PAK RED CRESCENT MEDICAL AND DENTAL COLLEGE

1. A 59-year-old man, heavy smoker had an 8-month history of cramps in the

left calf on walking. He noticed a small painful ulcer in his great toe, which is
not healing for past one month. which is the most appropriate investigation
use to diagnose
a. Colour flow duplex
b. Magnetic resonance (MR) angiography
c. Ankle brachial pressure index (ABPI)
d. Arteriography
e. Venography

Ans: (d)

2. A 40-year-old man with a past history of left thigh and calf claudi-cation
presented with rapidly increasing foot pain at rest since yesterday.
Examination revealed absent popliteal and distal pulses in the both legs.
There was mild sensory impairment over dorsum of his toes, but no motor
weakness. what is the mostly likely diagnosis
a. In situ thrombosis
b. Embolic occlusion
c. Popliteal entrapment
d. Deep venous thrombosis
e. Compartment syndrome

Ans: (b)

3. A 34-year-old lady with rheumatic mitral stenosis presented with a 6-hour

history of severs pain in left lower limb. Her femoral and distal pulses are not
palpable. The ipsilateral foot is cold, cyanosed and with reduced sensation.
contralateral pulses are palpable. Choose the most likely treatment from the
list given below
a. Endarterectomy
b. Embolectomy
c. Thrombectomy
d. Sympathectomy
e. Conservative

Ans: (b)

4. A 28-year-old male met with a vehicular accident yesterday with resultant

fracture of right femur shaft and undisplaced pelvic fracture. The next
evening you have been called to see this patient who is restless and
tachypneic for the past two hours. He is conscious but disoriented. His
respiratory rate is 34 per minute and his Sa02 is 96% on nasal oxygen. There
are no audible crepts on respiratory examination. His x-ray chest appears
grossly normal. Suggest your diagnosis
a. Fat embolism
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b. Venous thromboembolism
c. tumor emboli
d. Paradoxical embolism
e. Amnitotic fluid embolism

Ans: (a)

5. A 39-year-old male who underwent saphenofemoral ligation with striping and

multiple avulsions 6 year ago presents with recurrent varicosities in leg.
Select your most appropriate diagnostic list from the options given below
a. Hand held Doppler
b. Duplex sean
c. Ascending venorgraphy
d. Descending venography
e. Ultrasouna scan

Ans: (b)

6. A 39-year-old male resent with two year history of prominent tortuous veins
in his left leg, for which no specific treatment was taken, Since the past
month he has developed an ulcer above the medial malleolus with
surrounding pigmentation. Select the most likely etiology of leg ulceration
a. Neuropathic
b. Ischaemic
c. Venous ulcer
d. Marjolin’s ulcer
e. Meleney’s ulcer

Ans: (c)

7. Lymphangiography of the leg is performed by

a. An injection of sodium diatrizoate (Hypaque)
b. Injecting sodium diatrizoate retrogradely under pressure in to small vein
on the
Dorsum of the foot
c. Dissecting lymphatics through an incision on the dorsum of foot
d. The use of infusion pump
e. By ultrasound scan

Ans: (d)

8. Milroy’s disease in lymphoedema which is

a. Familial
b. Follows filariasis
c. Follows erysipelas
d. A sequel to white leg
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e. Infective

Ans: (a)

9. Chronically Lymphoedematous limb is predisposed to all of the following

except:
a. Thickening of skin
b. Recurrent soft tissue infections
c. Marjolin’s ulcer
d. Sarcoma
e. Meige’s disease

Ans: (c)

10.Wasting of the intrinsic muscles of the hand can be expected to injury of

following nerve.
a. Ulnar Nerve
b. Radial Nerve
c. Brachial Nerve
d. Axillary Nerve
e. Thenar and hypothenar Nerve

Ans: (a)

11. While you are on duty in the emergency room, a 12-year-old boy arrives with
from the and inflammation over the ball of his left foot and red streaks
extending up to the inner aspect of his leg. He remembers removing a wood
splinter from sole of his foot on the previous day. The most likely infecting
organism is:
a. Clostridium perfringens
b. Clostridium tetani
c. Staphlococcus
d. Streptococcus
e. E.Coli

Ans: (d)

12. Which one of the following cases is considered clean contaminated wound?
a. Open cholecystectomy for cholelithiasis
b. Herniorrhaphy with mesh repair
c. Lumpectomy with axillary node dissection
d. Appendectomy with walled off abscess
e. Gunshot wound to the abdomen with injuries to the small bowel and
sigmoid colon

Ans: (a)
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13.The true statement regarding tendon injury is the hand is?

a. Flexor digitorum superficialis inserts on the distal phalanx
b. Flexor digitorum profundus inserts on the middle phalanx
c. The tendon of Flexor digitorum superficialis arise from a common
muscle belly
d. The best results for repair of a flexor tendon are obtained with injuries
in zone 2.
e. The process of healing a tendon injury involves formation of tenoma

Ans: (e)

14.A 25 years old man is brought to the emergency room after sustaining burns
during a fire in his apartment. He has blistering and erythema of his face, left
upper extremity. He is agitated, hypotensive and tachycardia. Which one of
the following statements concerning this patient’s initial wound management
is correct?
a. Topical antibiotics should not be used as they will encourage the
growth of resistant organisms
b. Early excision of facial and hand burns is especially important
c. Escharotomy should only be performed if neurological impairment is
imminent
d. Excision of area of 3rd degree or deep 2nd degree burns usually takes
place 3-7 days after injury.
e. Split thickness skin grafts over the Escher of 3 rd degree burns should
be performed immediately in order to prevent fluid loss

Ans: (d)

15.Which of the following is true with regard to wound contraction?

a. It is the primary process affecting closure of a sutured or stapled
surgical wound
b. Bacterial colonization significantly shows the process of contraction
c. It may account for a maximum of 50% decrease in the size of a wound
d. It is based on specialized fibroblasts that contain actin myofilaments
e. The percentage reduction of wound size is increased with increased
adherency of skin to underlying tissue

Ans: (d)

16.True statement regarding squamous cell carcinoma of the lip include:

a. The lesion often arises in areas of persistent hyperkeratosis
b. More than 90% of cases occur on the upper lip
c. The lesion constitutes 30% of all cancers of the oral cavity
d. Radiotherapy is considered inappropriate treatment for these lesions
e. Initially metastases are to the ipsilateral posterior cervical lymph node
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Ans: (a)

17.A 25 years old man is brought to the emergency room after sustaining burns
during a fire in his apartment. He has blistering and erythema of his face, left
upper extremity. He is agitated, hypotensive and tachycardia. Which of the
following statements regarding this patient’s is correct?
a. High dose penicillin should be administered prophylactically
b. Tetanus prophylaxis is not necessary if the patient is immunized in the
previous 3 years
c. This burn can be estimated at 60% total body surface area using the
rule of nines
d. The most sensitive indicator of adequacy of fluid resuscitation is heart
rate
e. This patient should undergo immediate intubation for airway protection
and oxygen administration

Ans: (e)

18.Management of leukoplakia of the oral cavity includes:

a. Excision biopsy of all lesions
b. Application of topical antibiotics
c. Low dose radiation therapy
d. Ascertaining that dentures fit properly
e. Application of chemotherapeutic agents

Ans: (d)

19.Which of the following statements regarding carpel tunnel syndrome is

correct?
a. It is rarely secondary to trauma
b. It may be associated to pregnancy
c. It most often causes dysesthesia during waking hours
d. It is often associated with vascular compromise
e. Surgical treatment involves release of extensor retinaculum

Ans: (b)

20.A 40 years old lady underwent wide excision of a pigmented lesion of her
thigh. Pathological examination revealed malignant melanoma. Her groin
examination was normal. The patient should be advised that:
a. Radiotherapy will be an important part of subsequent therapy
b. The likelihood of groin node metastases is remote
c. Immunotherapy is an effective form of adjunctive treatment of
metastatic malignant melanoma
d. Groin dissection is not indicated unless and until groin nodes become
palpable
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e. Intralesional bacille Calmette Guerin (BCG) administration has been

found to aid in local control in the majority of patients

Ans: (d)

21.In hemolytic reaction caused by incompatible blood transfusion, the

treatment that is most likely to be helpful is:
a. The transfusion should be stopped immediately
b. It should be continued
c. The patient’s pulse, BP and urine output should not be recorded
d. Dialysis may not be necessary
e. White blood should be transfused

Ans: (a)

22.Which of the following inhalational anesthetics accumulates in air filled

cavities during general anesthesia
a. Propofol
b. Nitrous oxide
c. Sevoflurane
d. Thiopentone
e. Pethidine

Ans: (b)

23.Which statements regarding local anesthesia is true?

a. The complications of it is that large doses causes cardiac arrest
b. It is not available in 10 ml of 2%
c. It is not available in Lignocaine 200 mg
d. It is not available in Bupivacaine 150 mg
e. It is not available in pilocaine 400 mg

Ans: (a)

24.During blood transfusion, clotting of transfused blood is associated with:

a. When it is transfused in ordinary I.V set
b. When special blood bank refrigerators, store it at 4 degree ± 2 degree
centigrade
c. When blood is stored in CPD solution
d. When blood is screened for bacteria and viruses
e. When 410 ml of blood is collected in a bag containing 75 ml of
anticoagulant solution

Ans: (a)

25.The accidental aspiration of gastric contents into tracheobronchial tree

should be initially treated by
PAK RED CRESCENT MEDICAL AND DENTAL COLLEGE

a. Endoscopy
b. N/G tube
c. Gastrograffin
d. Barium meal
e. Suction

Ans: (e)

26.A 2-month-old boy is brought by parents as they noticed a strawberry like

swelling over the arm. They said that it appeared in the first month and is
increasing in size. On O/E, the sign of emptying is demonstrable What is most
likely diagnosis
a. Hemangioma
b. Lipoma
c. Granuloma
d. AV malformation
e. Ganglion

Ans: (a)

27.Keloid is made up of:

a. Dense collagen
b. Loose fibrous tissue
c. Granulomatous tissue
d. Loose areolar tissue
e. Platelets

Ans: (a)

28.Degloving injury is:

a. Surgeon made wound
b. Lacerated wound
c. Blunt injury
d. Avulsion injury
e. Abrasive wound

Ans: (d)

29.Ringer’s lactate does not contain:

a. Na
b. K
c. HCO3
d. C L
e. Water

Ans: (c)
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30.Most common causes of metabolic Alkalosis in surgical patient is:

a. Antacid therapy
b. Gastric outlet obstruction
c. Hyperventilation due to head injury
d. Steroid treatment
e. Hyperventilation

Ans: (b)

31.The likely metabolic complications of total parenteral nutrition within the first
two weeks of therapy would include all of cardiopulmonary failure:
a. Cardiopulmonary failure
b. Hyper osmolar nonketotic hyperglycemia
c. Zink deficiency
d. Hypophosphatemia
e. Respiratory failure

Ans: (b)

32.Massive blood transfusion is defined as:

a. 350 ml in 5 min
b. 500 ml in 5 min
c. 1 Litre in 5 min
d. Whole blood volume
e. White blood transfusion

Ans: (c)

33.All of the following are indication of total parental nutrition except

a. Postooperative ileus
b. Enterocolic fistula
c. Orally taking
d. Enterocutaneous fistula
e. Inflammatory bowel disease

Ans: (c)

34.Emergency procedures in deep burns cases are all except:

a. Tarsorrhaphy
b. Primary excision
c. Tracheostomy
d. Escharotomy
e. CVP line

Ans: (a)

35. All is true about the success of course of radiotherapy except:

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a. Radiosensitivity of the primary tumor

b. The volume of the tumor
c. The tumor site
d. Hypoxia of tissue
e. None of the above

Ans: (e)

36.The most sensitive tissues to radiotherapy are following except:

a. Bone Marrow
b. The gonads
c. The eye
d. Mucosa of the gastrointestinal tract
e. None of the above

Ans: (e)

37.The 64-year-old man undergoes CEA surveillance for cancer because his
brother and father both had cancer of colon. He should be informed that:
a. CEA is highly sensitive for diagnosis
b. If CEA is elevated preoperatively, it indicates unresectable disease
c. If CEA is elevated, after resection may indicate tumor recurrence
d. CEA is highly specific for colon cancer
e. CEA is present in normal adult colonic mucosa

Ans: (c)

38.Other agents which are used for cancer therapy is following except
a. Hormonal therapy
b. Immunotherapy
c. Gene therapy
d. Biological modifiers
e. None of the above

Ans: (e)

39.High risk HIV positive patients are following except

a. Homosexual lifestyle
b. A history of intravenous drug abuser
c. A history of hemophilia treated with factor VIII
d. Resident of Sub Sahara Africa
e. None of the above

Ans: (e)

40. A surgeon is operating HIV positive patients. He is observing all preventive

measure except:
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a. Wearing safety spectacles

b. Face mask
c. Water proof gown
d. Wearing two pair of gloves
e. All instruments are passed from scrub nurse to the surgeon in a dish
but was not returned in a dish

Ans: (e)

41.Kaposi’s sarcoma is common in

a. HIV individual
b. Colonic diverticulum
c. Pancreatitis
d. Hepatitis c positive
e. Normal adult

Ans: (a)

42. A 40-year-old man presents with 3 cm lump over his Rt arm. It is painless.
On examination, it is soft, mobile, lobulated and slip sign is positive. Choose
the single most management option:
a. Simple excision
b. Radiotherapy
c. Wide local excision
d. Cryotherapy
e. Radical excision

Ans: (a)

43.Commonest type of cutaneous malignant melanoma:

a. Acral letiginous melanoma
b. Amelanotic melanoma
c. Lentigo maligna melanoma
d. Nodular melanoma
e. Superficial spreading melanoma

Ans: (e)

44.It produces analgesia by two mechanisms, an opioid effect and an

enhancement of serotonergic and adnrenergic pathways:
a. Fentanyl
b. Pethidine
c. Morphine
d. Paracetamol
e. Tramadol

Ans: (e)
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45.It is used in obstetric analgesia. It produces prompt but short-lasting

analgesia. It is less potent analgesia even in high doses.
a. Fentanyl
b. Pethidine
c. Morphine
d. Paracetamol
e. Tramadol

Ans: (b)

46. Select the appropriate management option for Marjolin’s right leg ulcer:
a. Tangential excision and grafting
b. Local steroid injection
c. Escharotomy
d. Wide excision and skin grafting
e. Silver Sulfadiazine

Ans: (d)

47.Select the appropriate management option for hypertrophic scar to right

forearm:
a. Tangential excision and grafting
b. Local steroid injection
c. Escharotomy
d. Wide excision and skin grafting
e. Silver Sulfadiazine

Ans: (b)

48.Select the appropriate management option for deep dermal burns to thigh:
a. Tangential excision and grafting
b. Local steroid injection
c. Escharotomy
d. Wide excision and skin grafting
e. Silver Sulfadiazine

Ans: (a)

49.An 18 years old man is brought to the emergency department with a stab
wound just to the Rt. Of sternum in the sixth intercostal space. His BP is
80/60, Faint heart sound and pulses paradoxus are noted. Auscultation of Rt
chest reveals decreased breath sounds. The initial management of this
patient is:
a. Aspiration of right chest cavity
b. Aspiration of the pericardium
c. Echocardiogram
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d. Pericardial window
e. Insertion of central venous access line

Ans: (a)

50.A 22-year-old woman presents to the emergency department with a chief

complaint of sever left upper quadrant pain after being stabbed by her
husband. Her BP is 110/70, her pulse is 100/min and her respiratory rate is 24
beat/min. The best means to established the diagnosis is:
a. Four quadrant tap of abdomen
b. Physical examination
c. CT of the abdomen
d. Peritoneal Lavage
e. Upper GI series

Ans: (c)