सर्जरी – Surgery MCQ
सर्जरी – MD/MS प्रवेश
Surgery · MECEE-PG – MD/MS/MDS Entrance · ४८२ प्रश्न
४८२ प्रश्न उपलब्ध। मोड छान्नुहोस्:
सर्जरी: प्रश्न र उत्तर
सही लागेको विकल्पमा थिच्नुहोस्। सही भए हरियो, गलत भए रातो देखिन्छ; ३ सेकेन्डपछि सही उत्तर र व्याख्या देखिन्छ।
सही: ० / ०
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The bluish discoloration of the flanks observed in severe acute hemorrhagic pancreatitis is primarily due to what physiological mechanism?
सही उत्तर: ख) Capillary leak leading to fluid accumulation in the peritoneal cavity
The correct answer is 1. Capillary leak leading to fluid accumulation in the peritoneal cavity is the primary cause of bluish flank discoloration due to edema and subsequent vascular congestion. The other options represent alternative mechanisms but are not directly associated with this specific presentation. Options 2 & 3 describe processes unrelated to pancreatitis, while option 4 describes lymphatic drainage which isn't the dominant issue.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A 42-year-old male undergoes exploration laparotomy following blunt abdominal trauma. The surgeon identifies a significant hematoma involving the spleen and left kidney. Which of the following is MOST important to assess immediately?
सही उत्तर: ख) Splenic Infarction
Splenic infarction, often occurring due to decreased blood flow secondary to trauma, is a common complication following splenic rupture and significantly impacts patient prognosis. While other injuries are possible, splenic infarction needs immediate attention.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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Which surgical procedure is MOST frequently used for the treatment of symptomatic mitral valve stenosis?
सही उत्तर: क) Percutaneous Balloon Valvuloplasty (PBV)
Percutaneous Balloon Valvuloplasty (PBV) is the standard initial treatment for symptomatic mitral valve stenosis, aiming to widen the narrowed valve opening. While other procedures may be considered later, PBV offers a less invasive and often effective solution.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A 65-year-old patient presents with sudden onset of severe abdominal pain, rigidity, guarding, and rebound tenderness. Vital signs include hypotension and tachycardia. What is the MOST immediate concern in this presentation?
सही उत्तर: ग) Perforated Diverticulitis
Reynolds' pentad (rigidity, guarding, hypotension, tachycardia, fever) strongly suggests peritonitis, most commonly due to septic shock secondary to acute mesenteric ischemia. While other conditions could present similarly, the combination of these signs is highly indicative of this critical diagnosis requiring immediate intervention.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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Which of the following investigations is MOST appropriate for initial assessment of suspected appendicitis based on clinical presentation?
सही उत्तर: ख) Abdominal CT Scan with IV Contrast
Clinical suspicion of appendicitis, coupled with findings like right lower quadrant pain and elevated white blood cell count, points to ultrasound as the most rapid and cost-effective initial investigation. While CT scans are highly accurate, they involve radiation exposure; CBC provides supportive evidence but isn't diagnostic. MRI is generally reserved for complex cases.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A patient presents with fever, right upper quadrant pain, and jaundice. Ultrasound reveals multiple dilated bile ducts. This clinical presentation is MOST consistent with:
सही उत्तर: ग) Cholangitis (Bile Duct Inflammation)
The combination of RUQ pain, jaundice, and dilated bile ducts strongly suggests pancreatitis. The other conditions present with different combinations of symptoms and imaging findings.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A 35-year-old male presents with sudden onset of severe pain in the right shoulder after sustaining a blunt abdominal trauma. Physical examination reveals positive findings for Kehr's sign. This symptom is MOST likely due to:
सही उत्तर: ग) Post-operative pain following abdominal surgery
Kehr's sign (pain referred to the left shoulder tip after blunt abdominal trauma) is a classic manifestation of inflammation irritating the phrenic nerve, which transmits pain signals from the abdomen to the diaphragm and then can be referred to other areas like the shoulder. The others are not typical explanations for this sign.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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During laparoscopic cholecystectomy, the gallbladder appears unexpectedly normal with no evidence of inflammation or sludge. This finding would MOST likely represent:
सही उत्तर: ख) Choledocholithiasis (gallstone in the common bile duct)
The absence of inflammation and sludge during a cholecystectomy often indicates a normal gallbladder. Choledocholithiasis is characterized by obstruction within the common bile duct which would typically lead to complications in a cholecystectomy. Cholangitis involves inflammation of biliary tree, and Primary Sclerosing Cholangitis is usually associated with chronic symptoms.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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A patient presents with severe abdominal pain, fever, and hypotension. The Alvarado score reveals a high white blood cell count, elevated temperature, leukocytosis, and transient nitrates. Which of the following is the MOST appropriate initial management step?
सही उत्तर: घ) Administration of intravenous corticosteroids to reduce inflammation
The Alvarado score strongly suggests sepsis. Continuous monitoring is crucial in a critically ill patient, allowing for rapid response to changes in vital signs. While antibiotics are often used, observation and stabilization are the primary initial steps until a definitive diagnosis is established. The other options aren't the most immediate or appropriate action.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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Which of the following findings would MOST strongly suggest a sigmoid diverticulitis diagnosis?
सही उत्तर: ख) Left lower quadrant pain with guarding and rebound tenderness
The Alvarado score (MANTRELS) is primarily used for diagnosing acute abdomen, particularly sepsis. Left lower quadrant pain with guarding and rebound tenderness (characteristic of diverticulitis), along with other signs on the scoring system, strongly points towards this diagnosis. The other options represent alternative diagnoses like perforation, appendicitis or other conditions.
💬 टिप्पणी / गल्ती रिपोर्ट (०)
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