NEET SS 23 Test 5 – Nov 13

Topics Liver from Sabiston , General Surgery Bailey chapters 11,12,13, Trauma from Schwartz. This is a free test

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1. Q) Normal Portal pressure is less than 5 mm hg. It signifies pressure difference between

Portal vein - hepatic artery

portal vein - hepatic vein

hepatic vein - portal vein

Hepatic vein - Portal vein

Question 1 of 30

2. Q) Which of the following is true about liver enzymes ?

AST is liver specific

Albumin is synthesized in liver, bone marrow and blood

5′-Nucleotidase is found only in liver

ALP levels may be increased in malignant diseases of liver

Question 2 of 30

3. Q) Tachycardia after trauma is common. Sometimes tachycardia does not occur even after profound blood loss. Which condition is this?

a) People living in hills

Patient on Beta blocker

C) Athletes

d) All of the above

Question 3 of 30

4. Q) 35 year old male with blunt trauma chest. His intercostal tube is persistently hemorrhagic. What is the indication of operative treatment?

Initial drain output of 1000 ml blunt injury

Ongoing bleed 100 ml for 3 hours

Pericardial tamponade

Mild air leak from chest tube

Question 4 of 30

5. Q) Clinical audit is useful for all except?

a) Improve patient care

b) Revalidation of Surgeons

c) Cost management

d) Decision on new antibiotic policy

Question 5 of 30

6. Q) What kind of study is "Evaluation of treatment in a defined population"?

Observational

Case control

Cross Sectional

Longitudanal

Question 6 of 30

7. Q) Unconscious patient with a stab injury. Knife is dangling from deep in the upper abdomen. When will you remove the knife?

A) As soon as possible

B) At the site of scene

C) Emergency room after securing Iv lines

D ) in the operation theratre

Question 7 of 30

8. Q) What is true about the epidemiology of Hepatocellular carcinoma?

Hepatitis c is the most common cause world wide

lowest incidence of hcc is in India

More common in females

Obesity is a risk factor for HCC

Question 8 of 30

9. Q) WHat is true about hydatid disease of the liver ?

E. Multilocularis is the most common organism responsible

Humans are the intermediate host

More common in males than females

MOst commonly seen in left lobe of liver

Question 9 of 30

10. Q) Which is not a human factor responsible for incidents of inadequate patient safety?

Error of communication

Failure to use or interpret appropriate tests

Inadequate patient assessment; delays or errors in diagnosis

Fatigue, overwork, time pressures

Question 10 of 30

11. Q) A liver lobule has three zones which differ in enzymatic activity. Which zone of liver is most susceptible to hypotension ?

ZOne 1

Zone II

Zone III

All equal

Question 11 of 30

12. Q) 45 year old male with cirrhosis of liver and variceal bleed. WHich drug is least preferred in pharmacological management?

Antibiotic prophylaxis

Octreotide

Nitroglycerine

Prostaglandins

Question 12 of 30

13. Q) What brain injury is caused by venous disruptions in the skull

Epidural hematoma

Sub dural hematoma

Direct axonal injury

All

Question 13 of 30

14. Q) 35 year old male with bilateral multiple intrahepatic stones. Which is true about this condition

seen in Lower socio economic background

More in men as compared to women

Biliary obstruction is complete

Urso deoxy cholic acid is the treatment of choice

Question 14 of 30

15. Q) Which is true for various modalities for diagnosis of Hepatocellular carcinoma?

Biopsy is required before offering definitive resection

Most important for diagnosis is venous phase filling

liver radioisotope scans and angiography are common methods of diagnosis

AFP measurements have low sensitivity and specificity.

Question 15 of 30

16. Q) 60 year old male patient has 3 cm HCC with cirrhosis of liver. Which is not a clinical/radiological method to decide that patient has portal hypertension as this will decide weather the patient will go for resection/transplantation?

Splenomegaly

CT appearance of liver

Intra abdominal varices

High Alpha feto protein levels

Question 16 of 30

17. Q) Regarding informed consent, which of the following options is least desired?

a) JR should take the consent

b) Ample time is given to the patient to decide

c) Written material in patient's language should be given

d) Provision of translators

Question 17 of 30

18. Q) 45 year old male with mild gi bleed after blunt trauma abdomen with liver injury Patient is stable and there is no major drop in Hb. Next line of management?

Conservative

Ercp and stenting

Surgery

Trans arterial embolization

Question 18 of 30

19. Q) Sign out in operation theatre is done at the time of ?

Skin closure

Dressing

Extubation

Before patient leaves OT

Question 19 of 30

20. Q) Epithelioid hemangioendothelioma of the liver - true is

2nd most common primary tumor of liver after HCC

Solitary large right lobe tumor

Extra hepatic metastasis is seen in almost 100% cases

Vascular tumor

Question 20 of 30

21. Q) Most common biliary variation is ?

a) Variation in insertion of right posterior sectoral duct

b) Trifurcation of heoatic ducts

c) Right Posterior duct opening into Left hepatic duct

d) Right Posterior duct opening to Common hepatic duct

Question 21 of 30

22. Q) Which of the following is true about TIPS?

Rebleed rate of TIPS and chronic endoscopy therapy is same

Encephalopathy is same in TIPS and chronic endoscopy

It is best for short term portal decompression

TIPS function as an end to side Porto caval shunt

Question 22 of 30

23. Q) 45 year old lady with pain in epigastric region and more after food. She undergoes USG which shows a 12 cm hemiangioma in segment Vii Blood tests are normal. What should be the next step?

A) Liver resection

B) Right hepatic artery embolization and then resection

Follow up

Prostaglandin

Question 23 of 30

24. Q) A 17 year old male motorcyclist is injured in a road traffic accident. He is brought to the emergency departmentcomatose. He becomes haemodynamically unstable and a ruptured spleen is diagnosed. A laparotomy is proposed. What type of consent should be taken

Consent the parents

Proceed without consent

Consent by proxy

No treatment

Question 24 of 30

25. Q) A 30 year old women is involved in a road traffic accident she is a passenger in a car involved in ahead on collision with another vehicle. Her car is travelling at 60mph. She has been haemodynamically stable throughout with only minimal tachycardia. On examination she hasmarked abdominal tenderness and a large amount of intra abdominal fluid on CT scan. suspected site of injury is ?

spleen

liver

pancreas

DJ flexure

Question 25 of 30

26. Q) A 17 year old boy is involved in a motorcycle accident in which he is thrown from hismotorcycle. On admission he has distended neck veins and a weak pulse. The trachea is central. This is a case of?

Tension pneumothorax

Haemopericardium

C. Haemothorax

D. Aortic transection

Question 26 of 30

27. Q) A 22 year old man is involved in a accident. He suffers from bilateral tibial and fibula fractures. He is taken to theatre and intramedullary nails are inserted. 6h after surgery he complains of severe pain in his limb, which increases on passive plantar flexion. What is the best management plan?

Anticoagulation

B. Fasciotomy

C. Intravenous analgesia and clinical review in 8 hours

Exploration of tibia for displaced nail

Question 27 of 30

28. Q) A 42 year old lady has suffered from hepatitis C for many years and has also developed cirrhosis. On routine follow up,an ultrasound has demonstrated a 2.5cm lesion in the right lobe of the liver. What is the most likely etiology?

Haemangioma

B. Hepatocellular carcinoma

C. Hepatic metastasis

D. Polycystic liver disease

Question 28 of 30

29. Q) Which solute is not seen in hepatic bilE?

Bicarbonate

Bile acid

Copper

Protein

Question 29 of 30

30. Q) Which of the following is a non selective shunt?

Eck fistula

Warren shunt

Both

Inokuchi

Question 30 of 30