MCQ (Single Best Answer) For Doctors and Medical Students

  MCQ (Single Best Answer)
 Answers are given below.

Renal Calculi

1. All are renal Calculi except

A. Cholesterol

B. Calcium Oxalate

C. Calcium Phosphate

D. Uric Acid

2. The side effeec of anti tuberculous drug Pyrazinamide is
A. Peripheral Neuropathy
B. Joints pain
C. Optic Neuritis
D. Deafness

3. Cause of paralytic ileus is ?
A. Hyponatremia.
B. Hypochloremia
C. Hypokalemia
D. Hypocalcaemia.

4. All are present in Thyrotoxicosis except
A. Tremor
B. Palpitation

Typhoid ileal perforation

C. Increase Serum TSH
D. Weight loss

5. In Prostatic Cancer increase Serum
A. Alpha feto protein
B. Bilirubin
C. Ca 125
D. PSA

6. A patient history of constipation. Complain of painful defecation, pain remains 3 - 4 hours after defecation, stool contains streak of blood. The Diagnosis is
A. Fistula in Ano
B. Pilonidal Sinus
C. Anal Fissure
D. Hemorrhoid

7. Which Vitamin deficiency causes Scurvy?
A. Vitamin K
B. Vitamin D
C. Vitamin C

Typhoid ileal primary closure

D. Vitamin B 12

8. All are Anti-tuberculous drugs Except
A. Ethambutol
B. Streptomycin
C. Isoniazid
D. Nystatin

9. Treatment Option of Typhoid ileal perforation are Except
A. Primary ileal perforation closure.
B. Colostomy.
C. Loop Ileostomy.
D.Resection Anastomosis.

10. The drug Carbimazole is used in the Treatment of
A. Hypothyroidism
B. Hyperthyroidism
C. Cushing's Syndrom
D. Epilepsy

11. Treatment options of Anal Fissure except
A. Injection of 5% phenol in almond oil.

Renal Calculus

B. Local application of 0.2% GTN ointment.
C. Anal dilatation.
D. Lateral internal sphincterotomy.

12. In obstructive Jaundice patient, the colour of stool is
A. Clay
B. Yellow
C. Green
D. Redish

13. Treatment of Renal Calculi are except
A. Lithotripsy
B. PCNL (Per Cutaneous Nephrolithotomy)
C. Pyelolithotomy
D. Cystolithotomy

14. Treatment of Bradycardia during spinal anaesthesia is ?
A. Solucortif
B. Adrenaline

Acute Appendicitis

C. Atropine
D. Aminophyline.

15. CA-125 is a Tumor Marker for
A. Ca Cervix
B. Ca Pancreas
C. Ca Gall Bladder
D. Ovarian Cancer

16. Acute Appendicitis occurs most commonly in
A. Neonate
B. Children under 12 years
C. Teen Age
D. Old Age

Answers
1.A  2.B  3.C  4.C  5.D  6.C  7.C  8.D  9.B  10.B  11.A  12.A  13.D  14.C  15.D  16.C

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Posted at 00:25 |  by surgicaloperation

Pilonidal Sinus

Management of Pilonidal Sinus is possible conservatively by removing the hairs from the sinus, anti septic dressing and antibiotic.

2 comments

Posted at 22:50 |  by surgicaloperation

Anal Fissure

            A longitudinal tear in anal canal is called anal fissure. Cause is constipation. Symptoms are painful defecation and bleeding per rectum. Blood come in a streak along stool. Patient can manage medically. Laxative orally and pain killer. Sitz Bath ( sitting in a tub containing hot water and table spoon of dettol for 10 minutes ) twice a day. 0.2% GTN ointment for local application twice a day.

Anal fissure

          If medical treatment fail, then treatment is surgical. Anal dilation or Lateral interrnal Sphinctertomy under spinal anesthesia.

Anal Fissure

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Posted at 22:25 |  by surgicaloperation

Acute Appendicitis

Acute inflammation of appendix is called acute appendicitis.
Diagnosis
Sign & Symptoms are:
1. Pain in right iliac fossa, migrating in nature.
2. Fever
3. Vomiting
4. Loss of appetite
5. Tenderness at right iliac fossa

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Posted at 19:34 |  by surgicaloperation

Mirpurkhas

        Mirpurkhas is my sweet city. It is called the City of Mangoes and NGO's. It is the capital city of District Mirpurkhas. It is situated in Sindh province of Pakistan country. In1806, Mir Ali Murad Talpur founded the town of Mirpurkhas.

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Posted at 21:09 |  by surgicaloperation

Haemorrhoids (Piles) : A Common Problem of Community.

Dilatation of anal cushions are called haemorrhoids. They also called piles. It is a common problem of community. Constipation, chronic straining, obesity and previous childbirth may lead to development of symptomatic haemorrhoids. An increase prevelance is seen amongst higher socioeconomic groups.

The classical position of haemorrhoids are 3, 7 and 11 o'clock which corresponds to branches of the superior haemorrhoidal artery. Haemorrhoids (Piles) is a common problem of community.

If they confined to the tissue of the upper anal canal then called internal haemorrhoids. If they extend to the tissue of the lower anal canal then called external haemorrhoids.

Symptoms of haemorrhoids are

1. Bleeding per rectum

• Bright red in colour 
• Not mixed with stool 
• Drop by drop or like spray after defecation
• Painless. 

2. Prolapse

• Intermittent lump appearing at the anal margin
• Usually after the defecation
• May reduce spontaneously
•  May require manual reduction.

3. Soiling

4. Mucous Discharge

5. Itching

6. Pain (Particularly when thrombosed or prolapsed with ulceration and inflamation)       

Inspection of perianal area for sentinel skin tags, anal fissures, rectal polyps and tumours. Then perform Digital Rectal Examination (DRE) and Proctoscopy.

DRE is done to feel any rectal growth or polyp.

Proctoscopy is done to confirm the presence of haemorrhoids.

Classification of Haemorrhoids

• First degree.  Only bleeding per rectum.
• Second degree. Bleeding and prolapse which reduce spontaneously.
• Third degree.  Bleeding and prolapse on straining and manual reduction is required.  
• Fourth degree. Bleeding and persistent prolapsed.

Complications of Haemorrhoids are 

• Strangulation 
• Thrombosis
• Ulceration
• Gangrene
• Fibrosis
• Portal pyaemia
• Severe haemorrhage leads to anaemia.

Treatment of Haemorrhoids

Malignancy must be ruled out in elderly patients before the treatment started.

1. Symptomatic Treatment

• Avoidance of constipation and straining by the use of stool softener laxatives and bulking agents.

2.  Injection Sclerotherapy (Mitchell)

• Submucosal injection of the sclerosant (5% phenol in almond oil).
• For first or second degree haemorrhiods whose symptoms are not improved by conservative measures.
• 5 ml of sclerosant is injected in to the apex of the each pile pedicle and reassessed the patient after the period of eight weeks, if necessary then injections are repeated.
• Causes submucosal fibrosis and fixation of the overlying mucosa.
• Pain when needle of injection is in the wrong place and should be withdrawn.
• Superficial ulceration when injected too superficial.
• Prostatitis, pelvic sepsis, impotence and rectovaginal fistula when injected too deeply.

3. Rubber Band Ligation

• Most common OPD procedure.
• For first and second degree haemorrhiods.
• Applied above the base of the haemorrhiods.
• Two haemorrhoids at a time can be ligated.
• Causes ischaemic necrosis of piles.
• Slough off within ten days.
• Pain, urinary retention and rectal bleeding are complications.

4. Cryotherapy (Lloyd Williams) & Infrared Photocoagulation (Leicester) Techniques

• Work on same principles as rubber band ligation and sclerotherapy.
• Higher recurrence rate 
• Now a days not often used.

5. Haemorrhoidectomy

Indications for Haemorrhoidectomy

• Third and fourth degree haemorrhiods.
• Second degree haemorrhiods that not cured by non- operative treatment.
•  Fibrosed piles.
• Intero-external haemorrhiods with well defined external haemorrhiods.
• Haemorrhiodsal bleeding which sufficient to cause anaemia.

Types of Haemorrhoidectomy

• Milligan-Morgan procedure (Open haemorrhoidectomy) is the most commonly used.
• Ferguson  procedure (Closed haemorrhoidectomy).
• Diathermy haemorrhoidectomy.
• Ligasure haemorrhoidectomy.
• Stapled haemorrhoidopxy (is becoming popular now a days). 

Complications of Haemorrhoidectomy

• Pain, acute retention of urine and reactionary haemorrhage are early complications.
• Secondary haemorrhage, anal stricture, anal fissure, infection and incontinence  are late complications.

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Posted at 19:47 |  by surgicaloperation