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Worksheetspast year surgical mcq
Total questions: 70
Worksheet time: 43mins
Which of the following statements regarding flail chest is TRUE?
It occurs when more than two adjacent ribs are fractured in one place each
It causes paradoxical chest wall movement during respiration
It causes a left-to-right intracardiac shunt
Endotracheal intubation is always required in all cases
Flail chest alone is an absolute indication for thoracotomy
Which of the following is TRUE regarding acute cholecystitis?
It only occurs in the presence of gallstones
Charcot’s triad is a common presentation
White blood cell count remains normal in most cases
It may be associated with elevated serum amylase
A positive Murphy's sign confirms gallstones as the cause
Which of the following statements regarding sterilisation is CORRECT?
It kills all microbial life including spores
Autoclaving is suitable for sterilising steel instruments
Ethylene oxide is a non-corrosive gas used for sterilisation
Plastic instruments are sterilised using a hot air oven
Gamma irradiation is used for sterilisation in industrial settings
Which of the following is a recognised complication of massive blood transfusion?
Hypercalcaemia
Leukopenia
Coagulopathy
Hepatic coma
Hypokalaemia
Which of the following measures is proven to reduce the risk of surgical site infections?
Shaving the surgical site the day before admission
Prophylactic antibiotic administration
Insertion of an indwelling catheter
Pre-operative physiotherapy
Prolonged hospital admission before surgery
Which of the following statements is TRUE regarding prophylactic antibiotic use?
It is indicated in all patients with a history of rheumatic fever
Cefuroxime is effective against anaerobic organisms
Optimal timing is just before induction of anaesthesia
They should be given for five days post-operatively
Topical antibiotics are routinely used as prophylaxis
Which of the following neck swellings typically moves with deglutition?
Carotid body tumour
Thyroglossal duct cyst
Cystic hygroma
Pre-tracheal lymph node
Thyroid adenoma
Which of the following is TRUE about portal hypertension?
It is commonly caused by hepatic vein thrombosis
Associated ascites is exudative in nature
It may lead to hypersplenism
It is commonly associated with hyperalbuminemia
Esophageal varices are treated surgically in all cases
Which of the following is TRUE in a patient with gastric outlet obstruction?
Vomitus commonly contains bile
Patients develop hyperchloraemic metabolic acidosis
Succussion splash is a typical finding
Patients present with hypernatremia and fluid overload
Urine pH becomes alkaline due to vomiting
Which of the following statements is CORRECT about perforated gastric ulcer?
It is a diagnosis of exclusion
It often results from chronic NSAID use
It is managed conservatively unless complications arise
Free air under diaphragm confirms the diagnosis
It may progress to gastric lymphoma after 2 years
Which of the following is TRUE regarding keloid scars?
They remain confined within the original wound borders
Commonly occur in individuals with fair skin
Can be treated with intralesional steroid injections
Always regress spontaneously with time
Are more common over extensor surfaces
Which of the following is TRUE in children with intussusception?
Constipation is the earliest symptom
Inflamed Peyer’s patches may act as a lead point
Projectile vomiting is rare
Sign de Dance is a physical finding
Stools are frequently tarry
Which of the following statements is TRUE regarding colorectal carcinoma?
Right-sided cancers are more likely to cause obstruction
Familial adenomatous polyposis coli usually presents after 40 years of age
About 30% of patients have liver metastasis at diagnosis
HNPCC-associated tumours are usually right-sided
Anaemia is more typical of left-sided lesions
Which of the following is CORRECT about bladder carcinoma?
More common in females
Chronic bladder stones cause transitional cell carcinoma
Exposure to aniline dyes increases the risk
Urine cytology is useful for carcinoma in situ
Poor 5-year survival even in superficial tumours
Which of the following is TRUE regarding prostate cancer?
Commonly arises in the central zone
PSA is prostate-specific but not disease-specific
Bone metastases are typically osteolytic
Most patients present with LUTS
Hereditary prostate cancer does not exist
Which of the following conditions can cause blood-stained nipple discharge?
Fibroadenoma
Intraductal papilloma
Cystosarcoma phyllodes
Breast cyst
Galactocele
Which of the following is TRUE regarding minimally invasive surgery?
Always contraindicated in obese patients
Has a longer recovery time than open surgery
Requires minimal surgical skill
Commonly used for laparoscopic cholecystectomy
Associated with greater post-operative pain
Which of the following is TRUE regarding post-operative pain?
Reduces risk of cardiac ischaemia
Is best treated with oral analgesics only
Increases risk of deep vein thrombosis
Does not affect respiratory effort
Pain levels are the same across all patients with similar surgery
Which of the following is TRUE about autoclaving?
Cannot exceed the boiling point of water
Is less effective than dry heat sterilisation
Can be monitored using the Bowie-Dick test
Ineffective against bacterial spores
Requires dry conditions for effectiveness
Which of the following is TRUE regarding paraumbilical hernia?
It is located around the umbilicus
It is congenital in origin
It resolves spontaneously over time
It does not increase in size with time
It never requires surgical repair
Which of the following is TRUE regarding a perforated gastric ulcer?
It is commonly caused by chronic NSAID use
It is a diagnosis of exclusion
It is not a surgical emergency
It is diagnosed by endoscopy
It causes gastric lymphoma if untreated for 2 years
Which of the following conditions commonly presents with blood-stained nipple discharge?
Mammary duct ectasia
Intraductal papilloma
Fibroadenoma
Paget’s disease of the breast
Breast carcinoma
Which of the following is a recognised complication of massive blood transfusion?
Hyperkalemia
Hypercalcemia
Hepatic coma
Leukopenia
Polycythemia
Which of the following is TRUE regarding keloid scars?
They are normal wound healing scars
They are more common in individuals with fair skin
They extend beyond the borders of the original wound
They resolve spontaneously after 1 year
They cannot be treated
Which of the following statements regarding minimally invasive surgery is TRUE?
It can be used for cholecystectomy
It is associated with slower recovery than open surgery
It is not suitable for colectomy
It is contraindicated in obese patients
It requires minimal surgical training
Which of the following statements is TRUE about flail chest?
It occurs when two adjacent ribs are fractured in one place
It causes paradoxical chest wall movement
It causes a right-to-left shunt
It always requires emergency thoracotomy
It is managed only with pain control
Which of the following is TRUE regarding post-operative pain?
It reduces the risk of cardiac ischemia
It is best managed only with oral analgesics as needed
It may impair respiratory function
It has no relation to thromboembolic events
It is uniform across all patients with the same surgery
Which of the following conditions is commonly associated with obesity?
Obstructive jaundice
Wound dehiscence
Hypotension
Hypoglycemia
Hypothyroidism
Which of the following statements regarding disinfection is CORRECT?
Povidone-iodine is commonly used for pre-operative skin preparation
Chlorhexidine has less risk of skin irritation than povidone-iodine
Quaternary ammonium compounds are highly potent disinfectants
Chlorhexidine is not suitable for surgical scrubbing
Povidone-iodine has a narrower spectrum than chlorhexidine
Which of the following statements are true regarding varicocele?
It is an aneurysmal dilatation of the testicular artery
It is more common on the right side
It is associated with left renal tumour
It can cause infertility
Surgical intervention is always required
Which of the following are true regarding intussusception?
Colicky abdominal pain is a common presentation
Inflamed Peyer’s patches may act as a lead point
Constipation is an early sign
It is associated with projectile vomiting
Dance’s sign may be elicited on physical examination
Which of the following features are associated with gas gangrene?
Trismus
Putrid smell
Caused by exotoxin-producing gram-positive aerobic bacilli
Crepitus
Risus sardonicus
Which of the following statements are true regarding keloid scars?
More common in pigmented skin
Confined within original wound margins
More common over flexor surfaces
Tend to regress spontaneously
May have a familial predisposition
Which of the following are recognised complications of massive blood transfusion?
Thrombocytopenia
Acute pulmonary oedema
Hyperkalemia
Delayed wound healing
Hypocalcemia
Regarding colorectal cancer, which of the following are true?
Left-sided cancer typically presents with anemia
Obstruction is more common in left-sided tumours
Hereditary non-polyposis colorectal cancer is usually left-sided
Familial adenomatous polyposis presents before age 40
Occult liver metastases are present in ~30% at diagnosis
Which of the following are true regarding acute cholecystitis?
Can occur without gallstones
May present with Charcot’s triad
White blood cell count remains normal
Serum amylase may be raised
Positive Murphy’s sign indicates gallstone etiology
Which of the following are true in portal hypertension?
Can be caused by hepatic vein thrombosis
May lead to hypersplenism
Ascitic fluid is exudative in nature
Commonly associated with hyperalbuminemia
Bleeding esophageal varices may require surgical shunt
Which of the following swellings move with swallowing?
Carotid body tumour
Thyroid adenoma
Pretracheal lymph nodes
Thyroglossal cyst
Cystic hygroma
Regarding post-operative pain:
Increases risk of cardiac ischemia
Best managed with oral analgesics as needed
May improve respiratory function
Increases risk of deep vein thrombosis
Similar between patients undergoing same procedure
Regarding small intestinal obstruction (SBO):
Commonly caused by adhesions
Constipation is typically the first symptom
Fluid thrill is heard on examination
X-ray shows peripheral bowel dilation
Laparotomy is indicated if conservative measures fail
Perforated Gastric Ulcer
Which of the following are true?
Caused by chronic NSAID use
Surgical emergency
Diagnosed by air under diaphragm on X-ray
Diagnosis of exclusion
Progresses to gastric lymphoma in 2 years
Which of the following conditions can cause bloody nipple discharge?
Mammary duct ectasia
Intraductal papilloma
Fibroadenoma
Paget’s disease
Breast carcinoma
Which of the following are true about sterilisation?
Destroys all forms of microbial life
Autoclaving is used for steel instruments
Ethylene oxide is a corrosive gas
Plastic tools are sterilised in hot ovens
Gamma rays are used in industrial sterilisation
Squamous Cell Carcinoma
Which of the following are true?
Presents with undermined edge ulcer
May arise from chronic non-healing ulcers
Can be caused by HPV
May bleed easily
Treatable with local radiation
Flail chest injury
Which of the following statements are true?
Involves ≥2 ribs fractured in ≥2 places
Causes paradoxical movement
Leads to left-to-right shunting
May require intubation in severe cases
Not an indication for thoracotomy
Gastric outlet obstruction
Which of the following are true?
Causes hypochloraemic alkalosis
Vomitus contains bile
Patient is hyponatraemic and dehydrated
Urine becomes paradoxically acidic
Succussion splash may be present
Which of the following may complicate major abdominal surgery in jaundiced patients?
Bleeding
Wound infection
Keloid formation
Hepatorenal syndrome
Cardiomyopathy
Regarding bladder carcinoma:
More common in males
Dye exposure is a risk factor
Chronic bladder stones predispose to adenocarcinoma
Urine cytology is unreliable for carcinoma in situ
Superficial tumours have a good 5-year survival rate
Regarding paraumbilical hernia, which of the following statements are TRUE?
It usually occurs around the umbilicus
It is congenital in origin
It resolves spontaneously
It does not increase in size over time
It requires surgical repair
In the TNM staging of breast carcinoma, which findings are consistent with T2N2M1?
Tumour diameter >5 cm
Presence of peau d’orange
Palpable, fixed axillary lymph nodes
Oedema of the arm
Absence of distant metastasis
Which of the following are complications of massive blood transfusion?
Hyperkalaemia
Hypercalcaemia
Hepatic coma
Coagulopathy
Leucopenia
Regarding keloid scars, which of the following are TRUE?
It is a normal scar tissue
Treated with intralesional steroid injection
More common in fair-skinned individuals
Continues to grow after 1 year
Extends beyond original wound margins
Concerning autoclaving, which statements are TRUE?
Can reach higher temperatures than boiling water
Less effective penetration than dry heat
Monitored with the Bowie-Dick test
Monitored with Browne’s tube test
Kills all microorganisms but not all spores
Regarding basal cell carcinoma (BCC) of the skin, which of the following are TRUE?
Radioresistant
Originates from the basal layer of the epidermis
Rare type of skin cancer
Commonly metastasises to lymph nodes
Commonly found on the head and neck
Which of the following are features of a false cyst?
Has epithelial lining
Contains exudate
Can occur in a haematoma
Arises from embryonic remnants
Is compressible
Which of the following are methods to arrest haemorrhage?
Direct pressure
Clamping with haemostat
Application of topical lotions
Excision of visceral organ
Infrared radiation
Which of the following are proven to reduce surgical site infection risk?
Admission on the day of surgery
Shaving the operative site prior to admission
Early postoperative physiotherapy
Use of prophylactic antibiotics
Insertion of indwelling catheter
Which of the following are differential diagnoses for reducible groin swelling?
Ectopic testis
Saphena varix
Atheromatous femoral artery
Varicocele
Indirect inguinal hernia
Causes of sudden onset abdominal pain include:
Ruptured ectopic pregnancy
Intestinal obstruction
Acute diverticulitis
Perforated viscus
Dissecting aortic aneurysm
Preoperative preparation for biliary surgery includes:
Adequate bowel preparation
Oral vitamin K
External biliary decompression
Adequate hydration
Antibiotic prophylaxis
Which of the following factors promote wound healing?
Young age
Zinc supplementation
Chronic liver disease
Presence of haematoma
Presence of infection
Appropriate investigations for a male patient with LUTS include:
Urinalysis
Serum creatinine
Serum calcium
PSA
Kidney, ureter, bladder (KUB) X-ray
A neck swelling that moves with deglutition may be:
Thyroglossal duct cyst
Cystic hygroma
Pretracheal lymph node
Thyroid adenoma
Carotid body tumour
Regarding flail chest, which of the following statements are TRUE?
Involves fracture of one or more ribs in more than one place
Causes paradoxical chest wall movement
Always indicates the need for laparotomy
May lead to respiratory compromise
Typically managed with internal fixation
Concerning small bowel obstruction, which of the following are TRUE?
Commonly caused by adhesions
Constipation is the earliest symptom
Fluid thrill is commonly heard on examination
Peripheral bowel loop dilatation seen on plain X-ray
Requires laparotomy if conservative treatment fails
Raised intracranial pressure (ICP) is associated with:
Tachycardia
Hypotension
Apnoea
Transtentorial herniation
Foramen magnum herniation
Regarding internal haemorrhoids, which of the following are TRUE?
Involve venous dilatation within the anal canal
Second-degree haemorrhoids prolapse but reduce spontaneously
Always palpable on digital rectal examination
Contain an arterial component
First-degree haemorrhoids can be managed by rubber band ligation
Concerning postoperative pain, which of the following are TRUE?
Increases the risk of postoperative cardiac ischaemia
Best managed with oral analgesia
May improve respiratory function if relieved
Associated with increased risk of DVT
Similar pain experience in all patients undergoing the same procedure
The following are proven to reduce the risk of surgical site infection:
Admission on the day of surgery
Pre-admission shaving of the operative site
Early postoperative physiotherapy
Administration of prophylactic antibiotics
Use of indwelling urinary catheters
Concerning antibiotic prophylaxis, which of the following are TRUE?
Indicated in patients with rheumatic fever history
Cefuroxime is effective against aerobic organisms
Best administered just before induction of anaesthesia
Should be given for 5 days for optimal effect
Topical antibiotics are practiced in ophthalmic surgery
