1. Which is not correct about hypertrophic pyloric stenosis of infant? a. usually seen in first male child b.

forceful and projectile vomiting c. bilious vomitus d. Usg is the investigation of the choice 2. Metabolic effect of gastric outlet obstruction a. metabolic hypochloraemic acidosis b. metabolic hypochloraemic alkalosis c. metabolic hyperchloraemic acidosis d. metabolic hyperchloraemic alkalosis 3.Early gastric cancer a.limited to mucosa only b.limited to mucosa and submucosa with lymphnode envolvement c. limited to mucosa and submucosa with or without lymphnode envolvement d limited to mucosa , submucosa and muscularis 4.gastric Carcinoma is a. chemosensitive tumour b. Radiosensitive tumour c.chemo-radiosensitive tumour d.none of above 5.In blunt abdominal trauma, which is not the indication for emergency surgery a.Gas under diaphragm b. unstable vitals c. Shattered spleen d. Hemoperitoneum 6. Budd chiari syndrome is the disease affecting a.portal vein b.hepatic vein c..hepatic artery d.IVC 7. commonest route for the pyogenic liver abscess a. ascending infection from the biliary tree b.following trauma c.hematogenous d. portal pyemia 8 Hepatocellular carcinoma ; Tick the wrong statement a.associated with HCV & HBV b.alfa feto protein is raised c.primary carcinoma of liver d.liver resection is not possible as the treatment

9. In elective splenectomy, vaccine should be given against followings except a. Streptococcus b. mennigococcus c.pneumococcus d. H .influenza 10.Moynihans hump is related with a. portal vein b right hepatic artery c.hepatic vein d.right gastric artery 11.Which gall stone is related with bile stasis and infection a. black pigment stone b.brown pigment stone c.cholesterol stone d. mixed stone 12 In acute calculous cholecystitis, urgent cholecystectomy is advised if the patient come a.Within 48 hrs b.after 48 hrs c.within 72 hrs d.after 3 days of attack 13. charcots traid does not include a. pain b.fever c. jaundice d.vomiting 14.which is not the indication for CBD exploration a. history of obstructive jaundice b. Dilaed CBD c.stone in CBD d. three fold increase of SGPT 15. which is is wrong about the gall bladder carcinoma a.calcified gall bladder is a risk factor b.affect older age >70 yrs c.palpable mass is a late sign d. Ca 125 is the tumour marker 16. Which is the the USG finding suggesting of acute calculous cholecystitis

a. Dilated Gall Bladder b.stone in gall bladder stone c.pericholecystic fluid collection d. none of the above 17. which is false about chronic pancreatitis a.on and off pain abdomen b.loss of only endocrine function c.serum amylase may be normal d. irreversible morphological changes in parenchyma 18.commonest cause of pancreatitis in Nepal a. biliary b. alcoholic c. idiopathic d. Metobolic 19. Which the single most important progniostic indicator of pancreatitis a.Serum amylase b.severity of pain c.CRP d.Serum calcium level 20. Which is wrong about pancreatic pseudocyst a.usually following pancreratits b.walled by fibrous and granulation tissue c. contains fluid with pancreatic juice d. forms only after 3 months of attack 21.Which is false in obstructive jaundice a clay colored stool b.high colored urine c.indirect bilirubinaemia d.raised ALP 22which is the most common site for aintrabdominal abscess a.Pelvis b.right subphrenic space c. left subphrenic space d.Right sub hepatic abscess 23.commonest presentation of abdominal tuberculosis a.fever b. ascites c.pain abdomen d.night sweats

24.commonest mysenteric cyst a.enterogenous b. Urogenital c.Dermoid. d.chylolymphatic 25.Which is false about Hirschprungs disease a .abscence of ganglia in myenteric plexus in intestinal wall b.affected segment is contracted c. affected segment is dilated d.diagnosis need fullthickness rectal biopsy 26. Tick the wrong statement about meckels diverticulum a.affect 2 % of population b.3-5 cm in length c.found in antimesenteric border d.does not posses all three layer of intestinal wall 27Which is false about Ulcerative colitis a.Hereditory b.smoking seems to be protective c.full thickness colon wall is envolved d. disease start from rectum 28.Which wrong about the crohns disease a.skip lesion b. ileum is most commonly envolved c.mucosa : cobble stone appearance d. Non granulomatous disease 29. commonest site of colonic carcinoma a.ascending colon b. descending colon c.transverse colon d. sigmoid colon 30.A patient with atrial fibrillation came to ER with c/o central abdominal pain which was found to be out of all proportion to physical findings. What is your provisional diagnosis. a.strangulated inguinal hernia b.Volvulus c.Pancreatitis d. mesenteric vascular occlusion