RD TH

MCQS FOR 3 YEAR 5 SEMESTER

1. In history taking, the symptom that needs careful definition is:

A. Weakness
B. Lassitude
C. Pain
D. Malaise
2. A malignant lump when pains implies:
A. Rapid growth
B. Break down
C. Invasion of nerve
D. All of the above
3. Abdominal lump, not moving with respiration arises from:
A. Liver
B. Spleen
C. Kidney
D. Rectus
4. A tract connecting an abnormal cavity to an epithelial surface and lined with
granulation tissue is:
A. Sinus
B. Fistula
C. Tunnel
D. Duct

5. For a single chest X-ray, the effective X-ray dose is:

A. 0.1 mSv
B. 0.01 mSv
C. 0.02 mSv
D. 1 mSv
6. The effective X-ray dose is highest for:
A. Barium meal
B. Barium enema
C. CT chest
D. CT head

7. In acute abdomen, the first imaging of importance is:

A. Plan X-ray
B. Barium meal
C. CT scan
D. Laparoscopy
8. The radiation exposure in standard CT scan is equivalent to:
A. 100 CXR
B. 200 CXR
C. 400 CXR
D. 600 CXR
9. The first imaging option in hepatobiliary disease is:
A. US
B. IV cholangiogram
C. CT
D. Radionuclide scan
10. In colour Doppler blood flow towards transducer is:
A. Red
B. Blue
C. Mosaic
D. Green
11. The best imaging option for staging cervical cancer is:
A. CT
B. MRI
C. US
D. Laparoscopy
[Link] fracture is best imaged by:
A. X-ray
B. CT
C. Bone scan
D. MRI

13. Which of the following is required routinely prior to elective surgery in a patient of 65
years.
A. Blood sugar
B. Chest X-ray
C. Clotting screen
D. ECG
E. Each of the above
14. Thromboprophylaxis with anticoagulation prior to surgery carries risk of:
A. Intracranial and GI bleed
B. Increased surgical blood loss
C. Wound haematoma
D. Each of the above
15. Infection following surgery can be minimised by:
A. Good patient preparation
B. Good surgical practice
C. Sound sterile technique in theater
D. Preoperative antibiotic prophylaxis
E. Each of the above
16. Preoperative transfusion be considered if Hb is below:
A. 10 gm percent
B. 8 gm percent
C. 6 gm percent
D. 5 gm percent

17. Diabetics are high risk for surgical procedures because of:
A. Susceptibility to sepsis
B. Poor wound healing
C. Higher chance of CVA and MI
D. All of the above
18. Investigations advised in a diabetic prior to surgery include:
A. Carotid Doppler study
B. Lipid profile
C. Glycosylated Hb
D. All of the above
19. Investigations advised for a patient of COPD planned for surgery include all except:
A. PFT
B. Arterial blood gases
C. Chest X-ray
D. Bronchoscopy

20. Water is lost from the body by the undermentioned routes except:
A. Lungs
B. Skin
C. Faeces
D. Saliva
E. Urine
21. Sudden hypokalaemia occurs:
A. Following severe head injury
B. Following operation trauma
C. Diabetic coma treated by insulin and prolonged infusion of saline solution
D. All of the above
E. None of the above

23. Haemorrhage due to infection of operative wound is:

A. Primary haemorrhage
B. Reactionary haemorrhage
C. Secondary haemorrhage
D. Any of the above
24. Blood loss in surgical practice is done by assessing:
A. Blood clot of the size of a clenched fist is roughly equal to 500 ml
B. Moderate swelling in closed fracture of tibia equals to 500-1500 ml of blood loss
C. Moderate swelling in fractured shaft of femur equals to 500-2000 ml blood loss
D. Estimating Hb level
E. Monitoring pulse and BP
25. Shelf life of CPD preserved blood is:
A. 1 week
B. 2 weeks
C. 3 weeks
D. 4 weeks
26. Cryoprecipitate is a rich source of:
A. Factor V
B. Factor VII
C. Factor VIII
D. Factor XII
27. Low molecular weight dextran refers to the polymer with molecular weight below:
A. 10,000
B. 20,000
C. 40,000
D. 80,000
28. Dextran has which of the following properties:
A. Can induce abnormal bleeding
B. Improves blood flow in microcirculation
 C. Acts as blood substitute
D. Can interfere with blood grouping and cross matching
E. All of the above
29. Five percent dextrose-saline is
: A. Isotonic
B. Hypertonic
C. Hypotonic
D. All of the above
30. Cardiogenic shock occurs when infarction involves more than:
A. 25% of LV wall
B. 50% of LV wall
C. 75% of LV wall
D. 85% of LV wall
31. The skin is warm and dry in:
A. Anaphylactic shock
B. Septic shock
C. Burn shock
D. All of the above
32. Pulmonary capillary wedge pressure is equal to pressure in
A. LA
B. RA
C. Pulmonary vein
D. CVP
33. Normal central venous pressure is:
A. 0-5 cm saline
B. 5-8 cm saline
C. 8-12 cm saline
D. 12-15 cm saline
34. Which of the following is beneficial in severe infection
: A. TFPI
B. Bradykinin antagonist
C. Activated protein C
D. None of the above
[Link] store in liver is:
A. 200 gm
B. 300 gm
C. 400 gm
D. 500 gm
36. To prevent skeletal muscle protein break down, daily minimum glucose intake be:
A. 100 gm
B. 150 gm
C. 200 gm
D. 250 gm
37. Daily nitrogen loss is higher in:
A. Herniotomy
B. Cholecystectomy
C. Fractured femur
D. Appendicectomy
38. Which of the following is hypercatabolic state:
A. Burn
B. Sepsis
C. Pancreatitis
D. All of the above
39. Hypercatabolic state is said to exist when increase in metabolic rate and protein
catabolism exceeds: A. 10 percent
B. 25 percent
C. 40 percent
D. 50 percent
40. One gm of nitrogen is equivalent to how many grams of muscle:
A. 10
B. 20
C. 30
D. 40
41.A 19-year-old boy developed anaphylaxis after a mismatched blood transfusion. The
most likely mechansim of tissue injury is due to

[Link] activation
[Link] cell activation
[Link] activation
[Link] cells activation

42. A 56-year-old lady whois a known case of ischemic heart disease presented to the
ER with increasing shortness of breath and ankle [Link] auscultation of the
precordium there is a gallop rhythm,and respiratory auscultation revealed
bilateralinspiratory [Link] of the following drugs should be given
immediately?

[Link]
[Link]
[Link]
[Link]

43. For total parenteral nutrition, the preferred vein is:

A. Vein on forearm
B. Vein on antecubital fossa
C. Subclavian vein
D. Internal jugular vein
44. One litre of 20 percent intralipid is equivalent to:
A. 1000 kcal
B. 1500 kcal
C. 2000 kcal
D. 3000 kcal
45. Dermatitis, anaemia and increased capillary permeability in a patient on IV
alimentation with casein and glucose indicates deficiency of:
A. Iron
B. Copper
C. Essential fatty acids
D. None of the above
46. Jaundice during parenteral nutrition is due to:
A. Haemolysis
B. Cholestasis
C. Hepatitis
D. CBD stone

47. Healing by first intention means:

A. Using catgut
B. Obtaining union between 2 edges of an incision without subsequent break down
C. Immediate use of a protective dressing
D. Using staples
E. A method whereby an ulcer heals
48. The best dressing is:
A. Swab
B. Gauze
C. Skin
D. Silver foil
E. Aerosol plastic spray
49. Granulation tissue refers to:
A. Platelets and fibrin
B. Inflammatory cells and damaged tissues
C. Budding capillaries and fibroblasts
D. Slough and blood (p. 84)
50. Epithelialisation of wound is mediated by:
A. TGF β
B. EGF
C. FGF
D. PDGF
E. Each of the above
51. The organ which can regrow without scar after injury is:
A. Brain
B. Heart
C. Liver
D. Kidney
52. Debridement means:
A. Excising 1 mm of skin from the edge of a wound
B. Not excising skin but excising all damaged muscle
C. Amputation
D. Laying open all layers of a wound and excision of devitalised tissue
E. Suturing of a wound
53. Scalpel blade size useful for arteriotomy is:
A. 10
B. 11
C. 15
D. 22
54. Regarding wound closure by suture all are true except:
A. Wound edges be left slightly gaping to allow for swelling
B. Edges should be inverted
C. Knot should be to one side
D. Knot must be tight
55. As a general rule non-absorbable sutures from face be removed after:
 A. 2-3 days
B. 5 day
s C. 7 days
D. 14 days
56. During moderate exercise there is a decrease in:
[Link] oxygen difference
[Link] diastolic volume
[Link]
[Link] peripheral resistance (TPR)
57. All the following are non-absorbable sutures except:
A. Nylon
B. Polyester
C. Polybutester
D. Polypropylene E. Linen
58. Absorption of chromic catgut sutures in body is within:
A. 30 days
B. 60 days
C. 90 days
D. 180 days
59. Tissue reaction is minimal with which suture
A. Polydeaxanone
B. Polyglycolic acid
C. Polyglyconate
D. Polyglactin
60. In vessel anastomosis all are true except:
A. Polypropylene like suture gives best result
B. Intimal suture line be smooth
C. Needle must pass from outward to within
D. All knots must be secure

61. Advantages of laparoscopic surgery include:

A. Minimal trauma
B. Early recovery
C. Less post-surgical adhesion
D. All of the above

62. During laparoscopic cholecystectomy, bleeding can occur from:

A. Trocar site
B. Gallbladder bed
C. Cystic artery
D. All of the above
63. Robert Koch was by profession a:
A. Pathologist
B. Microbiologist
C. Surgeon
D. Chemist
64. Penicillin was first experimented in infection with:
A. Staphylococcus
B. Streptococcus
C. Clostridia
D. Pneumococcus
65. Positive risk factors for wound infection include:
A. Obesity B
b. Foreign body
C. Poor surgical technique
D. All of the above
66. The main organism of endotoxin release in multiple organ dysfunction syndrome is:
A. Proteus vulgaris
B. E. coli
C. Pseudomonas
D. Acenetobacter
67. The human body contains approximately how much organisms:
10
A. 10
14
B. 10
18
C. 10
22
D. 10

68. Which of the following surgical dressings has maximum advantage for deep wound
dressing:
A. Polymeric film
B. Hydrogels
C. Hydrocolloids
D. Fibrous polymers
69. What is the consensus about preoperative shaving:
A. Should be avoided
B. Is a must to a successful surgery
C. Clipping is best
D. Poses higher infection rate when done one night before

70. Antibiotic prophylaxis before surgery should be with:

A. Single low dose of broad spectrum antibiotic
B. Multiple small doses of broad spectrum antibiotic
C. Single high dose of broad spectrum antibiotic
D. Multiple high dose of broad spectrum antibiotic
71. Which operation theaters need ultraclean air:
A. General surgery
B. Orthopedics
C. Obstetrics
D. Neuro surgery
72. Which of the following is a medical device, needing decontamination:
A. Prostheses
B. Wheel chair
C. Continence aids
D. Contact lens
E. Each of the above
73. Flexible endoscopes are best disinfected by:
A. Savlon
B. Formaldehyde
C. Glutaraldehyde
D. Ethylene oxide
74. Ideal steam sterilisation of 121°C with pressure of 15lb/inch2 should have hold time
of:
A. 10 min
B. 15 min
C. 30 min
D. 45 min
75. Plastic components are best sterilised by:
A. Steam
B. Hot air
C. Ethylene oxide
D. Boiling
76. In almost all cases of orthopedic infections the contaminating organism is obtained
from:
A. Instruments
B. Patient’s skin
C. Room air
D. Fluids
77. Peracetic acid is used for sterilization of:
A. Sharp instruments
B. Heat sensitive instruments
C. Flexible endoscopes
D. Plastics

78. An ideal operating room should have how many doors:

A. 4
B. 5
C. 6
D. 7
79. The ideal temperature of operating room be 19º-22ºC with humidity of:
A. 20-30 percent
B. 35-45 percent
C. 45-55 percent
D. 55-65 percent
80. Wearing of elastic anklets on trousers will reduce bacterial count by nearly:
A. 10 percent
B. 25 percent
C. 50 percent
D. 75 percent
81. Mask use in operation theatre:
A. Protects patient from getting infection
B. Protects the doctor
C. Protect both doctor and patient
D. None is protected
82. To maintain good quality air in operation theater the air changes per hour be:
A. 10
B. 20
C. 30
D. 40
83. Improper arm positioning in operation table can lead commonly to palsy of:
 A. Ulnar nerve
B. Radial nerve
C. Median nerve
D. Scapular nerve
84. Anuria is a condition in which daily urine ouput:
[Link] to five liters
[Link] below 500 ml
[Link] at about1litre
[Link] between 1500 ml and 2 litres
85. For consent to treatment, patient be given information about all except:
A. Consequence of the treatment
B. Anticipated prognosis, side effects, and hazards
C. Reasons for surgery
D. HIV status of team operating
E. Alternative treatment available
86. For informed consent:
A. Signed consent form is the proof
B. Signed consent form along with notes of operative risk and practice is the proof
C. Signed consent form along with consent from near relatives in the proof
D. Signed consent form along with NOC from patient’s lawyer is enough

87. The leading cause of morbidity and mortality by trauma during first four decades of
life is:
A. Fall
B. Act of violence
C. Sports events
D. Vehicular accident

88. Tear of any of the following is life-threatening except:

A. Esophagus
B. Aorta
C. Urinary bladder
D. Diaphragm

89. Oxygen delivery to trauma patients with airway compromise be at a rate of:
A. 5 lit/min
B. 10 lit/min
C. 15 lit/min
D. 20 lit/min
90. Following blunt trauma, the most commonly injured intra-abdominal organ is:
A. Liver
B. Spleen
C. Pancreas
D. Kidneys
91. Intraosseous fluid therapy in small children is via:
A. Ileum
B. Lower tibia
C. Upper tibia
D. Lower femur
92. In delayed primary closure:
A. Delayed primary suture performed between 4th and 6th day after injury if wound is
healthy
B. If dead muscle is found at time of delayed primary closure, the muscle is excised and
wound closed
C. Traumatic amputations are completed at the lowest level and wound closed with
drain
D. Delayed primary suture performed in the 2nd week E. If there is much skin loss, split
skin graft is put immediately

93. For most injuries on the right side of colon:

A. Primary repair and anastomosis is satisfactory
B. A vented ilio transverse colostomy may not be warranted despite extensive
contamination and blood loss
C. Proximal ileostomy and distal mucous fistula is essential
D. All of the above procedures are mandatory E. None of the above procedures are
required

94. For left sided colonic injuries:

A. Managed conservatively
B. Managed by putting a corrugated rubber drain in the peritoneal cavity
C. If injury is associated with high risk factors, the injured colon resected, proximal
colostomy and distal mucous fistula made
D. If the interval between injury and operation is more than 8 hrs one stage procedure
may be undertaken

95. Musculo cartilaginous imaging is best done by:

A. X-ray
B. CT scan
C. MRI
D. US

96. Callus in MRI is seen as:

A. White
B. Opaque
C. Black
D. Gray
97. The level of consciousness in head injury is assessed by:
A. Glasgow Coma Scale
B. Pitsburg’s brainstem reflex
C. Doll’s eye phenomenon
D. Cold caloric response
E. Grasp reflex
98. Which of the following is preferred cannulation site for total parenteral nutrition:
a. Subclavian vein
b. Great saphenous vein
c. Median cubital vein
d. External jugular vein

99. Which is best method for supplementing nutrition in patients, who have undergone
massive resection of the small intestine is:
a. Parenteral
b. Enteral
c. Gastrostomy
d. All of the above

100. Which of the following solution is a colloid:

a. Normal saline
b. Albumin
c. Ringer lactate
d. Dextrose 5%

101. Pneumoperitoneum is created by:

a. O2
b. Co
c. Co2

102. Which of the following catheter material is most suited for long term use is:
a. Latex
b. Silicone
c. Rubber
d. Polyurethane

103. The following are absorbable suture materials, except:

a. Catgut
b. Polyglycolic acid
c. Prolene
d. Polydiaxone

104. In traumatic cases, shock is most likely due to:

a. Injury to intra-abdominal solid organ
b. Head injury
c. Septicemia
d. Cardiac failure
105. Which of the following is ideal in moderate hemorrhagic shock?
a. Dextrose
b. Ringer lactate
c. Blood
d. Dextran
106. Which of the following are colloids?
a. Albumin
b. Ringer lactate
c. Physiological saline
d. Dextrose saline
107. For shock best guidelines to check for adequacy of fluid therapy:
a. Hemoglobin
b. Urine output
c. Blood pressure
d. CVP
108. Mismatched blood transfusion manifests intraoperatively as:
a. Rise in BP
b. Excessive bleeding from the surgical site
c. Dyspnea
d. Hematuria
109. Massive transfusion in healthy adult male can
cause hemorrhage due to:
a. Increased tPA
b. Dilutional thrombocytopenia
c. Vitamin K deficiency
d. Decreased fibrinogen

110. Which of the following is triad of complication of massive blood transfusion?

a. Alkalosis, hypothermia, coagulopathy
b. Alkalosis, hyperthermia, coagulopathy
c. Acidosis, hyperthermia, coagulopathy
d. Acidosis, hyperthermia, coagulopathy
111. Which of the following should be avoided initially in hemorrhagic shock?
a. Ringer lactate
b. Dextrose 5%
c. Normal saline
d. None of the above
112. Investigation of choice for diagnosing intra-abdominal bleeding in an unstable
patient:

a. CT scan
b. MRI scan
c. USG
d. diagnostic peritoneal lavage

113. Source of chronic subdural hematoma is:

a. Arterial
b. Tear of bridging veins
c. Capillaries
d. None of the above

114. Extradural hemorrhage commonly occurs from tearing of:

a. Maxillary artery
b. Middle meningeal artery
c. Bridging veins
d. All of the above

115. First aid to control external hemorrhage is:

a. Endoscopic control
b. Apply pressure
c. Drugs
d. Operation

116. Catgut is prepared from submucosal layer of the intestine of:

a. Cat
b. Sheep
c. Human being
d. Rabbit
117. Vicryl, the commonly used suture material is a:
a. Homopolymer of polydiozanone
b. Co-polymer of glycolide and lactide
c. Homopolymer of glycolide
d. Homopolymer of lactide
118. PDS is absorbed within:
a. 7 days
b. 21 days
c. 100 days
d. 225 days
119. Surgically used suture material polydioxanone (PDS):
a. Is non absorbable and remains encapsulated
b. Undergoes hydrolysis and complete absorption
c. Undergoes phagocytosis and enzymatic degradation
e. Is specifically used for heart valves or synthetic grafts

120. Ways to prevent a highly infectious disease transmitted by aerosol; precautions

used:
a. Isolation ward
b. Facemask
c. Keep isolated in a room with positive pressure
d. Keep isolated in a room with negative pressure
e. Cohort nursing
121. Use of all the following significantly decreases airborne infection in operating room
except:
a. Laminar air flow
b. Air-conditioning
c. Ultraviolet light
d. Microfilters
122. A chest physician performs bronchoscopy in the procedure room of the out patient
department. To make the instrument safe for use in the next patient waiting outside, the
most appropriate method to disinfect the endoscope is by:
a. 70% alcohol for 5 min
b. 2% glutaraldehyde for 20 min
c. 2% formaldehyde for 10 min
d. 1% sodium hypochlorite for 15 min
123. All the following are sporicidal agents except:
a. Ethylene oxide
b. Phenol
c. Ozone
d. Gluteraldehyde
124. Flexible endoscopes are best sterilized with:
a. Formaldehyde
b. Ethylene oxide
c. Gamma irradiation
d. Peracetic acid
125. Best disinfectant for endoscope is:
a. Hypochlorite
b. Formaldehyde
c. Glutaraldehyde
d. Chlorohexidine

126. What is the best time to give prophylactic antibiotic?

a. 1 day before surgery
b. At the time of skin incision
c. At the time of induction
d. 2 days before to 3 days after surgery

127. Regarding antibiotics true statement:

a. No prophylaxis for clean contaminated surgery
b. No prophylaxis for gastric ulcer surgery
c. Prophylaxis for colorectal surgery
d. Local irrigation with antibiotic
128. When do we have to start antibiotics to prevent postoperative infection?
a. 2 days before surgery
b. After surgery
c. 1 week before surgery
d. 1 hour before surgery and continue after surgery
129. Ideally, when should antibiotics be given during a surgery?
a. At the time of induction
b. At the time incision
c. After the surgery is over
d. A couple of days prior surgery
130. Preferred time for prophylactic antibiotic:
a. 1 day before surgery
b. At the time of induction of anesthesia
c. I.V. during surgery
d. I.M. before 6 hours
e. Orally given
131. Optional timing of administration of prophylactic antibiotic for surgical patients is:
a. At the induction of anesthesia
b. Any time during the surgical procedure
c. One hour after induction
d. One hour prior to induction of anesthesia
132. Preoperative shaving is ideally done at:
a. Evening before
b. Morning of operation
c. Just before operation
d. At operation table
133. In a postoperative intensive care unit, five patients developed postoperative wound
infection on the same wound. The best method to prevent cross infection occurring in
other patients
in the same ward is to:
a. Give antibiotics to all other patients in the ward
b. Fumigate the ward
c. Disinfect the ward with sodium hypochlorite
d. Practice proper hand washing

[Link] period for treatment of open wound in hours:

a. 4
b. 6
c. 12
d. 24

135. Which of the following is the least likely complication after massive blood
transfusion?
a. Hyperkalemia
b. Citrate toxicity
c. Hypothermia
d. Metabolic acidosis
136. Fresh hold blood transfusion is done with in how much time of collection?
a. Immediately
b. 1 hours
c. 4 hours
d. 24 hours
137. Which of the following investigations should be done immediately to best confirm
a non matched blood transfusion reaction?
a. Indirect Coomb’s test
b. Direct Coomb’s test
c. Antibody in patient’s serum
d. Antibody in donor serum
138. Blood components products are:
a. Whole blood
b. Platelets
c. Fresh frozen plasma
d. Leukocyte reduced RBC
e. All of the above
139. A man is rushed to casualty, nearly dying after a massive blood loss in an accident.
There is not much time to match blood groups, so the physician decides to order for one
of the following blood groups. Which one of the following blood
groups should the physician decide:
a. O negative
b. O positive
c. AB positive
d. AB negative
140. One unit of fresh blood arises the Hb% concentration by:
a. 0.1 gm%
b. 1 gm%
c. 2 gm%
d. 2.2 gm%
141. Which of the following statements about acute hemolytic blood transfusion
reaction is true?
a. Complement mediated hemolysis is seen
b. Type III hypersensitivity is responsible for most cases
c. Rarely life threatening
d. Renal blood flow is always maintained
e. No need for stopping transfusion
142. True about blood transfusions:
a. Antigen ‘D” determines Rh positivity
b. Febrile reaction is not due to HLA antigens
c. Anti-d is naturally occurring antibody
d. Cryoprecipitate contains all coagulation factors
143. Which of the following is better indicator of need for transfusion?
a. Urine output
b. Hematocrit
c. Colour of skin
d. Clinical examination
144. 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
145. How long can blood stored with CPDA?
a. 28 days
b. 21 days
c. 35 days
d. 48 days
146. Massive transfusion in previous healthy adult male can cause hemorrhage due to:
a. Increased t-PA
b. Dilutional thrombocytopenia
c. Vitamin K deficiency
d. Decreased fibrinogen
147. Which of the following local anesthetic drug causes hypertension
a. lignocaine
b. bupivacaine
c. procaine
d. cocaineWhi

148. Massive blood transfusion is defined as:

a. Whole blood volume in 24 hours
b. Half blood volume in 24 hours
c. 40% blood volume in 24 hours
d. 60% blood volume in 24 hours
149. After blood transfusion the febrile non-hemolytic transfusion reaction (FNHTR)
occurs due to?
a. Alloimmunization
b. Antibodies against donor leukocytes and HLA Ag
c. Allergic reaction
d. Anaphylaxis
150. Blood grouping and cross-matching is must prior to infusion of:
a. Gelatin
b. Dextran
c. Albumin
d. FFP
151. Which of the following anesthetic drug causes emergence delirium?
a. thiopentone
b. etomidate
c. Ketamine
d. propofol
152. Collection of blood for cross matching and grouping is done before administration
of which plasma expander?
a. Hydroxyl ethyl starch
b. Dextran
c. Mannitol
d. Hemacele
153. Mismatched blood transfusion in anesthetic patient presents is:
a. Hyperthermia and hypertension
b. Hypotension and bleeding from site of wound
c. Bradycardia and hypertension
d. Tachycardia and hypertension
154. All of the following are major complications of massive transfusion except
a. Hypokalemia
b. Hypothermia
c. Hypomagnesaemia
d. Hypocalcaemia

155. A 26-year-old male is given penicillin injection without test dose. The patient starts
complaining of difficulty in breathing,dizziness,lump in his throat and swollen
[Link] BP is 90/50mm/Hg. What is the most suitable medication for this patient?
[Link]
[Link]
[Link]
[Link]

156. A 49 year old woman had been treated for chronic duodenal [Link] for the last
2.5 months she complains of projectile vomiting3-4 times every [Link] examination the
patient is dehydrated,cold and clammy. The best intravenous solution to start
resuscitation in this case is:
[Link]’s solution
[Link] saline
[Link] water
[Link] Saline

157. The most important physical sign differentiating septicaemic shock from
hypovolemic shock is:
[Link] pressure
[Link] temperature
[Link] rate
[Link] rate

158. A 42-year-old male came in an ER with epigastric pain,hematemesis and melena

for one day. Which of the following is the most suitable investigation?
[Link] swallow.
[Link] biopsy.
c.H-Pylori antibody titer.
[Link] Gl endoscopy.

159. A 5-year- old boy presents to ER with bleeding after road traffic [Link] parents
inform you that he is a known case of Hemophilia A. What is the most suitable
transfusion for the child?
[Link]
[Link] VIII
[Link] VII
[Link] Frozen Plasma

160. A 29 year old female received epidural for pain releif in [Link] had a wet tap.
Procedure was successfully repeated in the space above. She developed post dural
puncture headache. The most likely cause for this is:
[Link] arachanoidits
b. Loss of CSF
[Link] of 6th cranial nerves
[Link] of vasa nervosum

161. An11-year-old girl had tonsillectomy. After how many days may reactionary
bleeding occur in her?
[Link] the first week
[Link] tonsillectomy
[Link] the first 24 hours
[Link] 5th post operative day

162. The following blood gases were obtained on a 58 year old drowsy [Link] 7.66
(MR normal 7.35-7.45) P02 95 mmHg(80-100 mmHg) PC0234 mmHg(35-45 mmHg)
HC03 34mmol/L (20-26mmol/L) The most
likely condition is:
[Link] alkalosis
[Link] acidosis
[Link]
[Link] Hemorrhage

163. A 60 year old male was admitted in a state of [Link] was given rapid blood
transfusion following which he complained of pain in the lumbar region,tightness in the
chest and passed high coloured [Link]
most likely reaction he had was:
[Link] reaction
[Link] vs Host disease
[Link] Haemolytic reaction
[Link]

164. A 25 year old patient is having gastroenteritis. On examination he is severely

dehydrated. The most appropriate choice of l/V fluids will be:
a.0.9%Nacl
b.5%Dextrose
[Link]-saline
[Link]'s Lactate
165A 20-year-old AB negative male needs emergency transfusion in a remote area.
Unfortunately,the same blood type is not available in the blood [Link] of the
following blood types will most likely be given
to this patient?
a.A negative
[Link] positive
c.B positive
d.O positive
166. In the preserved blood platelet functional activity practically ceases through:
1. Storage 4:00
2. 12 hours
3. 24 hours
4. 3 days
5. 4 days

167. High risk of hepatitis associated with transfusion of all the above, except:
1. Blood Donors
2. Albumin
3. Plasma
4. cryoprecipitate
5. Platelets

168. The blood which flowed into the chest or abdominal cavity, suitable for reinfusion
in:
1. First day
2. 2 days
3. 3 days
4. 1 week
5. The term is not limited, if it is liquid

169. For neuromuscular moitoring in GA which nerve is monitored

1. ulnar nerve
2. median nerve
3. femoral nerve
4. radial nerve
5. sciative nerve

170. All of the following are seen in reefeding syndrome except:

1. hypokalemia
2. hypocalcemia
3. hypomagnesmia
4. hyperkalemia
5. dehydration

171. Which of the following IV induction agent is preferred in cardiac surgery:

1. propofol
2. ketamine
3. etomidate
4. thiopentone

172Most common cause of death after blood transfusion is

1. TRALI
2. TACO
3. FNHTR
4. Infections
5. Acute hemolytic reaction

173. Which of the following blood component has minimum risk of infections:
1. FFP
2. platelets
3. Packed RBC
4. Whole blood
5. cryoprecipitate

174. The absolute indication for mechanical ventilation in patients with respiratory
failure occurred when a shock is the level of pO2 inhalation of pure oxygen:
1. Below 40 mm Hg. Art.
2. Below 50 mm Hg. Art.
3. Below 60 mm Hg. Art.
4. Below 70 mm Hg. Art.

175. When respiratory failure indication for the transfer of the patient to the ventilator is:
1. pO2 less than 60 mmHg. Art. inhalation of 50% oxygen mixture
2. pO2 less than 60 mmHg. Art..
3. pO2 less than 60 mmHg.
4. pO2 less than 60 mmHg. Art.

176. In deciding to transfer the patient to the ventilator are guided by:
1. Only pO2
2. Only pCO2
3. pO2 and respiration rate
4. pO2 and the power of inspiration

177. When anaphylactic shock occurs massive release:

1. Histamine
2. The histamine and serotonin
3. histamine, serotonin, and slow reacting substance (MRS)
4. histamine, serotonin, bradykinin and acetylcholine

178. Clinic of acute hemorrhage occurs when blood loss in the amount of:
1. 250 ml
2. 500 ml
3. 1000 ml
4. 1500 ml
179. Spinal anesthesia in adult is given at level?
a.T12-L1
b.L1-L2
c.L3-L4
d.L5-S1

180. During the adult cardiac massage palm should be placed:

1. On the upper third of the sternum
2. On the border of the upper and middle third of the sternum
3. On the border of the middle and lower third of the sternum
4. In the fifth left intercostal space

181. In the treatment of asystole apply:

1. The external heart massage
2. Intravenous administration of epinephrine
3. Intravenous bolus of sodium bicarbonate
4. All of the above

182. With the development of anaphylactic shock, the most effective drug for
emergency treatment are:
1. Norepinephrine
2. Prednisolone
3. diphenhydramine
4. Adrenaline

183. Oliguria determined if the daily urine output is:

1. Less than 600 ml / day.

2. Less than 500 mL / day.
3. Less than 400 ml / day.
4. Less than 300 ml / day.
5. Less than 200 ml / day.

184. usually recover after laparotomy normal peristalsis:

1. Stomach through - 4 hours of the small intestine - the colon 24 hours - after the first
meal
2. Stomach - 24 hours of the small intestine - 4 hours colon - 3 days
3. Stomach - 3 days of the small intestine - the colon 3 days -3 days
4. Stomach - 24 hours of the small intestine - the colon 24 hours - 24 hours

185. Pathogenetically reasonable measures with traumatic shock are:

1. Compensation for loss of blood
2. Elimination of acute respiratory failure
3. Blocking the focus of pathological impulses
4. Repair or prosthetic function of damaged organs
5. All of the above

186. The blood should be given in the first few hours of treatment of acute blood loss
from the total volume of infusion of:
1. 25-30%
2. 40-50%
3. 75-80%
4. 10-20%

187. Intravenous infusion is done in bleeding from esophageal varices in portal

hypertension is used to:

1. Increases in blood viscosity

2. Reducing activity of blood
3. Reduce the pressure in the portal vein
4. Activation of the transition process prothrombin to thrombin

188. A 23yr old with suspected rupture of spleen is supposed to undergo emergency
[Link] BP is 90/50 mm of Hg. Ideal aneasthetc agent of choice:

1. opioids
2. remifentanyl
3. halothane
4. etomidate

189. The main indication for transfusion is;

1. Parenteral nutrition
2. Stimulation of hematopoiesis
3. Significant anemia from blood loss
4. Detoxification

190. The clinical picture of acute hemolytic reaction, occurring during the transfusion of
red blood cells, is characterized by:

1. intravascular hemolysis of transfused red blood cells

2. Acute renal failure
3. Fall in blood pressure
4. Increased bleeding

191. If you suspect a haemolysis carried out by centrifugation. Blood should not be
transfused even in extreme conditions, having:

1. Yellow color plasma

2. Pink plasma shade
3. Red plasma shade
4. You can pour any
192. TRALI is seen with which of the component of blood:

1. Platelets
2. whole blood
3. packed rbcs
4. FFP
193. reactionary haemorrhage occurs within
1.1-2 days
2.2-7 days
[Link] than 24 hours
4. after 7 days

[Link] cholecystectomy is
[Link] contaminated
[Link]
[Link]
[Link]

[Link] contains
[Link]
[Link] gelatin
[Link]
[Link]

[Link] conc. of postassium is seen in

[Link]
[Link]
[Link]
[Link]

[Link] of the following is a nonabsorbable suture

[Link].
[Link]
3. polyglactin.
[Link].

[Link] of sodium in ringer lactate is meq/l.

1. 154.
2.12
3.130.
4.144

[Link] case of acute trauma best guideline for quick replacement of fluids is
[Link]
[Link].
[Link] output
4.C.V.P
[Link] may be complicated by.
[Link] jaundice
[Link].
[Link].
[Link]

201,blood loss during major surgery is best estimated by

[Link] assessment
[Link] bottles
[Link]
[Link] output.

[Link] of a transfused RBC is

1. 1 hour
2. 1 days
3.15 days.
4. 50 days.

[Link] can be stored at.

1. 20-24 C FOR 5 DAYS
2. 20-24 C FOR 8 DAYS
3. 4-8 C FOR 5 DAYS
4. 4-8 C FOR 5 DAYS

[Link] reliable way to measure correct placement of ETT after insertion

1.So2 sat.
[Link] level
[Link] tidal CO2 conc.
[Link] pressure.

[Link] of choice from inhalation group

[Link]flurane
[Link]flurane
[Link]flurane
[Link]

206. Drug of choice from intravenous group

[Link]
[Link]
[Link] thiopental
[Link]

[Link] COMMON USED LOCAL ANAESTHESIA

[Link]
[Link]
[Link]

[Link] OF THE FOLLOWING IS NOT COMPONENT OF qsofa SCORE

[Link] respiratory rate

[Link] in BP
[Link]
[Link] in mental statue
209. Which of the following is required routinely
prior to elective surgery in a patient of 65 years.
A. Blood sugar
B. Chest X-ray
C. Clotting screen
D. ECG
E. Each of the above
210. Thromboprophylaxis with anticoagulation
prior to surgery carries risk of:
A. Intracranial and GI bleed
B. Increased surgical blood loss
C. Wound haematoma
D. Each of the above
211. Infection following surgery can be minimised
by:
A. Good patient preparation
B. Good surgical practice
C. Sound sterile technique in theater
D. Preoperative antibiotic prophylaxis
E. Each of the above
212. Preoperative transfusion be considered if Hb
is below:
A. 10 gm percent
B. 8 gm percent
C. 6 gm percent
D. 5 gm percent
213. Diabetics are high risk for surgical procedures
because of:
A. Susceptibility to sepsis
B. Poor wound healing
C. Higher chance of CVA and MI
D. All of the above
214. Investigations advised in a diabetic prior to
surgery include:
A. Carotid Doppler study
B. Lipid profile
C. Glycosylated Hb
D. All of the above
215. Investigations advised for a patient of COPD
planned for surgery include all except:
A. PFT
B. Arterial blood gases
C. Chest X-ray
D. Bronchoscopy
216. Vitamin K dependent clotting factors are all
except:
A. Factor II
B. Factor IV
C. Factor VII
D. Factor IX
217. While signing informed consent, all anticipated complications be explained whose
risk
is above:
A. 1 percent
B. 5 percent
C. 10 percent
D. 25 percent
218. While preparing the operation list, the order
be all except:
A. Diabetics first - dirty cases last
B. Dirty cases first - diabetics last
C. Day cases early
D. Major cases before minor

219. For present day anaesthesia, which of the

following preoperative medication is not
essential:
A. Heavy sedation
B. Antiemetic
C. Anticholinergic
D. All of the above
220. Which of the following nonpungent agent can
replace IV induction agents:
A. Ether
B. Halothane
C. Sevoflurane
D. Midazolam
221. Thiopentone induction is being largely
replaced by:
A. Halothane
B. Propofol
C. Ketamine
D. Midazolam
222. Most common cause of incompatibility in pre transfusion testing:
A. ABO
B. RH system
C. Duffy antigen
D. Lewis antigen
223. Nitrous oxide is:
A. Strong analgesic but weak anaesthetic
B. Weak analgesic but strong anaesthetic
C. Strong analgesic and anaesthetic
D. Analgesic and weak anaesthetic
224. Which of the following is used for induction
of anaesthesia:
A. Ketamine
B. Ether
C. Propofol
D. None of the above

225. The currently preferred agent for maintenance of anaesthesia is:

A. NO2
B. Isoflurane
C. Halothane
D. Ether
226. The narcotic agent used IV to supplement total intravenous anaesthesia is:
A. Morphine
B. Fentanyl
C. Pethidine
D. None of the above
227. Which of the following is a short acting neuromuscular blocking agent:
A. Pancuronium
B. Suxamethonium
C. Alcuronium
D. Sodium glycopyrrolate
228. Can a painful boil be made painless by injection of local anaesthetic into the lesion:
A. Yes
B. No
C. Possibly yes
D. Possibly no
229. Maximum safe dose of 1 percent lignocaine for infiltration is:
A. 25 ml
B. 40 ml
C. 50 ml
D. 75 ml
230. For prolonged local anaesthesia, the local
anaesthetic of choice is:
A. Procaine
B. Xylocaine
C. Bupivacaine
D. Prilocaine
231. Methemoglobinemia is due to overdosage of:
A. Lignocaine
B. Bupivacaine
C. Prilocaine
D. Repivacaine
232. In Bier’s block, the anaesthetic agent is injected into:
A. Artery
B. Vein
C. Brachial plexus
D. Around the nerve
233. The principal side effect of spinal and epidural anaesthesia is:
A. CSF leak
B. Temporal lobe herniation
C. Infection
D. Hypotension
234. The local anaesthetic whose accidental
intravascular injection can cause cardiac arrest
is:
A. Lignocaine
B. Procaine
C. Bupivacaine
D. Prilocaine
235. which of the following drug degrade by Hoffman method
A. suxamthonium
B. vecuronium
C. atracurium
D. rocurinum
236. Neuropathic pain responds to:
A. Opioids
B. COX-2 inhibitors
C. Carbamazepine
D. Diclofenac
237. Which of the following drugs causes adrenal suppression
A. propofol
B. ketamine
C. etomidate
D. thiopentane
238. Before elective anaesthesia, ECG is done to
exclude:
A. Atrial fibrillation
B. Heart block
C. Recent myocardial infarction/IHD
D. All of the above

239. Water is lost from the body by the undermentioned routes except:
A. Lungs
B. Skin
C. Faeces
D. Saliva
E. Urine
240. Pure water depletion occurs under the
following circumstances except:
A. Diminished intake
B. Inability to swallow due to painful
conditions of mouth and pharynx
C. Obstruction in oesophagus
D. Increased loss from lungs after tracheostomy
E. SIADH
241. Water intoxication in surgical wards occurs in
the following circumstances except:
A. Over prescribing of 5 percent glucose
solution
B. Colorectal washouts with plain water
C. During transurethral resection of prostate by
excessive intake of water from irrigation
fluid
D. Syndrome of inappropriate ADH secretion
E. Central diabetes insipidus
242. The most frequent cause of hyponatraemia in
surgical practice is all except:
A. Small intestinal obstruction
B. Duodenal, biliary, pancreatic or high
intestinal, external fistulas
C. Severe diarrhoea
D. SIADH
E. Central diabetes insipidus (CDI)
243. Sudden hypokalaemia occurs:
A. Following severe head injury
B. Following operation trauma
C. Diabetic coma treated by insulin and
prolonged infusion of saline solution
D. All of the above)

244. Scalpel blade size useful for arteriotomy is:

A. 10
B. 11
C. 15
D. 22
245. Regarding wound closure by suture all are true except:
A. Wound edges be left slightly gaping to allow
for swelling
B. Edges should be inverted
C. Knot should be to one side
D. Knot must be tight
246. To prevent terminal dog-ears at closure, the
subcutaneous tissue be excised at:
A. Centre
B. One end
C. Both ends
D. Any of the above
247. As a general rule non-absorbable sutures from face be removed after:
A. 2-3 days
B. 5 days
C. 7 days
D. 14 days
247. The synthetic suture scores over natural
sutures in:
A. Minimal inflammatory reaction
B. More complete absorption
C. Predictable strength
D. All of the above
248. All the following are non-absorbable sutures
except:
A. Nylon
B. Polyester
C. Polybutester
D. Polypropylene
E. Linen
249. Absorption of chromic catgut sutures in body
is within:
A. 30 days
B. 60 days
C. 90 days
D. 180 days
250. Tissue reaction is minimal with which suture
A. Polydeaxanone
B. Polyglycolic acid
C. Polyglyconate
D. Polyglactin
251. In vessel anastomosis all are true except:
A. Polypropylene like suture gives best result
B. Intimal suture line be smooth
C. Needle must pass from outward to within
D. All knots must be secured

252. Duration of spinal anaethesia is based directly on

[Link]
[Link]
c,weight
[Link]

253. Robert Koch was by profession a:

A. Pathologist
B. Microbiologist
C. Surgeon
D. Chemist
2. Penicillin was first experimented in infection
with:
A. Staphylococcus
B. Streptococcus
C. Clostridia
D. Pneumococcus
254. Positive risk factors for wound infection
include:
A. Obesity
B. Foreign body
C. Poor surgical technique
D. All of the above
255. The main organism of endotoxin release in
multiple organ dysfunction syndrome is:
A. Proteus vulgaris
B. E. coli
C. Pseudomonas
D. Acenetobacter

256. Essential granulation tissue constituents

include all except:
A. Fibroblasts
B. Macrophages
C. Polymorphs
D. Budding blood vessels
257. Drug of choice for malignant hyperthermia
A. thiopentone
B. Danntrolene
C. Lidocaine
D. halothane
258. Drug of choice for LAST is
A. thiopentone
B. 20 % intra lipid emulsion
C. Lidocaine
D. halothane
e. dantrolene
259. Which of the following surgical dressings has
maximum advantage for deep wound dressing:
A. Polymeric film
B. Hydrogels
C. Hydrocolloids
D. Fibrous polymers
260. What is the consensus about preoperative
shaving:
A. Should be avoided
B. Is a must to a successful surgery
C. Clipping is best
D. Poses higher infection rate when done one
night before
261. While proceeding to attend an emergency
surgery, scrubbing should be:
A. Vigorous
B. Up to the elbows
C. Confined to the nails
D. Any of the above
262. Which of the following theatre technique does
not help to reduce wound infection:
A. Aseptic technique
B. Drains and wound guards
C. Instrument sterilisation
D. Clean dissection
263. Cephalosporin/gentamicin plus metronidazole prophylaxis is indicated for all the
following types of surgery except:
A. Small bowel
B. Appendix
C. Orthopaedic
D. Oesophagogastric
264. Which of the following antiseptics is not
commonly used for skin preparation:
A. Chlorhexidine
B. Hexachlorphane
C. Cetrimide
D. Povidone iodine
265. MRSA is sensitive to:
A. Flucloxacillin
B. Aztreonan
C. Vancomycin
D. Cephalosporin
266. Which of the following enteric organism is
nonlactose fermenting:
A. Klebsiella
B. Proteus
C. Escherichia
D. All of the above
267. Which of the following organisms is not
susceptible to cephalosporins:
A. E. coli
B. Pseudomonas
C. Strepto. faecalis
D. Staph. aureus
268. which of the following potentially represents the most dangerous situation.

[Link]+mother with 1st Rh + child

b. Rh-mother with 1st Rh + child
c. Rh+mother with 2nd Rh + child
d. Rh-mother with 2nd Rh + child

269. A 35-year-old vegan presents with pain in the muscles,weak bones,repeated

infection,and delayed wound [Link] workup shows deficiency of one of the primary
macronutrients that is minimally
stored in the body,needs to be consumed regularly for survival. The deficient primary
macronutrient is most likely:
[Link]
[Link]
[Link]
[Link]

270. Recommended preoperative fasting interval by ASA for breast milk is

a. 2 hours
b. 4 hours
c. 6 hours
d. 8 hours
271. Which drug causes malignant hyperthermia
A. thiopentone
B. Danntrolene
C. propofol
D. suxamethonium

[Link] statement about Koch’s postulates is not correct?

[Link] organism must be found in every case of the disease
[Link] organism should be isolated and grown in culture
[Link] organism must cause disease when introduced to a healthy host
[Link] organism should remain in the host indefinitely.

[Link] antibiotic is most effective against MRSA and often used as prophylactic
measure in high risk cases?
[Link]
[Link]
[Link]
d. gentamycin
274. Which of the following conditions in pseudomonas spp. most commonly
associated with in hospital settings?
A,appendicitis
[Link]
c. burns and tracheostomy wounds
[Link]

[Link] of the following measures is not part of the universal precautions during
surgery ?

a. Use of a full face mask

b. Double gloving with a larger size on the inside
c. Allowing only essential personnel in the operating room
d. Permitting frequent movement in and out of the operating room
276. What is the recommended practice for preoperative skin shaving to reduce the risk
of surgical site infections?

a. Shaving the night before surgery

b. Shaving immediately before surgery in the operating theatre.
c. Shaving a week before surgery
d. Not shaving at all.

277.A surgeon is performing an operation on a patient with a known HIV infection. What
universal precaution should be taken to minimize the risk of transmission?

a. Single gloving
b. Wearing clogs for comfort
c. Using fully water proff,disposable gowns and drapes.
d. Allowing non essential personnel in the operating room
[Link] type of needle injury carries the greater risk of viral transmission?

a. Blunt needle injury

b. Hollow needle injury
c. Suture needle injury
d. Scalpel injury
[Link] of the following is not a recommended action if clinical response to
empirical antibiotic therapy is poor after sensitivities are known?

a. Changing antibiotics based on c/s results

b. Continuing the initial empirical antibiotics regardless of sensitivity results
 c. Reevaluating the patient and reviewing the culture results
d. Requesting further investigations to exclude persistent infection.
280. In the context of surgical infections, when should antibiotics be administered?

a. Only after c/s results are known

b. Immediately ,based on empirical evidence if indicated.
c. After the infection has fully established
d. Only after mild infections withour systemic signs
281. What are the potential non infectious causes of SIRS in the surgical patients?

a. Sepsis
b. Multiple Trauma
c. Bacteremia
d. UTI
282. Who is known as the father of medicine?

a. Galen
b. Hippocrates
c. Ambroise Pare
d. Ibn sena.
[Link] of the following is a key principle for the use of antibiotics in surgical
infections?

a. Antibiotics can replace surgical drains

b. It can be use for all surgical wounds
c. Use for spreading infections or signs of systemic infection
d. Must wait for c/s results.
[Link] of the following is a feature of minor surgical site infection?

a. Significant quality of pus

b. Delayed return home
c. Systemic illness
d. Discharge of infected serous fluid
[Link] applied the germ theory to reduce infection in fractures using antiseptics?

a. Semmelweis
b. Joseph Lister
c. Robert Koch
d. Louis Pasteur
286. Why should prophylactic antitbiotics be used in surgical procedure?

a. Only in clean surgery without prosthesis

b. Before bacterial growth established
c. During the postoperative period
d. Week before surgery
287. Bleeding in a case of obstructive jaundice is treated with
A. Fresh Frozen Plasma
B. Cryo precipitate
C. Whole blood
D. Buffy coat extract
288. Secondary hemorrhage is usually due to:
a) Trauma
b) Slipped ligature
c) Infection
d) All of the above
289. A comatosed patient who has sustained multiple closed injures is admitted
with severe hypotension. The hypotension ls most probably due to
a) Intracranial hematoma.
b) Cerebral concussion.
c) Internal hemorrhage.
d) Neurogenic shock.
e) Cardiogenic shock.

290. The best guide for the required blood transfusion ln hemorrhagic shock ls :
a) Arterial B.P.
b) Pulse rate.
c) Hematocrits.
d) Central venous pressure (CVP)
291. Secondary hemorrhage ls usually due to:
a. Trauma
b. Slipped ligature
c. infection
d. All of the above

292 . What is the best way to control external hemorrhage?

A. Direct pressure
B. Elevation
C. Proximal tourniquet
D. Artery forceps
293. The following disease may be transmitted during blood transfusion except
a. CMV
b. Malaria
c. Hepatitis A
d. Brucellosis

294. The best guide for the required blood transfusion ln hemorrhagic shock ls :
a. Arterial B.P.
b. Pulse rate.
c. hematocrit.
d. Central venous pressure (CVP)

295. The most serious complication of blood transfusion is:

a. Pyrogenic reactions.
b. Thrombophlebitis of recipient vein.
c. Circulatory overloading.
d. incompatibility reactions.
e. Viral hepatitis.

296. Which is the best fluid for resuscitation during shock state?
A. Crystalloids
B. Colloids
C. Plasma substitutes
D. 5% dextrose

297 . 5% dextrose in normal saline is -

A. Hypotonic
B. Isotonic
C. Hypertonic
D. A blood substitutes

298. Best treatment for external hemorrhage from an extremity is

A. elevation of the limb
B. proximal tourniquet
C. direct pressure
D. ligation of the bleeding vessel

299. The most serious complication of blood transfusion is:

a) Pyrogenic reactions.
b) Thrombophlebitis of recipient vein.
c) Circulatory overloading.
d) incompatibility reactions.
e) Viral hepatitis.

300. The earliest sign of hypocolcaemia is

a) Carpo-pedal spasms.
b) Positive Chovstek's sign.
c) Positive Trausseou's sign.
d) Tingling of fingers and circumoral region.
e) Defective blood coagulation,

301 . Transfusion of one unit of factor VIII concentrate will raise the level by
A. 1%
B. 2%
C. 10%
D. 25%

302. Ringer lactate does not contain

A. Sodium
B. Potassium
C. Chloride
D. Bicarbonate

303. Which of the following is not an ECG sign of hypokalemia

A. Tall T waves
B. U waves
C. Flat ST segment
304. Which of the following is an ECG sign of hyperkalemia
A. Tall T waves
B. U waves
C. Flat ST segment

305. The most effective treatment of anaphylactic shock is :

a) lV antihistaminic.
b) lV corticosteroids.
c) lV antibiotics
d) Intracardiac adrenaline.
306. The following conditions may lead to shock except:
a) Penicillin injection.
b) Myocardial infarction.
c) Quinsy.
d) Loss of 8% blood volume.
e) None of the above.

307. As regard vasovagal shock all are true except:

a) Usual cause is trauma to trigger area.
b) Psychic trauma is o recognized cause.
c) Atropine is the gold standard treatment of the condition.
d) Usually there is peripheral pooling of blood.

308. Septic shock responds best to

a) Massive antibiotics.
b) Intravenous infusion.
c) Adrenocortical steroids.
d) Drainage of septic collections.
e) Vasopressors.
309. In an otherwise healthy male with previously normal pulmonary and
cardiac function, how much of the pulmonary vascular bed must usually be
occluded to produce an unstable cardiovascular state (shock)?
a. 10%.
b. 20%.
c. 40%.
d. More than 50%.
310. The following types of shock may complicate femoral fracture except:
a. Hypovolemic.
b. Neurogenic.
c. Carcinogenic.
d. Septic.

311. The following conditions may lead to shock except:

a. Penicillin injection.
b. Myocardial infarction.
c. Quinsy.
d. Loss of 8% blood volume.
e. None of the above.
312. As regard vasovagal shock all are true except:
a. Usual cause is trauma to trigger area.
b. Psychic trauma is a recognized cause.
c. Atropine is the gold standard treatment of the condition.
d. Usually there is peripheral pooling of blood.

313. A comatosed patient who has sustained multiple closed injures is admitted
with severe hypotension. The hypotension is most probably due to :
a. Intracranial hematoma.
b. Cerebral-concussion.
c. Internal hemorrhage.
d. Neurogenic shock.
e. Cardiogenic shock.

314. After trauma, hypovolemic shock can be due to all except -

A. Pelvic fracture
B. Head injury
C. Blunt trauma to abdominal viscera
D. Hemothorax

315 . The recommended fluid for initial fluid challenge in a trauma victim in shock
is -
A. 5% dextrose
B. 10% dextrose
C. Dextrose normal saline
D. Hartman's solution

316 . A patient is brought to casualty with severe hypotension following a road

traffic accident. No external injury is evident. The cause of hypotension is:
A. Fracture rib
B. Intrathoracic and abdominal bleed
C. Iatrogenic shock
D. Intracranial bleed
317 . A 32yrs blunt trauma patient is brought to the emergency, in a state of shock;
he is not responding to IV crystalloids; Next step of management would be:
A. Albumin transfusion
B. Abdominal compression
C. An immediate laparotomy
D. Blood transfusion
318 . Postoperative shock, all are true except:
A. Hypotension is the 1st sign of hypovolemia
B. Acute tubular necrosis due to hypoperfusion is reversible.
C. It should be initially managed with normal saline.
D. Hypovolemia is the most common cause of postoperative kidney failure.
319 . A 35 year old Mona developed feature of septicemia Shock in form of
hypotension and low urine output. She was being the treatment for colonic
necrosis. What will be the m/n:
A. IV fluid + dopamine
B. IV fluid only
C. Only dopamine
D. Antibiotic in high dose
320 . Plasma expands are used in which shock ?
A. Septic shock
B. Vasovagal shock
C. Neurogenic shock
D. Cardiogenic shock

321 . A patient with multiple injuries, ribs, abdomen, spine. Has bradycardia and
hypotension - which type of shock is this?
A. Anaphylactic
B. Neurogenic
C. Hypovolemic and neurogenic
D. Hypovolemic and septic
322 . Which of the following is not an immediate cause of death?
A. Thromboembolism
B. Shock
C. Septicemia
D. Ventricular fibrillation
323. Which of the following statements regarding nutritional requirements in
infants are true?
a. The total daily water requirement is estimated to be 100 ml/100 kcal ingested
b. The resting energy expenditure is approximately twice that of an adult
c. The highest rate of nitrogen retention with parenteral nutrition occurs in infants
given approximately 40% of the calories as carbohydrate and the remainder as fat
d. The protein requirement for a newborn infant is approximately 2.5 g/kg/day
324. Which of the following will not lead to decrease in cell mediated immunity
A. protein energy malnutrition
B. zinc deficiency
C. selenium deficiency
D. iron deficiency
325. Parenteral nutrition is best given through
A. femoral vein
B. saphenous vein
C. subclavian vein
326 . All nutrients are included in Total Parental Nutrition, except
a. Proteins
B. Fibers
C. Lipids
D. Carbohydrates
327 . One is not the indication of total parenteral nutrition -
A. Acute pancreatitis
B. Enterocolic fistula
C. Chronic liver disease
D. Faecal fistula
328 . Most common metabolic complication following total parenteral nutrition is
A. Hepatic dysfunction
B. Metabolic acidosis
C. Hypophosphatemia
D. Essential fatty acid deficiency

329. All are components of Primary Health Care except

A. providing essential drugs
B. supplementary nutrition
C. treatment of locally endemic diseases and minor ailments
D. prevention of locally endemic diseases
330. A patient on total parenteral nutrition for 20 days presents with weakness,
vertigo and convulsions. Diagnosis is:
A. Hypercalcemia
B. Hyperkalemia
C. Hypomagnesemia
D. Hyperammonemia

331. A patient undergoes a prolonged and complicated pancreatic surgery for

chronic pancreatitis. Most preferred route for supplementary nutrition in this
patient would be:
A. Feeding Gastrostomy
B. Total Parenteral Nutrition
C. Oral feeding
D. Feeding Jejunostomy

332 . Which of the following is not an indication for parenteral nutrition -?

A. Ileus
B. Severe pancreatitis
C. Colo cutaneous fistula
D. Massive bowel resection
333. Which of the following is not a complication of total Parenteral Nutrition -?
A. Essential fatty acid deficiency
B. Metabolic bone disease
C. Hypophosphatemia
D. Congestive cardiac failure
334 . Most common complication of Total Parenteral Nutrition (TPN) isA. Acalculous
Cholecystitis
B. Hypokalemia
C. Catheter Related complications
D. Acidosis

335. 29yrs- old man, met an accident with a car and has been in 'deep coma' for
the last 15 days. Which of the following is the most suitable route for the
administration of protein and calories?
A. Nasogastric tube feeding
B. Central venous hyperalimentation
C. Jejunostomy tube feeding
D. Gastrostomy tube feeding

336. Which of the following induction agent is used to produce a 'street-fit' person
following surgery
A. midazolam
B. propofol
C. alfentanyl
D. thiopentone
337. Which of the following reacts with Soda lime in anaesthetic circuits
A. trichloroethylene
B. isoflurane
C. halothane
D. methoxyflurane
338. Which of the following anesthetics sensitizes the heart to catecholamines
A. Halothane
B. Isoflurane
C. Enflurane-
339. Thiopentone sodium has a short duration of action because
A. it is rapidly metabolized
B. it is rapidly redistributed

340. In emergency caesarian section rapid induction of anesthesia is done to

A. prevent gastric aspiration
B. prevent fetal depression
C. to decrease awareness
341 . Post operative Pulmonary Thromboembolism is seen in all, except:
A. Pregnant female
B. Oestrogen therapy
C. Tall and thin man
D. Obese male
342 . Which of these is not a risk factor for thromboembolism:
A. Myocardial infarction
B. Hypertension
C. Estrogen therapy
D. Superficial thrombophlebitis
343. Upper does limit of plain lignocaine in a 70 kg adult is -
A. 100 mg
B. 150 mg
C. 200 mg
D. 250 mg

344. What should be avoided when preparing the operative site with alcohol-based
antiseptic?
A. Using multiple applications
B. Leaving a pool of fluid on the skin
C. Using a concentrated solution
D. Including the nails in the scrub

345. What should be done for surgical patients preoperatively to reduce the risk of
acquiring MRSA?
A. Long preoperative hospital stay
B. No handwashing by medical staff
C. Short preoperative hospital stay
D. Preoperative skin shaving the night before surgery

346. What should be done immediately after a needle-stick injury occurs during surgery?
A. Continue with the procedure and report after completion
B. Wash the injured part under running water and report the incident
C. Apply antiseptic and ignore if there is no bleeding
D. Bandage the wound and keep working

347. What is the primary source of postoperative wound infections?

A) Exogenous sources from the ward or staff
B) Endogenous sources within the patient
C) Contaminated surgical instruments
D) Improper surgical technique

348. Which of the following statements about bacteraemia is FALSE?

A) It is common after superficial SSIs.
B) It can follow instrumentation in infected bile or urine.
C) It may occur through bacterial infection of indwelling intravenous cannulae.
D) It is dangerous if the patient has a prosthesis.

349. What is the benefit of rotating antibiotics in surgical units with resistant
Pseudomonas or other Gram-negative species?
A) Prevents overuse of a single antibiotic
B) Reduces the need for combination therapy
C) Lowers the cost of antibiotic therapу
D) Decreases the risk of antibiotic resistance

350. In cases of severe wound contamination, what is the recommended approach to

wound closure?
A. Immediate primary closure
B. Delayed primary closure
C. Continuous irrigation and primary closure
D. Leaving the wound open and secondary closure

351. What is the 'decisive period' in the context of preventing surgical infections?
A. The first 24 hours post-surgery 37/75
B. The first 48 hours post-surgery
C. Up to a 4-hour interval before bacterial growth becomes established
D. The preoperative preparation period

352. Who discovered penicillin, and who later isolated it for clinical use?
A. Robert Koch and Joseph Lister
B. Louis Pasteur and Ignaz Semmelweis
C. Alexander Fleming and Florey and Chain
D. Howard Florey and Ernst Boris Chain

353. Which factor is NOT a risk for increased wound infection?

A. Malnutrition
B. Immunosuppression
C. Poor surgical technique
D. Young age

354. What should be done if an infected wound is under tension or shows clear
evidence of suppuration?
A. Leave the wound as it is and monitor
B. Apply topical antiseptics and continue antibiotics
C. Remove sutures or clips and allow pus to drain
D. Perform a secondary closure immediately

355. Who formulated the first definition of infective disease through a set of postulates?
A. Louis Pasteur
B. Joseph Lister
C. Robert Koch
D. Ignaz Semmelweis

356. What is the primary treatment for an abscess?

A. Antibiotic therapру
B. Needle aspiration
C. Incision and drainage
D. Steroid therapy

357. What is the most likely complication of changing antibiotics without clear clinical
indications?
A. Improved patient outcomes
B. Decreased risk of antibiotic resistance
C. Increased risk of complications such as C. difficile enteritis
D. Faster resolution of infection

358. What is the most common cause of an abscess following surgery?

A. Pseudomonas aeruginosa
B. Staphylococcus aureus
C. Escherichia coli
D. Streptococcus pyogenes

359. Which of the following organisms is most commonly associated with urinary tract
infections, particularly in relation to urinary catheterization?
A. Escherichia coli
B. Klebsiella spp.
C. Proteus
D. Pseudomonas spp

360. Which host factor does NOT determine whether a wound will become infected?
A. Host response
B. Virulence of the infective agent
C. Size of bacterial inoculum
D. Age of the patient

361. Who discovered the germ theory of disease?

A. Robert Koch
B. Louis Pasteur
C. Joseph Lister
D. Alexander Fleming

362. What was a common belief about pus in infected wounds among early
civilizations?
A. Pus should always be avoided.
B. Pus should be left untreated.
C. Pus should be localized and drained.
D. Pus indicated a fatal infection.

363. Which of the following is the most common source of postoperative wound
infections?
A. Exogenous bacteria from hospital staff
B. Bacteria present in the ward environment
C. Endogenous bacteria within the patient
D. Bacteria from surgical instruments

364. What is the primary synergistic organism with aerobic Gram-negative bacilli in
causing surgical site infections (SSIs) after bowel operations?
A. Clostridium perfringens
B. Bacteroides fragilis
C. Staphylococcus aureus
D. Enterococcus spp

365. What is the main concern with the misuse of antibiotic therapy in surgical practice?
A. Increased cost
B. Increased recovery time
C. Risk of resistance
D. Allergic reactions

366. Which practice significantly reduced puerperal sepsis according to Ignaz

Semmelweis?
A. Use of antibiotics
B. Sterilization of instruments
C. Handwashing
D. Aseptic surgical techniques

367. Which civilization first documented the use of salves and antiseptics to prevent
surgical site infections?
A. Greeks
B. Egyptians
C. Assyrians
D. Romans

368. What type of surgical site infection (SSI) involves infection in the deeper
musculofascial layers?
A. Superficial SSI
B. Deep SSI
C. Organ space infection
D. Superficial surgical wound infection

369. Which antibiotic is typically used to treat infections caused by Bacteroides fragilis?
A. Metronidazole
B. Penicillin
C. Vancomycin
D. Ciprofloxacin

370. What is a key principle in the use of antibiotics for surgical infection treatment?
A) Antibiotics can replace the need for surgical drainage
B) Antibiotics should only be used for localized infections
C) Determining the organism and its sensitivity is crucial
D) Broad-spectrum antibiotics should always be used

371. Why is it important for medical and nursing staff to wash their hands after any
patient contact?
A. To maintain cleanliness
B. To prevent cross-contamination and infection
C. To satisfy hospital policies
D. To avoid unpleasant odors

372. What type of anesthesia is required for the creation of a surgical jejunostomy?
A) Local anesthesia
B) Regional anesthesia
C) General anesthesia
D) No anesthesia

373. What is the recommended nutritional support strategy for patients at risk of
refeeding syndrome?
A) Start at 20 kcal/kg per day
B) Start at 10 kcal/kg per day
C) Start at 5 kcal/kg per day
D) Start at 15 kcal/kg per day

374. Which of the following metabolic processes provides glucose production during
prolonged fasting (>48 hours)?
A) Glycogenolysis
B) Protein catabolism
C) Lipolysis
D) Adaptive ketogenesis

375. What should be included in the assessment of fluid replacement needs in a

patient?
A. Blood type and cross-match
B. Measurement of pulse and blood pressure
C. Respiratory rate
D. Complete blood count (CBC)
376. Which of the following is a common long-term complication at the site of a
jejunostomy insertion?
A) Thrombosis
B) Granulation tissue formation
C) Cardiac arrhythmia
D) Pulmonary edema

377. Which patients are at risk of developing refeeding syndrome?

A) Patients with a BMI >25 kg/m²
B) Patients with a BMI 15% in the last 3-6 months
C) Patients with mild weight loss
D) Patients with a history of regular exercise

378. Which of the following hormones is NOT typically increased during the metabolic
response to trauma?
A) Adrenaline (epinephrine)
B) Insulin
C) Cortisol
D) Glucagon

379. What should be included in the parenteral nutrition solution for patients requiring
long-term parenteral nutrition over many months? A) Daily doses of vitamin C
B) Weekly doses of vitamin D
C) Single-dose injection of vitamin B12
D) Monthly doses of folic acid

380. What is one of the first steps in inserting a nasojejunal feeding tube?
A) Administering a sedative
B) Measuring the distance between the xiphisternum and the tip of the nose
C) Confirming tube placement with a chest radiograph
D) Performing an abdominal ultrasound

381. Which of the following is commonly included in a parenteral nutrition formulation?

A) Pure glucose
B) Lipid emulsion with essential and non-essential amino acids
C) Steroids
D) Antacids

382. What is the primary indication for total parenteral nutrition (TPN)?
A) Mild dehydration
B) Short bowel syndrome
C) Minor surgery recovery
D) Uncontrolled hypertension

383. Which patient condition makes enteral feeding inappropriate?

A) Chronic malnutrition
B) Insufficient length of functioning intestine
C) Mild dehydration
D) Stable diabetes mellitus

384. What is a common complication of a gastrostomy regardless of the placement

technique?
A) Hypertension
B) Tuberculosis
C) Localized sepsis around the insertion site
D) Decreased lung capacity

385. Which muscle relaxant can cause histamine release and allergic reactions as a
disadvantage?
A. Suxamethonium
B. Vecuronium
C. Atracurium
D. Rocuronium

386. Which nerve block approach is commonly used for shoulder surgery?
A. Supraclavicular
B. Interscalene
C. Infraclavicular
D. Axillary

387. Which of the following is a common side effect of opioids?

A. Hypertension
B. Tachycardia
C. Nausea and vomiting
D. Hyperglycemia

388. What is a disadvantage of using vecuronium as a muscle relaxant?

A. Short duration of action
B. Hepatic and renal clearance dependency
C. Rapid onset of action
D. High incidence of allergic reactions

389. Which local anaesthetic agent has the highest maximum dose without adrenaline?
A. Lidocaine
B. Bupivacaine
C. Prilocaine
D. Ropivacaine

390. What is the primary advantage of adding adrenaline to local anaesthetic solutions?
A. Reduces the risk of infection
B. Decreases systemic toxicity
C. Prolongs the duration of action
D. Increases sensory-motor separation.

391. Who developed the original Laryngeal Mask Airway (LMA)?

A. Dr. William Morton
B. Dr. Horace Wells
C. Dr. John Snow
D. Dr. Archie Brain

392. How do non-depolarising muscle relaxants achieve their effect?

A. By direct muscle relaxation
B. By competitive blockade of postsynaptic receptors
C. By stimulating the vagus nerve
D. By increasing acetylcholine levels

393. What is the purpose of the cuff on an endotracheal tube?

A. To enhance patient comfort
B. To facilitate positive pressure ventilation and protect lungs from aspiration
C. To reduce the need for muscle relaxants
D. To increase the speed of induction

394. Which local anaesthetic is known to cause methaemoglobinaemia when

overdosed?
A. Lidocaine
B. Bupivacaine
C. Prilocaine
D. Ropivacaine

395. Which local anaesthetic should never be used intravenously due to its high
cardiotoxicity?
A. Lidocaine
B. Bupivacaine
C. Prilocaine
D. Ropivacaine

396. What is the main advantage of ultrasound-guided regional anaesthesia?

A. Shorter duration of anaesthesia
B. Lower success rate
C. Reduced risks of nerve damage and intravascular injection
D. Higher dose requirements

397. Which type of pain is poorly responsive to opioids?

A. Nociceptive pain
B. Neuropathic pain
C. Inflammatory pain
D. Acute pain

398. Which neuromuscular blocking agent is most commonly used for rapid
endotracheal intubation?
A. Vecuronium
B. Atracurium
C. Suxamethonium
D. Rocuronium

399. Which technique allows for prolonged analgesia by multiple dosing or continuous
infusion through a catheter?
A. Spinal anaesthesia
B. Epidural anaesthesia
C. Bier's block
D. Interscalene block

400. What is a potential complication of endotracheal intubation?

A. Enhanced blood flow
B. Reduced oxygen demand
C. Trauma to teeth, pharynx, or larynx
D. Increased muscle tone

401. Which agent has largely replaced thiopentone as the most widely used induction
agent in general anaesthesia?
A) Ketamine
B) Propofol
C) Etomidate
D) Sevoflurane

402. What is the function of double-lumen tubes in surgery?

A. To provide supplemental oxygen
B. To collapse one lung for surgical procedures C. To reduce anaesthesia depth
D. To increase blood flow to the lungs

403. What is the primary advantage of rocuronium in rapid-sequence induction?

A. Long duration of action
B. Non-dependence on renal clearance
C. Rapid onset and reversal with sugammadex D. Minimal cardiovascular effects

404. What is a key reason for maintaining the airway during general anaesthesia?
A) To increase oxygen levels
B) To prevent muscle tone loss
C) To keep the airway open due to loss of muscle tone
D) To improve blood circulation
405. What is a major risk associated with the long-term use of NSAIDs?
A. Hypotension
B. Gastrointestinal bleeding
C. Increased energy levels
D. Improved renal function

406. Which manoeuvre is used to facilitate bag-mask ventilation during induction of

anaesthesia?
A) Head tilt, chin lift
B) Neck extension
C) Shoulder lift
D) Leg elevation

407. What is a notable adverse effect of suxamethonium?

A. Bradycardia
B. Muscle pain
C. Hypertension
D. Dry mouth

408. What is the recommended management for an elderly patient on aspirin who
presents with a chronic subdural haematoma and stable neurology?
A) Immediate burr hole drainage
B) Discontinuation of aspirin and close monitoring
C) Continuation of aspirin theraру
D) Administration of thrombolytics

409. Which of the following management strategies is preferred for a smallchronic

subdural haematoma without significant symptoms?
A) Immediate surgical evacuation
B) Administration of high-dose corticosteroids C) Conservative management
D) Continuous anticoagulation

410. What imaging modality is the most appropriate for diagnosing an extradural
haematoma?
A) MRI
B) Plain X-ray
C) CT scan
D) Ultrasound

411. What is the typical treatment for a significant chronic subdural haematoma
presenting with mass effect and neurological deficits?
A) Administration of intravenous antibiotics
B) Burr hole drainage
C) Endovascular coiling
D) Radiotherapy

412. A 22-year-old man presents with a severe headache, hypertension, bradycardia, and
irregular respirations following a head injury. What is the most appropriate immediate
intervention?
A. Administer intravenous corticosteroids
B. Perform an urgent CT scan
C. Administer antihypertensive medication
D. Prepare for emergency decompressive craniectomy

413. A patient on anticoagulant therapy presents with a chronic subdural haematoma.

What is the first step in the management of this patient?
A) Continue anticoagulation therapy
B) Immediate surgical intervention
C) Reversal of anticoagulation
D) Administration of thrombolytics

414. What is the initial management for a patient diagnosed with a significant
extradural haematoma?
A) Observation and serial imaging
B) Administration of high-dose corticosteroids C) Urgent transfer to a neurosurgical
facility for possible evacuation
D) Immediate anticoagulation
415. Which patient population is most commonly affected by chronic subdural
haematomas?
A) Young athletes
B) Middle-aged adults
C) Elderly individuals, especially those on anticoagulants
D) Newborns

416. What is the cause of vasovagal shock?

A. Pooling of blood in the lower limbs
B. Severe infection
C. Head injury
D. Severe unbearable pain
417. One of the causes of neurogenic shock is
A. Spinal anaesthesia
B. Head injuries
C. Meningitis
D. Cardiac arrest
418. Injury to spinal cord can produce which type of shock?
A. Vasovagal shock
B. Neurogenic shock
C. Warm shock
D. Traumatic shock
419. In hypovolaemic shock, the cells change to
A. Aerobic metabolism
B. Anaerobic metabolism
C. Catabolic metabolism
D. Anabolic metabolism
420. What is the cause of death in burns within 48 hours?
A. Septic shock
B. hypovolaemic shock
C. Neurogenic shock
D. Vasovagal shock
421. What is the causes of cardiogenic shock?
A. Vasovagal attack
B. Congestive cardiac failure
C. Sever trauma
D. Pulmonary embolism
422. What is the cause of death in burns after 7–10 days?
A. Hypovolaemic shock
B. Cardiogenic shock
C. Warm shock
D. Neurogenic shock
423. What does anaerobic metabolism release?
A. Acitic acid
B. Salicilic acid
C. Lactic acid
D. Hydrocholic acid
424. What does cardiogenic shock produces?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
425. What is the normal central venous pressure?
A.1–4cmofsaline
B.5–8cmofsaline
C.9–12cmofsaline
D.12–16cmofsaline
426. What is the normal urine output?
A.0.5–1.5ml/kg/hour
B.1.5–2ml/kg/hour
C.2–2.5ml/kg/hour
D.3–3.5ml/kg/hour
427. What is oliguria?
A. <100 ml/day in adults
B. <500 ml/day in adults
C. <1000 ml/day in adults
D. <1500 ml/day in adults
428. What is the normal pH of blood?
A.7–7.36
B.7.36–7.44
C.7.45–7.49
D.7.00–7.99
429. High altitude mountain climbers without oxygen are prone to
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
430. Hyperpyrexia can cause one of the following
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
431. Where is Hypocalcaemia seen?
A. Hyperventilation
B. Excessive diarrhoea
C. Hyperparathyroidism
D. Enterocutaneous fistulae
432. ARDS results in
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
433. One of the complications of diabetes mellitus is
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
434. Prolonged starvation can produce
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
435. Which is the most important buffer system in the body?
A. Haemoglobin
B. Serum proteins
C. Electrolytes
D. Carbonic acid, bicarbonate
436. What is the ratio of carbonic acid to bicarbonate normally?
A. 1:10
B. 1:15
C. 1:20
D. 1:30
 437. What does persistent vomiting in gastric outlet obstruction
result in?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Respiratory acidosis
D. Hypokalalemic alkalosis
438. What happens in chronic renal insufficiency?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis
439. Uretric implantation into the colon results in
A. Hyperchloraemic acidosis
B. Hypochloraemic alkalosis
C. Hypernatremic alkalosis
D. Hypernatremic acidosis
440. What is gastric tetany due to?
A. Decreased absorption of calcium
B. Hypoparathyroidism
C. Gastrectomy
D. Metabolic alkalosis
441. What is the normal anion gap?
A.1–5mmol/litre
B.5–10mmol/litre
C.10–15mmol/litre
D.15–20mmol/litre
442. Where is paradoxical acid urea is seen?
A. Pyloric stenosis
B. Prolonged diarrhoea
C. Hyperpyrexia
D. Increased acid intake
443. What is the earliest sign of hypocalcaemia?
A. Lightheadedness
B. Muscle twitching
C. Numbness or tingling in the face, hands, or feet
D. Prolonged muscle spasms (tetany)
444. Prolonged intestinal aspiration can lead to
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis
445. ALL the following complications can occur as a result of blood transfusion except
A. Serum hepatitis
B. Hyperkalemia
C. Citrate intoxication
D. Malignancy
446. Which is the best method of assessing fluid replacement in shock?
A. Monitoring urine output
B. Checking for skin turgor
C. Central venous pressure monitoring
D. Blood pressure monitoring
447. Antibiotics are not necessary in all of the following types of shock except
A. Hemorrhagic shock
B. Cardiogenic shock
C. Vasovagal shock
D. Warm shock
448. When does Reactionary haemorrhage occur?
A. During the operation
B.Within6–8hours
D. After one month
E. Following infection of the wound
449. Under emergency conditions when there is no time for proper cross matching
which one of the following types of
blood can be given?
A. O-Rh positve
C. A
B. O-Rh negative
D. B
450. Which of the following is seen in severe alkalosis?
A. Hypocalcaemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalacaemia
451. A Himalayan mountain climber experienced tingling and numbness around his
mouth, fingertips and toes. Which of
the following is the cause for his symptoms?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
452. The fully developed picture of traumatic hypovolemic shock is characterized by all
of the following except
A. Oliguria
B. Peripheral vasoconstriction
C. Increased blood viscosity
D. Bradycardia
453. Hyperchloremic acidosis is seen frequently in patients with
A. Ureterocolic diversion
B. Severe vomiting
C. Chronic emphysema
 D. Pulmonary edema
454. Which is the practical method of assessing fluid balance in a surgical patient?
A. Blood pressure
B. Pulse rate
C. Urine output
D. Daily weighing the patient
455. Which is the most common anticoagulant solution used for blood storage?
A. 5% Dextrose
B. Acid citrate dextrose
C. Citrate phosphate dextrose adenine
D. Heparin
456. If the patient develops severe chills, fever, and chest pain after transfusion of 75 ml
of blood, it usually indicates
A. Haemolytic transfusion reaction
B. Pyrexial reaction
C. Blood contamination
D. Citrate toxicity
457. In evaluation of a patient for bleeding disorder, which is the single most useful
test?
A Bleeding time
C. Platelet count
B. Clotting time
D. Prothrombin time
458. Which is the correct Henderson–Hasselbalch equation?
A. PH = pK + log (base/acid)
B. PH = pK + log (acid/base)
C. pH = pK × log (base/acid)
[Link]=pK–log(acid/base)
459. Which one of the following is NOT a buffer system in the body?
A. Bicarbonate buffer system
B. Phosphate buffer system
C. Calcium buffer system
D. Protein buffer syaytem
460. Which of the following is the most important buffer inside red blood cells?
A. Plasma proteins
B. Haemoglobin
C. Phosphate buffers
D. Bicarbonate: carbonic acid buffer
461. Which explanation best describes: Why plasma proteins can function as buffers?
A. Plasma proteins combine with bicarbonate to make a stronger buffer
B. Plasma proteins are immune to damage from acids
C. Proteins have both positive and negative charges on their surface
D. Proteins are alkaline
462. The buffer that is adjusted to control acid–base balance is
A. Hemoglobin
C. Bicarbonate: carbonic acid buffer
B. Phosphate buffer
D. Calcium buffer
Shock and Acid–Base Balance 231
463. Carbonic acid levels are controlled through the
A. Respiratory system
B. Renal system
C. Digestive system
D. Metabolic rate of cells
464. Bicarbonate ion concentrations in the blood are controlled through the
A. Respiratory system
B. Renal system
C. Digestive system
D. Metabolic rate of cells
465. Which reaction is catalyzed by carbonic anhydrase?
A.–H2PO4 + H+ H2PO4
B. CO2 + H2O H2CO3
C. H2PO4−+OH− HPO42–−+H2O
D. H2CO3 HCO3−+H+
466. A central venous line is preferred to peripheral venous line because of the
following except
A. Less chance of thrombophlebitis
B. Can be maintained for longer duration
C. Can be used to monitor central venous pressure
D. Less risk of complications
467. Majority of the deaths after pelvic fracture is due to
A. Fat embolism
B. Venous bleeding
C. Arterial bleeding
D. Rupture bladder
468. When peripheral veins are NOT available for infusion in children, which site is used
for intraosseous infusion?
A. Sternum
B. Iliac crest
C. Lower end of femur
D. Upper end of tibia
469. The most common cause of death in sever pelvic fracture is
A. Fat embolism
B. Injury to bladder
C. Peritonitis
D. Hemorrhagic shock
470. Infection rates following surgery is proportionate to all of the following except
A. Incisions involving mucosal surfaces
B. Location of the operating theater
C. Sites of existing infection in the body
 D. The use of prosthetic implants
471. Surgical wound infection can be significantly reduced by the following, the most
important of which is
A. 20 air changes per hour with 5-mm pore filters
B. Reduction in the number of individuals in
the theater
C. Avoidance of excess movement of individuals
D. Use of prophylactic antibiotics
472. Which is the best method for sterilizing sharp operative instruments?
A. Steam sterilization under pressure
B. By ethylene oxide
C. By hot air
D. Glutaraldehyde
473. How are fibroptic endoscopes best sterilized?
A. Steam sterilization under pressure
B. By ethylene oxide
C. Low temperature steam and formaldehyde
D. Glutaraldehyde
474. What increases the incidence of infection in a patient?
A. Takes a bath before the surgery
B. Short preoperative stay
C. Swabbing of skin and nose
D. Shaving the part before surgery in the ward
475. What is the optimal disinfectant for skin preparation?
A. Surgical spirit
B. Ticnture iodine
C. Povidone iodine
D. Formalin
476. What is the correct autoclave setting for proper sterilization of instruments?
A. 100 degrees centigrade at 15 pounds per square inch
B. 134 degrees centigrade at 30 pounds per square inch
C. 121 degrees centigrade at 10 pounds per square inch
D. 140 degrees centigrade at 15 pounds per square inch
477. Which gas is best to sterilize heat sensitive equipment?
A. Formaldehyde
B. Nitrous oxide
C. Ethylene oxide
D. Glutaraldehyde
478. Which one of the following is a synthetic absorbable surgical suture?
A. Silk
B. Chromic catgut
C. Plain catgut
D. Polyglycolic acid sutures
479. How long does chromic catgut retain its tensile strength in the tissues?
A. One week
B. Two weeks
C. Three weeks
D. Four weeks
480. Catgut is derived from which part of the sheep’s intestine?
A. Serosa
B. Muscle coat
C. Muscularis mucosa
D. Submucosa
481. Which of the surgical sutures have highest tensile strength?
A. Cotton
B. Silk
C. Nylon
D. Stainless steel
482. Which suture has poor knotting properties?
A. Cotton
B. Silk
C. Nylon
D. Chromic catgut
483. Which suture produces more tissue reaction?
A. Silk
B. Nylon
C. Plain catgut
D. PDS
484. The following are the ideal characteristics of a surgical incision except
A. It should give direct and shortest access to the organ affected
B. It should be extensible
C. It should be as short as possible
D. It should heal with a strong and healthy scar
485. Which is the weakest incision for laparotomy in terms of healing?
A. Upper midline
B. Lower midline
C. Upper right paramedian
D. Lower right paramedian
486. What does serosanguinous discharge from a laparotomy incision indicate?
A. Seroma
C. Dehiscence
B. Infection
D. Herniation
487. Which is the most important characteristic of an ideal surgical suture material?
A. Adequate tensile strength
B. Good knot holding property
C. Should be least reactive (inert)
D. Easy handling property
488. The following are the causes of immediate postoperative pyrexia except
A. Pneumonia
B. Thrombophlebitis
C. Urinary tract infection
D. Surgical wound infection
489. In postoperative fever which cause is often missed?
A. Urinary tract infection
B. Pneumonia
C. Drugs
D. Thrombophlebitis
490. What is plaster of Paris made of?
A. Calcium sulphate
B. Calcium sulphate monohydrate
C. Calcium sulphate hemihydrate
D. Calcium sulphate dehydrate
491. What is Horsley’s bone wax is made of?
A. Vasaline
B. Sterile bees wax
C. Bees wax with paraffin
D. Vegetable gum with petroleum gelly
492. Which type of surgery, gastrectomy is considered as?
A. Contaminated
B. Clean-contaminated
C. Dirty
D. Potentially dirty
493. Local anesthesia with adrenalin should NOT be used in
A. Intercostal nerve block anesthesia
B. Axillary block anesthesia
C. Wrist block anesthesia
D. Digital block anesthesia
494. The following facts are true regarding braided suture except
A. Better tensile strength
B. Handling is easier
C. Knotting property is good
D. Infection rate is absent
495. The dose of Lignocaine without adrenalin in an adult should
NOT exceed
A. 2 mg/kg
B. 3 mg/kg
C. 4 mg/kg
D. 5 mg/kg
496. Local anaesthetic with adrenalin should be never used in the following areas except
A. Penis
B. Breast
C. Pinna
D. Digits
497. All the following facts about drains in surgery are true except
A. Drains should be removed within 48 hours
B. They are placed after drainage of a large abscess cavity
C. They are placed in the abdomen to detect and drain bile
D. They are placed in the abdomen to detect anastomotic leak
498. Which one of the following instrument is used in drainage of abscess?
A. Artery forceps
[Link]’sforceps
C. Kelly forceps
D. Sinus forceps

499. 11. All of the following are the structures seen at the porta hepatis except
A. Portal vein
B. Common hepatic duct
C. Hepatic artery
D. Hepatic veins
[Link] of the following drungs metabolize by Hoffman degradation?
[Link]
[Link]
[Link].
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