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Constipation in Childhood – Most Likely Diagnosis MCQ for INI CET, NEET SS, and Pediatric Surgery Exams

Q) A 4-year-old child presents with a history of infrequent, hard stools associated with painful defecation.

There is no history of vomiting, fever, or blood in the stool. On examination, there is a palpable fecal mass in the left lower abdomen, and the anal tone is normal.

What is the most likely diagnosis?
# Theme from Mock test 32

  • A) Hirschsprung disease
  • B) Functional constipation
  • C) Intussusception
  • D) Anal fissure
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Glenn Procedure in Single-Ventricle Heart Defects

Q) Which of the following best describes the main goal of the Glenn procedure performed in patients with single-ventricle congenital heart defects, such as after the Norwood operation?
#Congenital cardiac mock test on 8th Dec 24

  • A) To create a two-ventricle circulation by repairing the mitral and tricuspid valves.
  • B) To establish direct pulmonary blood flow by redirecting the superior vena cava to the pulmonary arteries.
  • C) To replace the right ventricle with a synthetic pump for systemic circulation.
  • D) To connect the left atrium directly to the right ventricle to improve systemic oxygenation.
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Q) A 60-year-old woman is found to have a 3.2 cm pancreatic cystic lesion on MRI. EUS shows internal echogenic material within the cyst cavity. To accurately determine whether this represents mural nodules rather than intraluminal debris, which of the following is the most definitive diagnostic approach?
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Breast cancer TNBC

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Q: Which of the following patients with operable breast cancer is the most appropriate candidate for preoperative systemic therapy?

A) A patient with ER-positive, HER2-negative breast cancer with a 1 cm tumor and clinically node-negative disease who desires breast conservation
B) A patient with HER2-positive breast cancer with a 3 cm primary tumor and clinically node-positive disease
C) A patient with triple-negative breast cancer with a 1 cm tumor and clinically node-negative disease who prefers mastectomy
D) A patient with ER-positive, HER2-positive breast cancer with a 1.5 cm tumor and no lymph node involvement
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Anticoagulation in valve surgery

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Q: In which operative valve procedure is lifelong anticoagulation required?

# Theme from mock test on 13.10.24 (Plastic and Cardiac)

a) Valve Repair
b) Mechanical valve replacement
c) Biological valve stentless
d) Biological valve homogenous
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Zones in Hand injury

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Q: What is the zone of injury due to a glass cut on the distal phalanx of the middle finger, flexor aspect?

Zone I
Zone II
Zone III
Zone IV
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Bariatric surgery in special circumstances

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Q: Which bariatric surgery procedure is preferred in patients who cannot comply with frequent follow-ups?

# Theme from Mock Test 5 on 13.10.24

a) Roux en Y Bypass
b) BPD
c) Duodenal switch
d) Sleeve gastrectomy
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Facial nerve pointers

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Q: What is the most consistent anatomical landmark of the facial nerve?

A) Anterior border of the posterior belly of the digastric muscle.
B) Posterior border of the posterior belly of the digastric muscle.
C) Superior border of the posterior belly of the digastric muscle.
D) Inferior border of the posterior belly of the digastric muscle.

Ivor Lewis Esophagectomy leak

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Q) After Ivor Lewis esophagectomy, on postoperative day 5 (POD 5), bile is seen in the chest tube.

The patient presents with a heart rate of 120 bpm, a temperature of 101°F, and blood pressure of 100/70 mmHg. What is the next appropriate step in management?

  • a) Stenting
  • b) Colonic replacement of gastric conduit
  • c) IV antibiotics
  • d) Conduit excision and esophageal diversion
Correct Answer: d) Conduit excision and esophageal diversion

In patients who develop a completely necrotic conduit post-esophagectomy, the risk of sepsis is high. These patients often require urgent surgical intervention. Upon confirming conduit necrosis, the conduit must be resected, and the patient should undergo diversion, which includes:

  • End esophagostomy
  • Venting gastrostomy
  • Feeding jejunostomy

It is crucial to maintain as much length of the remaining esophagus as possible to facilitate future reconstructive procedures.

Key Points:

  • Postoperative Day 5: Critical time for monitoring complications after esophagectomy.
  • Symptoms of Concern: Tachycardia, fever, and hypotension may indicate sepsis or other complications.
  • Surgical Intervention: Timely recognition and management are vital for patient outcomes.

For further reading, refer to Schakelford’s Surgical Anatomy of the Gastrointestinal Tract, page 477.

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