AIIMS/ NEET-PG 2017: Surgery MCQs 11-20

Q-11. Which of the following conditions is associated with multiple cutaneous sebaceous adenomas?
a) Turcot syndrome
b) Cowden syndrome
c) Gardner’s syndrome
d) Muir Torre syndrome

Answer: Muir Torre syndrome
Explanation:
Muir-Torre syndrome (MTS) is the combination of sebaceous neoplasms of the skin (sebaceous adenoma, sebaceous epithelioma, or sebaceous carcinoma) and a visceral malignancy (usually gastrointestinal or genitourinary carcinomas).
MTS has an autosomal dominant pattern of inheritance in 59% of all cases.

Q-12. The diagnostic method of choice for Hirschprung disease is
a) Rectal biopsy
b) Manometry
c) Contrast enema
d) MRI

Answer: Rectal biopsy
Explanation:
During normal fetal development, cells from the neural crest migrate into the large intestine (colon) to form the networks of nerves called Auerbach’s plexus and Meissner’s plexus. In Hirschsprug’s disease, the migration is not complete and part of the colon lacks these nerve bodies that regulate the activity of the colon.
Diagnostic techniques involve ano-rectal manometry, barium enema, and rectal biopsy.
The suction rectal biopsy is considered the current international gold standard in the diagnosis of Hirschsprug’s disease.
A histologic examination of the tissue would show a lack of ganglionic nerve cells.

Q-13. Most common site for felon is
a) Toe
b) Ring finger
c) Little finger
d) Thumb

Answer: Thumb
Explanation:
Felons are closed-space infections of the fingertip pulp. Felons and paronychias account for approximately one third of all hand infections. Thumb and index finger are the most commonly affected digits.

Q-14. Most common neoplasm of appendix is
a) Pseudomyxoma peritonei
b) Adenocarcinoma
c) Carcinoid
d) Lymphoma

Answer: Carcinoid
Explanation:
Carcinoids and argentaffin tumors comprise the majority of appediceal cancers.
Carcinoid tumors of the appendix are usually benign. Most appediceal carcinoids are found in the tip of the organ, while a few are at the base.
The appendix is the commonest location of carcinoid tumors of GI tract.

Q-15. Bull’s eye sign seen in
a) Intussusception
b) Volvulus
c) Hirschprung disease
d) Pyloric stenosis

Answer: Intussusception
Explanation:
The “bull’s eye” or “target sign” is the most commonly described ultrasound or CT appearance of an intussusception.
There is a thickened hypoechoic rim representing the edematous outer bowel, and there is a hyper-echoic center secondary to the compressed telescoping inner segment.

Q-16. Mirizzi syndrome is
a) Stone compressing CBD
b) Stone compressing left hepatic duct
c) Stone compressing cystic duct
d) Gas in gall bladder

Answer: Stone compressing CBD
Explanation:
Mirizzi’s syndrome is a rarely observed disorder that presents with obstructive jaundice. The condition is caused by a stone impacted in the gall bladder neck or cystic duct that impinges on the common hepatic duct, with or without a cholecystocholedochal fistula.
The condition is often confused with other serious conditions such as hilar cholangio-carcinoma, which present with similar clinical and imaging findings, and a pre-operative diagnosis may be a serious challenge.

Q-17. Hellers surgery is done for
a) Achalasia
b) Hiatus hernia
c) Esophageal carcinoma
d) Diffuse esophageal spasm

Answer: Achalasia
Explanation:
Achalasia is a primary esophageal motility disorder characterized by absence of esophageal peristalsis and increased pressure of the lower esophageal sphincter, which fails to relax completely in response to swallowing
Dysphagia is the most common symptoms and often for both liquid and solid.
Treatment is directed at relieving the outflow obstruction caused by failure of the lower esophageal sphincter to relax. Options include Botox injection, balloon dilation, partial fundoplication and Heller myotomy.

Q-18. Saints triad includes all except
a) Gall stones
b) Cholangitis
c) Diverticulosis
d) Hiatus hernia

Answer: Cholangitis
Explanation:
Saints triad includes the existence of the following three conditions:
Cholelithiasis
Hiatus hernia
Diverticulosis
Herniosis, the systemic connective tissue disease known to cause diverticulosis and hernia, may be responsible for Saint’s triad.

Q-19. Most common site of esophageal rupture in rigid Bronchoscopy
a) Cervical region
b) Cardiac region
c) Mid esophagus
d) GE junction

Answer: Cervical region
Explanation:
Medical instrumentation is the most common cause of esophageal perforation.
Instrumental perforations are most likely to occur in cervical esophagus.
The crico-pharyngeal area is most common site of injury.
Perforation during pneumatic dilatation of achalasia, occur proximal to the gastro-esophageal junction.

Q-20. Commonest used flap for head and neck surgery
a) Pectoralis major flap
b) Delto-pectoral flap
c) Latissimus dorsi flap
d) Temporalis flap

Answer: Pectoralis major flap
Explanation:
The pectoralis major flap is the most commonly used muscle or myo-cutaneous flap worldwide in head and neck surgery.