Medical Officer & Lady Medical Officer Test 1

Subject: General Surgery

 

Question No. 1

The primary objective of general surgery is to:

  1. Treat only fractures
  2. Diagnose and surgically manage diseases requiring operative intervention
  3. Treat only infectious diseases
  4. Manage psychiatric disorders

Question No. 2

The most effective method for preventing surgical site infection is:

  1. Routine antibiotic use
  2. Proper aseptic technique
  3. Frequent wound dressing
  4. Daily wound irrigation

Question No. 3

Which microorganism is most commonly responsible for surgical site infections?

  1. Escherichia coli
  2. Staphylococcus aureus
  3. Pseudomonas aeruginosa
  4. Candida albicans

Question No. 4

The normal duration for surgical hand scrubbing before the first operation of the day is approximately:

  1. 30 seconds
  2. 1 minute
  3. 2–5 minutes
  4. 10 minutes

Question No. 5

Which sterilization method is most suitable for standard surgical instruments?

  1. Boiling water
  2. Dry heat
  3. Steam under pressure (Autoclaving)
  4. Ultraviolet light

Question No. 6

The inflammatory phase of wound healing usually lasts:

  1. 1–3 days
  2. 10–14 days
  3. 3–4 weeks
  4. Several months

Question No. 7

Which vitamin deficiency most significantly delays wound healing?

  1. Vitamin A
  2. Vitamin C
  3. Vitamin D
  4. Vitamin K

Question No. 8

The strongest layer of the abdominal wall for surgical closure is the:

  1. Skin
  2. Subcutaneous tissue
  3. Fascia
  4. Peritoneum

Question No. 9

The universal donor blood group is:

  1. A positive
  2. B negative
  3. O negative
  4. AB positive

Question No. 10

The normal adult serum sodium concentration is:

  1. 110–120 mmol/L
  2. 125–130 mmol/L
  3. 135–145 mmol/L
  4. 150–160 mmol/L

Question No. 11

The most common extracellular cation is:

  1. Potassium
  2. Magnesium
  3. Sodium
  4. Calcium

Question No. 12

Which intravenous fluid is considered isotonic?

  1. 5% Dextrose
  2. 3% Saline
  3. Normal Saline (0.9%)
  4. Sterile Water

Question No. 13

Informed consent should preferably be obtained:

  1. After anesthesia
  2. Immediately before incision
  3. Before the surgical procedure while the patient is competent
  4. After surgery

Question No. 14

Which ethical principle refers to respecting a patient’s right to make decisions?

  1. Justice
  2. Beneficence
  3. Autonomy
  4. Non-maleficence

Question No. 15

Which nutrient is most essential for collagen synthesis?

  1. Fat
  2. Protein
  3. Carbohydrate
  4. Cholesterol

Question No. 16

The preferred prophylactic antibiotic for clean surgical procedures is usually:

  1. Cefazolin
  2. Vancomycin
  3. Ciprofloxacin
  4. Metronidazole

Question No. 17

The first step during preoperative assessment is:

  1. Obtain informed consent
  2. Complete history and physical examination
  3. Start antibiotics
  4. Arrange ICU admission

Question No. 18

The ASA Physical Status Classification is primarily used to assess:

  1. Nutritional status
  2. Surgical wound class
  3. Operative risk
  4. Pain severity

Question No. 19

Which patient has the highest ASA physical status?

  1. ASA I
  2. ASA II
  3. ASA III
  4. ASA V

Question No. 20

The safest fasting period for clear fluids before elective surgery is approximately:

  1. 30 minutes
  2. 2 hours
  3. 6 hours
  4. 12 hours

Moderate Level

Question No. 21

Which anesthetic technique provides complete unconsciousness with loss of protective airway reflexes?

  1. Local anesthesia
  2. Regional anesthesia
  3. General anesthesia
  4. Field block

Question No. 22

Spinal anesthesia is most commonly administered into the:

  1. Epidural space
  2. Subarachnoid space
  3. Intramuscular space
  4. Pleural cavity

Question No. 23

Pulse oximetry primarily measures:

  1. Blood pressure
  2. Hemoglobin concentration
  3. Oxygen saturation
  4. Cardiac output

Question No. 24

The earliest sign of postoperative hypovolemia is:

  1. Bradycardia
  2. Tachycardia
  3. Hypertension
  4. Hyperthermia

Question No. 25

The most common cause of fever within the first 24 hours after surgery is:

  1. Surgical wound infection
  2. Atelectasis
  3. Urinary tract infection
  4. Deep vein thrombosis

Question No. 26

The preferred route for postoperative analgesia in a patient unable to tolerate oral medications is:

  1. Oral
  2. Intravenous
  3. Topical
  4. Sublingual

Question No. 27

Deep vein thrombosis following surgery is best prevented by:

  1. Prolonged bed rest
  2. Early mobilization and thromboprophylaxis
  3. High-dose antibiotics
  4. Restricting oral fluids

Question No. 28

Enhanced Recovery After Surgery (ERAS) protocols primarily aim to:

  1. Increase hospital stay
  2. Reduce postoperative recovery time and complications
  3. Delay oral feeding
  4. Increase opioid consumption

Question No. 29

Which patient is the best candidate for day-care surgery?

  1. Hemodynamically unstable patient
  2. Patient requiring prolonged ICU monitoring
  3. Healthy patient undergoing a minor elective procedure
  4. Patient with uncontrolled diabetes and severe heart failure

Question No. 30

A patient develops sudden shortness of breath on the second postoperative day. The diagnosis that should be suspected first is:

  1. Pulmonary embolism
  2. Acute appendicitis
  3. Acute pancreatitis
  4. Cellulitis

Question No. 31

According to the ATLS protocol, the first priority in trauma management is:

  1. Control of fractures
  2. Airway maintenance with cervical spine protection
  3. Urinary catheterization
  4. CT scan of the whole body

Question No. 32

In the ABCDE approach, the letter “B” stands for:

  1. Bleeding
  2. Breathing
  3. Blood pressure
  4. Brain assessment

Question No. 33

The Glasgow Coma Scale evaluates:

  1. Renal function
  2. Neurological status
  3. Cardiac output
  4. Liver function

Question No. 34

A Glasgow Coma Scale score of 8 or less usually indicates:

  1. Mild head injury
  2. Moderate dehydration
  3. Severe head injury requiring airway protection
  4. Normal neurological function

Question No. 35

The most common immediately life-threatening chest injury is:

  1. Simple rib fracture
  2. Tension pneumothorax
  3. Clavicle fracture
  4. Chest wall contusion

Question No. 36

The preferred initial investigation for suspected pneumothorax in a stable patient is:

  1. ECG
  2. Chest X-ray
  3. Colonoscopy
  4. MRI Brain

Question No. 37

Kehr’s sign is classically associated with:

  1. Appendicitis
  2. Splenic injury
  3. Acute cholecystitis
  4. Pancreatitis

Question No. 38

Focused Assessment with Sonography in Trauma (FAST) is primarily performed to detect:

  1. Bone fractures
  2. Intra-abdominal free fluid
  3. Pulmonary embolism
  4. Deep vein thrombosis

Question No. 39

The most common organ injured in blunt abdominal trauma is:

  1. Liver
  2. Spleen
  3. Kidney
  4. Pancreas

Question No. 40

The earliest physiological response to acute blood loss is:

  1. Bradycardia
  2. Tachycardia
  3. Hyperthermia
  4. Hypertension

Moderately Difficult

Question No. 41

A pelvic fracture associated with hypotension should initially be managed by:

  1. Immediate laparotomy in all patients
  2. Pelvic stabilization and hemorrhage control
  3. Application of skeletal traction only
  4. Delayed assessment after 24 hours

Question No. 42

The Parkland formula is used in the management of:

  1. Head injury
  2. Burns
  3. Polytrauma
  4. Acute pancreatitis

Question No. 43

According to the Parkland formula, fluid resuscitation during the first 24 hours is calculated using:

  1. 2 mL × body weight × %TBSA
  2. 4 mL × body weight × %TBSA
  3. 6 mL × body weight × %TBSA
  4. 8 mL × body weight × %TBSA

Question No. 44

The first half of the calculated burn fluid requirement should be administered:

  1. During the first 24 hours
  2. Within the first 8 hours after injury
  3. During the second day
  4. After urine output improves

Question No. 45

The most common cause of early death following severe burns is:

  1. Contracture formation
  2. Airway injury and shock
  3. Osteomyelitis
  4. Hypertrophic scar

Question No. 46

Which type of shock is most commonly encountered in trauma patients?

  1. Cardiogenic shock
  2. Neurogenic shock
  3. Hypovolemic shock
  4. Septic shock

Question No. 47

Which surgical instrument is primarily used to grasp tough fascia?

  1. Babcock forceps
  2. Allis tissue forceps
  3. Sponge holding forceps
  4. Sinus forceps

Question No. 48

A Babcock forceps is best suited for handling:

  1. Bone
  2. Delicate bowel tissue
  3. Skin edges
  4. Thick fascia

Question No. 49

The Mayo scissors are primarily designed for cutting:

  1. Delicate vessels
  2. Heavy tissue and fascia
  3. Sutures only
  4. Skin staples

Question No. 50

The most commonly used absorbable suture material is:

  1. Silk
  2. Nylon
  3. Polyglactin 910 (Vicryl)
  4. Polypropylene

Question No. 51

The interrupted suture technique is preferred over continuous suturing because it:

  1. Requires less suture material
  2. Is quicker to perform
  3. Prevents complete wound dehiscence if one knot fails
  4. Produces less scar formation

Question No. 52

The commonly used incision for an open appendectomy is:

  1. Kocher incision
  2. McBurney incision
  3. Pfannenstiel incision
  4. Midline laparotomy

Question No. 53

The most important advantage of laparoscopic surgery compared with open surgery is:

  1. Longer hospital stay
  2. Increased postoperative pain
  3. Faster recovery with smaller incisions
  4. Higher wound infection rate

Question No. 54

Carbon dioxide is used for pneumoperitoneum because it:

  1. Supports combustion
  2. Is inexpensive, non-flammable, and rapidly absorbed
  3. Has a high risk of gas embolism
  4. Causes severe tissue injury

Question No. 55

The Veress needle is primarily used to:

  1. Close fascia
  2. Establish pneumoperitoneum
  3. Remove sutures
  4. Perform biopsy

Question No. 56

A closed suction drain commonly used after surgery is:

  1. Corrugated drain
  2. Penrose drain
  3. Jackson-Pratt drain
  4. Rubber tube drain

Question No. 57

The most important component of an operative note is:

  1. Patient’s occupation
  2. Details of the procedure performed and operative findings
  3. Ward location
  4. Marital status

Question No. 58

Which of the following is the most common cause of postoperative wound dehiscence?

  1. Vitamin A excess
  2. Surgical site infection
  3. Hypercalcemia
  4. Hypothyroidism

Question No. 59

The best method for obtaining tissue diagnosis from a suspicious breast lump is:

  1. Fine needle aspiration only
  2. Core needle biopsy
  3. Plain X-ray
  4. Urine examination

Question No. 60

The ideal biopsy for a small skin lesion suspected to be malignant is:

  1. Needle aspiration
  2. Excisional biopsy
  3. Bone marrow biopsy
  4. Endoscopic biopsy

Difficult

Question No. 61

The recommended compression-to-ventilation ratio during adult CPR by a single rescuer is:

  1. 15:2
  2. 20:2
  3. 30:2
  4. 40:2

Question No. 62

The recommended rate of chest compressions during adult CPR is:

  1. 40–60 per minute
  2. 60–80 per minute
  3. 100–120 per minute
  4. 140–160 per minute

Question No. 63

The recommended depth of chest compressions in an adult is approximately:

  1. 2 cm
  2. 3 cm
  3. 5–6 cm
  4. 8 cm

Question No. 64

The first action after confirming an unresponsive adult with absent normal breathing is to:

  1. Obtain blood investigations
  2. Start high-quality CPR
  3. Give intravenous fluids
  4. Perform ECG

Question No. 65

The Automated External Defibrillator (AED) is primarily used to treat:

  1. Asystole
  2. Pulseless ventricular tachycardia and ventricular fibrillation
  3. Sinus bradycardia
  4. Atrial flutter

Question No. 66

The most effective immediate management of complete airway obstruction in a conscious adult is:

  1. Chest tube insertion
  2. Heimlich maneuver (abdominal thrusts)
  3. Endotracheal intubation without assessment
  4. Cardioversion

Question No. 67

The head tilt–chin lift maneuver should NOT be used in:

  1. Cardiac arrest without trauma
  2. Suspected cervical spine injury
  3. Choking after foreign body removal
  4. Postoperative patient

Question No. 68

During trauma resuscitation, airway management should always be accompanied by:

  1. Pelvic stabilization
  2. Cervical spine protection
  3. Splinting of fractures
  4. Urinary catheterization

Question No. 69

The drug most commonly used first during cardiac arrest according to ACLS protocols is:

  1. Atropine
  2. Epinephrine (Adrenaline)
  3. Digoxin
  4. Furosemide

Question No. 70

The most reliable clinical indicator of adequate perfusion during burn resuscitation is:

  1. Body temperature
  2. Urine output
  3. Hemoglobin level
  4. Respiratory rate

Question No. 71

Primary bone healing usually occurs when:

  1. Fracture fragments remain mobile
  2. Rigid anatomical fixation is achieved
  3. Infection is present
  4. A large callus forms

Question No. 72

The most common fracture of the upper limb is:

  1. Scaphoid fracture
  2. Clavicle fracture
  3. Olecranon fracture
  4. Radial head fracture

Question No. 73

A Colles’ fracture involves the:

  1. Proximal humerus
  2. Distal radius
  3. Neck of femur
  4. Shaft of ulna

Question No. 74

The blood supply to the head of the femur in adults is mainly provided by the:

  1. Obturator artery
  2. Medial circumflex femoral artery
  3. Inferior gluteal artery
  4. Femoral vein

Question No. 75

The most common direction of shoulder dislocation is:

  1. Superior
  2. Inferior
  3. Posterior
  4. Anterior

Question No. 76

The most common cause of primary osteoarthritis is:

  1. Autoimmune disease
  2. Age-related degeneration of articular cartilage
  3. Septic arthritis
  4. Tuberculosis

Question No. 77

Which joint is most commonly affected in rheumatoid arthritis?

  1. Distal interphalangeal joints
  2. Sacroiliac joints
  3. Metacarpophalangeal joints
  4. Temporomandibular joints

Question No. 78

The most common primary malignant bone tumor in adults is:

  1. Osteosarcoma
  2. Chondrosarcoma
  3. Multiple myeloma
  4. Ewing sarcoma

Question No. 79

The most common causative organism of acute osteomyelitis is:

  1. Escherichia coli
  2. Staphylococcus aureus
  3. Klebsiella pneumoniae
  4. Pseudomonas aeruginosa

Question No. 80

The most common indication for total hip replacement is:

  1. Osteoarthritis
  2. Osteomyelitis
  3. Tuberculosis
  4. Bone cyst

Complex Clinical Scenario-Based Questions

Question No. 81

A 22-year-old man presents with severe right iliac fossa pain, nausea, and fever. Examination reveals tenderness at McBurney’s point with rebound tenderness. The most likely diagnosis is:

  1. Acute cholecystitis
  2. Acute appendicitis
  3. Acute pancreatitis
  4. Sigmoid volvulus

Question No. 82

A 68-year-old man presents with abdominal distension, vomiting, constipation, and high-pitched bowel sounds. The most likely diagnosis is:

  1. Acute hepatitis
  2. Intestinal obstruction
  3. Gastritis
  4. Acute cystitis

Question No. 83

A patient presents with severe epigastric pain radiating to the back and elevated serum lipase. The most likely diagnosis is:

  1. Acute appendicitis
  2. Acute pancreatitis
  3. Perforated peptic ulcer
  4. Cholangitis

Question No. 84

A patient has right upper quadrant pain, fever, and positive Murphy’s sign. The most likely diagnosis is:

  1. Acute appendicitis
  2. Acute cholecystitis
  3. Renal colic
  4. Splenic abscess

Question No. 85

A 60-year-old patient presents with painless rectal bleeding and weight loss. Which diagnosis should be considered first?

  1. Hemorrhoids
  2. Colorectal carcinoma
  3. Anal fissure
  4. Rectal prolapse

Question No. 86

A 72-year-old man presents with acute urinary retention secondary to benign prostatic hyperplasia. The immediate management is:

  1. Intravenous antibiotics only
  2. Urethral catheterization
  3. Radical prostatectomy
  4. Observation only

Question No. 87

A patient presents with sudden onset unilateral chest pain and dyspnea. Chest examination reveals hyperresonance and absent breath sounds on the affected side. The most likely diagnosis is:

  1. Pleural effusion
  2. Pneumothorax
  3. Pulmonary edema
  4. Pneumonia

Question No. 88

The definitive treatment for significant left main coronary artery disease is:

  1. Medical therapy alone
  2. Percutaneous aspiration
  3. Coronary artery bypass grafting (CABG)
  4. Balloon tamponade

Question No. 89

A patient develops stridor due to upper airway obstruction from a neck tumor. The most appropriate emergency procedure is:

  1. Bronchoscopy
  2. Cricothyrotomy or tracheostomy
  3. Nasogastric tube insertion
  4. Thoracostomy

Question No. 90

The most common benign thyroid swelling is:

  1. Papillary carcinoma
  2. Colloid goiter
  3. Medullary carcinoma
  4. Anaplastic carcinoma

Question No. 91

A patient with severe cellulitis develops rapidly progressive skin necrosis, crepitus, and septic shock. The most likely diagnosis is:

  1. Pyoderma gangrenosum
  2. Necrotizing fasciitis
  3. Erysipelas
  4. Cellulitis only

Question No. 92

A cold, pale, pulseless, painful lower limb of sudden onset is most suggestive of:

  1. Chronic venous insufficiency
  2. Deep vein thrombosis
  3. Acute limb ischemia
  4. Cellulitis

Question No. 93

The primary objective of damage control surgery is to:

  1. Complete definitive surgery in one operation
  2. Rapid control of hemorrhage and contamination before physiological stabilization
  3. Perform cosmetic wound closure
  4. Avoid blood transfusion

Question No. 94

A patient with generalized abdominal rigidity, rebound tenderness, and free air under the diaphragm most likely has:

  1. Acute hepatitis
  2. Gastrointestinal perforation
  3. Acute cystitis
  4. Acute pyelonephritis

Question No. 95

A patient develops fever, tachycardia, hypotension, and elevated serum lactate following bowel perforation. The most likely diagnosis is:

  1. Cardiogenic shock
  2. Surgical sepsis
  3. Neurogenic shock
  4. Hypoglycemia

Question No. 96

The most appropriate imaging investigation for suspected renal calculi in a stable adult is:

  1. Plain abdominal radiograph only
  2. Ultrasound only
  3. Non-contrast CT KUB
  4. Intravenous pyelography as the first investigation

Question No. 97

A patient presents after a road traffic accident with pelvic fracture, hypotension, and unstable vital signs. The priority management is:

  1. Immediate discharge
  2. Hemorrhage control and resuscitation
  3. Elective orthopedic fixation after one week
  4. Oral analgesics only

Question No. 98

Following thyroidectomy, a patient develops tingling around the mouth and carpopedal spasm. The most likely complication is:

  1. Hyperkalemia
  2. Hypocalcemia due to hypoparathyroidism
  3. Hyperthyroidism
  4. Laryngeal edema

Question No. 99

A patient with severe abdominal trauma is hypotensive despite adequate fluid resuscitation and has a positive FAST examination. The next step is:

  1. Discharge home
  2. Emergency exploratory laparotomy
  3. Repeat ultrasound after 24 hours
  4. Colonoscopy

Question No. 100

A patient develops severe pain out of proportion to examination findings following a tibial fracture. The limb is tense, and passive stretching causes marked pain. The most likely diagnosis is:

  1. Deep vein thrombosis
  2. Cellulitis
  3. Compartment syndrome
  4. Osteoarthritis
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