Surgery MCQS – Page 49 – 6000+ High-Yield MCQs & Explanations

Q) Which modality has no part in management of corrosive injury of esophagus?

a) Repeated Endoscopies routinely

b) Esophagectomy in some cases

c) Early emergency surgery routinely

d) Steroid use routinely

In corrosive injury of the esophagus, routine early emergency surgery is generally not indicated. The primary approach involves stabilization, assessing the extent of injury, and supportive care. Surgery is reserved for specific complications, such as perforation or severe necrosis.

Other than the need for emergency surgery for bleeding or perforation, elective oesophageal resection should be deferred for at least 3 months until the fibrotic phase has been established.

Oesophageal replacement is usually required for very long or multiple strictures. Resection can be difficult because of perioesophageal inflammation in these patients.

Regular endoscopic examinations are the best way to assess stricture development .

Significant stricture formation occurs in about 50% of patients with extensive mucosal damageo Corrosives can cause significant pharyngolaryngeal oedema

In unusual circumstances, e.g. with extensive necrosis after corrosive ingestion, emergency oesophagectomy may be necessary.

Questions on Esophagus

Alkali and acidic injuries to the esophagus, both leading causes of corrosive stricture of the esophagus, differ in their effects due to distinct chemical reactions with tissue.

Mechanism of Injury

Alkali Injuries: Ingested alkalis (e.g., drain cleaners) cause liquefactive necrosis, where tissue rapidly breaks down. This process allows alkalis to penetrate deep into the esophageal layers, often causing severe, widespread injury that extends to adjacent tissues. As a result, alkali injuries frequently lead to extensive scarring and stricture formation over time, significantly impacting the esophageal lumen.
Acidic Injuries: Acids like hydrochloric acid cause coagulative necrosis, resulting in protein denaturation and an eschar formation. This eschar limits acid penetration depth, typically causing more superficial injury compared to alkalis. However, mucosal damage can still be severe, leading to ulceration and potential esophageal stricture over time, especially if the injury affects the lower esophagus.

Q) Least common association of Carcinoma Pancreas is with

a) Smoking

b) Male gender

c) Obesity

d) Lynch Syndrome

Q) Not a consistent feature of severe acute pancreatitis

a) Persistent organ failure

b) CRP more than 150 mg/dl at 48 hours

c) Single organ failure

d) LDH >350 U /L

Another question on severe pancreatitis

Q ) Treatment of Primary Gastric Lymphoma is

a) Surgery

b) chemotherapy

c) Radiotherapy

d) Both chemo and radiotherapy

Q) Submandibular node without any apparent primary, next step should be

a) Tripple endoscopy

b) PET CT Head, Neck and thorax

c) Laryngoscopy

d) Chest X ray

Q) 57 year old male come to the surgery clinic with bleeding PR. He is diagnosed with Haemarrhoids . What is not an indication of haemorrhoidectomy

a) Persistent Second degree haemorrhoid 5 days after sclerotherapy

b) 3rd degree haemorrhoid

c) Fibrosed haemorrhoid

d) Interno-external haemorrhoids when the external haemorrhoid is well defined.

Ans a

Haemorrhoids can persist for 10 days after sclerotherapy

The indications for haemorrhoidectomy include:

● third- and fourth-degree haemorrhoids;

● second-degree haemorrhoids that have not been cured by non-operative treatments;

● fibrosed haemorrhoids;

● interno-external haemorrhoids when the external haemorrhoid is well defined.

Four degrees of haemorrhoids ●●

First degree – bleed only, no prolapse ●●

Second degree – prolapse but reduce spontaneously ●●

Third degree – prolapse and have to be manually reduced ●●

Fourth degree – permanently prolapsed

MCQS on Rectum

Q) True about OPSI is

a) OPSI is over estimated and not seen 2 years after splenectomy

b) Focus of infection is always in the lung or abdomen

c) Despite antibiotics and intensive care, the mortality rate is between 50% and 70% for full blown OPSI

d) H. influenza is the most common organism

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Q) Regarding the microscopic anatomy of stomach, false statement is ?

a) Parietal cells are abundant in the body of stomach and secrete H+

b) Chief cells produce pepsinogen I and II

c) G cells are abundant in gastric antrum

d) ECL cells are abundant in antrum

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Q) Most common intussusception in children is

a) Ileocolic

b) Ileoileal

c) Ileoileocolic

d) Colocolic

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Q) All of the following are indications for performing intra op cholangiography except:

A. Pain around the day of surgery
B. Anomalous biliary anatomy
C. Suspicious findings on ERCP
D. Abnormal hepatic function panel

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Corrosive Stricture esophagus

Association of carcinoma pancreas