Sunday, January 13, 2008

16 - surgery mcqs - 121 to 130

121. Regarding gas gangrene

a. It is due to Clostridium botulinum infection

b. Clostridial species are gram-negative spore forming anaerobes

c. The clinical features are due to the release of protein endotoxin

d. Gas is invariably present in the muscle compartments

e. Surgical debridement and antibiotics are an essential part of treatment


only d and e are right . it is due to clostridium perfringes . gram positive anaerobes - clostridia . systemic toxicity results from protein exotoxins .


122. Hodgkin's disease

a. Most commonly occurs in patients over 60 years of age

b. Usually presents as painless lymphadenopathy

c. The Pel-Epstein fever is a characteristic feature

d. Stage III disease is confined to one side of the diaphragm

e. Reed-Sternberg cells are a diagnostic feature


b , c , e are true . occurs mostly in early adult hood . pel- epstein fever is swinging pyrexia that occurs every few days . stage 3 disease is present on both sides of the diaphragm .


123. Regarding varicose veins

a. They affect over 20% of the population

b. Over 20% are recurrent varicosities

c. The sural nerve is in danger during stripping of the long saphenous vein

d. The saphenous nerve is closely associated with the short saphenous vein

e. 5% oily phenol is an appropriate sclerosant for venous sclerotherapy


only a and b are true . the saphenous nerve lies close to the long saphenous vein below the knee . the sural nerve lies close to the short saphenous vein . 5 % oily phenol is used for sclerosing hemorrhoids .

1-3 % sodium tetradodecyl sulphate are is the appropriate venous sclerosant .


124. The following are clinical features of Horner's syndrome

a. Miosis

b. Failure of abduction of the orbit

c. Ptosis

d. Increased sweating on the contralateral side of the forehead

e. Exophthalmos


only a and c . horner's syndrome results due to interruption of the sympathetic supply to the eye . it is characterised by ptosis , miosis , reduced sweating on the ipsilateral side and enopthalmos .


125. Side effects of suxamethonium include

a. A rash

b. A profound tachycardia

c. Muscle pain

d. Malignant hypopyrexia

e. Prolonged neuromuscular blockade


a , c , e are the answers . depolarising muscle relaxant like succinyl choline . rash is due to histamine release . a profound bradycardia rather than tachycardia often occurs . the post operative muscle pain is due to fasciculation . malignant hyperpyrexia is a life threatening complication . neuromuscular blockade occurs due to pseudo choline esterase deficiency .


126. Conn's syndrome

a. Is due to secondary hyperaldosteronism

b. Can result in hypokalaemia

c. Can result in a metabolic alkalosis

d. Is most often due to an adrenal adenoma

e. Can cause severe hypotension


b , c , d are true . conns syndrome is due to primary hyper aldosteronism . presents as hypertension and hypokalemia . hypokalemia results from failure of potassium reabsorption .


127. Haemorrhage of over one litre will produce

a. A reduction in renal blood flow

b. An increase in platelet count

c. A fall in arterial pH

d. Increased fibrinolysis

e. A fall in body temperature


all are true .


128. A prolonged prothrombin time is found in the following conditions

a. Liver failure

b. Adrenal failure

c. Pre-hepatic jaundice

d. Factor VII deficiency

e. Malabsorption with steatorrhoea


a , d , e are the right answers . liver failure reduces the synthesis of prothrombin . increased prothrombin time is seen in obstructive jaundice . malabsorption is associated with failure of vitamin k absorption.


129. The radial nerve

a. Is a branch of the posterior cord of the brachial plexus

b. Is derived from the posterior primary rami of C5 to C7

c. Supplies the extensors of the arm

d. Gives rise to the anterior interosseous nerve

e. Injury produces a classical wrist drop


a , c , e are the right answers . derived from the anterior primary rami of C5 to T1 . gives rise to the posterior interosseous nerve .


130. Amyloidosis

a. Appears as extracellular basophilic hyaline material

b. Can be stained with Congo Red dye

c. Show an apple green birefringence in polarised light

d. Is a complication of medullary carcinoma of the thyroid

e. Is a complication of Hodgkin's disease


only a is wrong . amyloid appears as an eosinophilic material . it is deposited in many inflammatory and malignant conditions .


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