GENERAL SURGERY PRACTICE 5

                                 SINGLE BEST OPTION SERIES            
                   INSTRUCTION: SELECT THE SINGLE BEST OPTION

1.       A professional singer after thyroidectomy had difficulty producing high pitched sound. The most likely cause is:

a.       Superior laryngeal nerve damage

b.      Recurrent larygngeal nerve damage

c.       Reactionary haemorrhage and tension haematoma

d.      Thyrotoxic crisis

e.      Hypoparathyroidism

2.       The following are late complications of thyroidectomy except:

a.       Hypothyroidism

b.      Hypoparathyroidism

c.       Keloids

d.      Hypertrophic scar

e.      Recurrence of goitre

3.       The following are consistent with typhoid perforation of the bowel except:

a.       Perforation usually occurs between the end of the first week of infection and the third week

b.      The perforation occurs majorly in the ileum

c.       Free air under the diaphragm is usual

d.      Leucocytosis with relative lymphocytosis is usual

e.      The perforation is usually longitudinal

4.       Abnormal widening of the palpebral fissure in a patient with thyrotoxicosis is known as:

a.       Joffroy’s sign

b.      Dalrymple’s sign

c.       Von Graefe’s sign

d.      Stellwag sign

e.      Mobius sign

5.       Which of the following is incorrect about carbimazole?

a.       It is a pro-drug

b.      It interfers with thyroid peroxidase enzyme

c.       Agranulocytosis may occur in patients taking it

d.      It doesn’t cross the placenta

e.      Aplastic anaemia is a recognized complication

6.       To demonstrate exomphthalmos in a patient with Graves disease, the ............. method is used:

a.       Lahey’s

b.      Crile’s

c.       Naffziger’s

d.      Pizillo’s

e.      All of the above

7.       The following swelling move with deglutition and protrusion of the tongue:

a.       Extrinsic carcinoma of the larynx

b.      Thyroglossal duct cyst

c.       Subhyoid bursa

d.      Pre-tracheal lymph nodes

e.      Simple goitre

8.       The most likely initial investigation of choice for suspected changes in thyroid morphology is:

a.       High frequency ultrasound

b.      Fine needle aspiration cytology

c.       Thyroid radioisotope scan

d.      CT-scan

e.      Bronchoscopy

9.       Complications of exophthalmos in patients with Graves’ disease usually include the following except:

a.       Keratitis

b.      Conjunctivitis

c.       Visual impairment

d.      Vitreous haemorrhage

e.      None of the above.

10.   The following are usually found in the upper limb of a patient with Graves disease except:

a.       Tremors

b.      Myxoedema

c.       Palmar erythema

d.      Thyroid acropachy

e.      Excessive sweating 

ANSWERS:

1. a

2. b

3. e

4. b

5. d

6. c

7. b

8. a

9. d

10. b

                                        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.