INI-CET 2017 - Surgery PYQs Practice Questions

Q: A 25-year-old patient presents with a neck swelling which moves with deglutition as shown below. Your diagnosis is?

Thyroglossal cyst. ***Thyroglossal cyst*** - A **thyroglossal duct cyst** is a common congenital neck mass that typically presents in the midline of the neck. - The classic characteristic feature is its **movement with deglutition** (swallowing) and often with protrusion of the tongue, due to its attachment to the hyoid bone and remnants of the thyroglossal duct. *Brachial cyst* - **Branchial cleft cysts** are usually located laterally in the neck, anterior to the sternocleidomastoid muscle, and do not typically move with deglutition. - They are remnants of the branchial arches failing to involute completely. *Cystic hygroma* - A **cystic hygroma** is a type of lymphangioma, commonly found in the posterior triangle of the neck or axilla. - It is typically a soft, compressible, and ill-defined mass that does not move with deglutition. *Cervical lymphadenopathy* - **Cervical lymphadenopathy** involves enlarged lymph nodes, which can be firm or tender depending on the cause (e.g., infection, malignancy). - While they are common in the neck, they are generally not mobile with deglutition unless they are very superficial and freely movable, but they do not typically have the same characteristic movement as a thyroglossal cyst. *Dermoid cyst* - A **dermoid cyst** is another congenital midline neck mass that can present in the submental region. - Unlike thyroglossal cysts, dermoid cysts do not move with deglutition or tongue protrusion as they are not attached to the hyoid bone. - They are typically non-tender, doughy masses that may contain hair, sebum, and skin elements. [Practice more Surgery PYQs on OnCourse]

Q: An 8-year-old boy presents to the casualty with history of fever and abdominal pain. On examination he was febrile and the pulse rate was 104/min. Identify the sign?

Blumberg sign. ***Blumberg sign*** - The image illustrates the elicitation of **rebound tenderness**, also known as the Blumberg sign, by pressing down deeply on the abdomen and then quickly releasing. - Pain on rapid withdrawal of the hand suggests **peritoneal irritation**, which is highly indicative of appendicitis in this clinical context. *Rovsing sign* - This sign involves palpating the **left lower quadrant** of the abdomen, which causes pain in the right lower quadrant. - The image shows palpation directly over or near the right lower quadrant, not the left. *Psoas sign* - Elicited by having the patient either **flex the right hip against resistance** or lying on their left side and extending the right hip. - The image clearly depicts abdominal palpation, not a hip maneuver. *Obturator sign* - This sign is checked by having the patient lie supine with the right hip and knee **flexed to 90 degrees**, then internally rotating the hip. - The image does not show any manipulation of the patient's hip; it shows abdominal palpation. *McBurney sign* - This sign refers to **point tenderness at McBurney's point** (one-third the distance from the anterior superior iliac spine to the umbilicus). - The image demonstrates a maneuver for rebound tenderness (pressing and releasing), not localized point tenderness at a specific anatomical location. [Practice more Surgery PYQs on OnCourse]

Question 1

A 30-year-old man presents with abdominal pain and fever for one day. He has history of diarrhea for last several months which contains blood. What is the diagnosis?

Accepted Answer

Toxic megacolon

Answer

Pneumatosis intestinalis

Answer

Cecal volvulus

Answer

Intestinal perforation

Answer

Fulminant colitis

Question 2

A 25-year-old patient presents with a neck swelling which moves with deglutition as shown below. Your diagnosis is?

Accepted Answer

Thyroglossal cyst

Answer

Brachial cyst

Answer

Cystic hygroma

Answer

Cervical lymphadenopathy

Answer

Dermoid cyst

Question 3

An 8-year-old boy presents to the casualty with history of fever and abdominal pain. On examination he was febrile and the pulse rate was 104/min. Identify the sign?

Accepted Answer

Blumberg sign

Answer

Rovsing sign

Answer

Psoas sign

Answer

Obturator sign

Answer

McBurney sign

INI-CET 2017 — Surgery