Tuesday, 14 October 2014

GENERAL SURGERY PRACTICE 2

                       SINGLE BEST OPTION SERIES
           
           INSTRUCTION: SELECT THE SINGLE BEST OPTION



1.       Regarding interpretation of MANTREL score, which of the following total score range is not suggestive of appendicitis?
a.       5-6
b.      7-8
c.       9-10
d.      All of the above
e.      None of the above
2.       The following findings from a patient suggest inflamed pelvic appendix except?
a.       Tenderness on the right side of the rectum on digital rectal examination.
b.      Diarrhoea
c.       Frequency of urination and dysuria
d.      Obturator sign
e.      Psoas’ sign
3.       Sharp pain elicited in the right iliac fossa when coughing in a patient with appendicitis is known as:
a.       Dunphy’s sign
b.      Roving’s sign
c.       Kocher’s sign
d.      Blumberg’s sign
e.      Markle sign
4.       Testicular retraction in a male on palpation of his right iliac fossa is known as
a.       Cope’s sign
b.      Aaron’s sign
c.       Pointing sign
d.      Markle sign
e.      Obraztsova’s sign
5.       Which of the following contribute the most useful findings to the diagnosis of appendicitis?
a.       High resolution ultrasonograhic finding of non-compressible tubular structure and appendix diameter greater than 6mm
b.      Contrast enhanced CT-Scan of the abdomen
c.       History and physical examination of the patient
d.      Leucocytosis
e.      Free air under  the diaphragm on chest X-ray
6.       The following may be useful in investigating patients with suspected appendicitis except:
a.       Pregnancy test
b.      Urinalysis
c.       Full blood count
d.      Radioisotope studies
e.      None of the above
7.       When doing appendicectomy in an obese patient, which of the following incision become more useful?
a.       Lanz
b.      Paramedian
c.       Gridiron
d.      Pfannenstiel
e.      Joel-Cohen
8.       The following are reasons to delay appendicectomy except:
a.       Appendix mass
b.      Subsiding attack on admission
c.       Patient is too ill for surgery
d.      Appendix abscess
e.      Absence of ultrasound facility
9.       Lanz incision is:
a.       Vertical
b.      Transverse
c.       Paramedian
d.      Perpendicular
e.      Semicircle
10.   The following are stages in the progression of appendicitis except:
a.       Acute focal appendicitis
b.      Acute suppurative appendicitis
c.       Granulomatous appendicitis
d.      Gangrenous appendicitis
e.      Phlegmonous appendicitis

ANSWERS:
1. a
2. d
3. a
4. b
5. c
6. e
7. b
8. e
9. b
10. c



                                        REMEMBER
” Some people sin by not working diligently for six days whereas, others – because of greed, unbelief or powerlessness- sin by working also on a day of rest and worship. Either way of breaking this   command results in poverty.”   By  Vishal Mangalwadi.
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