1. INTERMEDIATE MODULE QUESTIONS (SURGERY)
1. A 25 year driver suffers RTA and is brought to d. Acute mesenteric lymphadenitis
you in emergency; he has seatbelt mark over e. Gall stones
his body, which organ is mostly injured in a 10. The location of hernia sac in the case of
seat belt injury? femoral hernia is
a. Gall bladder a. Above the inguinal canal
b. Duodenum b. Medial to femoral vessels
c. Liver c. Lateral to femoral vessels
d. Spleen d. Anterior to femoral vessels
e. Kidney e. Posterior to femoral vessels
2. In the setting of pelvic trauma which part of 11. 22 year male got hit to his testis while playing
urethra is most commonly injured? cricket 4 hours back and he present to you with
a. Bulbar complaint of pain, on examination scrotum is
b. Prostatic well developed but empty on the right side,
c. Membranous there is a tender swelling palpable just medial
d. Penile to groin crease, what is your diagnosis
e. Retrobulbar a. Testicular torsion
3. Most appropriate investigation to diagnose an b. Testicular displacement
esophageal perforation is c. Scrotal abscess
a. X-ray chest d. Undecended testis
b. Ultrasound e. Tumor
c. Esophagoscopy 12. 35 year male presents with a hard non tender
d. Gastrograffin swallow swelling of the right testis swelling doesn’t
e. Abdominal X-ray transilluminate, inguinal lymph nodes are
4. A patient is admitted in your ward with palpable, he recalls the history of mild trauma
diagnosis of esophageal stricture, surgery is while playing 6 months back, what is the cause
planned what measures will you take to build of his testicular swelling?
up the patient nutritionally before surgery a. Heamtocele
a. Open gastrostomy b. Hydrocele
b. Percutanous gastrostomy c. Tumor
c. Fine tube jejunostomy d. Varicocele
d. Nasogastric tube feeding e. Benign cyst
e. TPN 13. 26 year male presents to you with scrotal
5. Diagnostic investigation for gastroesophageal swelling for 4 hours, on examination there is a
reflux disease is small swelling in the right side of scrotum and
a. Acid clearance test overlying skin is red, hot and tender, what will
b. Acid reflux monitoring (PH) be the treatment?
c. Urinay acid levels a. Excision biopsy
d. Manometry b. Exploration of scrotum
e. Endoscopy c. Incision and drainage
6. 55 year old male presents with esophageal d. Antibiotics and analgesics
mass, the most accurate diagnosis can be e. Scrotal support
established by 14. 27 year poor man complaint of backache, night
a. CT Scan sweats, and low grade fever, your examination
b. MRI reveals a swelling that extends above and
c. Endoscopy and Biopsy below the inguinal canal, what would be the
d. FNAC diagnosis?
e. Ultrasound a. Direct inguinal hernia
7. Heamomediastinum found on the chest X-ray, b. Indirect inguinal hernia
what is most probable diagnosis c. Femoral hernia
a. Tracheal injury d. Psoas abscess
b. Esophageal perforation e. Enlarged inguinal lymph node
c. Gastric perforation 15. Regarding strawberry gall bladder
d. Rupture of thoracic aorta a. It is a congenital condition
e. Bronchpulmonary fistula b. It occurs due to increased
8. 18 year old man presents to emergency with cholesterol deposition
complaint of abdominal pain and distention, c. Is premalignant
he has a history of fever for one week, what d. Occurs in liver cirrhosis
might be the cause of his abdominal symptoms e. Should always be considered
a. Duodenal perforation malignant
b. Gastric perforation 16. Which is the single best test to assess the
c. Acute appendicitis function of thyroid gland
d. Typhoid enteric perforation a. Free T3
e. Acute pancreatitis b. Free T4
9. 4 year old boy is brought to you with history of c. TSH
abdominal pain for 12 hours, pain is d. Total T3
associated with low grade fever, nausea and e. Total T4
vomiting one episode. Pain started in the 17. In a patient of trauma which of the following
centre and changes the position with change of injury can be immediately life threatening
posture what is most probable cause of pain? a. Bullet in head
a. Volvulus b. Depressed fracture of skull
b. Acute appendicitis c. sucking chest wound
c. Peptic ulcer d. Bleeding from a fractured limb
1 UROLOGICAL SURGERY WARD 19, JPMC, KARACHI

2. INTERMEDIATE MODULE QUESTIONS (SURGERY)
e. Pelvic fracture d. Commonly occurs in well
18. Which of the following injuries will lead to approximated stitched surgical
Volkmann’s ischemic contracture most wounds
commonly e. Minimum where skin is lax
a. Fracture of humerus shaft 26. NSAIDS do not cause
b. Radius ulna fracture a. Gastric erosions
c. Fracture of tibia and fibula b. Decrease in renal function
d. Supracondylar fracture of distal c. Decrease in platelate function
humerus d. Steroid synthesis
e. Dislocation of shoulder e. Decrease in inflammatory response
19. Which of the following fracture leads to non- 27. A patient known case of liver cirrhosis with
union frequently portal hypertension and ascites develops
a. Fracture of distal tibia hematoemesis, what is the most likely cause of
b. Scaphoid his bleeding
c. Proximal humerus a. Perforated peptic ulcer
d. Femur shaft b. Esophageal varices
e. Neck of femur c. Gastric erosions
20. A 43 year old man is working with electrical in d. Esophageal tear
his basement when he accidently touches an e. Gastroenteritis
bare wire and receives a current of 220v and 28. the factor which determines the poor prognosis
20amp, what can lead to a deleterious effect in CLD is
a. Cardiac arrhythmia a. Age
b. Hypovolemia b. Encephalopathy
c. Acute renal failure c. Ascites
d. Muscle injury d. Portal hypertension
e. Brain injury e. Constipation
21. Regarding myocutanous flap 29. The finding which favors pyogenic liver abscess
a. Arteriovenous shunting in the flap rather than amebic liver abscess is:
will not cause any significant problem a. Anchovy sauce appearance
b. Thrombosis of arteries will lead to b. Fever
arteriovenous shunting of blood and c. Jaundice
increase capillary perfusion d. Size
c. Thrombosis of veins will lead to e. Rural area of origin
arteriovenous shunting of blood and 30. 12 year boy present to emergency with
decreased capillary perfusion abdominal pain, vomiting and distention, you
d. Flap will survive despite of diagnose as a case of intestinal obstruction, on
arteriovenous shunting laparatomy you find a bunch of round worms
e. Thrombosis of blood vessel does not occluding the lumen and causing obstruction
occur in myocutanous flaps what will be the next step?
22. Fracture of proximal fibula is associated with a. Milking the worms down the IC valve
a. Injury to common peroneal b. Ileotomy and removal of worms
nerve c. Closure of abdomen, anti-round
b. Instability of knee joint worm medication
c. Non- union d. Normal saline enema
d. Fixation is mandatory e. Resection and anastomosis
e. No significant problem 31. Most common presenting symptom of
23. Injury to menisci most commonly occurs with pulmonary embolism
a. Compression at knee joint a. Dysphagia
b. Flexion and external rotation b. Respiratory distress
c. Extension c. Pleuritic chest pain
d. Lateral bending d. Tachycardia
e. Medial bending e. Hypotension
24. Triage 32. Next step in management of annular pancreas
a. A system of providing medical care at causing partial obstruction of duodenum
the scene of trauma a. Resection of pancreas
b. Dividing the patient on the basis of b. Duodenojejunostomy
age c. Gastojejunostomy
c. Scientific assessment of trial and d. Resection and anastomosis
error e. Whipple’s procedure
d. A system of sorting out and 33. A 6 year old girl complaint of pain in the left
classifying the trauma patients loin during micturation, what is the most likely
on the basis of priority of cause
treatment required a. Renal stone
e. System of transportation b. Stone in urethra
25. Contracture of wound c. Urethral stricture
a. Occurs to a maximum of 50% d. Pelviureteric junction obstruction
b. Is delayed by bacterial invasion of the e. Renal agenesis
wound 34. During spinal anesthesia drug is instilled in
c. Is maximum when skin is firmly a. Subdural space
attached to the underlying tissues b. Subarachnoid space
c. Epidural space
d. Spinal cord
2 UROLOGICAL SURGERY WARD 19, JPMC, KARACHI

3. INTERMEDIATE MODULE QUESTIONS (SURGERY)
e. Spinal canal d. Clot retention
35. A patient is going to operated for small bowel e. Bladder stone
obstruction, x-ray shows multiple air fluid 44. What is true regarding hypertrophic scar
levels, which inhalational anesthetic will cause a. Responds to pressure
further deterioration in her condition? b. More common in female
a. Halothane c. More common on face and anterior
b. Isoflurane chest
c. Enflurane d. Should always be excised
d. Ether 45. A 30 year male patient sustained a gun shot
e. Nitrous oxide wound to his right buttock, how will you
36. ANA score in a patient who is known classify his wound:
hypertensive and takes two tablets of 50mg a. Clean
atenolol daily, still his blood pressure is b. Clean contaminated
175/100. c. Contaminated
a. ANA I d. Dirty
b. ANA II e. Infected
c. ANA III 46. A 45 year female with previous history of gall
d. ANA IV stones presents to you with complaint of
e. ANA V jaundice and pain in RHC, what will be the
37. 65 year old female fell down from stair and most appropriate investigation for this patient
sustained fracture of neck of femur, what will a. Ultrasound
the position of fractured leg b. Serum amylase
a. Externally rotated c. ERCP
b. Internally rotated d. Upper GI series
c. Shortened and flexed at hip e. X-ray abdomen
d. Flexed at knee 47. A 46 year female presents with pain in
e. Shortened and internally rotated epigastrium, and vomiting. Her pain radiates
38. Most common dislocation at shoulder to back. What will be the most appropriate
a. Anterior investigation to confirm the diagnosis
b. Posterior a. ERCP
c. Superior b. CT scan
d. Inferior c. Ultrasound
e. Central d. Serum Amylase
39. The organisms involved in synergistic e. ABG’s
gangrene 48. A new born is born with omphalocele, urgent
a. Beta hemolytic streptococci surgery is needed to replace his viscera to
b. Streptococci and staphylococci abdomen because
c. Clostridium prefrenges a. Viscera are covered by maternal
d. Escherchia coli membrane
e. Bacteriodes b. Gut is malrotated
40. 42 year farmer sustains a trivial injury while c. Chances of infection
working in the field, he ignores it and 12 days d. Chances of dehydration
later he presents to you with fever, pain and 49. A patient with pelvic trauma presents to
neck stiffness, on examination you fine a tense emergency, where external fixation was
abdomen, what is your diagnosis applied to the pelvis to stabilize the fractures,
a. Intestinal obstruction but patient is still unstable and does not
b. Bacterial meningitis respond to resuscitation, what is the most
c. Viral meningitis appropriate treatment strategy
d. Cervical spine injury a. Laparatomy and ligation of bleeding
e. Tetanus vessels
41. Virulence of staphylococcus aures is b. Angioembolisation
determined by c. Laparatomy and packing of pelvis
a. Hemolysis of blood cells d. Internal fixation of fracture
b. Resistance to drugs e. Ligation of abdominal aorta below
c. Coagulase activity origin of renal arteries
d. Carbohydrate fermentation 50. 42 year male presents with complain of
e. Cell wall stability hemaemesis due to esophageal varices, patient
42. A 55 year old man presents to you with is vitally stable, what will be the treatment
dysuria, frequency of micturation and burning, option
on DRE prostate is palpable normally but it is a. Endoscopic banding and ligation
tender, which of the following organism most b. Partial gastrectomy
probably the cause of his symptoms? c. Portocaval shunt
a. Streptococcus d. Balloon temponade
b. Kleibsella e. octeriotide
c. E.Coli
d. Salmonella
e. Clostridium difficle
43. Commonest cause of acute urinary retention in
the females?
a. Urethral stricture
b. Stone in urethra
c. Retroverted gravid uterus
3 UROLOGICAL SURGERY WARD 19, JPMC, KARACHI