Additional High-Yield Surgery Topics MCQs

Surgery · 21 free questions with answers & explanations.

1. The Glasgow-Blatchford Score (GBS) is used in upper GI bleeding to predict the need for intervention. Which patient can be safely considered for outpatient management?
2. A 55-year-old diabetic male presents with a hot, swollen, erythematous scrotum developing over 24 hours with crepitus on palpation. He appears septic with HR 118 and temperature 38.9°C. The MOST appropriate immediate management is:
3. The International Association of Pancreatology (IAP) criteria for 'borderline resectable' pancreatic head cancer include which vascular parameter?
4. A 35-year-old man presents with a 4-hour history of left loin-to-groin colicky pain radiating to the scrotum, nausea, and haematuria. KUB shows a 5 mm calculus at the vesico-ureteric junction (VUJ). eGFR is normal. The MOST appropriate initial management is:
5. The Whipple procedure (pancreaticoduodenectomy) involves resection of the pancreatic head, duodenum, proximal jejunum, gallbladder, and common bile duct. Which reconstruction is performed to re-establish pancreatic exocrine drainage?
6. A 50-year-old man with cirrhosis develops an acute esophageal variceal bleed. After resuscitation, endoscopic band ligation (EBL) is performed and haemostasis achieved. For secondary prophylaxis to prevent re-bleeding, the recommended long-term therapy is:
7. A 72-year-old woman undergoes elective right hemicolectomy. On post-operative day 5, she develops a wound infection with erythema extending from the wound edges in a woody hard pattern across the abdominal wall, crepitus, and systemic sepsis. The diagnosis and management are:
8. In the endoscopic management of obstructive jaundice due to a distal CBD stricture from periampullary carcinoma, the preferred palliative biliary drainage procedure is:
9. A 40-year-old woman presents with a 6 cm cold, firm, painless neck swelling in the anterior triangle that moves upward on swallowing. Fine needle aspiration cytology (FNAC) shows Hurthle cell features with nuclear enlargement. The FNAC Bethesda System category most appropriate for Hurthle cell lesion/neoplasm is:
10. The CREST syndrome (Calcinosis, Raynaud's, Esophageal dysmotility, Sclerodactyly, Telangiectasia) — a limited form of systemic sclerosis — is associated with which anti-nuclear antibody?
11. A 78-year-old man is brought to the emergency department with sudden onset severe constant mid-back and abdominal pain. He is pale, diaphoretic, and has a pulsatile epigastric mass. Blood pressure is 80/50 mmHg. The MOST appropriate next action is:
12. Mirizzi syndrome is a rare cause of obstructive jaundice in which a gallstone impacts in Hartmann's pouch or the cystic duct and extrinsically compresses the common hepatic duct. The McSherry classification Type II includes:
13. A 58-year-old woman is found to have a 2 cm carcinoid tumour (well-differentiated neuroendocrine tumour) in the appendix on pathology after appendicectomy for acute appendicitis. No local or distant spread is identified. The appropriate additional management is:
14. The CHARM trial evaluated mechanical bowel preparation (MBP) before colorectal surgery. Its findings have influenced current enhanced recovery after surgery (ERAS) protocols. Based on current evidence, MBP alone (without oral antibiotics) before elective left colectomy:
15. A 62-year-old man presents with sudden onset severe tearing chest pain radiating to the back. CT aortography shows a Stanford Type A aortic dissection (involving the ascending aorta). The management is:
16. A patient undergoing laparoscopic cholecystectomy has an intraoperative cholangiogram (IOC) that shows a filling defect in the CBD and no flow of dye into the duodenum. The NEXT most appropriate step is:
17. In laparoscopic inguinal hernia repair (TAPP — transabdominal preperitoneal), the anatomical space dissected and where the mesh is placed is:
18. A 55-year-old man presents with episodic hypertension (BP reaching 200/120 mmHg), headache, palpitations, and diaphoresis. 24-hour urine shows elevated metanephrines and normetanephrines. CT confirms a 4 cm right adrenal mass. The 'Rule of 10s' for phaeochromocytoma includes which of the following as part of its description?
19. The DeMeester score is used in the evaluation of which surgical condition?
20. A 45-year-old man presents with painless rectal bleeding and a 2 cm sessile rectal lesion at 8 cm from the anal verge on flexible sigmoidoscopy. Histology confirms T1 rectal adenocarcinoma (submucosal invasion). MRI confirms no lymphovascular invasion, no perineural invasion, and lesion confined to the mucosa-submucosa on high-resolution MRI. The preferred management is:
21. The Sengstaken-Blakemore tube is used for temporising control of acute variceal haemorrhage. Which of the following correctly describes its balloon configuration?