INI-CET 2025 - Surgery PYQs Practice Questions

Q: Based on the provided X-ray image, identify the type of thyroid malignancy.

Follicular carcinoma. ***Follicular carcinoma*** - This is the **correct answer** based on the X-ray showing bone metastases. - Follicular carcinoma characteristically spreads via **hematogenous (bloodstream) route** to distant sites, particularly **bones and lungs**. - Bone metastases from thyroid cancer are **most commonly** due to follicular carcinoma, presenting as **lytic lesions** on X-ray. - Follicular carcinoma accounts for 10-15% of thyroid cancers but is responsible for the majority of thyroid cancer bone metastases. *Incorrect: Papillary carcinoma* - Although papillary carcinoma is the **most common thyroid malignancy** (80% of cases), it predominantly spreads via **lymphatic route** to regional lymph nodes. - Distant hematogenous metastases to bone are **uncommon** in papillary carcinoma. - When papillary carcinoma does metastasize distantly, lungs are more commonly affected than bones. *Incorrect: Hurthle cell carcinoma* - This is an **aggressive variant of follicular carcinoma** (Hürthle cell or oncocytic variant). - While it can spread hematogenously, it is significantly **rarer** than conventional follicular carcinoma. - It represents only 3-5% of differentiated thyroid cancers. *Incorrect: Thyroid lymphoma* - Primary thyroid lymphoma is a **rare malignancy** typically presenting as a rapidly enlarging neck mass. - Usually occurs in elderly patients with a history of **Hashimoto's thyroiditis**. - Distant bone metastases are **not characteristic** of primary thyroid lymphoma. [Practice more Surgery PYQs on OnCourse]

Question 1

A 40-year-old male presents to the emergency department with severe respiratory distress, BP: 70/59 mmHg, tracheal deviation to the right, distended neck veins, and absent breath sounds on the left side. These findings are suggestive of a tension pneumothorax. What is the most appropriate immediate next step in management?

Accepted Answer

Perform needle thoracostomy immediately

Answer

CT Chest

Answer

Airway, breathing, and circulation (ABC) assessment

Answer

Chest tube insertion

Question 2

Based on the provided X-ray image, identify the type of thyroid malignancy.

Accepted Answer

Follicular carcinoma

Answer

Papillary carcinoma

Answer

Hurthle cell carcinoma

Answer

Thyroid lymphoma

Question 3

A 35-year-old patient presents with colicky pain and is diagnosed with a ureteric stone. Which of the following is the best diagnostic investigation in this case?

Accepted Answer

Non-contrast CT KUB

Answer

Ureteroscopy

Answer

Ultrasonography KUB

Answer

Contrast-enhanced CT KUB

Question 4

Which of the following statements regarding Vacuum-Assisted Closure (VAC) therapy is correct?
1. It promotes granulation tissue formation
2. It reduces interstitial and periwound edema
3. It drains excessive exudate
4. It increases local blood flow

Accepted Answer

All correct

Answer

1 and 3 correct

Answer

2 and 4 correct

Answer

1, 2, 3 correct

Question 5

What is a true statement about Z plasty?

Accepted Answer

To increase length

Answer

It is a type of split-thickness skin graft

Answer

Zigzag suturing

Answer

Flap turning

Question 6

Identify the procedure shown in the image.

Accepted Answer

Dog ear excision

Answer

Keloid excision

Answer

Z plasty

Answer

Transposition flap

Question 7

Imminent gangrene is seen at which Ankle-Brachial Pressure Index (ABPI)?

Accepted Answer

0.3

Answer

0.9

Answer

0.7

Answer

0.5

Question 8

Which of the following is wrongly matched with its classification?

Accepted Answer

LA classification - Achalasia

Answer

Boston classification - Colon preparation for colonoscopy

Answer

Mannheim classification - Chronic pancreatitis

Answer

Miami classification - Parathyroid adenoma and hyperplasia differentiation

Question 9

Which of the following is not a contraindication for breast conservation surgery?

Accepted Answer

Multiple cancer in one quadrant

Answer

Scleroderma

Answer

History of radiation

Answer

Persistent positive margin

Question 10

Which of the following is not included in T4b classification of breast cancer?

Accepted Answer

Cellulitis/erythema over one-third of the breast (inflammatory breast cancer)

Answer

Satellite nodule

Answer

Ulceration

Answer

Peau d'orange

INI-CET 2025 — Surgery