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Total Questions: 200

KONCPT-GB PANT MODEL

Score : 0/800( 0.00 )

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Question 1:
Recombinant human activated protein C(drotecogrin alpha) is
indicated in all of the following except:
a) APACHE II score 18.
b) Evidence of multiorgan failure.
c) APACHE II score 28.
d) Adult patient with sepsis induced organ dysfunction.

Explanation

Correct Answer is

Option 1 a) APACHE II score 18.

ref: pg 85, box 5-2, sabiston volume 1, 19th edn.

Question 2:
All of the following statements are true except:

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a) An intestinal fistula with a tract length of >2 cm is a favorable factor for

healing.
b) Treatment with PPIs does not actively aid in closure of bowel fistula.
c) Duodenal stump fistulas have poorer healing compared to lateral
duodenal fistula.
d) Skin changes in relation to bowel fistulas are more with duodenal
fistulas compared to gastric fistulas.
Explanation

Correct Answer is

Option 3 c) Duodenal stump fistulas have poorer healing compared to

lateral duodenal fistula.
ref: sabiston 19th edn pg 319.

Report

Question 3:
Most common vasculitis affecting the hepatic arterial network is:
a) Kawasakis disease
b) Cogans disease.
c) Non specific medium vessel vasculitis.
d) Polyarteritis nodosa.
Explanation

Correct Answer is

Option 4 d) Polyarteritis nodosa.

ref: blumgart 5th edn, pg 351.

Question 4:
Not an indication of retrievable IVC filter?:

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a) In cases where anticoagulation therapy is contraindicated.

b) Extensive proximal thrombosis affecting the lower extremity.
c) Prophylaxis in craniovertebral injuries
d) As a protective measure in venous thrombolytic therapy.
Explanation

Correct Answer is

Option 3 c) Prophylaxis in craniovertebral injuries

ref: box 65-4, page 1817, sabiston 19th edn.

Question 5:
Lyres sign on DSA scan is a feature seen in:
a) Branchial cyst.
b) Potato tumor of neck.
c) Thyroglossal cyst.
d) Vertebral artery aneurysm.
Explanation

Correct Answer is

Option 2 b) Potato tumor of neck.

potato tumor= chemodectoma; ref: bailey, dhingra ENT.

Report

Report

Question 6:
The first successful coronary artery bypass grafting is credited to:
a) Cooley.
b) De bakey.
c) Gibbon.
d) Vineberg.
Explanation

Correct Answer is

Option 2 b) De bakey.

) ref: page 1652, table 60-2, sabiston 19th edn.

Report

Question 7:
Which of the following vessels shows maximum variation in size?
a) Superior mesenteric artery
b) Celiac artery.
c) Middle rectal artery.
d) Inferior rectal artery.
Explanation

Correct Answer is

Option 3 c) Middle rectal artery.

middle rectal artery; ref: shackelford 7th edn.

Report

Question 8:
Catchpole regimen is used in the management of which of the
following conditions?

a) Appendiceal carcinoid.
b) Mesenteric abscess.
c) Appendicular mass.
d) Ogilvies syndrome.
Explanation

Correct Answer is

Option 4 d) Ogilvies syndrome.

Ogilvies syndrome; ref: Bailey and love.

Report

Question 9:
Which of the following anti microbial agent has the propensity to
alter the acid base balance?
a) 0.5% silver nitrate.
b) Polymyxin B
c) Mafenide acetate 5%.
d) Dakins solution.
Explanation

Correct Answer is

Option 3 c) Mafenide acetate 5%.

mafenide acetate; ref: pg 533, table 21-5, sabiston 19th edn.

Report

Question 10:
All of the following statements about burn injuries are true except?

a) Hydrofluoric acid burns may present with alteration of QT interval on

ECG.
b) Formic acid burns may be associated with hemoglobinuria.
c) A 25 year old man with burns exclusively involving the hands mandates
referral to a burn unit.

d) Hydrochloric acid is the strongest inorganic acid known.

Explanation

Correct Answer is

Option 4 d) Hydrochloric acid is the strongest inorganic acid known.

ref: sabiston 19th edn., pages 543-545.

Report

Question 11:
Which of the following variants of melanoma exhibits neurotropism?
a) Lentigo maligna melanoma.
b) Desmoplastic melanoma.
c) Acral lentiginous melanoma.
d) Nodular melanoma.
Explanation

Correct Answer is

Option 2 b) Desmoplastic melanoma.

Desmoplastic melanoma.; ref: sabiston 19th edn., page 747.

Report

Question 12:
Pseudolymphoma or Lymphoma like benign picture is seen in all
except:
a) Monoclonal gammopathy.
b) Phenobarbitone therapy.
c) Sjogrens syndrome.
d) Dysgammaglobulinemia.
Explanation

Correct Answer is

Option 1 a) Monoclonal gammopathy.

-------------

Question 13:
The most well vascularised zone of a TRAM pedicled flap is?

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a) Zone I
b) Zone II
c) Zone III
d) All are equally well perfused
Explanation

Correct Answer is
Option 1 a) Zone I

Zone I; ref: sabiston page 875.

Question 14:
Not a component of the Bishop and Cairo criteria?

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a) Cardiac arrhythmia.
b) Seizure.
c) Serum potassium > 6meq/l.
d) Serum calcium > 8mg/dl.
Explanation

Correct Answer is

Option 4 d) Serum calcium > 8mg/dl.

Ref: Bishop and cairo criteria for tumor lysis syndrome: devita textbook of
oncology.

Report

Question 15:
A 50 year patient with CKD right side has been put on
immunosuppressive therapy. He is being planned up for renal
transplant. On 3rd day of starting the therapy, the patient develops
sudden onset high grade fever, with SBP falling to 70 mm Hg and
breathlessness. The TLC was recorded to be 25000. The 24 hour urine
output was 400 ml. What could be culprit agent?
a) Azathioprine.
b) OKT3.
c) Mycophenolate mofetil.
d) Basiliximab.
Explanation

Correct Answer is
Option 2 b) OKT3.

ref: sabiston 19th edn, page 642-645.

Question 16:
Not a pro inflammatory cytokine?
a) IL-7.
b) IL-10.
c) IL-5.
d) TNF alpha.
Explanation

Correct Answer is
Option 2 b) IL-10.

IL-10; ref: sabiston page 623.

Report

Report

Question 17:
As per the hospital safety codes issued by the NABH, which of the
following is not a correct match?
a) Code Blue: cardiorespiratory critical care.
b) Code Red: Fire.
c) Code pink: stable.
d) Code grey: Internal disaster.
Explanation

Correct Answer is

Option 3 c) Code pink: stable.

code pink: missing child.

Question 18:
Which part of the gut is maximal affected in blast injuries?

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a) Duodenum.
b) Proximal jejunum.
c) Terminal ileum.
d) Ascending colon.
Explanation

Correct Answer is

Option 3 c) Terminal ileum.

terminal ileum; ref: sabiston page 613.

Report

Question 19:
A 45 year man presented to surgery OPD with vague aching pain in
Right flank for the past 3 months. He has no other systemic
complaints. On USG, a mass was noted in right renal area with mixed
echogenecity. A CECT was done which revealed a mass involving the
lower pole of right kidney; about 8 cm in greatest dimension,
involving the right wall of IVC with evidence of involvement of the
right adrenal gland. There is involvement of the right paracaval
nodal group as well. No evidence of any systemic involvement. The
TNM staging would be?
a) T3N1M0
b) T4N1M0
c) T3cN2M0
d) T4N2M0

Explanation

Correct Answer is

Option 2 b) T4N1M0

ref: medscape staging of RCC. AJCC 10th edn.

Question 20:
Not a component of the TRISS scoring for trauma?
a) Mechanism of injury (blunt/penetrating)
b) Systolic BP.
c) Heart rate.
d) Age.
Explanation

Correct Answer is

Option 3 c) Heart rate.

heart rate; ref: sabiston page 433.

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Question 21:
All of the following statements are true except?

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a) The original description of damage control surgery was given by

Fabian and co-workers and had 5 phases.
b) Abdominal compartment syndrome is always associated with evidence
of a new organ dysfunction
c) Secondary abdominal compartment syndromes refer to the
conditions that originate from the abdominopelvic region.
d) Normal intra-abdominal pressure is 5-7 mmHg in a critically ill patient.
Explanation

Correct Answer is

Option 3 c) Secondary abdominal compartment syndromes refer to the

conditions that originate from the abdominopelvic region.
Ref: Sabiston page 471-472.

Report

Question 22:
All of the following statements about meconium ileus are true
except?

a) Affects 1 in 1000-2000 live births.

b) Associated with AFI<2
c) Presents with the cardinal signs of intestinal obstruction within the first
48 hours of life.
d) NAC containing enema is useful in non operative management.
Explanation

Correct Answer is

Option 2 b) Associated with AFI<2

associated with polyhydramnios, AFI> 5.

Question 23:
The most common site affected by lumbar disk herniation is?

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a) L4-L5
b) L5-S1.
a) L2-L3.
d) L3-L4
Explanation

Correct Answer is
Option 2 b) L5-S1.

Ref: sabiston page 1896, table 68-5.

Question 24:
Which of the following is not a correct match?

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a) Type I flap: gastrocnemius.

b) Type II flap: trapezius.
c) Type III flap: serratus anterior.
d) Type V flap: tibialis anterior.
Explanation

Correct Answer is

Option 4 d) Type V flap: tibialis anterior.

tibialis anterior is type IV; ref: sabiston page 1918.

Question 25:
Clinodactyly refers to?

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a) Curvature of digit in radial/ulnar deviation.

b) Total duplication of proximal/distal phalanges.
c) Splitting of a single digit.
d) Triphalangia with duplication.
Explanation

Correct Answer is

Option 1 a) Curvature of digit in radial/ulnar deviation.

Ref: sabiston page 1992.

Question 26:
Not true about hand infections?

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a) The most common causative organism in paronychia is Staphylococcus

sp.
b) Infection of the paronas space occurs deep to the pronator
quadratus muscle.
c) Herpetic whitlow follows a self limited course.
d) Kanavels cardinal signs have been given for flexor tenosynovitis.
Explanation

Correct Answer is

Option 2 b) Infection of the paronas space occurs deep to the pronator

quadratus muscle.
it occurs superficial to P. quadrates. Ref; sabiston page 1977-1979.

Report

Question 27:
Which of the following does not merit replantation of the amputated
digit?
a) Multiple injured digits.
b) Single digit amputation in children.

c) Thumb amputation.
d) Single digit amputation in an 18 year old proximal to FDS insertion.
Explanation

Correct Answer is

Option 4 d) Single digit amputation in an 18 year old proximal to FDS

insertion.
ref: sabiston page 1972.

Question 28:
Allens classification is used in which of the following?

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a)Fingertip injuries based on level of amputation.

b) Assessment of distribution of radial/ulnar arterial supply to the hand.
c) Neural injuries of hand.
d) None of the above.
Explanation

Correct Answer is

Option 1 a)Fingertip injuries based on level of amputation.

ref: Medscape. This question was asked in DNB SS 2014.

Question 29:
Most common variant of mesenteric cyst?
a) Chylolymphatic.
b) Enterogenous.
c) Urachal.
d) Dermoid.
Explanation

Correct Answer is

Report

Option 1 a) Chylolymphatic.
ref: bailey and love.

Question 30:
Thyroglossal cyst is a type of?

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a) Implantation dermoid.
b) Mucous retention cyst.
c) Cartilaginous remnant.
d) Tubulodermoid.
Explanation

Correct Answer is

Option 4 d) Tubulodermoid.
ref: bailey and love.

Question 31:
All of the following are correct match except?
a) Adamantinoma- metaphysic.
b) Ewings sarcoma- diaphysis.
c) Osteosarcoma- metaphysis.
d) Chondroblastoma- epiphysis.
Explanation

Correct Answer is

Option 1 a) Adamantinoma- metaphysic.

it arises from diaphysis. Ref: bailey and love.

Report

Question 32:
The Total surface area of the peritoneum is approx:

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a) 3 m2.
b) 4 m2.
c) 2 m2
d) 5 m2.

Explanation

Correct Answer is
Option 3 c) 2 m2

ref: sabiston page 1097

Report

Question 33:
A middle aged perimenopausal woman presents to surgical OPD with
complaints of a dragging sensation in lower abdomen. It apparently
increases on exertion. It developed suddenly about 2 mths back
following a bout of heavy sprinting exercise. On examination, an ill
defined fullness was noted in right lumbar region. On carnets test, it
showed no change in its size. Which of the following statements
about this condition is incorrect?
a) Most of the cases respond with analgesics and rest.
b) The condition is more common in athletic males than females.
c) There may be associated signs like grey turner/ cullens.
d) It is important to take history of OCP or warfarin intake in these cases.
Explanation

Correct Answer is

Option 2 b) The condition is more common in athletic males than

females.
more common in females. Ref: Sabiston page 1094; Rectus sheath
hematoma.

Report

Question 34:
Consider the following statements about congenital umbilical hernia.
Which of the following statements is not correct?

a) Gastroschisis mostly occurs to the right of the umbilicus.

b) Chances of concomitant congenital anomalies are more with
omphalocele than gastroschisis.
c) Periop fluid requirements are more with omphalocele than
gastroschisis.
d) Omphalocele forms a component of the cantrells pentalogy.
Explanation

Correct Answer is

Option 3 c) Periop fluid requirements are more with omphalocele than

gastroschisis.
ref: sabiston page 1855.

Question 35:
Which of the following statements is true?

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a) Levator scapulae is the most common flap used to cover the

exposed carotid artery post RND.
b) MRND type II saves the sternomastoid muscle.
c) The pectoralis major myocutaneous flap is also called the Bakamjian
flap.
d) The deltopectoral flap is considered the working horse for head and
neck reconstructions.
Explanation

Correct Answer is

Option 1 a) Levator scapulae is the most common flap used to cover the
exposed carotid artery post RND.

ref; sabiston page 818.

Report

Question 36:
Which of the following histological variants of RCC has the leafy
pattern on histology?
a) Clear cell.
b) Papillary.
c) Chromophobe.
d) Bellini duct.
Explanation

Correct Answer is

Option 3 c) Chromophobe.

Chromophobe; ref: campbells urology.

Report

Question 37:
Which of the following mandates surgical intervention in a patient
with hyperparathyroidism?
a) BMD at lumbar spine, hip or distal radius showing a T score of >-2.5.
b) Patient aged 25 years with primary hyperparathyroidism.
c) Patient aged 65 years with secondary hyperparathyroidism.
d) Serum calcium level of 10.5 mg/dl.
Explanation

Correct Answer is

Option 2 b) Patient aged 25 years with primary hyperparathyroidism.

ref: sabiston page 928; box 39-2.

Report

Question 38:
A patient aged 24 years presents with a malignant appearing thyroid
mass about 5 cms in greatest dimension, with involvement of
contralateral level 4,5,6 cervical nodes and multiple cutaneous
nodules on anterior part of left leg with histological evidence of
malignant cells. AJCC 7th edn stage?
a) Stage I
b) Stage II
c) Stage III
d) Stage IV.

Explanation

Correct Answer is

Option 2 b) Stage II

in age < 45 years, M1= stage II.

Question 39:

Report

The most common electrolyte imbalance seen in patients with

advanced stage Ca penis is?
a) Hyperphosphatemia.
b) Hyperkalemia.
c) Hypocalcemia.
d)Hypercalcemia.
Explanation

Correct Answer is

Option 4 d)Hypercalcemia.
Ref: campbells urology

Question 40:
Middle adrenal artery is a branch of?

Report

a) Abdominal aorta.
b) Renal artery.
c) Gonadal artery.
d) Inferior phrenic artery.
Explanation

Correct Answer is

Option 1 a) Abdominal aorta.

ref: sabiston page 964.

Question 41:
Not true about MEN syndrome?

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a)MEN I patients may present with collagenomas.

b) MEN 2b patients merit prophylactic thyroidectomy by 5 years of
age.
c) MEN 2a patients may present with amyloid deposition in papillary
dermis.
d) Hirschsprungs disease has been seen in association with MNE 2a.
Explanation

Correct Answer is

Option 2 b) MEN 2b patients merit prophylactic thyroidectomy by 5 years

of age.
surgery at infancy needed ( 6mths); ref: sabiston pages 1000-1004.

Report

Question 42:
DTIC (Dacarbazine) has been used in the management of which of the
following pancreatic NET?
a) GRFoma.
b) Neurotensinoma.
c) Glucagonoma.
d) Somatostatinoma.
Explanation

Correct Answer is

Option 3 c) Glucagonoma.

Glucagonoma. (ref: blumgart/shackelford).

Report

Question 43:
Which of the following conditions of hypergastrinemia is not
associated with increased acid output?
a) Pernicious anemia
b) Retained gastric antrum
c) ZES.
d) GOO.
Explanation

Correct Answer is

Option 1 a) Pernicious anemia

ref: sabiston page 952.

Report

Question 44:
Which of the following statements about thyroid anatomy is not
true?
a) Non recurrent laryngeal nerve may occur in 0.5% cases and is
more common on the left side.
b) Jolls triangle has inferior thyroid artery as one of its branches.
c) The parafollicular cells are concentrated along the upper part of the
thyroid gland.
d) The organ of Zuckerkandl is an important landmark in near total
thyroidectomy
Explanation

Correct Answer is

Option 1 a) Non recurrent laryngeal nerve may occur in 0.5% cases and is
more common on the left side.
more common on right side; ref: stell and marans head and neck.

Question 45:
Leaderhose disease is?

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a) Plantar fibromatosis.
b) Dermatofibrosarcoma protuberans
c) Fibrosarcoma of thigh.
d) Massive DVT of upper extremity.
Explanation

Correct Answer is

Option 1 a) Plantar fibromatosis.

ref: deVita oncology.

Report

Question 46:
Which of the following statements about benign breast diseases is
not true?

a) Mondors disease affects the thoracoepigastric veins.

b) Radial scars of breast may be associated with malignancy and therefore
require incision biopsy for diagnosis.
c) Ductal ectasia may be associated with smoking
d) Fat necrosis of breast carries around 20% malignant potential.
Explanation

Correct Answer is

Option 4 d) Fat necrosis of breast carries around 20% malignant potential.

ref: sabiston pages 838-840.

Report

Question 47:
Most common adverse effect seen in chronic therapy with aromatase
inhibitors in patients with carcinoma breast is?
a) DVT.
b) Osteoporosis.
c) Dyslipidemia.
d) Hypertrophic cardiomyopathy.
Explanation

Correct Answer is

Option 2 b) Osteoporosis.

ref: Schwartzs principles of surgery.

Question 48:
Not a component of the definition of metabolic syndrome?

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a) Serum TAG level > 150 mg/dL.

b) Random glucose level > 100mg/dL.
c) SBP > 130 mmHg.
d) HDL level < 40 mg/dL.
Explanation

Correct Answer is

Option 2 b) Random glucose level > 100mg/dL.

fasting glucose not random; ref: sabiston page 148.

Question 49:
Not true about enteral nutrition?

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a) Nasojejunal feeding is the preferred mode of nutrition in patients with

severe acute pancreatitis.
b) Refeeding syndrome is more common with parenteral nutrition
than enteral nutrition.
c) Janeways method is used for gastrostomy.
d) Modular formulas used for enteral nutrition contain a singular nutrient
as the source of calories.
Explanation

Correct Answer is

Option 2 b) Refeeding syndrome is more common with parenteral

nutrition than enteral nutrition.
more with enteral; ref: sabiston pages 132-135.; shackelford 7th edn.

Report

Question 50:
Calculate the serum osmolality in a patient with serum sodium 130
meq/L, Serum BUN of 40 mg/l and serum glucose of 300 mg/dl.
a) 380 mosm/l.

b) 290 mosm/l
c) 260 mosm/l.
d) 330 mosm/l.
Explanation

Correct Answer is

Option 2 b) 290 mosm/l

2* serum sodium + BUN/2.8 + glucose/18.

Report

Question 51:
Which of the following serum parameters is the best indicator of
oxygen debt?
a) Serum lactate.
b) pH.
c) sPO2.
d) Serum bicarbonate.
Explanation

Correct Answer is

Option 1 a) Serum lactate.

serum lactate; ref: sabiston page 75.

Report

Question 52:
Which of the following anesthetic agents causes redistribution
hypothermia?
a) Ketamine.
b) Propofol.
c) Meperidine.
d) Thiopentone.

Explanation

Correct Answer is

Option 2 b) Propofol.

propofol; ref: sabiston page 288.

Report

Question 53:
Which of the following statements about surgical wounds is correct?

a) Liechtensteins hernioplasty is an example of clean contaminated

wound.
b) Laparoscopic cholecystectomy with bile spillage intraop is an example
of infected wound.
c) The class I wounds have infection rate of around 1-3%.
d) A patient with Hinchey stage IV diverticulitis undergoing surgery is an
example of class III wound.
Explanation

Correct Answer is

Option 3 c) The class I wounds have infection rate of around 1-3%.

ref: sabiston page 226.

Question 54:
False about wound healing is:

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a) Doxorubicin therapy adversely affects wound healing.

b) In patients with obstructive jaundice wound healing is poor due to
inhibition of an oxidase enzyme by bile pigments.
c) Chevrons incision has one of the best wound healing rates.
d) Zinc is an important cofactor for wound healing.
Explanation

Correct Answer is

Option 2 b) In patients with obstructive jaundice wound healing is poor

due to inhibition of an oxidase enzyme by bile pigments.
hydroxylase enzyme not oxidase, inhibited by bile salts not pigments. (ref:
sabiston/ blumgart).

Question 55:
QUORUM guidelines ensure the quality of:

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a) Randomized controlled trials.

b) Cohort studies.
c) Clinical database.
d) Meta-analyses.
Explanation

Correct Answer is

Option 4 d) Meta-analyses.

Quality of Reporting of Meta-analyses. (QUORUM); ref: sabiston page 193.

Question 56:
Which of the following statements is false?

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a) The ANOVA test is used when comparing more than 2 groups with
continuous outcome variable.
b) Kaplan meier analyses is a measurement of time to event such as
survival analyses in cancer patients.
c) The power of a statistical study is determined by the number of false
negative or the beta error.
d) A wide confidence interval in a statistical study is indicative of
minimal uncertainity or high precision.
Explanation

Correct Answer is

Option 4 d) A wide confidence interval in a statistical study is indicative of

minimal uncertainity or high precision.
it indicates low precision; ref: sabiston pages 195-196.

Question 57:
Monocryl suture is a polymer of?

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a) Glycolide and lactide.

b) Glycolide and caprolactone.
c) Polyethylene terephthalate.
d) Polyester.
Explanation

Correct Answer is

Option 2 b) Glycolide and caprolactone.

ref: sabiston page 233.

Report

Question 58:
Most common fungal infection in recipients of renal transplant is?
a) Candida.
b) Cryptococcus.
c) Histoplasma.
d) Blastomyces.
Explanation

Correct Answer is

Option 1 a) Candida.

candida; ref: sabiston page 265.

Report

Question 59:
Bisgaards regimen is used in the management of which of the
following conditions?
a) Chronic venous ulcer.
b) Lymphedema.
c) Varicose veins.
d) Arterial ulcer.
Explanation

Correct Answer is

Option 1 a) Chronic venous ulcer.

Chronic venous ulcer; ref: bailey and love.

Question 60:

Report

Consider the following statements about arteriovenous fistulas:

I. In long standing cases, there occurs dilation of the proximal veins.

II. Cirsoid aneurysm is an AV fistula of internal carotid artery.

III. Caroticocavernous fistulas (CCF) are associated with radiological

dilation of superior ophthalmic vein.
IV. Nicoladonis sign is associated with fall in SBP.
a) a) I and II are true.
b) b) II,III,IV are true.
c) c) I,III, IV are true.
d) All are true.
Explanation

Correct Answer is
ref: sabiston.

Report

Question 61:
Which of the following statements about splenic anatomy is not
true?
a) The splenic milleu is usually acidotic
b) The distributed vascular pattern is the most common pattern in spleen.
c) Spleen develops from the ventral mesogastrium at around 5 weeks
of life.
d) The lienorenal ligament contains the tail of pancreas.
Explanation

Correct Answer is

Option 3 c) Spleen develops from the ventral mesogastrium at around 5

weeks of life.
ref: sabiston page 1548.

Report

Question 62:
Barley water fluid on aspirate is a feature of which of the following
pathologies of scrotum?
a) Spermatocele.
b) Lymphocele.
c) Pyocele.
d) Chylocele.
Explanation

Correct Answer is

Option 1 a) Spermatocele.
spermatocele.

Question 63:
Which of the following is a mismatch about intravenous fluids?

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a) Ringer lactate: fluid of choice in burns.

b) Isolyte G: rich in chloride ions.
c) 0.9% normal saline: contains 154 meq/l of sodium in one vac.
d) Hypertonic saline : used in wound management.
Explanation

Correct Answer is

Option 3 c) 0.9% normal saline: contains 154 meq/l of sodium in one vac.
contains 154 meq in 1 liter not 1 vac.

Report

Question 64:
Trigeminal neuralgia is most commonly associated with abnormality
in which vessel?
a) Anterior cerebral artery.
b) Superior cerebellar artery.
c) Inferior cerebellar artery.
d) Lenticulostriate artery.
Explanation

Correct Answer is

Option 2 b) Superior cerebellar artery.

ref: sabiston page 1904-5.

Question 65:
Supraduodenal artery of Wilkie is most commonly a branch of?

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a) Common hepatic artery.

b) Superior mesenteric artery.
c) Gastroduodenal artery.
d) Right hepatic artery.
Explanation

Correct Answer is

Option 1 a) Common hepatic artery.

ref: sabiston page 1419.

Report

Question 66:
Which of the following agents has been implicated in causing a
picture similar to gallstones (pseudolithiasis)?
a) Ciprofloxacin.
b) Ceftriaxone.
c) Penicillin.
d) Aspirin.
Explanation

Correct Answer is

Option 2 b) Ceftriaxone.

ceftriaxone; ref: blumgart.

Question 67:
Peritoneal mice are?

a) Calcific deposits of saponified fat in acute pancreatitis

b) Talc induced calcified peritoneal granuloma.
c) Necrosed appendices epiploicae.
d) Calcified tubercular mesenteric nodes.

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Explanation

Correct Answer is

Option 3 c) Necrosed appendices epiploicae.

ref: bailey and love.

Question 68:
Not true about internal hernias?

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a) Most common is paraduodenal hernia on the left side.

b) Approximately 75% of the mesocolic hernias occur on the left side.
c) The most common acquired internal hernia is Peterson hernia,
through the roux en y loop.
d) The mesocolic hernia sac should not be opened at the neck to avoid
injury to the superior mesenteric vessels
Explanation

Correct Answer is

Option 3 c) The most common acquired internal hernia is Peterson

hernia, through the roux en y loop.

most common is transverse mesocolic defect (stammers hernia); ref:

shackelford/ Sabiston page 1106.

Question 69:
False statement about laparoscopic inguinal hernia repair

Report

a) The myopectineal orifice is bounded by the coopers ligament medially

and rectus sheath laterally.
b) The aberrant obturator artery uis a branch of the inferior mesenteric
artery.
c) The indirect inguinal hernias develop in the lateral fossa.
d) Both a and b.

Explanation

Correct Answer is

Option 4 d) Both a and b.

both a and b; ref: shackelford pages 583-86.

Question 70:
False statement about dieulafoys lesion?

Report

a) Located primarily along the greater curvature.

b) Anomaly of gastric submucosal vessel.
c) Affects the territory of left gastric artery.
d) Thermal or sclerosant therapy is effective in 80% cases.
Explanation

Correct Answer is

Option 1 a) Located primarily along the greater curvature.

located in the LESSER CURVATURE; ref: sabiston page 1168.

Question 71:
AMBU stands for:

a) Artificial manual breathing unit.

b) Artificial mechanical breathing unit.
c) Auxiliary manual breathing unit.
d) Assisted mechanical breathing unit.
Explanation

Correct Answer is

Option 1 a) Artificial manual breathing unit.

.

Report

Question 72:
False about mediastinal masses:

Report

a) Neurogenic tumors are most commonly present in the posterior

mediastinum.
b) Thymoma with involvement of adjacent organs with no mets is
masaoka stage III.
c) During the surgical removal of dumbbell neural tumor, the intraspinal
part should be removed first.
d) The primary mediastinal goiter derives its main blood supply from
the superior thyroid artery.
Explanation

Correct Answer is

Option 4 d) The primary mediastinal goiter derives its main blood supply
from the superior thyroid artery.
it derives supply from thoracic aorta; ref; sabiston pages 1603-1606.

Report

Question 73:
The thoracic incision providing maximum exposure of operative field
is?
a) Posterolaterlal thoracotomy.
b) Anterolateral thoracotomy.
c) Median sternotomy.
d) Clamshell thoracotomy.
Explanation

Correct Answer is

Option 4 d) Clamshell thoracotomy.

clamshell

Question 74:
False statement about neuroblastoma:

Report

a) Shows spontaneous regression.

b) Hyperdiploidy is associated with favorable prognosis.
c) N myc amplification is associated with a favorable outcome.
d) Stage 4S has a better prognosis than stage 3.
Explanation

Correct Answer is

Option 3 c) N myc amplification is associated with a favorable outcome.

has worse outcome; ref: sabiston pages 1859-1860.

Report

Question 75:
Which of the following perforators does not fall in the Short
saphenous vein territory?
a) Bassis perforator.
b) Leonardos vein.
c) Soleal point perforator.
d) Gastrocnemius point perforator.
Explanation

Correct Answer is

Option 2 b) Leonardos vein.

Leonardos vein; ref: sabiston page 1801.

Question 76:

Report

False about extrahepatic biliary atresia?

a) Most common associated anomaly is preduodenal portal vein.

b) Cytomegalovirus has been implicated in the immunological theory of
pathogenesis.
c) Type 3 atresia is the most common type.
d) GGT levels are one of the earliest liver markers to rise alarmingly in
EHBA.
Explanation

Correct Answer is

Option 1 a) Most common associated anomaly is preduodenal portal vein.

polysplenia is most common anomaly. Ref; sabiston/blumgart.

Report

Question 77:
Pain in acute appendicitis caused by gentle traction on the right
testicle is called?
a) Ronsohoff sign.
b) Tenhorn sign.
c) Danforth sign.
d) Aaron sign.
Explanation

Correct Answer is

Option 2 b) Tenhorn sign.

ref: sabiston page 1147, table 47-1.

Question 78:
Not a component of the Blatchford scoring:
a) Melena.

Report

b) Raised blood urea.

c) Fall in SBP.
d) Elevated PT.
Explanation

Correct Answer is

Option 4 d) Elevated PT.

ref: Schwartz pretest.

Question 79:
Not true about GI hormone:

Report

a) GRP: stimulates release of secretin.

b) Peptide YY: mediates the ileal brake reflex.
c) GIP: released by the K cells.
d) CCK: relaxation of sphincter of Oddi.
Explanation

Correct Answer is

Option 1 a) GRP: stimulates release of secretin.

GRP stimulates release of all hormones except secretin; ref: sabiston page
1235, table 50-3.

Question 80:
True about short chain fatty acids:

Report

a) The primary SCFAs are acetate, propionate and butyrate in 5:1:1 ratio.
b) Acetate mediates cholesterol synthesis.
c) Butyrate is the least important SCFA.
d) About 90% SCFAs are lost in the feces.
Explanation

Correct Answer is

Option 2 b) Acetate mediates cholesterol synthesis.

) ref: sabiston page 1306.

Question 81:
The following statements about LGI bleed are true except:

Report

a) Bleeding from colonic diverticula usually occur at the neck.

b) The most common location for angiodysplasia is the rectosigmoid
junction as it is a watershed zone.
c) Heyde syndrome occurs in association with aortic stenosis.
d) Massive colonic hemorrhage complicates UC more commonly
compared to CD.
Explanation

Correct Answer is

Option 2 b) The most common location for angiodysplasia is the

rectosigmoid junction as it is a watershed zone.

most common site is right/ascending colon/caecum. Ref: sabiston page

1175-76.

Question 82:
Criminal nerve of grassi is a branch of:
a) Posterior vagus nerve.
b) Anterior vagus nerve.
c) Common vagal trunk.
d) Celiac branch of vagus.
Explanation

Correct Answer is

Report

Option 1 a) Posterior vagus nerve.

posterior vagus; ref: sabiston page 1183.

Question 83:
False statement about GI hormonal mediator:

Report

a) The predominant form of somatostatin is somatostatin-14.

b) In patients undergoing Roux en y gastric bypass, the ghrelin levels fall
by about 77%.
c) The major stimulant of neurotensin release in the gut is fat.
d) Elastase cleaves the peptide bonds involving the aromatic amino
acids.
Explanation

Correct Answer is

Option 4 d) Elastase cleaves the peptide bonds involving the aromatic

amino acids.
cleaves the neutral aliphatic AAs. (ref: sabiston page 1232).

Report

Question 84:
The most common neoplasm arising in a meckels diverticulum is:
a) Adenocarcinoma.
b) Carcinoid.
c) Lymphoma.
d) Sarcoma
Explanation

Correct Answer is

Option 2 b) Carcinoid.

carcinoid. (ref: sabiston page 1268-9, shackelford.)

Report

Question 85:
A 23 year old man presents with frequent bouts of pain abdomen and
symptoms of irritable bowel. On ileocolonoscopy there were multiple
areas of narrowing noted affecting the terminal ileum with colon. A
diagnosis of CD was made. As per the Vienna classification it will be
labeled as:
a) A1B1L2.
b) A1B2L4
c) A1B2L3
d) A2B2L3

Explanation

Correct Answer is

Option 3 c) A1B2L3

ref: Vienna classification sabiston page 1247.

Report

Question 86:
Which of the following is not a pathogenic mediator in amoebic
colitis?
a) Cryptidins.
b) Lectin.
c) Cysteine protease.
d) Amoebapore.
Explanation

Correct Answer is

Option 1 a) Cryptidins.

Cryptidins. (ref: blumgart amebic liver abscess).

Question 87:
Not true about duodenal diverticula:

Report

a) More common in males

b) Mostly affects the second part of duodenum.
c) Usually located along the mesenteric border of the bowel.
d) Hemorrhage is usually as a result of erosion through superior
mesenteric artery.
Explanation

Correct Answer is

Option 1 a) More common in males

more common in females. (ref: sabiston page 1265-66.)

Report

Question 88:
Which of the following statements about pneumatosis intestinalis is
true?
a) Most commonly affects the subserosa of ileocolic junction.
b) Males and females have an equal incidence.
c) Usually spares the rectum.
d) Rupture leads to a sterile pneumoperitoneum.
Explanation

Correct Answer is

Option 3 c) Usually spares the rectum.

ref: sabiston page 1272.

Report

Question 89:
All of the following are implicated as predisposing factors for Wilkies
syndrome except:
a) Young asthenic female.
b) Spinal surgery.
c) J pouch ileoanal anastomosis.
d) Angiodysplasia.
Explanation

Correct Answer is

Option 4 d) Angiodysplasia.
ref: sabiston page 1276.

Question 90:
All are true about the vascular anatomy of the gut except:

Report

a) The meandering artery of Moschkowitz connects the distal part of

IMA with the SMA.
b) The ileocolic artery is the most constant branch of SMA.
c) The middle colic artery shows more variability in branching than the
right colic artery.
d) Injury to the SMA proximal to inferior pancreaticoduodenal branch
carries the worst prognosis.
Explanation

Correct Answer is

Option 1 a) The meandering artery of Moschkowitz connects the distal

part of IMA with the SMA.

it connects the proximal parts; arc of riolan connects the distal parts. 9ref;
shackelford).

Question 91:
All are true about the physiology of colonic absorption except:

Report

a) The total absorptive surface area of colon is approximately 900cm2.

b) The stool contains less sodium than the ileal effluent.
c) The most widely expressed water channel for absorption in the colonic
epithelium is the Aquaporin 8.
d) The sodium/proton exchanger is activated in the distal colon and
is unaffected by the effect of aldosterone.
Explanation

Correct Answer is

Option 4 d) The sodium/proton exchanger is activated in the distal colon

and is unaffected by the effect of aldosterone.

it is activated in proximal colon and is under aldosterone control. (ref;

shackelford page 1729.

Question 92:
All are true about large gut volvulus except:

Report

a) Ileosigmoid knotting phenomenon is predisposed by a hypermobile

small bowel with a short redundant sigmoid.
b) The increased incidence of volvulus has been seen in places with high
intake of fibre in the diet.
c) Usually after successful detorsion of the sigmoid volvulus,
recurrences are only seen in about 10% cases.
d) Caecal volvulus has a somewhat higher incidence in females than
males.
Explanation

Correct Answer is

Option 3 c) Usually after successful detorsion of the sigmoid volvulus,

recurrences are only seen in about 10% cases.

recurrences are high, 70% requiring surgery. (ref: sabiston page 1315-6;

shackelford.)

Question 93:
All are true about esophageal anastomosis except

Report

a) The stapled technique has been associated with a lower rate of

strictures and leaks than hand sewn technique in cervical anastomosis.
b) Anastomotic leaks that occur before 48hrs are usually attributed to
graft ischemia due to arterial cause
c) There is no difference in leak rate between hand sewn v/s stapled
technique in intrathoracic anastomosis.
d) The chances of anastomotic site necrosis is less with cervical
anastomosis vis a vis thoracic anastomosis.
Explanation

Correct Answer is

Option 4 d) The chances of anastomotic site necrosis is less with cervical

anastomosis vis a vis thoracic anastomosis.
ref: sabiston page 1063.

Question 94:
False statement about the esophageal anatomy:

Report

a) The allisons membrane usually splits into 3 layers scaffolding

around the lower part of esophagus.
b) The laimers triangle is formed by the triangular area deprived of
musculature on the esophageal wall.
c) The gender differences in esophageal length are usually attributed to
variations in individuals height.
d) The retrosternal route of esophageal conduit is longer than the
posterior medistinal route.
Explanation

Correct Answer is

Option 1 a) The allisons membrane usually splits into 3 layers scaffolding

around the lower part of esophagus.
ref: shackelford pages 9-18.

Question 95:
False statement about the embryology of foregut:

Report

a) The fetus takes its first swallow by the 14th week of gestation.
b) The development of esophagus begins in the 3rd week of gestation.
c) The endodermal and mesodermal development of the gut tube are
under the control of homeobox genes.
d) The primitive esophagus at around 5th week of gestation is lined
by ciliated columnar epithelium.
Explanation

Correct Answer is

Option 4 d) The primitive esophagus at around 5th week of gestation is

lined by ciliated columnar epithelium.
ref: sabiston pages 1013-4.

Question 96:
False statement about the rectal pain syndromes

Report

a) Levator syndrome usually affects left side more commonly.

b) Proctalgia fugax is characteristically devoid of any relevant physical
signs.
c) Spasm of perianal musculature has been implicated in the
pathogenesis of proctalgia fugax.
d) True coccygodynia is not a functional pain syndrome going by the
definition.

Explanation

Correct Answer is

Option 3 c) Spasm of perianal musculature has been implicated in the

pathogenesis of proctalgia fugax.
spasm of rectal musculature not perianal; ref: shackelford page 1936.

Question 97:
False statement about management of hemorrhoids:

Report

a) The morinagas technique is based on closure of the

hemorrhoidal blood supply by interrupting the superior rectal artery.
b) In Transanal hemorrhoidal dearterialisation, suturing of rectal
mucosa is done about 2 cm distal to the dentate line.
c) The longos procedure for grade IV hemorrhoids has been found to be
associated with lesser in hospital stay post op.
d) The fergusson technique of hemorrhoidectomy is a closed method of
hemorrhoidectomy.
Explanation

Correct Answer is

Option 2 b) In Transanal hemorrhoidal dearterialisation, suturing of rectal

mucosa is done about 2 cm distal to the dentate line.
suturing 2-3 cm above the denate line; ref: shackelford pages 1900-3.

Report

Question 98:
The best flap technique for covering the defect after excision of
perianal bowens disease is:
a) Pearl anoplasty.
b) Christensens flap.
a) S-plasty.

d) Martin anoplasty
Explanation

Correct Answer is

Option 3 a) S-plasty.

S plasty; ref: shackelford page 1929-30.

Question 99:
False statement about Endo anal ultrasound:

Report

a) The perineal body thickness is assessed at the level of mid anal canal.
b) The internal anal sphincter is most prominently seen in the distal
anal canal.
c) The external anal sphincter usually appears hyperechoic.
d) In patients with SRUS, the submucosa appears hyperechoic because of
fibrosis
Explanation

Correct Answer is

Option 2 b) The internal anal sphincter is most prominently seen in the

distal anal canal.
shackelford pages 1765-9.

Report

Question 100:
The pickrell procedure of anal encirclage uses which of the following?
a) Silver wire.
b) Bulbocavernosus.
c) Gracilis.
d) Silicone elastomer.
Explanation

Correct Answer is

Option 3 c) Gracilis.

gracilis (ref: shackelford page 1778).

Question 101:
Hyperpigmented macules on glans penis are a feature of:

Report

a) Cronkhite Canada syndrome.

b) Mc kittrick Wheelock syndrome.
c) Cowden syndrome.
d) Banayan Riley Ruvalcaba syndrome.
Explanation

Correct Answer is

Option 4 d) Banayan Riley Ruvalcaba syndrome.

ref: shackelford page 2047.

Report

Question 102:
Rebeccamycin is a novel therapeutic agent used in the management
of:
a) Cholangiocarcinoma.
b) Carcinoma pancreas.
c) HCC.
d) Anal canal carcinoma.
Explanation

Correct Answer is

Option 1 a) Cholangiocarcinoma.
ref: wikipedia.

Report

Question 103:
Which pharmacological agent has been implicated in the prevention
of sinusoidal obstruction syndrome caused by oxaliplatin?
a) Aspirin.
b) Clopidogrel.
c) Dipyridamole.
d) Inchinkoto herb
Explanation

Correct Answer is

Option 1 a) Aspirin.

aspirin (ref: blumgart).

Report

Question 104:
Tunnel of love is an important landmark in which surgical procedure?
a) Miles procedure.
b) LAR
c) Kausch whipples procedure.
d) Freys procedure
Explanation

Correct Answer is

Option 3 c) Kausch whipples procedure.

..

Question 105:

Report

False about Crohns disease of perianal region:

a) Most of the manifestations are painful in nature.

b) Fissures are typical multiple and off-midline
c) Use of infliximab in perianal CD has been associated with higher
incidence of pouchitis post IPAA.
d) Sphincterotomy is the management of choice in crohns related
anal fissure.
Explanation

Correct Answer is

Option 4 d) Sphincterotomy is the management of choice in crohns

related anal fissure.
ref: sabiston pages 1399-1400.

Report

Question 106:
The upper limit of pressure while creating pneumoperitoneum for
lap cholecystectomy is:
a) 10-12 mmHg
b) 12-15 mmHg.
c) 8-10 mmHg.
d) 18-20 mmHg.
Explanation

Correct Answer is

Option 2 b) 12-15 mmHg.

ref: blumgart page 517; 5th edn.

Report

Question 107:
All of the following statements about intrahepatic calculi are false
except:

a) Intrahepatic biliary tract tumors arising in the setting of calculi express

CDX2 but stain negative for MUC2 in most of the cases.
b) There is a higher incidence of intrahepatic calculi in patients with
clonorchis infection as compared to ophisthorcis infection.
c) The intrahepatic calculi mostly arise in the setting of infection and hence
are poor in cholesterol concentration.
d) None of the above.
Explanation

Correct Answer is

Option 4 d) None of the above.

None of the above.

Report

Question 108:
Consider the following statements about IgG4 associated
cholangitis:I. More common in the 25-45 years age group. II. Females
are affected twice as commonly as males. III. Seldom affects any
other organ. IV. Obliterative phlebitis is a characteristic picture in
most of the cases. Which of the above statements is/are true?
a) I and IV.
b) I, II and IV.
c) Only IV.
d) None of the above is true
Explanation

Correct Answer is

Option 3 c) Only IV.

ref: blumgart page 678; 5th edn. Table 43.3.

Question 109:

Report

Arrow head appearance of bile ducts is a cholangiographic finding in:

a) Primary sclerosing cholangitis.
b) Recurrent pyogenic cholangitis
c) Biliary ascariasis.
d)Chronic graft rejection.
Explanation

Correct Answer is

Option 2 b) Recurrent pyogenic cholangitis

ref: blumgart page 681.

Question 110:
Creeping resection strategy is employed in surgical resection of:

Report

a) IPMN.
b) MCN
c) Intrahepatic cholangiocarcinoma.
d) Klatskin tumor
Explanation

Correct Answer is
Option 1 a) IPMN.

ref: shackelford page 1230; 7th edn.

Question 111:
Choose the incorrect statement about pancreatic embryology:

Report

a) The first detectable endocrine cells during pancreatic development are

the glucagon containing cells.
b) Ngn 3 marker is required for endocrine lineage development of the
gland.

c) The suppression of sonic hedgehog promotes dorsal pancreatic

development
d) The B celss form 70% of the core of the pancreatic endocrine cells
are are distributed peripherally in the gland.
Explanation

Correct Answer is

Option 4 d) The B celss form 70% of the core of the pancreatic endocrine
cells are are distributed peripherally in the gland.
ref: shackelford pages 1111-1119, sabiston page 944.

Report

Question 112:
On ERCP in a patient with a 3 weeks old pseudocyst presenting with
severe pain abdomen and features of obstructive jaundice the
following picture was reported: A 6*5 cms pseudocyst in the tail of
pancreas with a single stricture in the pancreatic duct
communicating with the apex of the cyst; rest of the duct and the
gland normal. Based on the above report which Nealons category
does it fall under?
a) Nealon type II.
b) Nealon type IV.
c) Nealon type III.
d) Nealon type VI.
Explanation

Correct Answer is

Option 2 b) Nealon type IV.

Ref: shackelford page 1150.

Question 113:

Report

The normal daily output of bicarbonate rich pancreatic juice is:

a) 1.5 L/day.
b) 2.0 L/day.
c) 2.5 L/day.
d) 0.5 L/day.

Explanation

Correct Answer is

Option 3 c) 2.5 L/day.

ref: shackelford page 1114.

Report

Question 114:
All of the following statements about colorectal NETs are true
except:

a) Colonic NETS are usually more proximal in location and are often large
at the time of diagnosis.
b) Most rectal NETS arise in the mid rectum.
c) Rectal NETs are mostly subserosal in location.
d) Segmental resection forms the mainstay of management in cases of
colonic NETs.
Explanation

Correct Answer is

Option 3 c) Rectal NETs are mostly subserosal in location.

mostly submucosal; ref: shackelford pages 2191-2.

Report

Question 115:
All of the following statements about pancreatic lymphoma are
true except:

a) Primary pancreatic lymphomas are rare malignancies accounting for

<0.5% cases.
b) They are more common in elderly males.
c) A normal leucocyte count is required to establish the diagnosis.
d) The behrns criteria is used for diagnosis and includes a pancreatic
mass in the absence of any lymph nodal enlargement in
peripancreatic area.
Explanation

Correct Answer is

Option 4 d) The behrns criteria is used for diagnosis and includes a

pancreatic mass in the absence of any lymph nodal enlargement in
peripancreatic area.
ref: shackelford page 1272.

Report

Question 116:
The most common primary source for isolated pancreatic metastases
is;
a) Ca lung.
b) Ca GB.
c) RCC.
d) Ca breast.

Explanation

Correct Answer is
Option 3 c) RCC.

ref: shackelford page 1273.

Report

Question 117:
Which of the following toxins does not cause centrilobular hepatic
necrosis?
a) Yellow phosphorus.
b) Amanita mushroom.
c) Carbon tetrachloride.
d) Valproate.
Explanation

Correct Answer is

Option 1 a) Yellow phosphorus.

ref: shacelford pages 1553-4.

Question 118:
The
most
common
chemoembolisation is:

sole

agent

used

in

Report

transarterial

a) FUDR.
b) Doxorubicin.
c) Methotrexate.
d) 5-FU.
Explanation

Correct Answer is

Option 2 b) Doxorubicin.
ref: blumgart page 1345.

Report

Question 119:
The PRETEXT staging is used in which of the following malignancies?
a) HCC.

b) HCC in children.
c) Hepatoblastoma.
d) Hepatic lymphoma.
Explanation

Correct Answer is

Option 3 c) Hepatoblastoma.
ref: blumgart page 1332.

Report

Question 120:
Which of the following statements most correctly describes Von
Myenburg complexes?
a) The incidence is about 30% in autopsied specimen.
b) They are commonly precursors of cholangiocarcinoma and hence need
special attention.
c) They represent hamartomas and are not connected with the
biliary tree
d) They represent aberrant remodeling of the hepatocytes and sinusoids.
Explanation

Correct Answer is

Option 3 c) They represent hamartomas and are not connected with the
biliary tree
ref: blumgart pages 1243-4.

Report

Question 121:
The least common genetic variant of hepatocellular adenoma is:
a)Beta catenin mutated.
b) HNF 1 alpha mutated.
c) MODY 3 associated

d) Telangiectatic variant.
Explanation

Correct Answer is

Option 1 a)Beta catenin mutated.

ref: blumgart 1236.

Question 122:
Choose the correct statement about HCC:

Report

a) The clear cell variant of HCC is usually associated with

hypercholesterolemia
b) The fibrolamellar variant are well defined and well encapsulated and
hence have the best prognosis.
c) The sclerosing variant of HCC usually affects the younger age group.
d) The nodular pattern of HCC is tyicalseen in patients with no cirrhosis.
Explanation

Correct Answer is

Option 1 a) The clear cell variant of HCC is usually associated with

hypercholesterolemia
ref: blumgart pages 1224-1228.

Report

Question 123:
The ablation modality for HCC least susceptible to heat and curret
sinking effects is:
a) Laser interstitial thermotherapy.
b) Irreversible electroporation.
c) HIFU.
d) Microwave ablation.

Explanation

Correct Answer is

Option 2 b) Irreversible electroporation.

ref: blumgart page 1415-6.

Report

Question 124:
The following statements about desmoid tumor are true except:

a) There has been a positive association found between desmoids tumor

and OCP intake.
b) The tumor appears homogenous and isointense compared with muscle
on T1 weighted imaging and on T2 weighted scans it appears slightly less
intense than fat.
c) The tumor stains positive for vimentin and negative for beta
catenin.
d) On histology, the centre of the tumor is acellular compared to the
periphery which contains most of the fibroblasts.
Explanation

Correct Answer is

Option 3 c) The tumor stains positive for vimentin and negative for beta
catenin.
positive for both vimentin and beta catenin; ref: sabiston page 1095.

Question 125:
Tillauxs triad is mentioned in reference to:
a) Omental cyst.
b) Slerosing mesenteritis.
c) Rectus sheath hematoma.
d) Mesenteric cyst.

Report

Explanation

Correct Answer is

Option 4 d) Mesenteric cyst.

mesenteric cysts.

Report

Question 126:
All of the following form boundaries of the grynfelts triangle except:
a) Serratus posterior inferior.
b) Quadrates lumborum.
c) Latissimus dorsi.
d) Internal oblique.
Explanation

Correct Answer is

Option 3 c) Latissimus dorsi.

ref: shackelford page 613.

Report

Question 127:
Ghrelin shows structural homology with which of the following
hormones?
a) Motilin.
b) Leptin.
c) Cholecystokinin.
d) Secretin.
Explanation

Correct Answer is

Option 1 a) Motilin.

motilin; ref: shackelford page 646

Report

Question 128:
A 25 year old male presents to the casualty with a history of being
stabbed in an altercation 2 hrs back. On examination his BP was
recorded to be 90 mm Hg systolic with pulse rate of 123/min. The
abdomen was tense and showed active signs of peritonitis. On
exploratory laparotomy, there was a laceration noted in the cardia of
the stomach, about 4 cm in size. Rest of the stomach and the gut was
healthy. As per the AAST grading what is the grade of injury?
a) Garde II
b) Grade IV.
c) Grade III.
d) Grade I.

Explanation

Correct Answer is

Option 1 a) Garde II

ref: shackelford table 54-1, page 680.

Report

Question 129:
Which of the following is a method of managing a difficult duodenal
stump?
a) Csendes repair.
b) Polyas repair.
c) Hill-baker repai.
d) Bancrofts repair.
Explanation

Correct Answer is

Option 4 d) Bancrofts repair.

ref: mastery of surgery.

Question 130:
Gambee suture is:

Report

a) Interrupted single layer inverted full thickness.

b) Continuous single layer full thickness.
c) Interrupted single layer seromuscular
d) Interrupted single layer mucosa only.
Explanation

Correct Answer is

Option 1 a) Interrupted single layer inverted full thickness.

ref: shackelford page 922-3.

Report

Question 131:
Valtrac sutureless anastomosis ring has been devised as a
biofragmentable device for sutureless intestinal anastomosis. The
device has 2 rings composed of:
a) Dexon and barium sulphate.
b) Prolene and dexon.
c) Fibrinogen and prolene.
d) Dexon and polyglactin.
Explanation

Correct Answer is

Option 1 a) Dexon and barium sulphate.

ref: shackelford page 927.

Report

Question 132:
A 30 year olf man presented to the casualty with a history of blunt
trauma abdomen by impact against the seatbelt on a RTA. On
exploratory laparotomy, the bowel showed evidence of gangrene
affecting the whole of jejunum and ileum with patches of gangrene
extending upto the proximal 2-3 cm of ascending colon. The rest of
the large bowel and duodenum was normal. There were pulsations
palpable in the root of mesentery. True statement is:
a) SMA trauma Fullen zone I.
b) SMA trauma Fullen zone III.
c) SMA trauma fullen zone II.
d) SMA trauma fullen zone IV.
Explanation

Correct Answer is

Option 2 b) SMA trauma Fullen zone III.

ref: shackelford page 962.

Question 133:
Taylor repair for peptic ulcer disease is:

a) Posterior TV alone.
b) Posterior TV with anterior HSV.
c) Posterior TV with anterior lesser curve seromyotomy.
d) Supradiaphragmatic TV.
Explanation

Correct Answer is

Option 3 c) Posterior TV with anterior lesser curve seromyotomy.

ref: shackelford page 704

Report

Report

Question 134:
Aprepitant is a novel antiemetic drug used mainly in chemotherapy
induced vomiting. It acts by:
a) Substance P agonist.
b) Kallikrein receptor inhibition
c) Neurokinin-1 receptor antagonist.
d) 5-HT4 agonist.
Explanation

Correct Answer is

Option 3 c) Neurokinin-1 receptor antagonist.

ref: shackelford page 782

Report

Question 135:
All of the following statements about enteric duplications are true
except:
a) Mostly are found along the antimesenteric side of ileum.
b) May be saccular or tubular in morphology.
c) Most of the patients are diagnosed in the first year of life.
d) They may be located in subserosal or intermuscular layers of the
Explanation

Correct Answer is

Option 1 a) Mostly are found along the antimesenteric side of ileum.

ref: shackelford page 809.

Question 136:

Report

False statement about gastric volvulus is:

a) Most of the cases are organoaxial, usually secondary to diaphragmatic

hernia
b) Primary gastric volvulus may be associated with splenic abnormalities
c) The classification of gastric volvulus into 2 types was stated by
Borchardt.
d) Acute gastric volvulus presents with the Borchardt triad in 70% cases.
Explanation

Correct Answer is

Option 3 c) The classification of gastric volvulus into 2 types was stated by

Borchardt.
ref: shackelford page 876-7.

Question 137:
True statements about hepatic artery aneurysm are all except:

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a) More common in young females.

b) Most of the cases are pseudoaneurysm in the present era.
c) Frank rupture may occur in 10-30% cases
d) Extrahepatic aneurysms are more likely to be degenerative secondary
to atherosclerotic changes.
Explanation

Correct Answer is

Option 1 a) More common in young females.

ref: shackelford pages 1100-1.

Report

Question 138:
Investigation of choice for diagnosis of Mesenteric venous
thrombosis is:

a) CECT scan
b) MRI.
c) Duplex scan.d) Angiography.
Explanation

Correct Answer is

Option 1 a) CECT scan

ref; shackelford pages 1082-3.

Report

Question 139:
On a bowel contrast study done in view of suspected small bowel
atresia, it was found that there was atresia of the mid jejunum with
proximal dilatation and the distal atretic segment was separated
from the proximal segment by a large V shaped gap in the
mesentery. What type of atresia it is as per the Louw classification?
a) Type IIIa.
b) Type IV.
c) Type IIIb.
d) Type II.

Explanation

Correct Answer is

Option 1 a) Type IIIa.

ref: shackelford page 1050.

Report

Question 140:
SOX 11 is a new immunohistochemical marker used in the diagnosis
of:
a) Enteropathy T cell lymphoma
b) Burkitt lymphoma

c) Mantle cell lymphoma

d) Marginal zone lymphoma.
Explanation

Correct Answer is

Option 3 c) Mantle cell lymphoma

ref: shackelford page 1038

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Question 141:
The following esophageal pathology presents with severe chest pain
and dysphagia with multiple peaks on esophageal motility study and
a distal contractile integral to the tune of 8000-9000 mm Hg-s-cm:
a) Nutcracker esophagus.
b) Jackhammer esophagus
c) Type III achalasia.
d) Diffuse esophageal spasm.
Explanation

Correct Answer is

Option 2 b) Jackhammer esophagus

ref: shackelford page 140.

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Question 142:
The type of achalasia cardia showing best response to therapy is:
a) Type I.
b) Type II.
a) Type III.
d) All show equal response
Explanation

Correct Answer is

Option 2 b) Type II.

ref: shackelford page 351.

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Question 143:
According to the Gross classification of TEF, the type that has to be
approached by the cervical incision is:
a) Type A
b) Type B.
c) Type D
d) Type E.

Explanation

Correct Answer is

Option 4 d) Type E.

ref; shackelford page 511.

Report

Question 144:
The shoe shine maneuver is an intraoperative maneuver used in:
a) Laparoscopic sleeve gastrectomy.
b) Laparoscopic Nissens fundoplication.
c) Laparoscopic Roux en Y gastric bypass.
d) Laparoscopic hellers myotomy.
Explanation

Correct Answer is

Option 2 b) Laparoscopic Nissens fundoplication.

ref; shackelford page 231

Question 145:
False statement about esophageal carcinogenesis is:

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a) BMP-4 is involved in metaplasia of squammous to cardiac mucosa.

b) The intestinal metaplasia when present, is always located at the top of
the neosquammocolumnar junction
c) Exposure to a pH of 3-5 promotes oxyntocardiac mucosa
development and is relatively protective against carcinogenesis.
d) Cdx-2 gene mediates intestinal metaplasia and poses a high risk for
carcinoma development
Explanation

Correct Answer is

Option 3 c) Exposure to a pH of 3-5 promotes oxyntocardiac mucosa

development and is relatively protective against carcinogenesis.
ref: shackelford pages 288-9.

Report

Question 146:
All of the following are eligible candidates for EMR for esophageal
cancer, except:
a) Lesion 1 cm in size.
b) No lymph nodal involvement
c) Polypoid lesion with evidence of ulceration on the apex.
d) Well differentiated histology.
Explanation

Correct Answer is

Option 3 c) Polypoid lesion with evidence of ulceration on the apex.

ref: shackelford page 302.

Report

Question 147:
The local ablative therapy used for barrets esophagus that carries
the maximum risk of metaplastic changes hidden beneath the
normal appearing epithelium is:
a) Ps-PDT.
b) ALA-PDT
c) SRER.
d) EMR.

Explanation

Correct Answer is

Option 1 a) Ps-PDT.

ref: shackelford page 314.

Report

Question 148:
Following statements are true about myogenic dysphagia except:

a) Mostly seen in oculopharyngeal form of muscular dystrophy.

b) There is overactivity of pharyngeal muscles, which showed
irregular peaks.
c) Nocturnal bronchorrhea often wakes up the patient at night.
d) Shows a good response to cricopharyngeal myotomy.
Explanation

Correct Answer is

Option 2 b) There is overactivity of pharyngeal muscles, which showed

irregular peaks.
ref; shackelford pages 329-33

Report

Question 149:
The most common genomic event in esophageal carcinogenesis is:
a) Chromosome 8q amplification
b) KRAS mutation.
c) P16INK4A inactivation.
d) PTEN activation.
Explanation

Correct Answer is

Option 1 a) Chromosome 8q amplification

ref: shackelford page 388.

Question 150:
False statement about esophageal diverticula:

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a) Killian-Jameisson diverticula are located below the cricopharyngeus and

are lateral in location.
b) Most traction diverticula arise within 4-5 cm proximal or distal to the
carina.
c) Epiphrenic diverticula are false diverticula and have a predilection
to involve the region around 5 cm distal to the carina.
d) The techinique of dividing the zenkers diverticulum septum using laser
technology was introduced by Van overbeek.
Explanation

Correct Answer is

Option 3 c) Epiphrenic diverticula are false diverticula and have a

predilection to involve the region around 5 cm distal to the carina.
involves the distal 10 cm of esophagus. Ref: shackelford pages 363-72.

Report

Question 151:
Consider the following risk factorsI. High carbohydrate diet. II.
NSAIDs. III. Obesity. IV. Scleroderma. V. H. pylori.
a) I and V are protective against adenocarcinoma of esophagus
b) I and III are protective against SCC esophagus.
c) III, IV and V are high risk factors for adenocarcinoma esophagus.
d) All are high risk factors for SCC esophagus.
Explanation

Correct Answer is

Option 2 b) I and III are protective against SCC esophagus.

ref: shackelford pages 377-8.

Question 152:
Endoscopic study results are normal in case of:

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a) Vigorous achalasia.
b) DES.
c) Achalasia type I.
d)Nutcracker esophagus.
Explanation

Correct Answer is

Option 1 a) Vigorous achalasia.

ref: sabiston page 1026, table 43-2.

Question 153:
The most common location of congenital esophageal cysts is:

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a) Upper 1/3rd
b) Lower 2/3rd.
c) Middle 1/3rd.
d) Equally distributed.
Explanation

Correct Answer is

Option 1 a) Upper 1/3rd

ref: sabiston page 1048.

Report

Question 154:
All of the following statements about liver fibrosis are true except:

a) Ethanol induced fibrosis takes place by activation of kupffer cells

through TLRs.
b) The hepatic stellate cells (HSCs) act as storehouse of vitamin A and stain
positive for GFAP in a quiescent liver.
c) In fibrogenesis, the collagen type I in space of disse is progressively
replaced by collagen type IV.
d) The French METAVIR scoring is the most widely used scoring system for
hepatic fibrosis worldwide.
Explanation

Correct Answer is

Option 3 c) In fibrogenesis, the collagen type I in space of disse is

progressively replaced by collagen type IV.
type IV replaced by type types I and III. Ref: blumgart pages 102-8.

Report

Question 155:
The ability of hepatic artery to respond acutely to changes in portal
flow is called the hepatic arterial buffer response. What is the
proposed mediator of this response?
a) Accumulation of substance P.
b) Accumulation of adenosine.
c)Decrease in pH.
d) Calcium accumulation in sinusoids.
Explanation

Correct Answer is

Option 2 b) Accumulation of adenosine.

ref: blumgart page 75.

Question 156:
All of the following are scoring systems for liver fibrosis except:

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a) Ishak-Knodell.
b) APRI.
c) SHASTA.
d) Littles scoring
Explanation

Correct Answer is

Option 4 d) Littles scoring

it is for cholangitis; ref: blumgart page 108.

Report

Question 157:
What is the preferred site of placement of HAI pump in a patient with
HCC in the Right lobe with an aberrant right hepatic artery?

a) Gastroduodenal artery.
b) Common hepatic artery.
c) Left hepatic artery.
d) Superior mesenteric artery.
Explanation

Correct Answer is

Option 1 a) Gastroduodenal artery.

ref: blumgart page 1423.

Report

Question 158:
All of the following are correct about the Belghitis maneuver except:

a) The most pivotal step in this maneuver is defining the anterior plane of
the IVC.
b) The upper surface of the liver is exposed up to the anterior surface of
suprahepatic IVC.
c) The maneuver has been proposed for left and extended left
hepatectomies.
d) The veins draining the caudate process are also ligated while
mobilization.
Explanation

Correct Answer is

Option 3 c) The maneuver has been proposed for left and extended left
hepatectomies.
ref: blumgart page 1487.

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Question 159:
Laparoscopic hepatic resection can be undertaken in the following
cases except:

a) Tumor located in segment VII.

b) Location in segment II.
c) Cystic lesion 4 cm in segment IV.
d) Benign lesion 5 cm in segment II about 2 cm from the major vessels.
Explanation

Correct Answer is

Option 1 a) Tumor located in segment VII.

ref: blumgart page 1530; table 90E.1.

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Question 160:
The following hemodynamic changes are observed in a patient with
hepatic vascular exclusion except:
a) Severe decrease in cardiac preload.
b) 10% decrease in MAP.
c) Decrease in systemic vascular resistance.
d) 25% decrease in pulmonary artery pressure.
Explanation

Correct Answer is

Option 3 c) Decrease in systemic vascular resistance.

ref: blumgart page 1545.

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Question 161:
Not included in the Kings College hospital criteria for nonacetaminophen induced FHF:
a) Serum bilirubin >300 micromol/L.
b) Age <10 years.
c) Halothane induced FHF.
d) Jaundice to encephalopathy time <7 days.

Explanation

Correct Answer is

Option 4 d) Jaundice to encephalopathy time <7 days.

ref: blumgart page 1694.

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Question 162:
Which of the following condition shows recurrence following liver
transplantation:
a) Galactosemia.
b) Byler disease.
c) Niemann-pick disease.
d) Erythropoietic protoporphyria.
Explanation

Correct Answer is

Option 4 d) Erythropoietic protoporphyria.

ref: blumgart pages 1666-7.

Report

Question 163:
All of the following statements about vascular complications post
liver transplant are true except:
a) Doppler US is the best screening method for HAT and may be used
liberally after 2 weeks of transplant.
b) Sirolimus therapy has a positive association with development of HAT in
the pediatric liver transplants
c) PVT observed several years post transplant usually results in formation
of cavernomatous collaterals.
d) HAT very rarely presents with biliary complications
Explanation

Correct Answer is

Option 4 d) HAT very rarely presents with biliary complications

ref: blumgart pages 1788-9.

Question 164:
Which of the following is not a component of the PELD score?

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a) Serum creatinine
b) Serum bilirubin.
c) INR.
d) Serum albumin.
Explanation

Correct Answer is

Option 1 a) Serum creatinine

ref: Blumgart page 1756.

Report

Question 165:
The most predictive finding on endoscopic ultrasound done for
chronic pancreatitis is:
a) Honeycombing lobularity.
b) Irregular main pancreatic duct contour
c) Main pancreatic duct calculi.
d) Pancreatic duct dilation> 3.5 mm in the body.
Explanation

Correct Answer is

Option 3 c) Main pancreatic duct calculi.

ref: sabiston page 1529; box 56-4.

Question 166:
The correct sequence
carcinogenesis is:

of

molecular

pathway

of

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pancreatic

a) K ras->DPC4-->CDKN2A.
b) Kras->CDKN2A-->p53.
c) P53-->Kras-->CDKN2A.
d) Kras->MYC-->PTEN.
Explanation

Correct Answer is

Option 2 b) Kras->CDKN2A-->p53.

ref: sabiston page 1537, fig. 56-21.

Question 167:
The first laparoscopic pancreatoduodenectomy is credited to:

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a) Lortat-Jacob.
b) Kendrick- Cusati.
c) Gagney-Pomp.
d) Palanivelu.
Explanation

Correct Answer is

Option 3 c) Gagney-Pomp.
ref: sabiston page 1542.

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Question 168:
Following are the metabolic risk factors for development of acute
pancreatitis except:
a) Hypercalcemia.
b) Hyperparathyroidism.
c) Type III hyperlipidemia.
d) Type II hyperlipidemia.
Explanation

Correct Answer is

Option 3 c) Type III hyperlipidemia.

ref: sabiston page 1521.

Report

Question 169:
Accessory Gall bladder appearance on cholangiography is a feature
of:
a) Type III choledochal cyst.
b) Forme fruste type choledochal cyst.
c)Type VI choledochal cyst.
d) Type II choledochal cyst.
Explanation

Correct Answer is

Option 4 d) Type II choledochal cyst.

.

Question 170:
The middle hepatic artery in adults is usually a branch of:
a) Celiac trunk.

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b) Common hepatic artery.

c) Left hepatic artery.
d) Right hepatic artery.
Explanation

Correct Answer is

Option 3 c) Left hepatic artery.

ref: sabiston page 1419.

Question 171:
Goodsalls ligature surgery is done for:

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a) Fistula in ano.
b) Hemorrhoids.
c) Rectal prolapse.
d) Fissure in ano.
Explanation

Correct Answer is

Option 1 a) Fistula in ano.

fistula in ano.

Report

Question 172:
The most common cause of mortality in recipients of pancreas
transplant is:
a) Cardiovascular disease.
b) Graft leak.
c) Infection.
d) Graft vein thrombosis.
Explanation

Correct Answer is

Option 1 a) Cardiovascular disease.

ref: sabiston page 679.

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Question 173:
Which of the following biochemical markers has been studied on
experimental basis as a potential marker of intestinal function in
short gut syndrome?
a) Serum ornithine.
b) Serum arginine.
c) Serum calprotectin.
d) Serum conitine
Explanation

Correct Answer is

Option 3 c) Serum calprotectin.

serum calprotectin; ref: sabiston page 686.

Report

Question 174:
The most common indication for undergoing small bowel transplant
in pediatric age group based on the epidemiological data is:
a) Gastroschisis.
b) Necrotizing eneterocolitis.
c) Midgut volvulus.
d) Jejunoileal atresia.
Explanation

Correct Answer is

Option 1 a) Gastroschisis.

ref: sabiston page 683.

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Question 175:
All of the following statements are true about Transplant of human
organs act except:

a) Given in 1994 and underwent amendment in 2008.

b) It has been amended to include organs and tissues but not blood.
c) The term near relatives has been expanded to include the
grandparents, uncles and aunts in the amended act.
d) The treating medical staff and ICU care staff are not entitled to
request the relatives of the dead for the provision of organ donation.
Explanation

Correct Answer is

Option 4 d) The treating medical staff and ICU care staff are not entitled
to request the relatives of the dead for the provision of organ donation.
ref: transplant of human organs act (amended) online.

Question 176:
Not true about HNPCC is:

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a) Autosomal dominant condition, accounting for about 2% of all

colorectal cancers.
b) The earliest description given by Aldred Warthin in 1913.
c) Subset of patients who have positive gene mutation but do not
meet the Amsterdam criteria are labeled as familial cancer type X.
d) The first two MMR genes identified in HNPCC were MSH2 and MLH1.
Explanation

Correct Answer is

Option 3 c) Subset of patients who have positive gene mutation but do

not meet the Amsterdam criteria are labeled as familial cancer type X.
shackelford pages 2041-2.

Report

Question 177:
All of the following statements about juvenile polyposis syndrome
are correct except:

a) The polyps in JPS appear at an earlier age than in cases with

solitary juvenile polyp alone.
b) Juvenile polyposis of infancy is characterized by protein losing
eneteropathy.
c) In patients with SMAD4 mutation there may be association with
Hereditary hemorrhagic telangiectasia.
d)Screening colonoscopy should begin by the age of 15-18 years.
Explanation

Correct Answer is

Option 1 a) The polyps in JPS appear at an earlier age than in cases with
solitary juvenile polyp alone.
ref: shackelford page 2045.

Report

Question 178:
All of the following statements about cowden syndrome are true
except:

a) Mutation of PTEN gene, chromosome 10q.

b) As per the NCCN criteria, neurological involvement in the form of
Lhermite Duclos syndrome comes under minor criteria of diagnosis.
c) Males with cowden syndrome have an increased risk of developing
Carcinoma breast.
d) Colorectal cancer falls under the minor diagnostic criteria of cowden
syndrome.

Explanation

Correct Answer is

Option 2 b) As per the NCCN criteria, neurological involvement in the

form of Lhermite Duclos syndrome comes under minor criteria of
diagnosis.
it is major criteria; ref: Schwartz pretest; shackelford pages 2046-7.

Question 179:
The most common extraintestinal manifestation of FAP is:

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a) Desmoid tumor.
b) Thyroid cancer.
c) CHRPE.
d) CNS tumor.
Explanation

Correct Answer is

Option 3 c) CHRPE.

shackelford page 2035.

Question 180:
Reverse 3 sign on Barium enema is a feature seen in:
a) Acute appendicitis.
b) Ileocaecal TB.
c) Caecal diverticula.
d) Carcinoma head of the pancreas.
Explanation

Correct Answer is

Option 1 a) Acute appendicitis.

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ref: shackelford page 2021.

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Question 181:
A patient who presented with history of pain abdomen and altered
stools for last 3 mths was found to have multiple strictures all >5 cm
length spanning over a length of 150-200 cm distal to DJ flexure on
exploratory laparotomy done in view of acute intestinal obstruction.
The surgeon took the decision of preserving the bowel since the
contamination was minimal and hence thought of stricturoplasty.
Which of the following would be the best method in this case?
a) Judd stricturoplasty.
b) Moskel- Neumayer stricturoplasty.
c) Michelassi stricturoplasty.
d) Jaboulays stricturoplasty.
Explanation

Correct Answer is

Option 3 c) Michelassi stricturoplasty.

ref: shackelford page 895.

Question 182:
All of the following statements about IPAA are true except:

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a) To achieve an adequate length of the pouch without undue

tension on the mesentery, the middle colic artery may be divided
close to the origin from SMA.
b) The anastomosis is fashioned between the apex of the ileal pouch and
the anal dentate line.
c) The S pouch was the earliest pouch described.
d) In cases of inability to mobilize the ileal pouch adequately, saphenous
vein may be used as an interposition graft to the SMA.

Explanation

Correct Answer is

Option 1 a) To achieve an adequate length of the pouch without undue

tension on the mesentery, the middle colic artery may be divided close to
the origin from SMA.
ref: sabiston page 1327-8.

Question 183:
All are true about Post IPAA pouchitis except:

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a) The Pouchitis disease activity index incorporates recatl bleeding

and stool urgerncy as two of its important criteria.
b) The incidence of Pouchitis varies between 11-34%.
c) Extraintestinal manifestations similar to those seen in IBD may be
present.
d) The mainstay of management is medical therapy in the form of
steroids and immunosuppressants.
Explanation

Correct Answer is

Option 4 d) The mainstay of management is medical therapy in the form

of steroids and immunosuppressants.
ref: shackelford page 1995-7.

Report

Question 184:
Which of the following scenarios would not be a contraindication to
resection of locally recurrent rectal cancer?
a) Patient giving a history of sciatica.
b) Presenting with bilateral hydronephrosis
c) ASA grade III.

d) Bony involvement of S3-4.

Explanation

Correct Answer is

Option 4 d) Bony involvement of S3-4.

ref: shackelford page 2140, box 170-3

Question 185:
All are true about colorectal lymphoma except:

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a) Caecum is one of the most common sites.

b) T-cell histology predominates in countries like Taiwan and china.
c) Affects females of elderly age group twice as commonly as males.
d) Prognosis worse than that of gastric and small gut lymphoma.
Explanation

Correct Answer is

Option 3 c) Affects females of elderly age group twice as commonly as

males.
shackelford page 2192-3.

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Question 186:
As per the RTOG garding of radiation enteritis, small bowel
perforation secondary to radiation necrosis falls under which grade?
a) Grade 4
b) Grade 5
c) Grade 2
d) Grade 3.

Explanation

Correct Answer is

Option 1 a) Grade 4

ref: shackelford page 988, table 78-1.

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Question 187:
All of the following have been clinically accepted as agents for
radioprotection except:
a) Glutamine.
b) Pentoxifylline.
c) Sucralfate.
d) WR-2771.
Explanation

Correct Answer is

Option 1 a) Glutamine.

ref: shackelford page 995; table 78-2.

Question 188:
All of the following statements about GIST are true except:

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a) The GISTs in Carneys triad are usually C-Kit negative.

b) Most of the pediatric GISTs are CD117 positive but very few actually
harbor C-kit mutation.
c) Type III tumors are located in the antropyloric region and are best
approached by laparoscopic distal gastrectomy.
d) The most common site of genetic mutation of KIT involves the exon 11
in juxtamembrane domain.
Explanation

Correct Answer is

Option 3 c) Type III tumors are located in the antropyloric region and are
best approached by laparoscopic distal gastrectomy.

ref: shackelford pages 1029-34.

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Question 189:
Following points are true about the anatomy of small gut except:

a) Jejunum has thicker and heavier walls than ileum.

b) Ileal mesentery has more fat reservoir than the jejuna mesentery.
c) The ileal mesentery has shorter vas recta with many short loops than
the jejunal mesentery.
d) There are approximately 4-6 jejunal and 12-14 ileal branches
originating from the right side of the SMA to supply the jejunum and
the ileum respectively.
Explanation

Correct Answer is

Option 4 d) There are approximately 4-6 jejunal and 12-14 ileal branches
originating from the right side of the SMA to supply the jejunum and the
ileum respectively.
left side not right sideref: shackelford pages 1067-71; figure 84-8.

Question 190:
All are true about chronic mesenteric ischemia except:

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a) Females are affected more than males by a ratio of 3:1.

b) On a long run, the patients develop sitophobia and may present with
loss of weight.
c) The Darmouth criteria on duplex velocity scan assesses the end
diastolic velocity, with a value of >55 cm/sec in Coeliac artery and >45
cm/sec in SMA corresponding to >50% stenosis.
d) The evolution of symptoms in CMI is typically rapid and explosive
(over a few days).
Explanation

Correct Answer is

Option 4 d) The evolution of symptoms in CMI is typically rapid and

explosive (over a few days).
ref: shackelford pages 1084-5.

Question 191:
All of the following statements about CHPS are true except:

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a) Pyloric stenosis typically occurs between 2nd and 8th week of life
affecting the male child more than the female.
b) No genetic association or abnormality has been noted with CHPS.
c) Association with H.pylori infection has been noted.
d) On clinical examination, peristaltic waves may be seen passing from left
to right side of the abdomen.
Explanation

Correct Answer is

Option 2 b) No genetic association or abnormality has been noted with

CHPS.
ref: shackelford page 815.

Question 192:
Sugarbaker operation is done for:
a) Sciatic hernia.
b) Lumbar hernia.
c) Parastomal hernia.
d) Obturator hernia.
Explanation

Correct Answer is

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Option 3 c) Parastomal hernia.

ref: sabiston page 1138

Question 193:
Camerons ulcers are seen in:

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a) Antropyloric region.
b) Greater curvature.
c) Lesser curvature.
d) Cardia.
Explanation

Correct Answer is

Option 3 c) Lesser curvature.

ref: shackelford page 497.

Question 194:
All are true about pancreatic transplantation except:

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a) Need for insulin therapy or hyperglycemia in the donor at the time

of organ procurement is an absolute contraindication.
b) Since the procured pancreas is more sensitive to warm injury, it should
be well flushed with preservative to eliminate blood.
c) During dissection of the organ from the donor, it is important to avoid
breeching the pancreatic capsule at all cost.
d) The preferable cold ischemia time for the gland is <12 hours
Explanation

Correct Answer is

Option 1 a) Need for insulin therapy or hyperglycemia in the donor at the

time of organ procurement is an absolute contraindication.

ref: shackelford page 1253.

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Question 195:
Which of the following prognostic modalities has a value if done
within 24 hours of admission in a case of acute pancreatitis?
a) BISAP.
b) CRP.
c)Imrie.
d) Ranson.

Explanation

Correct Answer is
Option 1 a) BISAP.

ref: shackelford page 1124.

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Question 196:
Not a component of the Sugiura procedure for portal hypertension:
a) Splenectomy.
b) Pyloroplasty.
c) Vagotomy.
d) Proximal gastrectomy.
Explanation

Correct Answer is

Option 4 d) Proximal gastrectomy.

ref: Blumgart pages 1141-2.

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Question 197:
In all of the following conditions the normal relationship of portal
triad to the central hepatic venule is disrupted except:
a) Primary biliary cirrhosis.
b) Alcoholic cirrhosis.
c)Wilsons disease.
d) Hereditary hemochromatosis.
Explanation

Correct Answer is

Option 1 a) Primary biliary cirrhosis.

ref; Blumgart page 1081

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Question 198:
Plasminogen activator inhibitor levels have found usefulness as a
diagnostic marker in cases of:
a) Budd-Chiari syndrome.
b) Veno-occlusive disease.
c) Membranous obstruction of IVC.
d) Myeloproliferative disease.
Explanation

Correct Answer is

Option 2 b) Veno-occlusive disease.

ref: Blumgart page 1199.

Question 199:

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FNH like lesions are seen in all of the following conditions except:
a) Budd- Chiari syndrome.
b) Hereditary hemorrhagic telangiectasia.
c) Congenital hepatic fibrosis.
d) Nodular regenerative hyperplasia.
Explanation

Correct Answer is

Option 4 d) Nodular regenerative hyperplasia.

ref: Blumgart page 1267.

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Question 200:
As per the Japanese classification of gastric carcinoma,
retropancreatic group of lymph nodes correspond to which LN
station?
a) 10.
b) 11.
c) 13.
d) 15.

Explanation

Correct Answer is
Option 3 c) 13.

ref: sabiston page 1210; table 49-6.

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