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Sample Questions for Patan Entrance Exam. for Internship

• During Shock which of the following statement is false (d)
  a. The final mechanism of different kinds of shock is a decrease of cardiac output.
  b. A rising pulse rate is an earlier and more reliable sign than a falling BP
  c. The surest way to know a patient received enough fluid is to monitor urine output.
  d. Fluid replacement is first step in every kind of shock.
  
  2. In chest injury patient need thoracotomy in following conditions except (d)
  a. Initial chest tube drainage ³ 1.5 L of blood
  b. Chest tube drainage ³ 500 ml per hour
  c. Air continues to bubble out of the underwater seal for 5 days
  d. Big flial chest
  
  3. For hydatid cyst, it is not true that (c)
  a. Human is a accidental intermediate host
  b. Echinococcus granulosus is a kind of tapeworm and causing parasite
  c. It's normal habitat is the small intestine of the sheep
  d. Nearly two third of all hydatid cysts found in the liver.
  
  4. Indication for IOC during cholecystectomy are following except (a)
  a. H/O any kind of pancreatitis
  b. Alkaline phosphate value increased
  c. Multiple GB stones with dilated CD and /or CBD
  d. Anatomy not clear
  
  5. A rodent ulcer is (b)
  a. a squamous cell carcinoma
  b. a basal cell carcinoma
  c. only occurs on the face
  d. a venous ulcer
  
  6. A partial thickness burn of the skin (a)
  a. is sensitive
  b. requires a split skin graft
  c. will separate as sloughs in 2-3 weeks
  d. requires a free flap graft
  
  7. The maximum safe time that a tourniquet may be left on for the purpose of obtaining a bloodless field in hand surgery is (should not exceed) (a)
  a. 30 minutes
  b. 1 hour
  c. 2 hours
  d. 3 hours
  
  8. When anaesthetizing for an infected index finger the procedure which is contraindicated is (b)
  a. 2% xylocaine injection locally
  b. 1% xylocaine with adrenaline injection locally
  c. a 'ring' block
  d. a rubber tourniquet
  
  9. An overdose of Heparin is treated by ( c)
  a. prostaglandins
  b. phenindione
  c. protamine sulphate
  d. prostigmine
  
  10. Buerger's disease is ( d)
  a. due to atherosclerosis
  b. an obliterative arteritis of young females
  c. a complication of diabetes
  d. often associated with attacks of thrombophlebitis
  
  11. The most common cause of airway obstruction in an unconscious patient is (b)
  a. chest injury
  b. falling back of the tongue
  c. foreign body in the airway
  d. fractured larynx
  
  12. The commonest type of shock in a trauma patient is (b)
  a. cardiogenic shock
  b. hemorrhagic shock
  c. neurogenic shock
  d. septic shock
  
  13. If a tension pneumothorax is found during the primary survey, it should be (a)
  a. decompressed immediately
  b. decompressed by chest drain insertion as part of the secondary survey
  c. decompressed after chest X-ray confirmation
  d. decompressed when tracheal shift develops
  
  14. Evaporative water loss continues in burn patient for ( c)
  a. 2 to 4 days
  b. 4 to 6 days
  c. until the wound is healed
  d. none of the above
  
  15. Burn shock or fluid shift is caused by ( b)
  a. Interstitial fluid from injured tissues leaking into the wound
  b. Serum from the bloodstream leaking into injured tissues
  c. Severe red blood cell damage due to the injury
  d. Intracellular fluid leaking into interstitial spaces
  
  16. Ludwig's angina is due to ( d)
  a. a type of coronary artery spasm
  b. oesophageal spasm
  c. retropharyngeal infection
  d. a virulent infection of the cellular tissues around the submandibular salivary gland
  
  17. Hashimoto's disease is ( b)
  a. a granulomatous thyroiditis
  b. an auto-immune thyroiditis
  c. an infiltrating fibrosis of the thyroid and the adjacent muscles
  d. focal thyroiditis
  
  18. In hypertrophic pyloric stenosis (a)
  a. the cause is unknown
  b. the musculature of the pyloric antrum is atrophied
  c. vagotomy is indicated
  d. firstborn female infants are most commonly affected
  
  19. Meckel’s diverticulum (b)
  a. arises from the mesenteric border of the jejunum
  b. may contain heterotopic pancreas
  c. is only present in the male sex
  d. is present in 20% of the human race
  
  20. In acute appendicitis (b)
  a. the tongue is clean
  b. rigidity may be absent if the appendix is pelvic in position
  c. vomiting usually precedes pain
  d. classically the pain begins in the RIF
  
  21. A ventral hernia is (d)
  a. An hiatus hernia
  b. an inguinal hernia
  c. an obturator hernia
  d. an incisional hernia
  
  22. The boundaries of the inguinal canal include (d)
  a. anteriorly- transversalis fascia
  b. posteriorly- psoas
  c. superiorly- rectus abdominis
  d. inferiorly-inguinal ligament
  
  23. Regarding rupture of the bladder it is true except (a)
  a. intraperitoneal rupture is usually caused by a fractured pelvis
  b. most cases of extraperitoneal rupture cannot be differentiated from a rupture of the posterior urethra and the treatment is the same
  c. laparotomy is indicated for intraperitoneal rupture
  d. if operation is delayed for more than 12 hours the mortality rises to over 50%
  
  24. Extravasation of urine in cases of complete rupture of the bulbous urethra (a)
  a. cannot pass behind the mid-perineal point
  b. can pass into the inguinal canals
  c. can pass in to the upper half of the thigh
  d. cannot pass up the abdominal wall beneath the deep layer of the superficial fascia
  
  25. Regarding torsion of the testis (c)
  a. it occurs only after puberty
  b. it requires treatment by bed rest and cold compresses
  c. if affecting an imperfectly descended testis it is difficult to distinguish it from a strangulated inguinal hernia
  d. need orchidopexy on affected side

26. In generalized peritonitis (d)
a. The patient rolls around in agony
b. Operation is contra indicated
c. The pulse rate falls progressively
d. The cause may be other than perforation of the gastrointestinal tract

27. A direct inguinal hernia ( c)
a. Cannot contain bladder as part of the wall of the sac
b. Never extend into the scrotum
c. Has its neck always medial to the inferior epigastric artery
d. Is a hernia through the inguinal canal

28. Regarding BPH it is true except ( c)
a. Is a disease of the elderly, rarely affecting men below 40 years of age
b. The cause is still unknown
c. Symptoms are directly related to size of prostate
d. On late stage it can cause renal failure

29. In penile cancer true except (d)
a. It has been associated with chronic inflammatory disease, venereal disease and phimosis
b. Most frequently occurs in glans
c. 95% of cases are SCC
d. Hematogenous as well as lymphatics spread is the rule

30. For testicular cancer, it is true that (b)
a. This is the most common solid tumor of old men
b. 10% of patients have a prior history of an undescended testis
c. They generally grow rapidly, with doubling times of 10-30days
d. Primarily because of effective radiotherapy, they have become the most curable of all cancers.

31. Regarding J/M staging system of urinary bladder cancer which is false (c )
a. Stage O – carcinoma in situ
b. Stage A - tumor invading lamina propria
c. Stage B – Tumor invades to muscle
d. Stage C – Tumor invades adjacent organs

32. For Wilm’s tumor which is not true (a)
a. Accounts for 95% of all urinary tract malignancy occurring in childhood
b. Also knows as nephroblastoma
c. Usually present with an enlarging, smooth abdominal mass onfined to one side of the abdomen
d. A radical nephrectomy is necessary

33. For common bile duct T tubes which statement is false (d)
a. Placed for decompression and drainage of bile after ECBD for cholangitis
b. Must placed after removal of stone from CBD
c. A cholangiogram through the T tube must be performed before removal of it.
d. Should be removed when its drainage is below 50 ml/24hrs.

34. The cause of pyrexia within 48 hours of an operation is unlikely due to except (b)
a. Urinary infection
b. The trauma of the operation
c. Atelectasis
d. Blood transfusion

35. The first aid treatment of ruptured varicose veins at the ankle includes ( c)
a. Keeping the patient in the sitting position
b. Applying a tourniquet
c. Direct pressure on the bleeding point
d. Douching with cold water

36. Regarding phaeochromocytoma it is true that (b)
a. It is bilateral in about 30% of cases
b. It produces noradrenaline
c. Treatment is mainly antihypertensive drugs
d. It causes pigmentation of the skin

37. Operative urinary diversion is indicated in following condition except (d)
a. When the bladder has been removed
b. In case of ectopia vesicae
c. When the bladder sphincters have lost their normal neurological control
d. As a routine in the treatment of vesicogaginal fistula

38. The complication of colostomy are following except (b)
a. Prolapse
b. Tenesmus
c. Stenosis
d. bleeding

39. Debridement of a wound means (c )
a. Excising 1mm skin from the edges of a wound
b. Not excising skin but excising all damaged muscle
c. Laying open and therefore unleashing all layers of a wound
d. Delayed primary suture

40. Which of the following statement is false ( c)
a. The chance of a normal couple conceiving is estimated to be approximately 25% per month, 75% by 6 months and 90% by 1 year.
b. Approximately 20% of cases of infertility are due to a male factor, with an additional 30% of cases involving both male and female factors
c. The semen analysis allows the separation of patients into sterile and fertile groups.
d. A varicocele is the most common surgically correctable abnormality found in infertile men and responsible for sperm motility.

41. Regarding testicular biopsy following are true except
a. Azoospermic patients generally need testicular biopsy( c)
b. Unilateral biopsies enough in symmetric testis of azoospermic patient
c. Testicular biopsy or FNAC should be done in testicular mass.
d. The most serious complication is inadvertent biopsy of the epididymis

42. Regarding BPH is false that (b)
a. Age and normal androgen hormone status are the major etiologic risk factor
b. PSA must be below 4.0 ng/ml
c. Is only one cause of the prostatism in aging men
d. It first develops in the periurethral transition zone of the prostate

43. Which of the following is false in medical treatment of BPH (c )
a. Medical therapy represents an alternative for individuals who are deemed appropriate candidates for prostatectomy but who lack absolute indications for surgery
b. Finasteride is inhibitor of the enzyme 5 alpha reductase
c. Tamsulosin is alpha 2- antagonist
d. Flutamide is orally administered nonsteroidal antiandrogen

44. Regarding Neuroblastoma which is false (a)
a. More than half originate in the adrenal gland
b. The most common malignant tumor of infancy
c. Arise from cells of the neural crest that form the sympathetic ganglia and adrenal medulla
d. Up to 70% of patients have metastatic disease at the time of diagnosis

45. Which of the following doesn't cause crampy pain (c )
a. Uretric stone
b. Small bowel obstruction
c. Biliary stone
d. Large bowel obstruction

46. Regarding acute pancreatitis which statement is false (d)
a. Nine out of 10 patients have mild to moderate symptoms and a self limited course
b. In 90% of the cases cause is related to excessive alcohol intake or biliary tract disease
c. The elevation of serum lipase is a more accurate indicator
d. The degree of hyperamylasemia is a reliable predictor of the severity of pancreatitis

47. Reynold’s pentad contains following except (a)
a. Continuous chills and fever
b. Jaundice
c. Abdominal pain
d. Shock and CNS depression

48. Addion’s disease is due to (a)
a. Acute cortical haemorrhage of the adrenals
b. Basophil adenoma of the pituitary
c. Medullary carcinoma of the thyroid
d. Rheumatic fever

49. For volvulus of the intestine, it is true that it (d)
a. Only affects adults
b. Does not cause strangulation
c. Cannot be untwisted
d. Is a cause of a distended abdomen

50. Gynaeciomazia is (b)
a. An abnormal enlargement of the female breast
b. Associated with leprosy
c. Associated with ovarian cysts
d. Encountered in patients with Down’s syndrome