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Question 1
Incorrect
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Which type of thyroid tumour represents 75 - 80% of thyroid cancer cases? This type is predominant in children and in patients who have had a previous history of head or neck radiation.
Your Answer: Follicular carcinoma
Correct Answer: Papillary carcinoma
Explanation:Papillary thyroid carcinoma is the most common thyroid cancer. This cancer has a high cure rate with 10-year survival rates for all patients with papillary thyroid cancer estimated at 80% to 90%.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 2
Incorrect
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A 5-year-old child diagnosed with nephrotic syndrome developed generalised oedema. What is the mechanism for the development of oedema in patients with nephrotic syndrome?
Your Answer:
Correct Answer: Decreased colloid osmotic pressure
Explanation:The development of oedema in nephrotic syndrome has traditionally been viewed as an underfill mechanism. According to this view, urinary loss of protein results in hypoalbuminemia and decreased plasma oncotic pressure. As a result, plasma water translocates out of the intravascular space and results in a decrease in intravascular volume. In response to the underfilled circulation, effector mechanisms are then activated that signal the kidney to secondarily retain salt and water. While an underfill mechanism may be responsible for oedema formation in a minority of patients, recent clinical and experimental findings would suggest that oedema formation in most nephrotic patients is the result of primary salt retention. Direct measurements of blood and plasma volume or measurement of neurohumoral markers that indirectly reflect effective circulatory volume are mostly consistent with either euvolemia or a volume expanded state. The ability to maintain plasma volume in the setting of a decreased plasma oncotic pressure is achieved by alterations in transcapillary exchange mechanisms known to occur in the setting of hypoalbuminemia that limit excessive capillary fluid filtration.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 3
Incorrect
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A 30-year-old male has had a sore throat for the past 5 days. Over the past 24 hours, he has noticed increasing and severe throbbing pain in the region of his right tonsil. He has pyrexia and on examination, he is noted to have swelling of this area. What is the most likely cause?
Your Answer:
Correct Answer: Quinsy
Explanation:Patients with a Quinsy or peritonsillar abscess (PTA) typically present with a history of acute pharyngitis accompanied by tonsillitis and worsening unilateral pharyngeal discomfort. Patients also may experience malaise, fatigue, and headaches. They often present with a fever and asymmetric throat fullness. Associated halitosis, odynophagia, dysphagia, and a hot potato–sounding voice occurs.
The presentation may range from acute tonsillitis with unilateral pharyngeal asymmetry to dehydration and sepsis. Most patients have severe pain. Examination of the oral cavity reveals marked erythema, asymmetry of the soft palate, tonsillar exudation, and contralateral displacement of the uvula.
Indications for considering the diagnosis of a PTA include the following:
Unilateral swelling of the peritonsillar area
Unilateral swelling of the soft palate, with anterior displacement of the ipsilateral tonsil
Nonresolution of acute tonsillitis, with persistent unilateral tonsillar enlargement
A PTA ordinarily is unilateral and located at the superior pole of the affected tonsil, in the supratonsillar fossa. At the level of the supratonsillar fold, the mucosa may appear pale and even show a small pimple. Palpation of the soft palate often reveals an area of fluctuance. Flexible nasopharyngoscopy and laryngoscopy are recommended in patients experiencing airway distress. The laryngoscopy is key to ruling out epiglottitis and supraglottitis, as well as vocal cord pathology. -
This question is part of the following fields:
- Generic Surgical Topics
- Head And Neck Surgery
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Question 4
Incorrect
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Thalamic syndrome will most likely result in:
Your Answer:
Correct Answer: Hyperaesthesia
Explanation:Signs and symptoms of thalamic syndrome include contralateral hemi anaesthesia, burning or aching sensation in one half of a body (hyperaesthesia), often accompanied by mood swings.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 5
Incorrect
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A 21 year old lady notices a non-tender, mobile breast lump while doing her breast self-examination. The lump is smooth and not tethered to her skin. What is the diagnosis?
Your Answer:
Correct Answer: Fibroadenoma
Explanation:Answer: Fibroadenoma
A fibroadenoma is a painless, unilateral, benign (non-cancerous) breast tumour that is a solid, not fluid-filled, lump. It occurs most commonly in women between the age of 14 to 35 years but can be found at any age. Fibroadenomas shrink after menopause, and therefore, are less common in post-menopausal women. Fibroadenomas are often referred to as a breast mouse due to their high mobility. Fibroadenomas are a marble-like mass comprising both epithelial and stromal tissues located under the skin of the breast. These firm, rubbery masses with regular borders are often variable in size.
Fibroadenoma tends to occur in early age. It is most commonly found in adolescents and less commonly found in postmenopausal women. The incidence of fibroadenoma decreases with increasing age and generally found before 30 years of age in females in the general population. It is estimated that 10% of the world’s female population suffers from fibroadenoma once in a lifetime.
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This question is part of the following fields:
- Breast And Endocrine Surgery
- Generic Surgical Topics
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Question 6
Incorrect
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A 48-year-old man smoker presented to the doctor complaining of a persistent cough and shortness of breath. A chest X-ray indicated the presence of a right upper lung mass. Biopsy of the mass revealed the presence of pink cells with large, irregular nuclei. What is the most probable diagnosis?
Your Answer:
Correct Answer: Squamous cell carcinoma
Explanation:Squamous cell carcinoma, is a type of non-small cell lung cancer that accounts for approximately 30% of all lung cancers. The presence of squamous cell carcinoma is often related with a long history of smoking and the presence of persistent respiratory symptoms. Chest radiography usually shows the presence of a proximal airway lesion. Histological findings include keratinisation that takes the form of keratin pearls with pink cytoplasm and cells with large, irregular nuclei.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 7
Incorrect
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Painful erections along with deviation of the penis to one side when erect are seen in which of the following conditions?
Your Answer:
Correct Answer: Peyronie’s disease
Explanation:Peyronie’s disease leads to development of fibrous plaques in the penile soft tissue and occurs in 1% of men, most commonly affecting white males above 40 years age. It is a connective tissue disorder named after a French surgeon, François de la Peyronie who first described it. Symptoms include pain, hard lesions on the penis, abnormal curvature of erect penis, narrowing/shortening, painful sexual intercourse and in later stages, erectile dysfunction. 30% cases report fibrosis in other elastic tissues such as Dupuytren’s contractures of the hand. There is likely a genetic predisposition as increased incidence is noted among the male relatives of an affected individual.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 8
Incorrect
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A 45-year-old female will undergo a diagnostic laparoscopy. Which of the agents listed below should be used for inducing pneumoperitoneum?
Your Answer:
Correct Answer: Carbon dioxide
Explanation:Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum. This causes an increase in intra-abdominal pressure (IAP). Carbon dioxide is insufflated into the peritoneal cavity at a rate of 4–6 litre min−1 to a pressure of 10–20 mm Hg. The pneumoperitoneum is maintained by a constant gas flow of 200–400 ml min−1.
Carbon dioxide is the most frequently used gas for insufflation of the abdomen as it is colourless, non-toxic, non-flammable and has the greatest margin of safety in the event of a venous embolus (highly soluble). It is absorbed readily from the peritoneum, causing an increase in PaCO2. This has direct, as well as indirect (by raising catecholamine levels), effects on the cardiovascular system. Thus, tachycardia, increased cardiac contractility and reduction in the diastolic filling can result in decreased myocardial oxygen supply to demand ratio and greater risk of myocardial ischaemia.
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This question is part of the following fields:
- Principles Of Surgery-in-General
- Surgical Technique And Technology
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Question 9
Incorrect
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A 37 year old woman presents to the clinic with signs of lymphoedema that has occurred after a block dissection of the groin for malignant melanoma several years ago. She has persistent lower limb swelling despite having used pressure stockings. This has impaired her daily life activities. Currently there is no evidence of a recurrent malignancy. Lymphoscintigraphy shows significant occlusion of the groin lymphatics. However, examination reveals the distal lymphatic system to be healthy. Which of the following options would be most helpful in this case?
Your Answer:
Correct Answer: Lymphovenous anastomosis
Explanation:Lymphovenous anastomosis – Identifiable lymphatics are anastomosed to sub dermal venules. Usually indicated in 2% of patients with proximal lymphatic obstruction and normal distal lymphatics.
Causes of lymphoedema:
Primary:
Sporadic, Milroy’s disease, Meige’s disease
Secondary:
Bacterial/fungal/parasitic infection (filariasis)
Lymphatic malignancy
Radiotherapy to lymph nodes
Surgical resection of lymph nodes
DVT
ThrombophlebitisOther options given:
Homans operation – Reduction procedure with preservation of overlying skin (which must be in good condition). Skin flaps are raised and the underlying tissue excised. Limb circumference typically reduced by a third.Charles operation – All skin and subcutaneous tissue around the calf are excised down to the deep fascia. Split skin grafts are placed over the site. May be performed if overlying skin is not in good condition. Larger reduction in size than with Homans procedure.
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This question is part of the following fields:
- Generic Surgical Topics
- Vascular
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Question 10
Incorrect
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A middle aged man presented in OPD with a low grade fever and a persistent cough. His blood smear showed an increase in cells with large bi-lobed nuclei. Which of these cells represent the one seen on the smear?
Your Answer:
Correct Answer: Monocytes
Explanation:Monocytes are white cells that protect the body against harmful pathogens. They are mobile and are produced in the bone marrow, mature there and circulate in the blood for about 1-3 days, where they enter the tissues and transform into macrophages. They are characteristically identified by their large bi-lobed nuclei.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 11
Incorrect
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Which of the following key features will be seen in an organ undergoing atrophy?
Your Answer:
Correct Answer: A greater number of autophagic vacuoles
Explanation:Atrophy is characterised by the breakdown of intracellular components along with organelles and packing them into vacuoles known as autophagic vacuoles. This is an adaptive response that separates the damaged cellular structures from the rest of the cells.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 12
Incorrect
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A 13-year-old girl has complained of pain in her left arm for 4 months. An X-ray reveals a mass along with erosion of the affected humerus. Histologically, the tumour is found to be formed by small, round, blue cells. What is the most likely diagnosis?
Your Answer:
Correct Answer: Ewing’s sarcoma
Explanation:Ewing’s sarcoma is formed by small, round, blue cells, and is common in children. The usually develop in limbs, and clinical findings include pain and inflammation, with lytic destruction showing up on X-rays.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 13
Incorrect
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Which tumour site is more commonly involved in adults than in children?
Your Answer:
Correct Answer: Lung
Explanation:In adults, the most common primary site of tumour is in the lungs, compared to children wherein the most common primary site is the blood.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 14
Incorrect
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A 34-year-old Asian male presents with cervical lymphadenopathy. The patient is suspected to have tuberculous lymphadenopathy. Excision biopsy of one of the nodes showed granulomatous inflammation. Which histopathologic feature is most likely consistent with the diagnosis of tuberculosis?
Your Answer:
Correct Answer: Caseation necrosis
Explanation:The granulomas of tuberculosis tend to contain necrosis (caseating tubercles), but non-necrotizing granulomas may also be present. Multinucleated giant cells with nuclei arranged like a horseshoe (Langhans giant cells) and foreign body giant cells are often present, but are not specific for tuberculosis. A definitive diagnosis of tuberculosis requires identification of the causative organism by microbiological cultures.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 15
Incorrect
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A 27-year-old woman, who had been taking a combined oral contraceptive for 6 months, presented with inguinal pain and oedema of the left leg. Which of the following investigations would you recommend to help confirm the diagnosis?
Your Answer:
Correct Answer: Duplex scan
Explanation:Oral combined contraceptive pill (OCCP) is a drug used for birth control and treating a number of other conditions. Women who take the OCP have a higher risk of developing deep vein thrombosis (DVT), usually in the legs. Duplex ultrasonography is a safe and non-invasive technique which is used for diagnosing the presence of lower extremity thrombi.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 16
Incorrect
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A 33 year old woman presents with a history of recurrent infections and abscesses in the neck. Examination reveals a midline defect with an overlying scab which moves upwards on tongue protrusion. Which of the following is the most likely diagnosis?
Your Answer:
Correct Answer: Thyroglossal cyst
Explanation:Congenital neck masses are developmental anomalies typically seen in infants or children. Common conditions include thyroglossal duct cysts, branchial cleft cysts, and cystic hygromas. These malformations present as painless neck masses, which can cause dysphagia, respiratory distress, and neck pain due to compression of surrounding structures. The location of the mass depends on the embryological structure the cysts arise from. Diagnosis is made based on clinical findings and imaging results (ultrasound, CT, MRI), which also help in surgical planning. Treatment consists of complete surgical resection to prevent recurrence and complications such as infection or abscess formation.
The thyroglossal cyst is present from birth and usually detected during early childhood. It presents as a painless, firm midline neck mass, usually near the hyoid bone, which elevates with swallowing and tongue protrusion. May cause dysphagia or neck/throat pain if the cyst enlarges. -
This question is part of the following fields:
- Generic Surgical Topics
- Head And Neck Surgery
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Question 17
Incorrect
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Linezolid is an antibiotic used for the treatment of infections caused by bacteria that are resistant to other antibiotics. Which of the following organisms is most likely to be effectively treated by linezolid?
Your Answer:
Correct Answer: Methicillin-resistant Staphylococcus aureus
Explanation:Linezolid is a synthetic antibiotic used for the treatment of infections caused by multiresistant bacteria, including streptococci and methicillin-resistant Staphylococcus aureus (MRSA). Linezolid is effective against Gram-positive pathogens, notably Enterococcus faecium, S. aureus, Streptococcus agalactiae, Streptococcus pneumoniae and Streptococcus pyogenes. It has almost no effect on Gram-negative bacteria and is only bacteriostatic against most enterococci.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 18
Incorrect
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A 35 year old woman with jaundice is scheduled for ERCP. However, the procedure is complicated and she is returned to the ward, with signs of jaundice still present accompanied by severe abdominal pain that is generalized. What should be the next best step in management?
Your Answer:
Correct Answer: Arrange an abdominal CT scan
Explanation:Complications of ERCP include pancreatitis, duodenal perforation, duodenal haemorrhage, infection, stent migration, and complications secondary to endoscopy. CT is performed if patients have severe abdominal pain, jaundice, elevated white blood cell count, and fever after ERCP.
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This question is part of the following fields:
- Generic Surgical Topics
- Hepatobiliary And Pancreatic Surgery
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Question 19
Incorrect
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An 18 year old male is given a total of 6 litres of 0.9% sodium chloride solution, over 24 hours after having an elective right hemicolectomy. Which of the following complications may develop?
Your Answer:
Correct Answer: Hyperchloremic acidosis
Explanation:Answer: Hyperchloremic acidosis
Hyperchloremic acidosis is a form of metabolic acidosis associated with a normal anion gap, a decrease in plasma bicarbonate concentration, and an increase in plasma chloride concentration. In general, the cause of a hyperchloremic metabolic acidosis is a loss of base, either a gastrointestinal loss or a renal loss.
1) Gastrointestinal loss of bicarbonate (HCO3-)
-Severe diarrhoea (vomiting will tend to cause hypochloraemic alkalosis)
-Pancreatic fistula with loss of bicarbonate rich pancreatic fluid
-Nasojejunal tube losses in the context of small bowel obstruction and loss of alkaline proximal small bowel secretions
-Chronic laxative abuse
2) Renal causes
-Proximal renal tubular acidosis with failure of (HCO3-) resorption
-Distal renal tubular acidosis with failure of H+
secretion
-Long-term use of a carbonic anhydrase inhibitor such as acetazolamide
3) Other causes
-Ingestion of ammonium chloride, hydrochloric acid, or other acidifying salts
-The treatment and recovery phases of diabetic ketoacidosis
-Volume resuscitation with 0.9% normal saline provides a chloride load, so that infusing more than 3-4L can cause acidosis
-Hyperalimentation (i.e., total parenteral nutrition).This patient received 6L of 0.9% normal saline which lead to hyperchloremic acidosis.
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This question is part of the following fields:
- Post-operative Management And Critical Care
- Principles Of Surgery-in-General
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Question 20
Incorrect
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A 52 year old man undergoes a renal transplant from a living related donor. He is well for the first five months, but on review in the renal clinic, he is noted to have persistent hypertension and a slight deterioration in renal function. What is the best explanation for this?
Your Answer:
Correct Answer: Renal artery stenosis
Explanation:Transplant renal artery stenosis (TRAS) is a well-recognized vascular complication after kidney transplant. It occurs most frequently in the first 6 months after kidney transplant, and is one of the major causes of graft loss and premature death in transplant recipients. Transplant renal artery stenosis (TRAS) is the narrowing of the transplant renal artery, impeding blood flow to the allograft. It accounts for 1–5% cases of post-transplant hypertension. Patients with TRAS have activated RAAS and usually present with worsening or refractory hypertension, fluid retention and/or allograft dysfunction without evidence of rejection.
Percutaneous transluminal angioplasty with stent placement is generally the first-line therapy to correct hemodynamically significant stenosis in TRAS, especially for lesions that are short, linear and distal to the anastomosis. -
This question is part of the following fields:
- Generic Surgical Topics
- Organ Transplantation
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Question 21
Incorrect
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Low molecular weight heparin (LMWH) has less side effects than heparin and is used in the prophylaxis and treatment of venous and arterial thrombotic disorders. Which of the following is LMWHs mechanism of action?
Your Answer:
Correct Answer: Inhibition of factor Xa
Explanation:Low molecular weight heparin (LMWH) is a anticoagulant that differs from normal heparin in that it has only short chains of polysaccharide. LMWH inhibits thrombin formation by converting antithrombin from a slow to a rapid inactivator of coagulation factor Xa.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 22
Incorrect
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Following a bee sting, a women develops a 2cm red, raised, swollen lesion at the site of the sting . Which of the following findings is likely to be seen in this lesion?
Your Answer:
Correct Answer: Vasodilation
Explanation:Inflammation is the immediate response of the body towards infections or irritations. The cardinal signs of inflammation are 1. redness/rubor, 2. tumour/swelling, 3.dolar/pain, 4.calor/heat and organ dysfunction (function laesa). Inflammation has 2 components; vascular and cellular. Blood vessels dilate upstream of the inflamed area leading to the rubor and calor and constrict downstream, increasing pressure and causing fluid to leak out of the capillary, resulting in swelling. The cellular component includes infiltration by neutrophils. Leukocyte arrival and functions include; 1. margination: cells marginated from the centre to the periphery of the vessel, 2. rolling: selectins are upregulated on the vessel walls, 3. adhesion: upregulation of the adhesion molecules ICAM and VCAM on the endothelium interact with integrins on the leukocytes resulting in adhesion, 4. diapedesis and chemotaxis: diapedesis is the transmigration of the leukocyte across the endothelium of the capillary and towards a chemotactic product and 5. phagocytosis: engulfing the offending substance/cell.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 23
Incorrect
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A 30-year-old male presents with a discharging sinus in his nasal cleft. He is found to have a pilonidal sinus. Which statement is false?
Your Answer:
Correct Answer: In a patient with an acute abscess the Bascoms procedure is the treatment of choice.
Explanation:Typical pilonidal sinus disease (PSD) occurs in the natal cleft i.e. sacrococcygeal region.
However, some occupation related pilonidal sinuses occurs in webs of fingers e.g. hairdresser, sheep shearer, dog groomer, slaughterman or milker.
Other locations where pilonidal sinuses may occur include penis shaft, axilla, intermammary area, groin, nose, neck, clitoris, suprapubic area, occiput, prepuce, chin, periungual region, breast, face and umbilicus.Although the pilonidal disease may manifest as an abscess, a pilonidal sinus, a recurrent or chronic pilonidal sinus, or a perianal pilonidal sinus, the most common manifestation of pilonidal disease is a painful, fluctuant mass in the sacrococcygeal region.
Initially, 50% of patients first present with a pilonidal abscess that is cephalad to the hair follicle and sinus infection. Pain and purulent discharge from the sinus tract is present 70-80% of the time and are the two most frequently described symptoms. In the early stages preceding the development of an abscess, only cellulitis or folliculitis is present. The abscess is formed when a folliculitis expands into the subcutaneous tissue or when a pre-existing foreign body granuloma becomes infected.
The diagnosis of a pilonidal sinus can be made by identifying the epithelialized follicle opening, which can be palpated as an area of deep induration beneath the skin in the sacral region. These tracts most commonly run in the cephalad direction. When the tract runs in the caudal direction, perianal sepsis may be present.The ideal treatment for a pilonidal sinus varies according to the clinical presentation of the disease. First, it is important to divide the pilonidal disease into the following three categories, which represent different stages of the clinical course:
– Acute pilonidal abscess
– Chronic pilonidal disease
– Complex or recurrent pilonidal diseaseAcute pilonidal abscess:
A pilonidal abscess is managed by incision, drainage, and curettage of the abscess cavity to remove hair nests and skin debris. This can be accomplished in the surgical office or the emergency department, using local anaesthesia.
If possible, the drainage incision should be made laterally, away from the midline. Wounds heal poorly in the deep, intergluteal natal cleft, for two reasons. The first is the frictional motion of the deep cleft, which creates continuous irritation to the healing wound; the second is the midline nature of the wound, which is a product of constant lateral traction during sitting.Chronic pilonidal disease is the term applied when patients have undergone at least one pilonidal abscess drainage procedure and continue to have a pilonidal sinus tract. The term also refers to a pilonidal sinus that is associated with a chronic discharge without an acute abscess. Surgical options for management of a noncomplicated chronic pilonidal sinus include the following:
Excision and laying open of the sinus tract
Excision with primary closure
Wide and deep excision to the sacrum
Incision and marsupialization
Bascom procedure
Asymmetrical incisions
Skin flaps have also been described to cover a sacral defect after wide excision. Similarly, this keeps the scar off the midline and flattens the natal cleft. -
This question is part of the following fields:
- Colorectal Surgery
- Generic Surgical Topics
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Question 24
Incorrect
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The blood investigations of a 30-year old man with jaundice revealed the following : total bilirubin 6.5 mg/dl, direct bilirubin 1.1 mg/dl, indirect bilirubin 5.4 mg/dl and haemoglobin 7.3 mg/dl. What is the most likely diagnosis out of the following?
Your Answer:
Correct Answer: Haemolysis
Explanation:Hyperbilirubinemia can be caused due to increased bilirubin production, decreased liver uptake or conjugation, or decreased biliary excretion. Normal bilirubin level is less than 1.2 mg/dl (<20 μmol/l), with most of it unconjugated. Elevated unconjugated bilirubin (indirect bilirubin fraction >85%) can occur due to haemolysis (increased bilirubin production) or defective liver uptake/conjugation (Gilbert syndrome). Such increases are less than five-fold usually (<6 mg/dl or <100 μmol/l) unless there is coexistent liver disease.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 25
Incorrect
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The extent of cancer growth can be described through staging. What is taken into consideration when staging a cancer?
Your Answer:
Correct Answer: Local invasion
Explanation:Cancer stage is based on four characteristics: the size of cancer, whether the cancer is invasive or non-invasive, whether the cancer has spread to the lymph nodes, and whether the cancer has spread to other parts of the body, in this case beyond the breast. Staging is important as it is often a good predictor of outcomes and treatment is adjusted accordingly.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 26
Incorrect
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A 55-year-old female is admitted one week following a cholecystectomy with profuse diarrhoea. Apart from a minor intra-operative bile spillage incurred during removal of the gallbladder, the procedure was uncomplicated. What is the most likely diagnosis?
Your Answer:
Correct Answer: Clostridium difficile infection
Explanation:Clostridium difficile is an anaerobic, gram-positive, spore-forming bacillus that is responsible for the majority of cases of antibiotic-associated diarrhoea in surgical patients. While the spectrum of disease may range from asymptomatic carrier state to life-threatening toxic megacolon, the typical presentation in surgical patients is diarrhoea developing in the first few days after initiation of antibiotic therapy, including single-dose prophylactic perioperative antibiotics.
In routine cases with bile spillage, surgeons generally do use antibiotic prophylaxis; 80% give one dose only while 88% give one or more prophylactic doses of an antibiotic. Co-amoxiclav is the most commonly used antibiotic in all settings. -
This question is part of the following fields:
- Clinical Microbiology
- Principles Of Surgery-in-General
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Question 27
Incorrect
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The most important difference between interstitial fluid and plasma is the:
Your Answer:
Correct Answer: Protein concentration
Explanation:Interstitial fluid (or tissue fluid or intercellular fluid) is a solution that surrounds the cells of multicellular animals. It is the main component of the extracellular fluid, which also includes plasma, lymph and transcellular fluid. Plasma, the major component in blood, communicates freely with interstitial fluid through pores and intercellular clefts in capillary endothelium. Interstitial fluid consists of a water solvent containing amino acids, sugars, fatty acids, coenzymes, hormones, neurotransmitters, salts, as well as waste products from the cells. Red blood cells, platelets and plasma proteins cannot pass through the walls of the capillaries. The resulting mixture that does pass through is essentially blood plasma without the plasma proteins. Tissue fluid also contains certain types of white blood cells. Once the extracellular fluid collects into small vessels it is considered to be lymph, and the vessels that carry it back to the blood are called the lymphatic vessels. The lymphatic system returns protein and excess interstitial fluid to the circulation.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 28
Incorrect
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A 65 year old man with a longstanding history of severe osteoarthritis of the hip is scheduled to undergo a total hip replacement. The skin has been prepared and antibiotics administered. Which of the following would be the most important precaution in reducing the risk of infection?
Your Answer:
Correct Answer: Laminar flow theatre
Explanation:Laminar flow theatres aim to reduce the number of infective organisms in the theatre air by generating a continuous flow of bacteria free air. In laminar flow theatres air may be ‘changed’ in theatre more than 300 times per hour compared to standard positive pressure theatre rates of 15-25 air changes per hour.
Shaving skin on the ward increases infection rates and extended chemoprophylaxis increases the risk of antibiotic associated diarrhoea -
This question is part of the following fields:
- Principles Of Surgery-in-General
- Surgical Technique And Technology
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Question 29
Incorrect
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Tumours derived from all three germ-cell layers in new-borns usually occur in which of the following sites?
Your Answer:
Correct Answer: Sacrococcygeal area
Explanation:A teratoma is a tumour with tissue or organ components resembling normal derivatives of more than one germ layer. It is derived from all three cell layers. The most common location of teratoma in new-born infants is in the sacrococcygeal area.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 30
Incorrect
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The vagus nerve passes through which of the following foramen?
Your Answer:
Correct Answer: Jugular foramen
Explanation:The jugular foramen is a large foramen in the base of the skull. It is located behind the carotid canal and is formed in front by the petrous portion of the temporal bone, and behind by the occipital bone. Cranial nerves IX, X, and XI and the internal jugular vein pass through the jugular foramen.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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SESSION STATS - PERFORMANCE PER SPECIALTY
