Pg Blazer - Online Test Series 27 - Surgery | Attempts: 2813

2.

Which is not elevated in a child presenting with jaundice, icterus, pruritus & clay coloured stools.

Gamma glutanyl transpeptidase
Alkaline phosphatase
5′-nucleotidase
Glutamate dehydrogenase

Correct Answer

A. Glutamate dehydrogenase

Explanation

Glutamate dehydrogenase is not elevated in a child presenting with jaundice, icterus, pruritus, and clay-colored stools. This enzyme is not typically used as a marker for liver dysfunction or cholestasis. Gamma glutamyl transpeptidase (GGT), alkaline phosphatase, and 5'-nucleotidase are commonly elevated in liver diseases and can help diagnose the cause of jaundice.

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1

3.

A 50 year old male presented with history of hematemesis – 500 ml of blood and on examination shows BP – 90/60, PR – 110/min and splenomegaly 5 cm below lower costal margin. Most probable diagnosis is

Mallory Weiss tear
Duodenal ulcer
Gastritis
Portal hypertension

Correct Answer

A. Portal hypertension

Explanation

The most probable diagnosis in this case is portal hypertension. The patient's history of hematemesis (vomiting blood) along with low blood pressure and rapid heart rate suggests significant bleeding. The presence of splenomegaly (enlarged spleen) is a common finding in portal hypertension. This condition occurs when there is increased pressure in the portal vein, which carries blood from the intestines to the liver. It can be caused by liver cirrhosis, liver disease, or obstruction of blood flow within the liver. Portal hypertension can lead to varices (enlarged veins) in the esophagus or stomach, which can rupture and cause severe bleeding.

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4.

A 45 yr old female complains of progressive lower limb weakness, spasticity, urinary hesitancy. MRI shows intradural enhancing mass lesion. Most likely diagnosis is -

Dermoid cyst
Lntradural lipoma
Neuroepithelial cyst
Meningioma

Correct Answer

A. Meningioma

Explanation

The most likely diagnosis in this case is a meningioma. Meningiomas are tumors that arise from the meninges, which are the protective layers that cover the brain and spinal cord. They are more common in females and can cause symptoms such as lower limb weakness, spasticity, and urinary hesitancy when they compress the spinal cord. The MRI findings of an intradural enhancing mass lesion further support the diagnosis of a meningioma. Dermoid cysts, intradural lipomas, and neuroepithelial cysts are less likely to present with these symptoms and MRI findings.

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5.

Hypotension in acute spinal injury is due to

Loss of sympathetic tone
Loss of parasympathetic tone
Orthostatic hypotension
Vasovagal attack

Correct Answer

A. Loss of sympathetic tone

Explanation

In acute spinal injury, the loss of sympathetic tone is the main reason for hypotension. The sympathetic nervous system plays a crucial role in maintaining blood pressure by regulating the constriction of blood vessels and the release of adrenaline. When there is damage to the spinal cord, the sympathetic nerves may be affected, leading to a loss of their ability to regulate blood pressure effectively. This can result in a drop in blood pressure, causing hypotension.

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6.

Most common biochemical abnormality in congenital pyloric stenosis.

Hyperkalemic metabolic acidosis
Hypokalemic metabolic acidosis
Hyperkalemic metabolic alkalosis
Hypokalemic metabolic alkalosis

Correct Answer

A. Hypokalemic metabolic alkalosis

Explanation

Hypokalemic metabolic alkalosis is the most common biochemical abnormality in congenital pyloric stenosis. This condition is characterized by a decrease in potassium levels in the blood (hypokalemia) and an increase in pH (alkalosis). Pyloric stenosis is a narrowing of the passage between the stomach and small intestine, leading to vomiting and dehydration. The loss of gastric acid through vomiting causes the body to compensate by retaining bicarbonate, leading to metabolic alkalosis. Additionally, the loss of hydrogen ions in the vomit results in the loss of potassium, leading to hypokalemia.

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7.

Early postoperative complication of ileostomy

Obstruction
Prolapse
Diarrhoea
Necrosis

Correct Answer

A. Obstruction

Explanation

Post operative complications that occur with sufficient frequency in ileostomy are : Nipple valve slippage, pouchitis, intestinal obstruction and fistula.
Ref: The ASCRS Manual of Colon and Rectal Surgery
Complications of ileostomy are Obstruction, Vitamin B12 anaemia, Pouchitis, Stoma problems, Valve malfunction and Phantom rectum
Ref: National Health Service UK website

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8.

Barrets esophagus is commonly associated with one of the following:

Adenocarcinoma
Squamous cell carcinoma
Sarcoma
Gastrointenstinal stromal tumor

Correct Answer

A. Adenocarcinoma

Explanation

Barrett's esophagus is a condition in which the normal lining of the esophagus is replaced by abnormal cells, usually as a result of chronic acid reflux. This condition is commonly associated with adenocarcinoma, a type of cancer that develops in the glandular cells of the esophagus. Adenocarcinoma is the most common type of esophageal cancer and is often preceded by Barrett's esophagus. Squamous cell carcinoma, sarcoma, and gastrointestinal stromal tumor are not typically associated with Barrett's esophagus.

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9.

Which of the following brain tumours is highly vascular in nature?

Glioblastoma
Meningiomas
C P angle epidermoid
Pituitary adenomas

Correct Answer

A. Glioblastoma

Explanation

Meningioma is also highly valscular, but it is said that glioblastoma is so vascular that it may resemble an arteriovenous malformation!

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10.

A 40 year-old female patient presented with dysphagia to both liquids and solids and regurgitation for 3 months. The dysphagia was non-progressive. What is the most likely diagnosis?

Caricnoma of the esophagus
Lower oesophageal mucosal ring
Achalasia cardia
Reflux esophagitis with esophageal stricture

Correct Answer

A. Achalasia cardia

Explanation

The most likely diagnosis in this case is achalasia cardia. Achalasia is a disorder of the esophagus where the lower esophageal sphincter fails to relax properly, leading to difficulty in swallowing (dysphagia) and regurgitation. It is more common in middle-aged individuals and the symptoms typically persist over time without worsening (non-progressive). Carcinoma of the esophagus, lower esophageal mucosal ring, and reflux esophagitis with esophageal stricture can also cause dysphagia, but the non-progressive nature of the symptoms in this patient makes achalasia cardia the most likely diagnosis.

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Pg Blazer - Online Test Series 27 - Surgery

Barrett’s esophagus is diagnosed by

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Which is not elevated in a child presenting with jaundice, icterus, pruritus & clay coloured stools.

A 50 year old male presented with history of hematemesis – 500 ml of blood and on examination shows BP – 90/60, PR – 110/min and splenomegaly 5 cm below lower costal margin. Most probable diagnosis is

A 45 yr old female complains of progressive lower limb weakness, spasticity, urinary hesitancy. MRI shows intradural enhancing mass lesion. Most likely diagnosis is -

Hypotension in acute spinal injury is due to

Most common biochemical abnormality in congenital pyloric stenosis.

Early postoperative complication of ileostomy

Barrets esophagus is commonly associated with one of the following:

Which of the following brain tumours is highly vascular in nature?

A 40 year-old female patient presented with dysphagia to both liquids and solids and regurgitation for 3 months. The dysphagia was non-progressive. What is the most likely diagnosis?