General Surgery

NEET, DNB questions from general surgery

Virchow’s triad

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Virchow's Triad MCQ
Q) Which of the following does not form a part of Virchow's triad?
a) Endothelial damage
b) Slow blood flow
c) Platelet defects
d) Hypercoagulable state
Correct Answer: c) Platelet defects
Explanation: Virchow triad (venous stasis, endothelial injury, and hypercoagulability) describes the factors contributing to venous clot formation and thromboembolism. Platelet defects are associated with arterial thrombosis and not venous. Virchow is known as "the father of modern pathology" and founder of social medicine. --- Virchow’s Triad: Unraveling the Factors Behind Thrombosis 1. Endothelial Damage: Endothelial cells line blood vessels. When injured, they expose tissue factor, initiating clot formation. Seen in atherosclerosis, sepsis, trauma. 2. Abnormal Blood Flow: Stasis or turbulence promotes clotting. Causes include prolonged immobilization, atrial fibrillation, varicose veins. 3. Hypercoagulability: A state of increased clotting tendency. Causes: • Oral contraceptives, obesity, pregnancy • Inherited mutations (e.g. factor V Leiden) • Smoking, malignancy Most thrombi result from a combination of the above factors. Recognizing the triad aids in prevention and diagnosis of thromboembolic disease.

Dumping Syndrome

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Q) What is the mechanism of action of Octreotide in dumping syndrome ?

a) Acceleration of gastric emptying

b) Shortening of small bowel transit time

c) Inhibition of endocrine secretions

d) All the above

Answer: C

  • Octreotide alleviates both early and late dumping symptoms through inhibition of hormone mediators.
  • It also delays gastric emptying time and inhibits splanchnic vasodilation.

Shack, 8th, 722.

  • These peptides not only inhibit gastric emptying but also affect small bowel motility so that intestinal transit of the ingested meal is prolonged.

Sabistan, 21st, 1217.

Snippets

  • Late dumping occurs 1 to 3 hours after a meal and is less common.
  • The basic defect of late dumping is also rapid gastric emptying; however, it is related specifically to carbohydrates being delivered rapidly into the proximal intestine.

Duodenal Ulcer Bleed management

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Q) Which of the following is TRUE regarding the management of a bleeding duodenal ulcer?

a) Hemoglobin should be maintained at 9 g/dL during resuscitation
b) Truncal vagotomy may be considered after control of bleeding with over-sewing
c) A visible black spot on endoscopy indicates high risk of rebleeding
d) Surgery is considered after a single failed endoscopic attempt

Trace elements deficiency

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MCQ on Trace Element Deficiency
Q) Which of the following trace elements deficiency causes impaired glucose tolerance, anemia, neutropenia, and leukopenia?
✅ Answer: B. Copper

🔍 Explanation:
Copper deficiency is associated with impaired glucose tolerance, anemia, neutropenia, leukopenia, and changes in skin and hair pigmentation.
Copper also plays a crucial role in collagen and elastin synthesis, scavenges free radicals, and is linked to fatal arrhythmias in its deficiency.

- **Zinc deficiency** causes growth retardation, immune dysfunction, and delayed wound healing but is not typically linked to significant neutropenia.
- **Molybdenum deficiency** is rare and linked to metabolic disorders but not hematological abnormalities.
- **Selenium deficiency** leads to cardiomyopathy (Keshan disease) and myopathy, but not neutropenia or leukopenia.

🧠 Key Point: Copper plays a vital role in multiple metabolic processes, and its deficiency can cause a range of hematological and metabolic abnormalities.

📘 Reference: MCQs on Nutrition and Perioperative Management

Skin Grafting

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Q) Skin Grafting is healing by 

a) Primary Intention

b) Secondary intention

c) Tertiary Intention

d) None of the above

Questions on Wound Healing

Ans c

Delayed primary closure, or tertiary intention, is utilised when there is a high probability of the wound being infected.

The wound is left open for a few days and, provided any infective process has resolved, the
wound is closed to heal by primary intention.

Skin grafting is another form of tertiary intention healing

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