INI-CET 2018 - Surgery PYQs Practice Questions

Q: The following image shows:

Ommaya reservoir. ***Ommaya reservoir*** - The image displays an **Ommaya reservoir**, characterized by a **dome-shaped port** connected to a catheter. This device is typically implanted subcutaneously on the scalp and the catheter is placed into a cerebral ventricle. - It is used for repeated access to the **cerebrospinal fluid (CSF)**, primarily for administering chemotherapy directly into the CSF or for drawing CSF samples. *Chemo-port* - A chemo-port (also known as a port-a-cath) is a central venous access device, usually implanted under the skin in the chest, with the catheter tip residing in a large central vein. - While also used for chemotherapy, its structure differs, primarily being a **subcutaneous port** with a catheter ending in the venous system, not directly in brain ventricles like an Ommaya reservoir. *Peripherally inserted Central catheter* - A PICC line is a long, thin tube inserted into a peripheral vein (usually in the arm) and advanced until the tip reaches a large vein in the chest near the heart. - It is used for long-term intravenous access but is not designed for direct access to the cerebrospinal fluid. *Thermo-probe* - A thermo-probe is a device used to measure temperature, often in a medical context for monitoring body temperature during surgery or critical care. - Its design is entirely different, typically consisting of a sensor at the tip of a flexible wire, without the distinct reservoir and catheter structure seen in the image. [Practice more Surgery PYQs on OnCourse]

Q: What technique has been depicted in the image shown below?

Sentinel lymph node biopsy. ***Sentinel lymph node biopsy*** - The image shows a **skin incision in the axilla**, which is the typical site for accessing **axillary lymph nodes for biopsy**. - A surgical instrument is poised to enter the incision, consistent with the procedure for **identifying and removing the sentinel lymph node**. *Brachytherapy* - This involves placing **radioactive sources** inside or next to the area requiring treatment, usually for cancer. - The image does not depict any radioactive sources or the specialized equipment used for brachytherapy. *USG* - **Ultrasonography (USG)** uses sound waves to create images of internal body structures. - The image shows a surgical incision and instrument, not an ultrasound transducer or screen. *Lateral pectoral nerve block* - A **nerve block** involves injecting an anesthetic close to a nerve to relieve pain or numb an area. - While it involves an injection, the image shows an incision in the axillary region, which is typically for surgical access, not solely for nerve block administration. [Practice more Surgery PYQs on OnCourse]

Q: What does the image show? (AIIMS Nov 2018)

Pneumatic compression stockings. ***Pneumatic compression stockings*** - The image clearly shows sleeves wrapped around the patient's legs, connected by **tubes to a device** that inflates and deflates these sleeves, characteristic of **intermittent pneumatic compression (IPC)**. - IPC devices are used to prevent **deep vein thrombosis (DVT)** by promoting venous blood flow through cyclical compression. *Anti-shock garment* - An anti-shock garment (e.g., **military anti-shock trousers (MAST)**) is a full-body or lower-body suit that applies circumferential pressure to the lower extremities and abdomen to auto-transfuse blood to the core organs in cases of **hypovolemic shock**. - The device in the image covers only the legs and appears to be designed for intermittent, not sustained, compression. *Alginate dressings* - **Alginate dressings** are topical wound care products derived from seaweed, used to absorb exudate from wounds. - They are used directly on wounds and do not involve mechanical devices or full limb coverage like that shown. *Compression stockings (Unna boot)* - While an Unna boot is a type of **sustained compression bandage** (paste bandage) for leg ulcers, it provides continuous, static compression and is typically left in place for days. - The device in the image is clearly an **active, intermittent mechanical system** with a pump, not a static bandage. [Practice more Surgery PYQs on OnCourse]

Q: A patient presented to the emergency department with severe abdominal pain. An erect radiograph was performed. Based on the findings, what should be the management?

Laparotomy. ***Laparotomy*** - **Pneumoperitoneum** (free air under diaphragm) on erect X-ray indicates **perforated viscus**, requiring immediate surgical exploration and repair. - Emergency **laparotomy** allows identification of perforation site, peritoneal lavage, and definitive repair to prevent **sepsis** and **peritonitis**. *Gastric lavage* - Used for **gastric decontamination** in poisoning cases or **upper GI bleeding**, not for perforated viscus. - Does not address the underlying **perforation** and may worsen contamination by increasing intragastric pressure. *ICD insertion* - **Intercostal drainage** is indicated for **pneumothorax** or **pleural effusion**, not abdominal pathology. - **Pneumoperitoneum** requires surgical intervention, not chest tube drainage. *USG FAST* - **Focused Assessment with Sonography in Trauma** is used to detect **free fluid** in trauma patients. - While useful for diagnostic purposes, it does not provide **definitive management** for established perforation requiring immediate surgery. [Practice more Surgery PYQs on OnCourse]

Question 1

The following image shows:

Accepted Answer

Ommaya reservoir

Answer

Chemo-port

Answer

Peripherally inserted Central catheter

Answer

Thermo-probe

Question 2

What technique has been depicted in the image shown below?

Accepted Answer

Sentinel lymph node biopsy

Answer

Brachytherapy

Answer

USG

Answer

Lateral pectoral nerve block

Question 3

What does the image show? (AIIMS Nov 2018)

Accepted Answer

Pneumatic compression stockings

Answer

Anti-shock garment

Answer

Alginate dressings

Answer

Compression stockings (Unna boot)

Question 4

A patient presented to the emergency department with severe abdominal pain. An erect radiograph was performed. Based on the findings, what should be the management?

Accepted Answer

Laparotomy

Answer

Gastric lavage

Answer

ICD insertion

Answer

USG FAST

INI-CET 2018 — Surgery