
C. Can be a miliary form
D. Transudate
14. Nonoperative treatment for peritonitis may be followed in the following
except:
A. Moribund patients
B. Sealed perforation
C. Localised peritonitis
D. Generalised peritonitis

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15. The following catheters are commonly used for percutaneous drainage of
subphrenic abscess:
A. Pigtail catheter
B. Trocar catheter
C. Sump catheter
D. Foley’s catheter
16. More reliable sign of peritonitis is:
A. Cough tenderness
B. Tenderness on pressure
C. Rebound tenderness
D. Guarding
17. Presence of sunken eyes, pale and pinched face, dry cracked tongue, cold
perspiration and cyanosis are all typical features of:
A. Hippocratic facies
B. Gargoyle facies
C. Marshall hall facies
D. Mask like facies
18. Following are risk factors for spontaneous bacterial peritonitis except:
A. Cirrhosis
B. Nephrotic syndrome
C. Chronic renal failure
D. Carcinoma stomach
19. Which of the following is true for pneumococcal peritonitis?
A. Common in young boys
B. Age is around 15 years

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C. Peritoneal fluid is transudate
D. It is typically odourless
20. Following are about pseudomyxoma peritonei except:
A. Common in women
B. Ovary is the main source
C. Surgery cannot cure the disease
D. Chemotherapy is also used

Small Intestine
1. Pathology of ulcerative colitis includes all of the following, except:
A. Punched out ulcers
B. Pseudopolyposis
C. Pipe stem colon
D. Pus cells
2. Toxic megacolon is seen in the following, except:
A. Intestinal tuberculosis
B. Ulcerative colitis
C. Amoebic colitis
D. Salmonella colitis
3. String sign of Kantor is seen in:
A. Crohn’s disease
B. Tubercular enteritis
C. Typhoid enteritis
D. Amoebic colitis

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4. Guarding and rigidity can be minimal in enteric perforation of terminal
ileum because:
A. The perforation is usually small
B. It is self-sealing and self-limiting
C. Zenker’s degeneration of abdominal muscles
D. Occurs in the antimesenteric border of the terminal ileum
5. Flask-shaped (bottle neck) ulcers are a feature of:
A. Intestinal tuberculosis
B. Crohn’s disease
C. Intestinal amoebiasis
D. Typhoid enteritis
6. Malignancy in small intestine is rare because:
A. Bacteria in the intestine are protective
B. Blood supply is very good
C. No stasis, rapid transit of food
D. Low levels of immunoglubulins
7. Most common site of gastrointestinal perforation in enteric fever is:
A. Duodenum
B. Jejunum
C. Colon
D. Terminal ileum
8. Adaptation to short gut syndrome includes all of the following, except:
A. Decreased transit time
B. Increased villus size

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C. Absorption from colon
D. Increased length of bowel
9. The symptoms of carcinoid syndrome is due to:
A. Histamine
B. Serotonin
C. Prostaglandins
D. Epinephrine
10. Tenderness in the Sir Philip Manson-Bahr’s point is a feature of:
A. Rectosigmoid involvement in amoebic colitis
B. Acute appendicitis
C. Acute cholecystitis
D. Crohn’s disease
11. The commonest site for gastrointestinal stromal tumour is:
A. Oesophagus
B. Stomach
C. Duodenum
D. Jejunum
12. Carney’s triad includes all of the following, except:
A. Gastrointestinal stromal tumours
B. Pulmonary chondromas
C. Extra-adrenal chondromas
D. Familial hamartomatous polyposis
13. One of the drugs used in the treatment of carcinoid syndrome is:
A. Metronidazole

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B. Bromocriptine
C. Streptomycin
D. Serotonin
14. The most common site for a carcinoid tumour is:
A. Stomach
B. Duodenum
C. Appendix
D. Rectum
15. Causes of short gut syndrome include all of the following, except:
A. Mesenteric ischaemia
B. Necrotising enterocolitis
C. Crohn’s disease
D. Radiation enteritis
16. C-kit receptor is expressed in:
A. Gastrointestinal stromal tumour
B. Peutz-Jegher syndrome
C. Carcinoid syndrome
D. Crohn’s syndrome
17. The most recent and promising drug used in the treatment of Crohn’s
disease is:
A. Trastuzumab
B. Infliximab
C. Monteleukast
D. Fab antibodies

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18. Most common anal problem in Crohn’s disease is:
A. Anal fistula
B. Haemorrhoids
C. Anal fissure
D. Perianal abscess
19. Transmural inflammation is characteristic of:
A. Crohn’s disease
B. Tuberculous enteritis
C. Typhoid enteritis
D. Ulcerative colitis
20. ‘Hose pipe rigidity’ is a feature of:
A. Crohn’s disease
B. Tuberculous enteritis
C. Typhoid enteritis
D. Ulcerative colitis
21. The most common symptomatic presentations of Meckel’s diverticulum in
children of 2 years of age is:
A. Haemorrhage
B. Perforation
C. Diverticulitis
D. Intestinal obstruction
22. The drug used to control diarrhoea in neuroendocrine tumour is:
A. Streptozotocin
B. Sunitinib

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C. Methysergide
D. Octreotide
23. Investigation of choice for gastrointestinal NET is:
A. Ultrasound
B. CT scan
C. MRI scan
D. FDG–PET scan

Large intestine
1. The following feature is true of adenomatous polyps of the large intestine:
A. Most are sessile
B. Most can be removed by colonoscopic snaring
C. Adenoma smaller than 15 mm in diameter do not carry the risk of malignant
potential
D. Young people are more likely to have these polyps
2. Common premalignant conditions for colonic cancer include the following,
except:
A. Familial polyposis coli
B. Ulcerative colitis
C. Adenomatous polyp
D. Peutz-Jeghers syndrome
3. Flexion of the hip can be present in:
A. Carcinoma splenic flexure
B. Carcinoma caecum
C. Carcinoma sigmoid colon

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D. Carcinoma hepatic flexure
4. Abscess in the lateral abdominal wall can be a feature of:
A. Acute pancreatitis
B. Perforated carcinoma caecum
C. Diverticular perforation
D. Meckel’s diverticular perforation
5. Mechanical bowel preparation is best given using:
A. Plenty of saline
B. Oral mannitol
C. Glycerine enema
D. Whole gut irrigation using oral polyethylene glycol
6. Which one of this is true in colonic surgery?
A. No touch technique of Turnbull
B. Right-sided lesions are treated by colostomy
C. Left-sided lesions are treated by resection
D. Removal of 30 cm of ileum along with colon
7. Following is true about prognostic factors of carcinoma colon, except:
A. Elderly patients have poorer prognosis
B. Perioperative blood transfusion has poor prognosis
C. Survival is good if it is limited to mucosa and there are no nodes
D. Obstruction and perforation is associated with poor prognosis
8. Regarding colonoscopic screening, which one of the following is true?
A. It is done if there is distal adenoma
B. It is painless and easy to perform

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C. It is not useful for screening of colonic cancer
D. Detection of all advanced colorectal neoplasia is only up to 20%
9. Proliferative growth is more common in the __________ colon:
A. Right
B. Left
C. Rectosigmoid
D. Splenic flexure
10. The ‘Gold standard’ investigation for detection of colonic cancer is:
A. Ultrasound abdomen
B. CT scan
C. Barium enema
D. Colonoscopy and biopsy
11. Following are the features of intestinal tuberculosis, except:
A. It can be secondary to pulmonary tuberculosis
B. Terminal ileum and caecum are commonly involved
C. Ulcers are transverse
D. Ulcers do not result in stricture
12. In which of the following malignancies anaemia is an important method
of presentation?
A. Malignant melanoma
B. Carcinoma breast
C. Carcinoma caecum
D. Carcinoma pancreas
13. The most common fistula in diverticulitis is:

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A. Colovesical
B. Colovaginal
C. Colorectal
D. Colocolic
14. Which of the following is a true diverticulum?
A. Sigmoid diverticulum
B. Meckel’s diverticulum
C. Parabronchial diverticulum
D. Laryngeal diverticulam
15. In hereditary nonpolyposis colorectal cancer, which carcinoma is more
often seen?
A. Rectum
B. Rectosigmoid
C. Transverse colon
D. Caecum and ascending colon
16. Incidence of malignancy in familial polyposis coli is:
A. 10%
B. 30%
C. 50%
D. 100%
17. Following are true for carcinoembryonic antigen, except:
A. It is a glycoprotein
B. It is tumour marker for carcinoma colon
C. It should be done in all cases of carcinoma colon before surgery

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D. Produced by colorectal epithelium and cleared by kidney
18. Following are true for right hemicolectomy for carcinoma caecum, except:
A. Right one-third of transverse colon is also removed
B. Greater omentum should be removed
C. Terminal 30 cm of the ileum should be removed
D. Duodenum can get injured during surgery
19. Indications for postoperative chemotherapy following colectomy for
carcinoma include following, except:
A. Signet ring carcinoma
B. Lymph nodes are positive
C. Lymphovenous involvement
D. Involvement of muscularis propria
20. The most common aerobic organism present in a sigmoid colonic faecal
fistula is:
A. Clostridia
B. Lactobacillus
C. Bacteroides fragilis
D. E. coli

Intestinal Obstruction
1. Which of the following is true for closed loop obstruction?
A. Can occur with constrictive growth in the hepatic flexure
B. Ileocaecal valve is incompetent
C. Perforation of the sigmoid colon is common
D. Occurs with partial obstruction

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2. Which of the following is not the cause of gangrene in intestinal
obstruction?
A. Ileocaecal tuberculosis
B. Mesenteric vascular occlusion
C. Necrotising enterocolitis
D. Volvulus
3. Faeculent vomiting is pathognomonic of:
A. Jejunal obstruction
B. Terminal ileal obstruction
C. Duodenal obstruction
D. Colonic obstruction
4. Cardinal features of intestinal obstruction include all of the following
except:
A. Colicky abdominal pain
B. Vomiting
C. Diarrhoea
D. Abdominal distension
5. The following is true in a plain X-ray of abdomen in intestinal obstruction:
A. Caecum can appear as round shadow
B. Ileum has valvulae conniventes
C. Colon has haustrations
D. Sigmoid appears shapeless
6. Features of strangulation includes all of the following except:
A. Tachycardia
B. Disappearance of pain abdomen

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C. Fever
D. Acidosis
7. The features of viable bowel includes all of the following except:
A. Normal peristalsis
B. Normal pulsations are visible
C. Normal pink colour is present
D. Peritoneal sheen is absent
8. Conservative treatment is advocated in intestinal obstruction when there is:
A. Disseminated malignancy with obstruction
B. Complete obstruction with adhesions
C. Postoperative obstruction with peritonitis
D. Crohn’s disease unresponsive to medications
9. ‘Bent inner tube design’, ‘Omega sign’, ‘Bird’s beak design’ are all seen in:
A. Sigmoid volvulus
B. Caecal volvulus
C. Meckel’s diverticulum
D. Bascule
10. The most common cause of intestinal obstruction in infants aged 6–18
months is:
A. Worms
B. Bands
C. Intussusception
D. Adhesions
11. Red currant jelly stools are characteristic of:

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A. Worms
B. Bands
C. Intussusception
D. Adhesions
12. Dance’s sign (signe de dance) is a feature of:
A. Worms
B. Bands
C. Intussusception
D. Adhesions
13. The investigation of choice in mesenteric vascular occlusion is:
A. Ultrasound abdomen
B. Plain X-ray abdomen
C. CT with or without angiogram
D. MRI
14. The most common cause of intestinal obstruction in neonates is:
A. Bands
B. Duodenal atresia
C. Imperforate anus
D. Meconium ileus
15. The most common congenital anomaly of small intestine is:
A. Bands
B. Duodenal atresia
C. Stenosis
D. Meckel’s diverticulum

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16. Features of paralytic ileus include the following except:
A. Gross abdominal distension
B. Pain abdomen
C. Failure to pass flatus
D. Tinkling sounds
17. Melanosis of lips and mucosa with intestinal obstruction should arouse
the suspicion of:
A. Gardner’s syndrome
B. Turcot’s syndrome
C. Peutz-Jeghers syndrome
D. Down’s syndrome
18. Which is the factor precipitate sigmoid volvulus?
A. Short colon
B. Broad attachment at the base
C. Empty colon
D. Long mesentery of the colon
19. Common factor precipitating sigmoid volvulus in patients with
Parkinsonism, multiple sclerosis, hypothyroidism is:
A. Diarrhoea
B. Constipation
C. Drugs
D. Long mesentery of the colon
20. Investigation of choice for detecting bleeding Meckel’s diverticulum is:
A. CT scan
B. Pet scan

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C. MRI scan
D. Technetium scan
21. Presence of intramural air is diagnostic of:
A. Gall stone ileus
B. Sigmoid perforation
C. Duodenal atresia
D. Intestinal gangrene
22. Following complications can occur after gastrojejunostomy except:
A. Dumping syndrome
B. Intussusception
C. Volvulus
D. Stomal ulcer
23. Following are the causes of adult intussusception except:
A. Meckel’s diverticulum
B. Submucous lipoma
C. Carcinoma caecum
D. Hypertrophy of Peyer’s patches
24. The most common anomaly associated with Hirschsprung’s disease is:
A. Down’s syndrome
B. Hypothyroidism
C. Meckel’s diverticulum
D. Anorectal atresia
25. Following are causes of paralytic ileus except:
A. Anastomotic leak

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B. Retroperitoneal irritation
C. Hyperkalaemia
D. Fracture spine

Rectum and Anal Canal

1. Splash in the pan is classically described for bleeding from which
condition?
A. Carcinoma rectum
B. Fissure in ano
C. Haemorrhoids
D. Polyp
2. Which of the following are causes of anorectal fistulae in males except:
A. Crohn’s disease
B. Tuberculosis
C. Ulcerative colitis
D. Lymphogranuloma venereum
3. Following are true about peritoneal coverings/fascia of the rectum except:
A. Upper one-third is completely covered
B. Middle one-third is covered anterolaterally
C. Lower one-third is covered anteriorly
D. Waldeyer's fascia separates the rectum from sacrum
4. About signet ring carcinoma rectum, following are true except:
A. It is seen in young patients
B. Cells are filled with mucus and nucleus is displaced

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C. It carries bad prognosis
D. Not an indication for chemotherapy
5. Following are true for clinical features of carcinoma rectum except:
A. Can give rise to tenesmus
B. Can present as bloody slime
C. Can present as liver secondaries
D. Can cause closed loop obstruction
6. The ideal surgical treatment for growth at 8 cm from the anal verge is:
A. Abdominoperineal resection
B. Abdominosacral resection
C. High anterior resection
D. Total mesorectal excision
7. On-table lavage of the intestines for resection and anastomosis can be done
via:
A. Enterotomy
B. Colotomy
C. Enema from rectum
D. Appendicular stump
8. Local excision of malignant rectal tumour can be done, if:
A. The tumour is up to 6 cm size
B. Up to 60% of the rectal wall involvement
C. Lymphatic invasion is accepted
D. Tumour is well differentiated
9. Prolapse rectum is caused by several factors except:

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A. Birth injuries to the nerve fibres
B. Defective collagen metabolism
C. It does not start as intussusception
D. Deep rectovesical pouch
10. Below the dentate line, squamous epithelium has:
A. No basal cells
B. Hair
C. Sweat glands
D. Pigment forming cells
11. Above the dentate line, lymphatic drainage goes to:
A. Para-aortic nodes
B. Superficial inguinal lymph nodes
C. Deep inguinal lymph nodes
D. Pudendal lymph nodes
12. Following are true for prolapsed piles except:
A. External sphincter grips the pile mass and cause gangrene
B. Thrombosis can occur
C. Portal pyaemia can be a complication
D. Requires hemorrhoidectomy
13. Which one of these precautions must be taken while applying band for
haemorrhoids?
A. Bands are applied in grade 1 pile masses
B. Bands are applied in grade 4 haemorrhoids
C. Bands are applied below the dentate line

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D. Bands should not be applied in patients who are taking anticoagulants
14. Anal stenosis is a complication of:
A. Stapler haemorrhoidopexy
B. Open haemorrhoidectomy
C. Too low application of the band
D. Cryosurgery
15. Following are true for injection line treatment of haemorrhoids except:
A. It is given perivascular
B. Given above the level of dentate line
C. It is painful
D. It is given in submucosal plane
16. Following are true for stapler haemorrhoidopexy except:
A. Recurrence rate is less
B. Less discomfort than open haemorrhoidectomy
C. Anal stenosis is not a complication
D. Ideal for 3rd or 4th degree haemorrhoids
17. In multiple fistula in ano and high fistula, which one of the following
should not be done?
A. Biopsy of the track
B. Colostomy
C. Fistulogram
D. Multiple fistulotomy
18. Majority of the cases of fissure in ano are:
A. Anterior

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B. Posterior
C. Anterolateral
D. Posterolateral
19. In lateral sphincterotomy:
A. Pecten fibres are ruptured
B. It is blunt sphincterotomy
C. External sphincter is divided
D. Internal sphincter is divided
20. In cases of pilonidal sinus:
A. Hair is demonstrated in the wall
B. It is congenital
C. It is known for recurrence
D. It undergoes malignant change

Lower Gastrointestinal Bleeding

1. The most common position of the appendix is:
A. Subhepatic
B. Subcaecal
C. Retrocaecal
D. Pelvic
2. The incidence of appendicitis is less after 30 years because:
A. The appendix undergoes involution
B. The lymphatic tissue in the appendix decreases
C. Most people would have had their appendices removed

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D. The vascularity reduces
3. The name Seshachalam is associated with which of the following arteries?
A. Accessory appendicular artery
B. Appendicular artery
C. Ileocolic artery
D. Posterior caecal artery
4. Appendicular orifice is occasionally guarded by an indistinct semilunar
fold of mucous membrane called:
A. Valve of Gerlach
B. Valve of Heister
C. Valve of Kerckring
D. Valve of Houston
5. The most common scoring system used for appendicitis is ___________
scoring system.
A. Child-Pugh
B. Furtado
C. Murray
D. Alvarado
6. Palpation of left iliac region of abdomen produces pain in the right iliac
region in appendicitis because of:
A. Sympathetic reaction
B. Displacement of colonic gas and small bowel coils
C. Sigmoid colon is also affected
D. Ileocolic reflex
7. Cope’s psoas test is positive in:

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A. Retrocaecal appendicitis
B. Pelvic appendicitis
C. Preileal appendicitis
D. Subcaecal appendicitis
8. Rebound tenderness in acute appendicitis is called:
A. McBurney’s sign
B. Blumberg’s sign
C. Rovsing’s sign
D. Sherren’s sign
9. The most common cause of non-obstetric emergency with abdominal pain
in pregnancy is due to:
A. Acute appendicitis
B. Acute cholecystitis
C. Acute gastritis
D. Acute hepatitis
10. Contraindications for incidental appendicectomy include all of the
following except:
A. Crohn’s of caecum
B. Radiation treatment of the rectum
C. Immunocompetent individuals
D. Previous vascular reconstruction in the abdomen
11. The following statement is TRUE about appendicular abscess:
A. Abscess greater than 4–6 cm in size needs to be drained by laparotomy
B. Appendicectomy must be done along with laparotomy for appendicular
abscess

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C. Can present with diarrhoea
D. Conservative management is advised till inflammation settles down.
12. Most common aerobic bacterium involved in acute appendicitis is:
A. Salmonella typhi
B. Streptococcus
C. Escherichia coli
D. Clostridium perfringens
13. The following statement is FALSE about occurrence of faecal fistula
following appendicectomy:
A. Faecal fistula can occur if the cause of appendicitis is carcinoma caecum
B. Faecal fistula can occur if chronic diseases such as tuberculosis is present
C. Faecal fistula can occur if purse string sutures are not applied properly
D. It is always due to actinomycosis
14. The most reliable symptom of acute appendicitis is:
A. Fever
B. Migratory pain
C. Right iliac fossa pain
D. Vomiting
15. Appendicular perforation is common because of the following reasons
except:
A. Appendix is a cul-de-sac
B. It has blood supply with profuse collaterals
C. It has a narrow lumen
D. The muscle coat of appendix is thin
16. Appendicular mucosa contains following, except (predominantly):

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A. Columnar epithelium
B. Neuroendocrine cells
C. Goblet cells
D. Paneth cells
17. About Paneth cells following are true except:
A. They are found mainly in colon
B. Found just below crypts of Lieberkühn
C. Have antibacterial property
D. They produce lysozymes
18. Following precautions have to be taken to treat appendicitis in a pregnant
lady in the 2nd trimester except:
A. Initial evaluation should be by ultrasound imaging
B. MRI is the most ideal imaging
C. Gadolinium contrast should be used
D. Open (Hasson) technique is used in laparoscopic appendicectomy.

Hernias
1. Length of inguinal canal is:
A. 4 cm
B. 6 cm
C. 8 cm
D. 10 cm
2. Which of the following is not a boundary of the Hesselbach’s triangle?
A. Rectus abdominis

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B. Inguinal ligament
C. Inferior epigastric artery
D. Testicular artery
3. Following are true about external ring except:
A. It is not a ring
B. It is a defect in the internal oblique aponeurosis
C. Invagination test is done through external ring
D. It transmits spermatic cord
4. About deep inguinal ring, which one of the following is true?
A. It is a defect in the external oblique aponeurosis
B. It is a defect in the internal oblique aponeurosis
C. It is a defect in the transversalis fascia
D. It is a defect in the cremasteric fascia
5. Following are true for deep inguinal ring, except:
A. Deep ring is a defect in the transversalis fascia
B. Indirect hernial sac comes out lateral to the deep ring
C. Pantaloon hernia can be on both sides of deep ring
D. It is closed at the end of hernia repair to prevent recurrence
6. The ideal surgical treatment for sliding inguinal hernia will be:
A. Herniotomy
B. Bassini’s herniorrhaphy
C Marsey’s repair
D. Lichtenstein’s repair
7. Following are contents of the spermatic cord except:

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A. Vas deferens
B. Testicular artery
C. Genital branch of genitofemoral nerve
D. Ilioinguinal nerve
8. About sliding inguinal hernia following are true, except:
A. Urinary bladder can be the part of hernial sac
B. It can be both direct or indirect type
C. The hernial sac should be twisted as in indirect hernia treatment
D. Often it is irreducible
9. Richter’s hernia refers to:
A. Hernia containing intestines
B. Strangulated hernia
C. Only a part of circumference of the intestine is caught in a hernial sac
D. Hernia containing urinary bladder
10. Immediate structure anterior to direct hernial sac is:
A. External oblique aponeurosis
B. Internal oblique aponeurosis
C. Transversalis facia
D. Posterior rectus sheath
11. Femoral hernia has following features, except:
A. It is more common in women
B. It is below and lateral to pubic tubercle
C. It is known for strangulation
D. It can be managed by hernia truss

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12. Diagnostic feature of a saphena varix is:
A. It is transilluminant
B. It is soft and reducible
C. It is below the pubic tubercle
D. Disappears on elevation of the leg
13. Which one of the following hernias is called Littre’s hernia?
A. Hernia containing Meckel’s diverticulum
B. Hernia containing urinary bladder
C. Hernia containing sigmoid colon
D. Hernia containing ovary
14. Which one of the following is the most important step in preventing
recurrence of hernia?
A. Complete excision of cremasteric muscle
B. Reconstruction of the external ring
C. Reconstruction of the internal ring
D. High ligation of the sac
15. Following are true for strangulated inguinal hernia, except:
A. It will be tense
B. Tender
C. Irreducible
D. Impulse on cough is present
16. Following are true for anatomy of the femoral canal, except:
A. Femoral canal is the outermost compartment of femoral sheath
B. Femoral canal extends from femoral ring to saphenous ring

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C. Femoral canal is below and lateral to pubic tubercle
D. Femoral canal contains lymph node of Cloquet
17. In obstructed femoral hernia, at surgery which of the following steps
should not be done?
A. Best done with low approach through incision directly over the swelling
B. Closure of the ring is done by prolene suture material
C. Abnormal obturator artery should be looked for
D. Urinary bladder may be in danger
18. Following hernias are known for high chances of strangulation, except:
A. Femoral hernia
B. Obturator hernia
C. Spigelian hernia
D. Direct hernia
19. In which condition femoral hernia occurs behind the femoral vessels?
A. Prune-belly syndrome
B. Poliomyelitis
C. Congenital dislocation of the hip
D. Defect in the lacunar ligament
20. In cases of epigastric hernia, all are true, except:
A. It is more common in muscular men
B. Impulse on cough is common
C. Sac is uncommon
D. It is tender
21. Spigelian hernia, is an example for:

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A. Direct hernia
B. Indirect hernia
C. Interstitial hernia
D. Type of femoral hernia
22. In Spigelian hernia swelling is seen:
A. Below and lateral to umbilicus
B. Below the umbilicus
C. Around the umbilicus
D. Just above the umbilicus
23. Differential diagnosis of lumbar hernia includes the following, except:
A. Lipoma
B. Cold abscess
C. Haematoma
D. Meningocoele
24. Following are true for obturator hernia, except:
A. Hernia is covered by pectineus muscle
B. Pain is radiated to the knee
C. Cannot be felt by vaginal examination
D. Patients keep their leg semiflexed
25. The most common presentation of obturator hernia is:
A. Groin swelling
B. Intestinal obstruction
C. Bruising below inguinal ligament
D. Tender mass on vaginal examination

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Umbilicus and Abdominal Wall
1. The most common bedside investigation done for suspected blunt
abdominal trauma for bleeding is:
A. CT scan
B. MRI scan
C. Diagnostic peritoneal lavage
D. Ultrasound
2. Which one of the following is a definite indication for laparotomy in blunt
injury abdomen?
A. Splenic injury
B. Pancreatic injury
C. Liver injury
D. Aspiration of bile in the peritoneal aspirate
3. If air bubble like picture is found within the thorax following blunt injury
abdomen what do you suspect?
A. Splenic rupture
B. Liver injury
C. Injury to the stomach
D. Diaphragmatic injury
4. How do you rule out a head injury with factors given below?
A. Hypotension responding to fluid
B. CSF rhinorrhoea
C. Fracture skull
D. Hypertension and bradycardia
5. Which is an important sign of hollow viscus perforation?

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A. Cullen’s sign
B. Grey Turner’s sign
C. Mallet Guy sign
D. London sign
6. The following are true for conservative management of liver injury, except:
A. Hollow viscus injury should not be there
B. Free contrast in and around liver in CT scan
C. Grade I and Grade II injury
D. Haemodynamically stable patient
7. Pringle manoeuvre refers to:
A. Compression of left gastric artery to stop the bleeding from giant gastric
ulcer
B. Compression of hepatic artery to stop the bleeding during liver resection
C. Compression of hepatic artery and portal vein in front of foramen of
Winslow
D. Compression of gastroduodenal artery during Whipple’s procedure
8. The salvage procedure to buy time in massive bleeding from liver include
following:
A. Pringle manoeuvre
B. Plug by omentum
C. Perihepatic packing
D. Portovenous shunt
9. Perforation within 4 cm of the ileocaecal junction following blunt injury is
better treated by:
A. Suturing and drainage

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B. Resection and anastomosis and drainage
C. Suture and bypass
D. Exteriorisation
10. Which of the following is not a feature of retroperitoneal duodenal
perforation?
A. Can occur with steering wheel injury
B. Chilaiditi sign may be present
C. Free gas under diaphragm
D. Guarding and rigidity is minimal
11. Initial third of resuscitation in haemorrhagic shock in blunt abdominal
trauma is:
a. Ringer lactate
b. Saline
c. Dextrose
d. Plasma
12. Death triad in blunt abdominal trauma is:
a. Hyperthermia, acidosis, coagulopathy
b. Hypothermia, acidosis, coagulopathy
c. Hypothermia, alkalosis, coagulopathy
d. Hyperthermia, alkalosis, coagulopathy

Abdominal Mass
1. The most diagnostic sign of a renal mass is:
A. Moves with respiration
B. Upper pole cannot be felt

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C. It enlarges downwards
D. Ballotability
2. Which one of the following lower horizontal lines divides abdomen into
regions?
A. Transpyloric line
B. Transcolic line
C. Transtubercular line
D. Transanterior superior iliac spine line
3. Which of the following masses does not move with respiration?
A. Kidney
B. Hepatic flexure
C. Tail of the pancreas
D. Para-aortic lymph node mass
4. Notch is a diagnostic sign of which mass?
A. Spleen
B. Liver
C. Kidney
D. Adrenal gland
5. Which of the following does not have intrinsic mobility?
A. Fibroadenoma breast
B. Ovarian cyst
C. Mesenteric cyst
D. Multinodular goitre
6. The following are true for renal masses except:

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A. It is bimanually palpable
B. It is ballotable
C. It does not move with respiration
D. Upper border is usually not felt
7. Blumer’s shelf refers to:
A. Rectouterine pouch
B. Rectovesical pouch
C. Rectosacral pouch
D. Rectoprostatic pouch
8. Following tumours can occur in the abdominal wall except:
A. Desmoid tumour
B. Endometriosis
C. Dermoid tumour
D. Fibromatosis
9. Following appendicectomy, after 2 months, if woody indurated mass
develops in the right iliac fossa with sinuses, what is the diagnosis?
A. Tuberculosis
B. Crohn’s disease
C. Amoeboma
D. Actinomycosis
10. Acute intussusception mass has the following features except:
A. Mass is tender
B. Mass is felt in the umbilical region
C. It is a sausage-shaped mass

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D. In the right iliac fossa caecum gurgles
11. Which of the following masses does not have cross fluctuation?
A. Iliopsoas abscess
B. Plunging ranula
C. Collar stud abscess
D. Branchial cyst
12. Following are true for retroperitoneal sarcoma except:
A. Common in young patients
B. Mass does not move with respiration
C. It can attain a hard and large mass
D. Free fluid is usually present in the abdomen
13. The diagnostic feature of mesenteric cyst is:
A. It is present in the umbilical region
B. It is dull to percuss
C. It falls forward
D. Moves at right angle to the direction of mesentery
14. Which of the following masses is non tender?
A. Hepatoma
B. Appendicular mass
C. Carcinoma stomach
D. Cholecystitis
15. Murphy’s triad of symptoms include the following except:
A. Pain
B. Vomiting

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C. Fever
D. Jaundice
THE END COMPILED BY KANDY EMMA MBChB KIU-WC 2024

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