Principles of general surgery MCQ 143+

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• Heat loss of patients during surgery be minimized by
  ক

  Using heat reflecting blanket

  খ

  Administration of IV fluid

  গ

  Humidification of inspired gas

  ঘ

  Maintaining environment temperature at 200 C

  ঙ

  Small dose of phenothiazine
• Pneumoperitoneum on abdominal skiagram may be due to
  ক

  Perforation of gas containing hollow viscus

  খ

  Following laparoscopy

  গ

  Peritonitis due to clostridial infections

  ঘ

  Intestinal obstruction

  ঙ

  Traumatic rupture of urinary bladder
• Sebaceous cyst
  ক

  Infections

  খ

  ulceration are the common complications

  গ

  Rupture causes systemic spread

  ঘ

  Exudation cyst

  ঙ

  Commonly found in palm and foot

  চ

  Always contain punctum
• ATLS guideline constitutes ABCDE of trauma care
  ক

  A stands for airway

  খ

  C stands for circulation

  গ

  E stands for exposure

  ঘ

  B stands for bleeding

  ঙ

  D stands for disorder
• Full thickness skin graft is preferable to split-thickness graft where there is a high priority for
  ক

  Reliability of graft “take"

  খ

  Sensory return

  গ

  Durability

  ঘ

  Extent of wound coverage

  ঙ

  Coverage of the pressure bearing area
• Heparin prophylaxis against DVT after surgery
  ক

  Low molecular weight heparin is a preferred alternative

  খ

  Concomitant antibiotics are contraindicated

  গ

  Must be started one week before surgery

  ঘ

  Given intra muscularly

  ঙ

  More effective in obese elderly
• Statements regarding to informed consent
  ক

  Consent should be obtained by the person

  খ

  doing the operation

  গ

  Every possible hazard

  ঘ

  however remote the possibility

  ঙ

  should be explained in details

  চ

  Legally

  ছ

  a signed consent from a patient is proof that valid consent has been properly obtained

  জ

  The written communication material must always be in English

  ঝ

  Consent is necessary before physical examination of a patient
• An abdominal wound dehiscence
  ক

  Is more common is jaundiced patients

  খ

  Is increased in patient on steroid therapy

  গ

  Usually occurs before the 5th postoperative day

  ঘ

  Frequently recurs

  ঙ

  Is often fatal
• Post-operative pain
  ক

  Is worst in thoracic operation

  খ

  Is worst in the evening

  গ

  Causes atelectasis

  ঘ

  Is improved by coughing

  ঙ

  Causes hypoventilation
• Acute respiratory obstruction immediately following an abdominal surgery may occur dueto
  ক

  Tracheo-bronchial secretion

  খ

  Pleural effusion

  গ

  Tongue fall back

  ঘ

  Paralytic ileus

  ঙ

  Obstruction by a foreign body
• Post operative complication of DM with hyperkalemia and keto-acidosis is corrected by
  ক

  Adequate hydration by normal saline

  খ

  Encounter Ca-gluconate

  গ

  Hemodialysis

  ঘ

  Infusion of 5% DA with insulin

  ঙ

  Potassium supplementation is required despite any initial Hyperkelemia
• Hypoxia in the immediate post operative may occur due to
  ক

  Residual effect of general anesthesia

  খ

  Atelactasis

  গ

  Wound hematoma after neck surgery

  ঘ

  Tracheomalcia

  ঙ

  Bilateral superior laryngeal nerve palsy
• After major surgery there is
  ক

  Increased plasma cortisol level

  খ

  Negative nitrogen balance

  গ

  Negative sodium balance

  ঘ

  Potassium retention

  ঙ

  Decreased tendency for blood clotting
• Causes of post-operative hypoxia are
  ক

  Residual effect of muscle relaxants

  খ

  Nitrous oxide diffusion

  গ

  Central depression due to sedatives

  ঘ

  Decreased V/Q scatter

  ঙ

  Shivering
• Pyrexia within 24 hours of surgery may be due to
  ক

  Atelectasis

  খ

  Pneumonia

  গ

  Deep vein thrombosis

  ঘ

  Urinary tract infection

  ঙ

  Wound infection
• Pyrexia within 24 hours of surgery is due to
  ক

  Atelactasis

  খ

  Pneumonia

  গ

  Transfusion reaction

  ঘ

  Deep vein thrombosis

  ঙ

  Wound infection
• Common suture materials used in surgery
  ক

  Silk is a natural protein

  খ

  Polypropylene is non –absorbable

  গ

  Tensile strength of polypropylene is infinite

  ঘ

  Nylon is polyester polymer

  ঙ

  Tissue reaction of nylon is high
• The following are natural non-absorbable suture materials
  ক

  Silk

  খ

  Nylon

  গ

  Polydiaxonone

  ঘ

  Polyglactin 910

  ঙ

  Polypropylene
• The synthetic absorbable suture materials are
  ক

  Polyglactin 910

  খ

  Polydiaxonone

  গ

  Chromic catgut

  ঘ

  Polypropylene

  ঙ

  Nylon
• Non-absorbable suture materials are
  ক

  Nylon

  খ

  Polypropylene

  গ

  Silk

  ঘ

  Polydiaxonone (PD

  ঙ

  Polyglactin 910
• Followings are nonabsorbable suture materials
  ক

  Polypropylene

  খ

  Silk

  গ

  Catgut

  ঘ

  Polyglactin 910

  ঙ

  Polyglycolic acid
• Dexon suture material
  ক

  Is polyglycolic acid

  খ

  Evokes less tissue reaction than catgut

  গ

  Has less tensile strength than polyglactin 910

  ঘ

  Is completely absorbed within 1-2 weeks

  ঙ

  Is used in vascular repair
• Suture materials are sterilized by
  ক

  Ethylene oxide gas

  খ

  Gamma radiation

  গ

  Autoclaving

  ঘ

  Glutaraldehyde solution

  ঙ

  Lysol
• General rule of removal of non-absorbable sutures should be
  ক

  10 days in abdomen

  খ

  10-14 days in lower limb

  গ

  10-12 days in upper limb

  ঘ

  7-8 days in face

  ঙ

  2-3 days in scalp
• Cryosurgery
  ক

  Is relatively pain free

  খ

  Is difficult to get a tissue for histology

  গ

  Is difficult to know the depth of penetration

  ঘ

  Produces good scar

  ঙ

  Local anesthesia is essential
• In laparoscopy, Pneumoperitoneum in made by the following gases
  ক

  Carbon Dioxide

  খ

  Nitrous oxide

  গ

  Oxygen

  ঘ

  Hydrogen sulfide

  ঙ

  Carbon monoxide
• In laparoscopic procedure gases used for creating pneumoperitoneum
  ক

  CO2

  খ

  Nitrous oxide

  গ

  O2

  ঘ

  Halogen

  ঙ

  Xenon
• Gases used for the creation of pneumoperitoneum in laparoscopic procedure are
  ক

  Carbondioxide

  খ

  Nitrous oxide

  গ

  Oxygen

  ঘ

  Carbon monoxide

  ঙ

  Neon
• Limitations of minimal access surgery
  ক

  Difficulty with haemostasis

  খ

  Extraction of large specimens

  গ

  Loss of tactile feedback

  ঘ

  Steep learning curve

  ঙ

  Wider field of vision
• Advantages of minimal access surgery are
  ক

  Decreased heat loss from body cavities

  খ

  Less wound related complications

  গ

  Early ambulation

  ঘ

  Easy retrieval of larger specimens

  ঙ

  Excellent tactile feedback