1) After cholecystectmy patient has abdominal pain fever leukocytosis , most likely required

is
1. Ct Abdopelvis
2. Per cutaneous aspiration of abscess
3. ERCP
4. Exploration of wound and open drainage
2) UI6732016970
3) SOME QUESTIONS FROM 28th OCTOBER 2015 IMM Theory Paper
For All those who are going to appear in 20th APRIL 2016 Attempt,
1. Most commonly injured nerve during General Anesthesia?
(A) Ulnar
(B) Median
(C) Radial
(D) Common Peroneal
(E) Axillary
2. Best treatment option for 5cm HCC of liver?
(A) Surgery
(B) Radiotherapy
(C) Chemo-embolization
(D) Chemotherapy
(E) Immunosuppression
3. Most commonly used treatment for 6 into 11 cm Hydatid cyst of liver?
(A) Medical
(B) PAIR
(C) Surgery
(D) Immunotherapy
(E) Any of them
4. Which anaesthesia should be avoided in diabetics?
(A) Ether
(B) Isopropyl
(C) Alcohol
(D) Amide
(E) All of them
5. Etiology of acute thyroiditis
(A) Viral
(B) Bacterial
(C) Fundal
(D) Immune
(E) Idiopathic
6. The most common complication which occurs during application of exsanguinator
(A) Skin Ulceration
(B) Nerve Injury
(C) Vascular Injury
(D) Distal Ischemia
(E) Lymphatic distortion
7. The best treatment option for perforated appendix
(A) Emergency appendectomy
(B) Appendectomy and Wash
(C) Lower mid line laparotomy
(D) Appendectomy and Drainage
(E) None of them
8. The most important factor for wound infection
(A) Steroid
(B) Foreign body
(C) Infection
(D) Suture material
(E) Cellulitis
9. Which type of cell is found in peripheral blood film of post-splenectomy patient
(A) Tear drop cells
(B) Target cells
(C) Basophils
(D) Heinz bodies
(E) Spherocytes
10. At 6th post-operative day after appendectomy, discharge is coming from wound with fever and raised
WBC count which is resistant to change in antibiotics, the most probable pathology is
(A) Actinomycosis
(B) Abdominal Collection
(C) Burst Abdomen
(D) AIDS
(E) Ileus
11. A cirrhotic patient starts bleeding intraoperative, best fluid to give is
(A) Whole blood
(B) Packed RBCs
(C) FFP
(D) PCC
(E) Vit K
12. Patient having crush injury has reduced urine output on 2nd day of admission, the best thing to do is
(A) Double the amount of fluid
(B) Start manitol
(C) Pass CVP line
(D) Give ammonium chloride
(E) Give hypertonic saline
13. Appendectomy wound is
(A) Clean Contaminated
(B) Contaminated
(C) Dirty
(D) Clean
(E) None of these
14. Abdomen is closed with which non absorbable suture
(A) Vicryl
(B) Prolene
(C) Silk
(D) Synthetic
(E) PDS
15. Single rescuer adult CPR Compression:Ventilation
(A) 15:2
(B) 30:2
(C) 10:2
(D) 30:1
(E) 15:1
16. Treatment of choice for recurrent typhoid fever
(A) Sulphonamide
(B) Ceftriaxone
(C) Cholecystectomy
(D) Conservative treatment with fluid and antibiotics
(E) None of them
17. The best treatment plan for both choledocholithiasis & cholelithiasis in a patient is
(A) Laparoscopic cholecystectomy + Laparoscopic choledochotomy
(B) First ERCP then Laparoscopic choledochotomy
(C) Open cholecystectomy plus choledochotomy with T-Tube insertion
(D) ERCP only
(E) Open cholecystectomy
18. Best management of a 60 years old patient with advanced CA Pancreas having bilirubin level of 3.1
mg/dl is
(A) Bypass operation
(B) Biliary and Duodenal stenting
(C) MRCP
(D) Whipples procedure
(E) None of them
19. The most commonly injured structure in pelvic fracture
(A) Urethra
(B) Bladder
(C) Prostate
(D) Seminal vesicle
(E) Any of them
20. The treatment of choice for pelvic fracture with ongoing pelvic bleeding even after application of
pelvic binder and the patient is unstable with no sign of intra-peritoneal bleed
(A) Laparotomy
(B) Angio-embolization
(C) External fixator
(D) Conservative management with blood transfusion
(E) None of them
21. For organ donation from a brain stem dead patient, what will you do next
(A) Opinion from court
(B) Take decision by yourself
(C) Ask the patients relatives
(D) Take matter to hospital administration
(E) Refer matter to your senior
22. The most likely diagnosis in a 6 years old male patient with pain in right iliac fossa for 1 day with
tenderness and fever
(A) Acute appendicitis
(B) Mesenteric lymphadenitis
(C) Mesenteric ischemia
(D) DU perforation
(E) Sigmoid volvulus
23. During passage of subclavian CVP line, the nerve which is likely to be injured and found posterior to
axillary artery
(A) Axillary
(B) Radial
(C) 2nd intercostal
(D) Nerve to Serratus anterior
(E) None of these
24. The terminal portion of CBD in relation to head of pancreas is found
(A) Medial to it
(B) Posterior to it
(C) Lateral to it
(D) Embedded into parenchyma to pancreas
(E) Medial to it
25. In a hotel bomb blast 250 people died on spot. The most immediate cause of death
(A) Asphyxia
(B) CVA
(C) Cardiac Arrest
(D) Inhalational Injury
(E) Blunt abdominal trauma
26. Which is not included in SIRS
(A) Temp > 38 C
(B) RR> 20
(C) HR>90
(D) Source of infection
(E) WBC count >12000
27. A 45-year-old man skidded from the road at high speed and hit a tree. Examples of deceleration
injuries in this patient include:
(A) Aortic valve rupture
(B) Kidney injury
(C) Posterior dislocation of shoulder
(D) Mesenteric avulsion
(E) Stomach rupture
28. Majority of cases of closed renal trauma can be managed with conservative treatment, as this type
of injury is
(A) Intraperitoneal
(B) Transperitoneal
(C) Extraperitoneal
(D) Intrapelvic
(E) Any of above
29. A patient with spinal trauma comes with severe pain, tachycardia and hypotension, the first drug to
be given is
(A) Atropine
 (B) Nor epinephrine
(C) Vasopressin
(D) Morphine
(E) Fluid
30. Which is contraindication of laparoscopic cholecystectomy
(A) Fatty patient
(B) Pregnancy veg
(C) Acute cholecystitis
(D) Cholelithiasis with CBD stones
(E) Older age
4) OCTOBER 2015 IMM SURGERY THEORY PAPER
5) 1. Most commonly injured nerve during General Anesthesia?
(A) Ulnar
(B) Median
(C) Radial
(D) Common Peroneal
(E) Axillary
2. Best treatment option for 5cm HCC of liver?
(A) Surgery
(B) Radiotherapy
(C) Chemo-embolization
(D) Chemotherapy
(E) Immunosuppression
3. Most commonly used treatment for 6 into 11 cm Hydatid cyst of liver?
(A) Medical
(B) PAIR
(C) Surgery
(D) Immunotherapy
(E) Any of them
4. Which anaesthesia should be avoided in diabetics?
(A) Ether
(B) Isopropyl
(C) Alcohol
(D) Amide
(E) All of them
5. Etiology of acute thyroiditis
(A) Viral
(B) Bacterial
(C) Fundal
(D) Immune
(E) Idiopathic
6. The most common complication which occurs during application of exsanguinator
(A) Skin Ulceration
(B) Nerve Injury
(C) Vascular Injury
(D) Distal Ischemia
 (E) Lymphatic distortion
7. The best treatment option for perforated appendix
(A) Emergency appendectomy
(B) Appendectomy and Wash
(C) Lower mid line laparotomy
(D) Appendectomy and Drainage
(E) None of them
8. The most important factor for wound infection
(A) Steroid
(B) Foreign body
(C) Infection
(D) Suture material
(E) Cellulitis
9. Which type of cell is found in peripheral blood film of post-splenectomy patient
(A) Tear drop cells
(B) Target cells
(C) Basophils
(D) Heinz bodies
(E) Spherocytes
10. At 6th post-operative day after appendectomy, discharge is coming from wound with
fever and raised WBC count which is resistant to change in antibiotics, the most probable
pathology is
(A) Actinomycosis
(B) Abdominal Collection
(C) Burst Abdomen
(D) AIDS
(E) Ileus
6) 11. A cirrhotic patient starts bleeding intraoperative, best fluid to give is
(A) Whole blood
(B) Packed RBCs
(C) FFP
(D) PCC
(E) Vit K
12. Patient having crush injury has reduced urine output on 2nd day of admission, the
best thing to do is
(A) Double the amount of fluid
(B) Start manitol
(C) Pass CVP line
(D) Give ammonium chloride
(E) Give hypertonic saline
13. Appendectomy wound is
(A) Clean Contaminated
(B) Contaminated
(C) Dirty
(D) Clean
(E) None of these
 14. Abdomen is closed with which non absorbable suture
(A) Vicryl
(B) Prolene
(C) Silk
(D) Synthetic
(E) PDS
15. Single rescuer adult CPR Compression:Ventilation
(A) 15:2
(B) 30:2
(C) 10:2
(D) 30:1
(E) 15:1
7) 16. Treatment of choice for recurrent typhoid fever
(A) Sulphonamide
(B) Ceftriaxone
(C) Cholecystectomy
(D) Conservative treatment with fluid and antibiotics
(E) None of them
17. The best treatment plan for both choledocholithiasis & cholelithiasis in a patient is
(A) Laparoscopic cholecystectomy + Laparoscopic choledochotomy
(B) First ERCP then Laparoscopic choledochotomy
(C) Open cholecystectomy plus choledochotomy with T-Tube insertion
(D) ERCP only
(E) Open cholecystectomy
18. Best management of a 60 years old patient with advanced CA Pancreas having
bilirubin level of 3.1 mg/dl is
(A) Bypass operation
(B) Biliary and Duodenal stenting
(C) MRCP
(D) Whipples procedure
(E) None of them
19. The most commonly injured structure in pelvic fracture
(A) Urethra
(B) Bladder
(C) Prostate
(D) Seminal vesicle
(E) Any of them
20. The treatment of choice for pelvic fracture with ongoing pelvic bleeding even after
application of pelvic binder and the patient is unstable with no sign of intra-peritoneal
bleed
(A) Laparotomy
(B) Angio-embolization
(C) External fixator
(D) Conservative management with blood transfusion
(E) None of them
8) 21. For organ donation from a brain stem dead patient, what will you do next
(A) Opinion from court
(B) Take decision by yourself
(C) Ask the patients relatives
(D) Take matter to hospital administration
(E) Refer matter to your senior
22. The most likely diagnosis in a 6 years old male patient with pain in right iliac fossa for
1 day with tenderness and fever
(A) Acute appendicitis
(B) Mesenteric lymphadenitis
(C) Mesenteric ischemia
(D) DU perforation
(E) Sigmoid volvulus
23. During passage of subclavian CVP line, the nerve which is likely to be injured and
found posterior to axillary artery
(A) Axillary
(B) Radial
(C) 2nd intercostal
(D) Nerve to Serratus anterior
(E) None of these
24. The terminal portion of CBD in relation to head of pancreas is found
(A) Medial to it
(B) Posterior to it
(C) Lateral to it
(D) Embedded into parenchyma to pancreas
(E) Medial to it
25. In a hotel bomb blast 250 people died on spot. The most immediate cause of death
(A) Asphyxia
(B) CVA
(C) Cardiac Arrest
(D) Inhalational Injury
(E) Blunt abdominal trauma
9) 26. Which is not included in SIRS
(A) Temp > 38 C
(B) RR> 20
(C) HR>90
(D) Source of infection
(E) WBC count >12000
27. A 45-year-old man skidded from the road at high speed and hit a tree. Examples of
deceleration injuries in this patient include:
(A) Aortic valve rupture
(B) Kidney injury
(C) Posterior dislocation of shoulder
(D) Mesenteric avulsion
(E) Stomach rupture
28. Majority of cases of closed renal trauma can be managed with conservative
 treatment, as this type of injury is
(A) Intraperitoneal
(B) Transperitoneal
(C) Extraperitoneal
(D) Intrapelvic
(E) Any of above
29. A patient with spinal trauma comes with severe pain, tachycardia and hypotension,
the first drug to be given is
(A) Atropine
(B) Nor epinephrine
(C) Vasopressin
(D) Morphine
(E) Fluid
30. Which is contraindication of laparoscopic cholecystectomy
(A) Fatty patient
(B) Pregnancy
(C) Acute cholecystitis
(D) Cholelithiasis with CBD stones
(E) Older age
10) IMM 28 OCTOBER 2015.
GATHERED SOME FROM MEMORY.
MAXIMUM 60 PERCENT WAS FROM MASUK
1.Recurrent typhoid attack in patient after 01 month
Cholecystectomy
Quinolone
Aminoglycosides
2.Lap chole containdicated in
Pregnancy
Peritonitis
3.Nosocomial Ventilator associated pneumonia
St aureus
St pneomonie
Gr positive anaerobe
4.Patient with Multiple injuries.He is extensively bleeding from leg wound.Next step in
management
Airway
Breathing
Stop bleeding .
5.Best way to secure airway in multiple trauma pt...
Cuffed Ett
Guedels
6.Patient burnt in close roo. Space Most common cause of death wud be
Inhalational injury
Pulmonaty conyusion
Infection
7.Radial artery most commonly used for monitering ABGs
8.Anaesthetic agent CI in Diabetic pts Ether
NO2
Halothane
9.Tensile strength of wound achieve in
2weeks
6 weeks
06 months
01 yr
02 yr
10.Axillary block nerve damage in posterior side
Radial
Median
Axillary
11.APACHE ...Ph 7.2...score 3
12.Burn Anterior chest abdomen and both upper limb
600 ml/hr
900ml/hr
13 14 and 15
Differant scenarios of GCS 8/15...9/15...se mi consious valay ka 06/15
16.Septic shock
Dopamine plus nor epi plus antibiotics
Dobutamine
Epinephrine
17. 2 litre fluid loss.Mechanism to avoid damage to vital organs....
Baroreceptors
Rennin angiotensin
CNS ischaemic response
18. Incison in wound for Perforated Appendix
Dirty wound
Contaminated
Clean contaminated
19. Pt with 01 day history of perforated appendix and peritneal spread.
You will do.
Appendectomy plus lavage
Appendectomy and drainage
Lavage and drainge.
19.Chronic abscess on 18th day after appendicular absess with mass
Actinomycosis
CA colon
20.Cbd join Pancreatic duct to form common Duct
Posterior to head of pancreas
Within substance
Anterior to head of pancrease
21.Pt with 1.5 cm stone at CBD with feature of ascending cholangitis.
Whats next.
ERCP removal followed by Lap chole
Emergency chole plus choledochotomy.
20.MRSA positive case of colitis treatment
Vancomycin
Tazocin.
Chloramphenical
21.1st sign of compartment syndrome
Distal pain
Paresthesia
Pallor
22.1st sign of SIRS
Tachycardia
Fever
23.1st sign of Raised ICP
Altered mental status
Bradycardia
Vomitting
24.Football patient struck and got down. Next day he fainted suddenly
EDH
SDH
Subarachnoid
25.Subdural haematoma due to Meningeal artey
Venous
Vertebral
26.Anuerysm bleed goes to which space
Subarachnoid
Subdural
27. Rate if CPR with single attendant breath should be
15.2
5.1
15.4
28.Compression for CPR with 2 attendant
30.2
15.2
60.2
29. C7 /t1 injury leads to
Horner syndrome
30.Cause of Massive lower GIT bleed un adult
CA colon
Diverticulitis
Ulcerative colitis
31.Screening of DVT.
Duplex scan
Venography
32.Recurrence of Rectal CA best diagnosed with
MRI
CECT
Barium swallow
33.Huge neck abscess shud be treated...bcos it can
Compress airway
Esophageal pressure
34.Completaly relaxed patient should be placed on which ventilation mode
CMV
SIMV
PEEP
35.Tibial condyle # in 12 yrs old child can
Affects growth in child
Haemarthrosis
Non union
36.Fat embolism diagnosed
Fat in urine
ABGs
CT scan
37. Best test to diagnose Pulmo embolism
Pulmonay Angio
CT
38. Pt with fracture of C6 is excessively breathing with sweating and
hypertension.Medicine to give
Propanol
Morphine
Toradol
Dicloran
39. Pt with bleed was in hypovolemic shock Best way to asses effective resuscitation is
0.5ml /kg /hr urine output
Serum electrolytes
CVP insertion and measurement
40.Patient with stab injuty to chest hypotention oliguric and unconcious.He has absent
breath sounds.He is not responding to fluids.Most likely he has...
Tension pnemothorax
Pericardial tamponade.
Injury to major vessels and heart
41.Stab injury to 2nd lt ICS.Most damage to
Lt ventricle
Lt atrium
Rt atrium
42.Fall from ht.Most common damage to which organ
spleen
43.Post splenectomy blood picture show..
RBC inclusions
Mega ovalocytes
Tear cells
Heinz bodies
44.Pelvic # leads most commonly to which damage...
urethra
Prostate
Bladder
45.Pt of pelvic fracture .Ext fixator applied. Still unstable Best managment wud be.
Laparotomy and Pelvic packing
Angio embolization
Conservative
46. Most common fracture of spine after RTA involve
C8T1
T12L1
C5
48.Most common fracture after facial trauma
Nasal bone
Mandible.
Le forte 2
49. Esophageal corrosive injury How to best manage
Thin tube Jejunostomy
TPN
Gastrostomy
50. Post splenectomy sepsis best way to avoid
Chloramphenical
Erythromycin
Pneumococcal vaccine.
51. Post splenectomy what do you see on peripheral blood films
Mega ovalocytes
Heinz cells
Target cell
RBC inclusions
78. Post splenectomy complication you expect
ARDS
Pneumonia
Pleural effusion
110.Splenic Injury ContraIndication to Conservative Mangement.
CT show ACTIVE BLEED
Nonexpanding Haematoma
Hamatoma inv 20 percent surface
51. Tetanus prophylaxis in unknown history person with household injury
Active plus passive immunization
Wound care plus active immunization
Active immunization only
52. Person after head injury with BP 160 / 100 , pulse 60 and having respiratory
problem.Its
Cushing triad
Cushing syndrome
53.Pericardiocentesis
54. 2* 2cm adrenal mass after CT.Next
Urinary Catecholeamine
Biopsy
Removal
Cortisol suppression
55.Blast injury cause of death
Blunt trauma
Cardiopulmonary arrest
56. Superficial femoral artery damahe after gun shot main Prosthetic graft (Venous graft
option not available)
57. Femoral artery 5cm damage main venous graft
58. CA Head of pancrease with Gasttoduodenal artey involvement.
Next palliation wud be
ERCP + stenting
Chemotherapy
Ileal Bypass
Pancreaticoduodenectomy
60. Treatment of Gastric varices in patient with ascites and splenomegaly in cirrhosis
Endoscopic Band ligation
Vasopressin
Splenectomy
61. Massive haematemesis in pt with hepatic failure.
Endoscopic screlotherapy
Portocaval anastomosis
62.Patient given blood tranfusion.Which is deficient in stored blood.
Factor 5 n 8
Factor 7
Factor 12
63.Patient given 15 units of blood still bleeding.What could be cause
Dilutional thrombopenia
Factor 7 def.
DIC
64. Patient 10 mins after transfusion .BP lowers, oliguric and urine show bleeding.
Major hemolytic rxn due to cleric mistake
Minor rxn to to Wbcs
65. Fluid n manitol after hemolytic rxn of transfusion leading to oliguria.
66.Sac of femoral hernia lies
Medial to femoral vessel
Anterior to cooper ligament
67.Eschar bandage if appliesd can damage limb by
Skin Necrosis
Vascular injury
68 100 % oxygen in Patient develooe Malignant hyperthermia
69. Treatment of CO poisoning...
Hyperbaric O2
69.Case of multiple neck masses and wt loss Suspected TB.Best test to diagnose
PCR
Montoux
BIOPSY
CXR
70.Pt of Throid swelling thyroid scan show solitary nudule.Next appropriate test to
diagnose.
FNAC
CT scan
MRI
71.Smuggler shud be operated when Drug release in system.
72. Burn patient common non bacterial infection
Candida infection
Mycoplasma
73.Patient died with no consent for organ transplant. What to do for transplant.
Family consent
DO not transplant
74. Electrolytes which shud b measure in small small bowel obstruction
S.electrolytes
PH
75.Hypertrophic scar
Applied pressure can reduce
Have genetic predisposition
More common in black
76.GERD best test
24 hr PH
Barium
Monometry
77. X ray findings of small bowel obstruction
Valvulae connivantes
Haustration
Air under diaphagm
79.How would clinically you wud differentiate between Lipoma and sabaceous cyst
Mobility
Skin pinch
Fluctuations
79.Pneumothorax in ventilation occurs after ....
Peep greater then 10 mm
Airway less then 40mm
80.After passing Cvp pt has dysnepnea , tachycardia
Pneumothorax
Pulmonay embolism
Fat embolism
81.Radial nerve at wrist damage after suicide attempt.
Loss of Sensation thumb web and thenar eminence
Loss of flexion
Loss of extension
82.After fall on outstreched hand and Colles fracture after correction what you see.
Dinner fork deformity
Loss of supination and pronation
83.Inj dopamin
Inc coronary blood flow at high dose
Inc splanchnic flow at high dose
Decrease cardiac flow at low dose
84. Pt after RTA with shortness of breath neck viens distended hyperresonent breath
sounds (tension Pneumothorax )
Needle thoracocentesis
Percardiocentesis
IV fluids.
85.Pt with stab injury chest hypovolemia dyspnoea Raised JVP and Muffled heart sounds
(Pericardial tamponade) What wud you immediately do.
Pericardiocentesis
Tube thorostomy
Open thoracotomy
86.Pt with multiple rib sounds after RTA . He has hissing sounds on inspiration (Flail
chest)Most appropriate
Ventilation plus thoracostomy
Tube thorostomy
Fixation with wires
87. In Open pneumothorax all can be done except
cover 4 sides
88. Pt after fracture of both tibia fibula was managed .After 2 days started chest pain and
dyspnoea
Pul embolism
ARDS
Fat embolism
89.Pelvic absess and hypoxemia po2 less then 55 and hepercarbia pco2 greater then 60
(ARDS).Best investigation...
Ventilation perfusion scan
Pulmonay Angio
CT scan
90. Fat embolism best diagnosed with
ABGs
CT scan
Fat in urine
91.Calories in severe malnourish...
30/kg/day
50kcal /kg /day
100 kcal / kg day
92.Carbohydrates given in what ratio of nitogen ratio.
100kcal/ G N
150 kcal/ GN
93. During GA most common nerve damge would be
Ulnar nerve
Radial nerve
Common peroneal
Axillary
94. Adult male with pain central abdomen Then pain travel to epigastrium after 8 days
and finally to Rt hypochondrium
Portal pyemia
Pancreatitis with cholidolithiasi
Acute cholycystitis
95. 3 yr old child with pain lower abdomen along with leucocytosis and nausea for 01
day.Most common cause
Acute appendicitis
Mesenteric adenitis
Intussuseption
96. You being an expert medic found an unconscious person on road Next step AFTER
AIRWAY mangment u wud do according to new ATLS guidelines
Pass ET tube
Rebreathing mask
Secure cerviacal spine
97.HYDATID CYST BIG in size Best mangement ...
RESECT
Medical traetment
98.PAIN FINGER FLEXED
TENOSYNOVITIS
Felon
Koilonychia
99. 55 yr male with Mass in rt testes and painless epidymis . Nxt step you do
High inguinal exploration
Scrotal orchidectomy.
Medicines
FNAC
100. Pt with PERF DIVERTICULUM RESECT AND COLOStomy
Resection Anastomosis
Hartsman.
101. CA COLON patient presented 02 months afyter his surgery.Nest diagnosis wud be.
CT
MRI
Barium swallow
102. ACUTE THYROIDITIS Most commonly caused by
BACTERIAL
Viral
Idiopathic
103. Most common complications of TPN
Hyperglycemia
Hpercalcemia
Hypophospahtemia
104.TPN is preferred over enteral nutrition in which of following
Low output fistula
Sever pancreatitis
105.INTERVAL APPENDECTOMY mangment after appendectomy is done in
After 2 M
On pain of appendicitis
Just regular physical followup monthly
106.MULTIPLE FISTULAS
Fistulogram
CT scan
MRI
107.ANAL PAIN with fever and no hsitory of trauma.
ISCHIORECTAL ABSCESS
Cocxydynia
108.Renal TB.Most important feature.
STERILE PYURIA..
109.NON BACT PERITONITIS...TB LYMPHADENITIS
112.TRAUMA PT Injury to T6.
Increase sweating and tachycardia along with BP
ADRENALIN
Propanol
Dobutamine
113. Person on prolonged MALNUTRITION.What effect you see on Immunity ..
Increase LYMPHOCYTES
Hypersenstivity type 1
Hypersenstivity type 3
Increase Albumib
114.After trauma has STERNUM
EXCESSIVE SCAR TISSUE...
KELOID
115. Patient with 15 years history of VENOUS ULCER.What you find on Examination .
SHELVING EDGES
Rolling edges
Everted edges
Punched out
116. Patient is operated for large goiter .Post op first feature of hypocalcemia wud be
TINGLING sensation in hand and around mouth
Tetanic seizures.
Fever
Arrhythmia
117.BONE CYSTS INC CALCIUM...HYPERPARATHYROIDISM
118. Patient after blast die immediately.Cause of death wud be.
Blunt trauma by waves
Cardiopulmonary arrest
Splinters.
119.Newborn infant with OMPHALOCOEL MAJ .What should be done
Immediate surgery with SKIN COVER
Delayed opertaion after 06 months
Gauze soak dressing
120.CIRRHOTIS PTS POOR PROG..
INC BILIRUBIN
Age
121.PT after gunshot wound to leg is bleeding profusely What wud be next step
Apply DIRECT PRESSURE
Apply tournique
Maintain airway.
HEMATURIA...CT
RADIAL ARTERY ...FOR MONITORING
IHD PT DM ..SWAN GANZ MONITORING
122.Pt with history of Polyps in family undergoes removal of a polyp.What kind of tissue
you expect on histopath ADENOMATOUS
Haematomatous
Villius.
123.GERD best test to confirm
24HR PH
Manometry
ABGs.
CT scan
124. UNABLE TO FLEX LAT THREE FINGERS Damge to
Median nerve
Ulnar nerve
Radial nerve
125.CALUS FORMATION occurs ar
At which stage ..
Haematoma formation
Haematoma with vascularization
Mineralization
Lameller bone formation.
126.Patient with tumor of ASCENDING COLON CA Most common feature wud be ...
ANEMIA
Wt loss
Constpation.
Malena.
128.Perforated Esophagus after vomitting.Pt has pneomomediastinum How to diagnose
XRAY ERECT spine
Xray Abdome
CT scan.
Endoscopy
129.RENAL INJ BLEED h5oes to.
INTAPERITONEAL
Extraperitoneal
130.Which patients are admitted after burn
Adult with 15% TBSA burned
 131. Differance Between THERMAL ELECTRIC BURN
SPINAL INJ
Arrythmias.
133.Pt has presented in trauma after fall from bike .Best way to keep Airway pateng
HEAD TILT CHIN lift
Head tilt only.
Head tilt with guedels airway.
144.BURST ABD on 7th POD.
TOWEL COVER till infection settle
Antibiotics.
134.RECTUS sheat can be closed with following nonabsorbable monofilament sutures.
PROLENE
Polycolic acid
Polyglactin.
135.LOCAL anaesthesia act by blocking.
NA CHANNEL
K channels
Calcium.
136 Moderate increase in BMR ocxurs in
MAJ TRAUMA.
Burns
Sepsis
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24) IMM PAPER APRIL 22nd, 2015

25) -Most common organism isolated in surgical patients? E.coli, staph.aureus, candida,
streptococcus.
26) -Most commonly, synergistic gangrene is caused by? Streptococcus, staphylococcus &
streptococcus, clostridium.

27) -23yrs old male patients, s.p subtotal thyroidectomy, k.c Graves' disease, lab shows
decrease TSH & elevated thyroid hormones. Most appropriate next step of management
would be? Total thyroidectomy, radio iodine, anti.thyroid drugs, propranolol.

28) - Most common emergency management of urethral injury, with multiple injuries is? I.v
fluids & antibiotics, foleys catheterisation per urethrum, supraPubic cystostomy,
suprapubic cystostomy with railroad catheterisation.

29) - a 73 yrs old male patient Known hypertensive on B.Blocker, undergoing

herniorrapyh,under general anaesthesia, suddenly becomes hypotensive, BP
90/60mmHg, pulse 50bpm, what would be the next immediate step of management?
Increase I.v fluids, elevate the foot end, I.v atropine, I.v epinephrine.

30) - a 43 yrs old obese male patient, admitted in ICU, underwent elective thoracotomy. What
is the best method to prevent DVT in this case? Early ambulation, dextran therapy, I.V
Heparin, pneumatic compression device.

31) - Emergency management for reversal of warfarin is? Ffp, cryoprecipitate, vitamin K.

32) - a young patient undergoing emergency surgery has been transfused 10 units of whole
blood. Few mins later, he started oozing from all surgical sites. Most likely cause of this
is? Dilutional thrombocytopenia, loss of factor VIII, loss of factor V.

33) - most common condition in children, mimicking acute appendicitis is? Mesenteric
adenitis.

34) - a 60yrs old male patient, developed bilateral painless swelling in the parotid region over
3 months. Most likely it is? Adenocarcinoma, pleomorphic adenoma, warthins tumour.

35) - a 30yrs old male patient developed a firm/hard swelling in testis for last 6 months. Most
definitive next step of management would be? Testicular biopsy, ultrasound, MRI

36) - young female patient complaining of numbness & tingling in left arm. Most appropriate
investigation for this condition would be? X-ray c.spine, MRI c.spine.

37) - middle aged male patient presented with a large mass in colon. Investigations revealed
regional lymph nodes enlargement and hepatic metastasis. Most appropriate step of
management? Radiotherapy, chemotherapy, hormonal therapy, surgery.

38) - a young patient presented in emergency department after RTA. He is tachypneic. On

auscultation, left breath sounds are absent. Next step of management? Endotracheal
intubation, needle thoracocentesis in left intercostal space, Abgs analysis, chest X-ray.
39) - most sensitive investigation for a recurrent papillary carcinoma of thyroid is?
S.calcitonin, s.TSH, S.calcium, S.Thyroglobulin.

40) - Young male patient present in emergency with a stab wound in the neck. He's dyspneic,
bleeding from the wound. A palpable crepitus is present in neck. Most likely the injury is?
Esophageal laceration, injury to trachea, injury to major vessel.

41) - a young female has been stabbed in the right sub costal region. Examination reveals a
4cm laceration. Which of the following would indicate a need for laparotomy in this
patient? CT Scan, ultrasound FAST, Chest X-RAY Erect.

42) - Currently which technique is recommended for bowel anastomosis? Lambert suture, all
four layer closure, single sero-submucosal layer closure.

43) - Burst abdomen will be best managed by which of the following? Cover all viscera in a
sterile drape & close the abdomen when wound closure is favourable, immediately close
the sheath with tension suture, immediately close the sheath with continuous suture.

44) - middle aged female patient is undergoing hyperalimentation, which major surgery is
most likely responsible for hyperalimentation of this patient?

45) - which of the following condition, would cause 90gm/day loss of nitrogen? Laparotomy
for peritonitis, major upper limb surgery, major lower limb surgery, thoracoscopy,
thoracotomy.

46) - A patient during surgery in general anaesthesia develops shivering. Which of the
following medication would be given? Propofol, ketorolac, ibrufen, isoflurane.

47) - Post operatively, most common sign of gastric dilatation is? Vomiting, bloating, hiccups.