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Topic SEQs MCQs

Principles 2 7
Perioperative Workup and Care 2 7
Trauma 2 8
Skin 1 2
Head and Neck 1 2
Elective Orthopedics 1 2
Miscellaneous (Burn, Principles of Oncology, Principles of Pediatric Surgery, 1 2
Elective Neurosurgery, Diagnostic Imaging, GI Endoscopy, Tissue Diagnosis)

1. Write a short note on prophylactic antibiotics.

2. Define Systemic Inflammatory Response Syndrome (SIRS). Write down its diagnostic criteria.
3. Enumerate advantages and disadvantages of minimal access surgery.
4. A taxi driver has sustained multiple injuries when he had a head on collision with a dumper. He
has been brought to the trauma center in a critical state. Exam revealed pulse of 148 bpm, BP
60/40 mmHg, and RR 36/min.
a. What type of shock is this patient experiencing?
b. How will you manage this patient?
c. What are the long term complications of poorly managed shock?
5. Define disinfection. What are the different methods of disinfection?
6. Define surgical site infections. Discuss different etiological risk factors for SSI. What are the
different types, and how do you treat such infections?

Preoperative Preparation
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1. Write a short note on informed consent.

Perioperative Management of High Risk Surgical Patient

1. A 45 year old male is on warfarin after prosthetic mitral valve replacement. He is planned for
elective laparoscopic cholecystectomy. How will you treat him in the perioperative period?
2. A 70 year old man with periampullary carcinoma is being prepared for palliative surgery. He is
deeply jaundiced with fever and deranged clotting profile.
a. How will you prepare this patient for surgery?
b. Write down the name of the minimally invasive procedure likely to be used for relief of
symptoms.
c. What complications can arise if he is left untreated?
d. Enlist three post-op complications if he undergoes major surgery.
3. Briefly write down principles of management of a patient admitted in ICU.
4.
a. What are the indications of admitting a surgical patient in the ICU?
b. Enumerate the parameters used to monitor the patient in a surgical ICU.

Post-Operative Care and Complications

1. What are the most common causes of fever in early post-op period? Write down investigations
to find out the cause.
2. Define hypoxia. What are its causes after prolonged abdominal surgery?
3. A 60 year old obese male developed dehiscence of laparotomy wound following an emergency
surgery for perforated CA sigmoid colon.
a. What do you understand by the term wound dehiscence?
b. Enumerate various risk factors for wound dehiscence.
c. How would you manage this patient?
4. A 40 year old man who weighs 65 kg is being observed in the ICU. 24 hours post operatively he
develops convulsions. His serum Na is 118 mEq/l.
a. What is the likely cause of hyponatremia?
b. What is the likely pathophysiology of convulsions in this patient?
c. Enlist steps of treatment of this patient.
5. What are the causes of hypokalemia? How will you diagnose and manage this condition?

Anesthesia and Pain Relief

1. A 50 year old female is being administered general anesthesia for laparoscopic cholecystectomy.
a. Enumerate 4 essential steps which the anesthesiologist must adopt to ensure correct
placement of endotracheal tube in trachea.
b. Enlist 6 complications of endotracheal intubation.
2. Enlist monitoring parameters of an anesthetized patient.
3. Write a note on intra-operative monitoring during general anesthesia.

Day Case Surgery

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1. A 25 year old male has been advised day case surgery for left indirect inguinal hernia.
a. What do you understand by the term day case surgery?
b. Enumerate selection criteria for day case surgery.
c. Enlist discharge criteria after day case surgery.

1. Give a detailed account of damage control resuscitation and surgery in a poly trauma patient with
particular emphasis on its definition, indication, stages and principles.
2. A 24 year old male pedestrian was hit by a car and got a mild head injury. You are planning to
discharge him from emergency. Enumerate parameters of the discharge criteria and warning signs
to be discussed with this patient.
3. An 18 year old man is brought to the ER with a stab wound just to left of sternum in sixth IC. His
BP is 80 mmHg systolic. Muffled heart sounds and pulsus paradoxus are noted. Auscultation of
left chest reveals decreased breath sounds. What will be the initial management of this patient in
the emergency department?
4. A 27 year old male was brought to the A&E Department after he sustained a bullet injury in his
right lower chest. On examination, pulse is 140 bpm, BP is 80/50 and RR is 36 per minute.
a. What are the likely injuries in this patient?
b. What investigations will you ask for in this patient?
c. Enlist treatment options for this patient.
5. A 14 year old boy has fallen from a height of 30 feet. He was brought to A&E department in
unconscious state. His right leg is deformed and he has vomited twice.
a. Outline initial management plan.
b. How do you rule out significant head injury?
6. A young man was brought in the emergency after an RTA. He opens his eyes to pain, verbal
response is inappropriate words, and shows abnormal flexion to pain.
a. Calculate his GCS.
b. What is its significance?
c. How will you manage this case in the ER?
7. A 60 year old female presents to the ER with blunt injuries to her rib cage. On clinical examination,
she is diagnosed to be suffering from right flail chest.
a. What is flail chest? Write down its two pathophysiological effects.
b. What are the different methods to relieve her pain?
8. Where and how will you monitor a critically ill patient after polytrauma?
9. A patient involved in a motor vehicle accident arrives in the ER unsconscious with multiple facial
fractures, brisk bleeding into his mouth and throat and gurgling irregular labored breathing.
a. What is the most important immediate option in management?
b. What are the various methods and indications of definitive airway?
10.
a. Define flaps.
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b. Write down the different basis on which flaps are classified.

c. Give details of classification.

1. A 49 year old postman had undergone several operations to excise recurrent infections in both
axillary regions. The lesions are diagnosed as hidradenitis suppurativa.
a. What are the commonly causative bacteria?
b. Which structures are involved in it?
c. Enlist regions involved other than the ones mentioned above.
2. A 30 year old lady has presented with itching and change in color of a mole on her shin.
a. What is the most likely diagnosis?
b. How would you investigate this patient?
c. What are the various treatment options?

1. A 62 year old alcoholic pan-chewer presents with an indurated ulcer 1.5 cm in length in the left
lateral aspect of his tongue, not fixed to the alveolar ridge. There are no clinically abnormal glands
palpable in the neck.
a. Outline investigation plan of the patient.
b. What is the treatment plan for this patient?
c. What is the clinical stage of the disease in this patient?
2. A 47 year old paan-chewer has presented with a non healing ulcer on the lateral margin of tongue.
a. What is the most probable diagnosis?
b. How do you stage this disease?
c. Briefly outline stage wise treatment options.

1. A 34 year old male presented with sudden onset back pain with bilateral sciatica and bladder
dysfunction after heavy weight lifting. What warning signs will you look for in this patient that
may suggest serious underlying pathology?
2. A 24 year old female came to ER after RTA. She was a front seat passenger, who received a
contusion over right lower leg. Physical examination revealed tense swelling in right calf region.
Pain is worse on palpation and passive movements of foot.
a. What is the most likely diagnosis of this patient?
b. What are the differential diagnosis of this condition?
c. What are the late features of this condition?
d. How would you treat this condition?

Burns
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1. A 35 year old factory worker male is brought to ER after bring rescued from a burning plastic
factory store room in which he remained trapped for 15 minutes. He has evidence of flame burns
to head and neck, front of chest and anterior abdomen. He is in pain, confused, complains of
difficulty in breathing with hoarse voice and is coughing out carbonaceous sputum. Pulse is
110/min, BP 110/70 mmHg, RR 28/min (labored), Temp 37 degree Celsius.
a. What is the approximate burn surface area employing Lung and Browder Chart?
b. How will you assess depth of burn in this patient?
c. What complications of burns do you expect in this patient?
d. Briefly outline initial management plan for this patient.
2. A 40 year old lady is brought to the burns department with 30% flame burn in the kitchen to her
face, neck, front of chest and both hands. Her weight is 68 kg.
a. How would you recognize inhalational injury?
b. Write down IV fluid resuscitation schedule for first 24 hours for this lady.
c. How would you monitor fluid resuscitation in this patient?

Surgical Oncology

1. What are the principles of management of solid organ cancers? Define the term “Radical Surgery”
for cancer.

Diagnostic Imaging

1. Discuss the role of USG imaging in surgical practice.