Pg Blazer - Online Test Series 16 - Surgery

1. Prognosis in head injury is best given by

Glasgow coma scale

Age of patient

Mode of injury

CT head

The Glasgow Coma Scale is the best predictor of prognosis in head injury. This scale assesses the patient's level of consciousness based on eye opening, verbal response, and motor response. It provides a numerical score that correlates with the severity of the injury and helps to determine the likelihood of recovery and long-term outcomes. Age of the patient, mode of injury, and CT head may provide additional information, but the Glasgow Coma Scale is considered the most reliable and widely used tool for assessing prognosis in head injury cases.

Explanation

The Glasgow Coma Scale is the best predictor of prognosis in head injury. This scale assesses the patient's level of consciousness based on eye opening, verbal response, and motor response. It provides a numerical score that correlates with the severity of the injury and helps to determine the likelihood of recovery and long-term outcomes. Age of the patient, mode of injury, and CT head may provide additional information, but the Glasgow Coma Scale is considered the most reliable and widely used tool for assessing prognosis in head injury cases.

2. Which of the following colonic polyps is not premalignant

Juvenile polyps

Hamartomatous polyps associated with Peutz-Jegher’s syndrome

Villous adenoma

Tubular adenomas

Juvenile polyps are not premalignant.

Explanation

Juvenile polyps are not premalignant.

3. A patient has carcinoma of right tongue on its lateral border of anterior 2/3rd, with lymph node of size 4 cm in level 3 on the side of the neck, stage of disease is

N0

N1

N2

N3

AJCC staging for oral cavity tumours:

N0 - No clinically palpable lymph nodes
N1 - Single ipsilateral node less than 3cm
N2a - Single ipsilateral lymph node 3-6cm
N2b - Multiple ipsilateral lymph nodes less than 6cm
N2c - Bilateral / Contralateral lymph nodes less than 6cm
N3 - Nodes more than 6cm

Explanation

AJCC staging for oral cavity tumours:

N0 - No clinically palpable lymph nodes
N1 - Single ipsilateral node less than 3cm
N2a - Single ipsilateral lymph node 3-6cm
N2b - Multiple ipsilateral lymph nodes less than 6cm
N2c - Bilateral / Contralateral lymph nodes less than 6cm
N3 - Nodes more than 6cm

4. True about Branchial cyst is

Cysts are more common than sinuses

Mostly arises from 2nd branchial system

Causes dysphagia and hoarseness

Sinus should always be operated

Branchial cysts are congenital abnormalities that occur due to the incomplete closure of the branchial apparatus during embryonic development. They are more common than sinuses, which are also a result of branchial apparatus anomalies. Branchial cysts most commonly arise from the second branchial system, which is the most frequently affected branchial arch. These cysts can cause symptoms such as dysphagia (difficulty swallowing) and hoarseness. The treatment for branchial cysts may involve surgical removal, but the decision to operate depends on various factors and should be determined on a case-by-case basis.

Explanation

Branchial cysts are congenital abnormalities that occur due to the incomplete closure of the branchial apparatus during embryonic development. They are more common than sinuses, which are also a result of branchial apparatus anomalies. Branchial cysts most commonly arise from the second branchial system, which is the most frequently affected branchial arch. These cysts can cause symptoms such as dysphagia (difficulty swallowing) and hoarseness. The treatment for branchial cysts may involve surgical removal, but the decision to operate depends on various factors and should be determined on a case-by-case basis.

5. A 60 year old smoker came with the history of painless gross hematuria for one day. The investigation of choice would be :

Urine routine and microscopy

Plain x—ray KUB

USB KUB

Urine for malignant cytology

Painless gross hematuria indicates the diagnosis of urinary tract malignancy.

Explanation

Painless gross hematuria indicates the diagnosis of urinary tract malignancy.

6. Adjuvant chemotherapy is of definite value in

CA colon

CA pancreas

CA gall bladder

CA oesophagus

Adjuvant chemotherapy is beneficial in the treatment of colon cancer. It is used after surgery to kill any remaining cancer cells and reduce the risk of recurrence. This type of chemotherapy has been shown to improve overall survival rates and increase the chances of cure. Therefore, it is considered a standard treatment option for patients with colon cancer.

Explanation

Adjuvant chemotherapy is beneficial in the treatment of colon cancer. It is used after surgery to kill any remaining cancer cells and reduce the risk of recurrence. This type of chemotherapy has been shown to improve overall survival rates and increase the chances of cure. Therefore, it is considered a standard treatment option for patients with colon cancer.

7. Carcinoembryonic antigens (CEA) is increased in all except

Lung cancer

Breast cancer

Colon cancer

Osteogenic sarcoma

CEA is increased in adenocarcinoma of colon, pancreas, breast, ovary and lungs

Explanation

CEA is increased in adenocarcinoma of colon, pancreas, breast, ovary and lungs

8. Most common site of Morgagni hernia :

Right anterior

Right posterior

Left anterior

Left posterior

Morgagni hernia is a rare type of congenital diaphragmatic hernia. It occurs when there is a defect in the diaphragm muscle, allowing abdominal organs to protrude into the chest cavity. The most common site for a Morgagni hernia is the right anterior portion of the diaphragm. This means that the hernia occurs on the right side of the diaphragm towards the front of the body.

Explanation

Morgagni hernia is a rare type of congenital diaphragmatic hernia. It occurs when there is a defect in the diaphragm muscle, allowing abdominal organs to protrude into the chest cavity. The most common site for a Morgagni hernia is the right anterior portion of the diaphragm. This means that the hernia occurs on the right side of the diaphragm towards the front of the body.

9. Severity of acute pancreatitis correlate with levels of all ofthe following except

Glucose

Amylase

Transaminase

Calcium

Amylase levels can be used to diagnose acute pancreatitis. But there is no correlation between amylase levels and severity of acute pancreatitis.

Explanation

Amylase levels can be used to diagnose acute pancreatitis. But there is no correlation between amylase levels and severity of acute pancreatitis.

10. Tumor marker for primary hepatocellular carcinoma are all except

Alpha feto protein

Alpha 2 macroglobulin

PIVKA-2

Neurotensin

Alpha 2 macroglobulin is not a tumor marker for primary hepatocellular carcinoma. Tumor markers are substances that are produced by cancer cells or by the body in response to cancer. Alpha feto protein (AFP) and PIVKA-2 are commonly used tumor markers for hepatocellular carcinoma, as they are elevated in the blood of patients with this type of cancer. Neurotensin, although not commonly used as a tumor marker for hepatocellular carcinoma, has been found to be associated with cancer progression in some studies. However, alpha 2 macroglobulin is not considered a specific marker for hepatocellular carcinoma.

Explanation

Alpha 2 macroglobulin is not a tumor marker for primary hepatocellular carcinoma. Tumor markers are substances that are produced by cancer cells or by the body in response to cancer. Alpha feto protein (AFP) and PIVKA-2 are commonly used tumor markers for hepatocellular carcinoma, as they are elevated in the blood of patients with this type of cancer. Neurotensin, although not commonly used as a tumor marker for hepatocellular carcinoma, has been found to be associated with cancer progression in some studies. However, alpha 2 macroglobulin is not considered a specific marker for hepatocellular carcinoma.