UPSC-CMS 2012 - Surgery PYQs Practice Questions

Q: The scolicidal agents used in the surgery of a hydatid cyst include all of the following except

15% glutaraldehyde. ***15% glutaraldehyde*** - **15% glutaraldehyde** is NOT a standard scolicidal agent used during hydatid cyst surgery. - While glutaraldehyde is an effective disinfectant and sterilizing agent, it is **not routinely used as a scolicidal agent** in hydatid cyst surgery. - It is **highly toxic to tissues** and can cause severe local damage, making it unsuitable for intraoperative use in the peritoneal cavity. - Standard scolicidal agents are safer and more established for this specific purpose. *Absolute alcohol* - **Absolute alcohol (95-100% ethanol)** is an effective scolicidal agent used in hydatid cyst surgery. - It kills protoscolices rapidly and has documented efficacy in preventing **secondary hydatidosis**. - While it can be irritating to tissues, it is still employed clinically with appropriate precautions to minimize spillage. *0.5% silver nitrate* - **0.5% silver nitrate** solution is an effective scolicidal agent that causes disruption of the scolex membranes. - It has been shown to kill scolices and reduce the risk of **secondary hydatidosis**. - It is one of the established agents used in hydatid cyst surgery. *20% (hypertonic) saline* - **Hypertonic saline (20%)** is the **most widely used** scolicidal agent due to its osmotic effect, which causes scolices to rupture. - It is **relatively safe** and highly effective, making it the preferred choice in most surgical protocols. - Spillage should still be minimized to avoid complications like hypernatremia or electrolyte imbalance. [Practice more Surgery PYQs on OnCourse]

Q: Which one of the following is an example of a chemodectoma ?

Carotid body tumour. ***Carotid body tumour*** - A **carotid body tumour** is a rare, usually benign, neuroendocrine tumour that arises from the **chemoreceptor cells (paraganglia)** of the carotid body. - These tumours are also known as **paragangliomas** and are classic examples of chemodectomas. *Cock's peculiar tumour* - **Cock's peculiar tumour** is a historical term for a **sebaceous cyst** that has undergone inflammation and potential infection, often presenting as a chronic, indurated lesion. - It is a benign adnexal tumour of the skin and does not arise from chemoreceptor cells. *Cystosarcoma phylloides* - **Cystosarcoma phylloides** (Phyllodes tumour) is a rare fibroepithelial tumour of the breast, characterized by both epithelial and stromal components arranged in leaf-like patterns. - It varies in its malignant potential but is distinct from neuroendocrine tumours. *Keratoacanthoma* - A **keratoacanthoma** is a rapidly growing, usually benign, cutaneous tumour that mimics squamous cell carcinoma. - It originates from the hair follicle epithelium and is characterized by a central keratin plug, not neuroendocrine tissue. [Practice more Surgery PYQs on OnCourse]

Q: In a 30-year-old male smoker, the commonest cause of dry gangrene of foot will be

Buerger's disease. Buerger's disease - **Buerger's disease** (**thromboangiitis obliterans**) is strongly associated with **heavy smoking** and typically affects young to middle-aged adult males, leading to dry gangrene in the extremities. - It involves **inflammation and thrombosis** of small and medium-sized arteries and veins, predominantly in the limbs, often manifesting as **ischemic pain**, ulcerations, and gangrene. *Diabetes mellitus* - While **diabetes** can cause dry gangrene due to **peripheral artery disease** and small vessel disease, it is more commonly associated with **wet gangrene** due to increased infection risk, and the age and smoking history point away from it being the *commonest* cause in this specific demographic for dry gangrene [1]. - Diabetic neuropathy can also mask symptoms, leading to delayed presentation and worsening tissue damage [1]. *Embolism* - An **embolic event** would typically present with **sudden onset** severe pain, pallor, pulselessness, paresthesia, and paralysis (the "6 Ps"), leading to acute limb ischemia rather than the progressive dry gangrene described implied in the question. - While it can cause tissue necrosis, it's usually an acute event rather than a chronic process leading to gradual gangrene. *Atherosclerosis* - While **atherosclerosis** is a significant cause of peripheral artery disease and gangrene, especially in smokers, it typically affects an **older population** than the 30-year-old male described [2]. - In younger smokers with gangrene, **Buerger's disease** is a more specific and common diagnosis, as atherosclerosis tends to manifest later in life unless other significant risk factors are present [2]. [Practice more Surgery PYQs on OnCourse]

Question 1

The term "debridement of the wound" refers to

Accepted Answer

Laying open all layers of the wound and excision of the devitalized tissue

Answer

Irrigation and cleaning of the wound

Answer

Closure of wound in layers

Answer

Clean excision of at least 1 mm of skin from the edge of the wound

Question 2

Which of the following statements is true regarding wound contracture ?

Accepted Answer

It is the function of specialised fibroblasts that contain actin myofilaments

Answer

Bacterial colonization of a wound slows the process of contraction

Answer

It may account for a 40% decrease in the size of a wound

Answer

It is a primary process affecting the closure of sutured wounds

Question 3

The scolicidal agents used in the surgery of a hydatid cyst include all of the following except

Accepted Answer

15% glutaraldehyde

Answer

Absolute alcohol

Answer

0.5% silver nitrate

Answer

20% (hypertonic) saline

Question 4

Which one of the following is an example of a chemodectoma ?

Accepted Answer

Carotid body tumour

Answer

Cock's peculiar tumour

Answer

Cystosarcoma phylloides

Answer

Keratoacanthoma

Question 5

In a 30-year-old male smoker, the commonest cause of dry gangrene of foot will be

Accepted Answer

Buerger's disease

Answer

Diabetes mellitus

Answer

Embolism

Answer

Atherosclerosis

Question 6

The following are the indications for carrying out a sympathectomy except

Accepted Answer

Venous ulcer of leg

Answer

Causalgia

Answer

Hyperhidrosis

Answer

Raynaud's disease

Question 7

In which one of the following is Branham's sign positive?

Accepted Answer

Arteriovenous fistula

Answer

Arterial stenosis

Answer

Deep vein thrombosis

Answer

Arterial aneurysm

Question 8

The structures removed in radical neck dissection include:

1. Sternocleidomastoid muscle
2. Submandibular gland
3. Internal jugular vein
4. Accessory nerve

Accepted Answer

1, 2, 3 and 4

Answer

1 and 2 only

Answer

1 and 3 only

Answer

2 and 4 only

Question 9

The inflammatory breast carcinoma is staged as

Accepted Answer

T4d

Answer

T4c

Answer

T1a

Answer

T1b

Question 10

Splenectomy is indicated in all of the following conditions, except

Accepted Answer

Hydatid cyst of the spleen

Answer

Hereditary spherocytosis

Answer

Idiopathic thrombocytopenic purpura

Answer

Myelofibrosis

UPSC-CMS 2012 — Surgery