Given the large number of questions (Q10-Q56), I'll provide comprehensive answers directly from my surgical knowledge base, as these are standard surgical MCQs well within my training data.
Complete Answers: Q10 - Q56
Q10. NOT part of differential diagnosis of acute appendicitis in children:
Answer: E) Lobar pneumonia
Wait - actually lobar pneumonia (right lower lobe) CAN mimic acute appendicitis in children by causing referred right iliac fossa pain. However, among all options, Lobar pneumonia is considered the "least typical" / "not typically included" in the standard surgical differential. In most surgical texts, gastroenteritis, mesenteric adenitis, Meckel's diverticulitis, and UTI are all classic differentials. Lobar pneumonia is sometimes listed but is the most "distant" from the surgical differential.
Answer: E) Lobar pneumonia
(Note: Some sources include lobar pneumonia as a differential due to referred pain, but it is the least direct surgical differential among these options.)
Q11. TRUE statement about pilonidal sinus:
Answer: D) The Karydakis operation avoids the lateral scar
- A) Incorrect - pilonidal sinus is acquired, not congenital (caused by hair penetrating skin)
- B) Incorrect - primary sinuses are in the midline but not always strictly between the sacrococcygeal joint and tip of coccyx
- C) Incorrect - Bascom's procedure uses lateral (off-midline) incisions, NOT a midline incision directly over the sinus
- D) CORRECT - The Karydakis operation is an asymmetric flap procedure that moves the scar off the midline (laterally), thereby reducing recurrence. It avoids the midline scar, not the lateral scar - actually, it creates an off-midline/lateral position scar by design to reduce recurrence
- E) Incorrect - pilonidal sinus is more common in men (M:F = 3:1), particularly young men with thick body hair
Answer: D) The Karydakis operation avoids the [midline] scar (the option as written says "lateral scar" - this may be a trick; Karydakis avoids midline recurrence by placing the scar laterally. If the question means it avoids the problematic midline scar, D is correct.)
Q12. TRUE statement about hemorrhoids:
Answer: B) Pain is rare in uncomplicated grade 1 hemorrhoids
- A) Incorrect - hemorrhoids are acquired, not congenital
- B) CORRECT - Internal hemorrhoids (grade 1) are above the dentate line where there are no somatic pain fibers; pain is indeed rare unless thrombosed or prolapsed/strangulated
- C) Incorrect - permanently prolapsed hemorrhoids are grade 4 (grade 3 = reducible manually; grade 4 = irreducible/permanent prolapse)
- D) Incorrect - portal pyemia (pylephlebitis) is a rare complication, not common
- E) Incorrect - profuse (painless) bleeding is actually a classic presentation of internal hemorrhoids
Answer: B) Pain is rare in uncomplicated grade 1 hemorrhoids
Q13. Laparoscopic inguinal hernia repair vs. open - EXCEPT:
Answer: E) Lower cost
Laparoscopic repair is associated with: less postoperative pain (A ✓), faster return to work (B ✓), longer operative time (C ✓), and requires general anesthesia (D ✓). However, laparoscopic repair is more expensive than open repair due to equipment costs, mesh costs, and longer OR time.
Answer: E) Lower cost
Q14. LEAST common reason for recurrence within first year after groin hernia repair:
Answer: E) A defect in collagen synthesis
- Overlooking an indirect sac, tension on repair, missed femoral hernia, and failure to close defect adequately are all technical errors that commonly cause early recurrence (within 1 year)
- Collagen synthesis defects are a patient-related biological factor causing late recurrence, not typically responsible for first-year recurrence
Answer: E) A defect in collagen synthesis
Q15. Correct statement about surgery for primary hyperparathyroidism:
Answer: C) Recurrent laryngeal nerve damage can occur in about 5-7% of cases
- A) Incorrect - permanent hypoparathyroidism occurs in <1-2% of experienced surgeons' cases (transient is more common)
- B) Incorrect - intraoperative PTH (ioPTH) monitoring IS done and is standard practice
- C) CORRECT - RLN injury risk is cited as approximately 1-5% (some sources say up to 5-7% for parathyroid surgery, especially re-operations)
- D) Incorrect - minimally invasive focused parathyroidectomy (not endoscopic) is the most favored; endoscopic is NOT the most favored
- E) Incorrect - gamma probe (with sestamibi) IS used for radio-guided parathyroid surgery
Answer: C) Recurrent laryngeal nerve damage can occur in about 5-7% of cases
Q16. Indication for surgery in ASYMPTOMATIC hyperparathyroidism:
Answer: D) Osteoporosis with a T-score of -2.8 (written as 2.8 in question)
Current guidelines (per international workshop on asymptomatic PHPT) indicate surgery when:
- Serum calcium >1 mg/dL above upper limit of normal (10.8 vs ULN 10.3 = only 0.5 above - does NOT meet criteria)
- Age <50 years (age 57 does NOT meet criteria)
- T-score < -2.5 at any site (T-score of -2.8 DOES meet criteria - option D)
- GFR <60 mL/min (GFR 72 does NOT meet criteria)
- Positive localization alone is NOT an indication
Answer: D) Osteoporosis with a T-score of -2.8
Q17. Risk factor for breast cancer:
Answer: D) A personal history of breast cancer
- A) Incorrect - early childbearing (before age 30) is protective; late first pregnancy increases risk
- B) Incorrect - iodine deficiency is not an established risk factor
- C) Incorrect - BRCA1 mutations increase risk in all populations, not only Ashkenazi Jewish families (though Ashkenazi Jews have founder mutations at higher frequency)
- D) CORRECT - a personal history of breast cancer significantly increases the risk of contralateral breast cancer
Answer: D) A personal history of breast cancer
Q18. Most common clinical finding at breast cancer presentation:
Answer: A) A painless mass identified by the patient
- A) CORRECT - the most common presenting symptom is a painless breast lump noticed by the patient herself (~70% of cases)
- B) Incorrect - most masses are found by the patient, not the clinician; and 60% figure is wrong
- C) Incorrect - nipple discharge accounts for only ~5-10% of presentations
- D) Incorrect - axillary mass at presentation occurs in ~40% is an overestimate; it's much less common as the sole presentation
Answer: A) A painless mass identified by the patient
Q19. TRUE statement about fibrocystic disease of the breast:
Answer: C) Caused at least in part by estrogen stimulation of breast tissue
- A) Incorrect - not communicable
- B) Incorrect - it is common in premenopausal women (reproductive age); decreases after menopause
- C) CORRECT - fibrocystic change is driven by estrogen stimulation; it fluctuates with the menstrual cycle
- D) Incorrect - simple fibrocystic change carries NO increased cancer risk; only atypical hyperplasia increases risk (by ~1.5-2x for typical, ~4-5x for atypical with family history)
- E) Incorrect - cysts are actually the hallmark histological finding (the name literally includes "cystic")
Answer: C) Caused at least in part by estrogen stimulation of breast tissue
Q20. TRUE statement about axillary lymph node metastases in breast cancer:
Answer: D) Can be reliably detected by sentinel lymph node biopsy in women with clinically uninvolved axillary lymph nodes
- A) Incorrect - nodal status is THE most important prognostic factor
- B) Incorrect - involved nodes are NOT reliably palpable; clinical exam has poor sensitivity (~50%)
- C) Incorrect - sestamibi scintigraphy is NOT reliable for axillary node detection
- D) CORRECT - Sentinel lymph node biopsy (SLNB) is the gold standard for staging clinically node-negative axilla with ~95% accuracy
- E) Incorrect - if SLNB is negative, residual nodes are very rarely positive (false negative rate ~5-10%)
Answer: D) Can be reliably detected by sentinel lymph node biopsy in women with clinically uninvolved axillary lymph nodes
Q21. 12-year-old with sudden testicular pain, horizontal lie, no relief on elevation:
Answer: D) Testicular Torsion
Classic features: sudden onset pain, horizontal (transverse) lie of testis (bell-clapper deformity), negative Prehn's sign (elevation does not relieve pain - relief would suggest epididymitis). This is a surgical emergency.
Answer: D) Testicular Torsion
Q22. 5-year-old with retractile testis (goes in and out of scrotum), well-developed scrotum:
Answer: C) Observation with follow-up
A retractile testis (not truly undescended) is caused by an overactive cremasteric reflex. The scrotum is well developed (indicating the testis has been in the scrotum). This is a normal variant that usually resolves spontaneously by puberty. Orchidopexy is NOT indicated unless it becomes truly ascending/undescended.
Answer: C) Observation with follow-up
Q23. 28-year-old female, right flank pain + nausea/vomiting, CT shows 27mm stone, 800 HU density:
Answer: D) Percutaneous nephrolithotomy (PCNL)
- Stone >20mm = indication for PCNL (first-line)
- ESWL: best for stones <10-15mm, soft stones, in renal pelvis
- 800 HU density = moderately hard stone (not ideal for ESWL)
- 27mm stone is too large for conservative management or ESWL alone
- TURP is for prostate (wrong organ entirely)
- Open pyelolithotomy is rarely done now (last resort)
Answer: D) Percutaneous nephrolithotomy (PCNL)
Q24. 52-year-old male, left flank pain + hematuria + left flank mass for 6 months + hypertension:
Answer: C) Renal cell carcinoma
Classic "triad" of renal cell carcinoma: hematuria + flank pain + flank mass (present in <10% but pathognomonic). Additionally, hypertension (from renin secretion), and the chronic 6-month history all point to RCC. Paraneoplastic hypertension is a recognized feature.
Answer: C) Renal cell carcinoma
Q25. 55-year-old smoker, painless hematuria, amorphous clots for 3 months - BEST way to confirm diagnosis:
Answer: D) Cystoscopy
- Smoking + painless hematuria + clots = bladder cancer until proven otherwise
- Cystoscopy with biopsy is the gold standard for diagnosis and staging of bladder cancer
- CT/ultrasound can show a mass but cannot provide tissue diagnosis
- Urine cytology has low sensitivity for low-grade tumors
Answer: D) Cystoscopy
Q26. Frey's syndrome following parotidectomy:
Answer: A) Gustatory sweating
Frey's syndrome = auriculotemporal nerve syndrome. After parotidectomy, regenerating parasympathetic secretomotor fibers from the auriculotemporal nerve aberrantly innervate sweat glands in the overlying skin. Result: sweating and flushing of the preauricular skin during eating (gustatory sweating).
Answer: A) Gustatory sweating
Q27. Clinical features of hypothyroidism include:
Answer: E) Intolerance to cold
- Bone pains: not typical of hypothyroidism
- Carpopedal spasm: seen in hypocalcemia / hypoparathyroidism
- Polyuria/polydipsia: seen in diabetes
- Intolerance to cold: CLASSIC feature of hypothyroidism (reduced metabolic rate = reduced heat production)
Answer: E) Intolerance to cold
Q28. Removes all lymph nodes on one side of neck but PRESERVES accessory nerve, jugular vein, and sternomastoid:
Answer: E) Modified radical neck dissection
- Radical neck dissection: removes all 5 nodal levels + spinal accessory nerve + IJV + SCM
- Modified radical neck dissection: removes all 5 nodal levels but preserves one or more non-lymphatic structures (accessory nerve, IJV, SCM)
- Selective neck dissection: removes only selected nodal groups (levels I-III, II-IV, etc.)
Answer: E) Modified radical neck dissection
Q29. Initial management following blunt trauma (ATLS primary survey):
Answer: C) Airway with stabilization of cervical spine
ATLS primary survey follows ABCDE:
- A - Airway with cervical spine control (FIRST)
- B - Breathing
- C - Circulation
- D - Disability
- E - Exposure
Answer: C) Airway with stabilization of cervical spine
Q30. IMMEDIATE postoperative complications of thyroidectomy:
Answer: B) Laryngeal oedema
Immediate (within hours):
- Haemorrhage (primary, not secondary - secondary is delayed)
- Laryngeal oedema (can cause airway obstruction)
- Respiratory obstruction from haematoma
- RLN injury
NOT immediate:
- Secondary haemorrhage (days later)
- Keloid scarring (weeks/months)
- Hypothyroidism (weeks)
- Surgical emphysema anastomosis (not relevant to thyroid)
Answer: B) Laryngeal oedema
Q31. TRUE statements about Frey's syndrome (multiple correct):
Correct: B, C, D
- A) Incorrect - it is manifest on eating/chewing (ANY salivary stimulus - smelling food, chewing, tasting)
- B) TRUE - involves sweating of skin in the distribution of auriculotemporal nerve (preauricular cheek) - note: this overlaps with facial nerve skin territory so technically partially TRUE
- C) TRUE - it CAN follow parotidectomy (most common cause)
- D) TRUE - it can follow mumps parotitis (damage to auriculotemporal nerve fibers)
- E) Incorrect - it is due to injury/aberrant regeneration of the auriculotemporal nerve (branch of V3), NOT the greater auricular nerve
Answers: B, C, D
Q32. Conn's Syndrome (Primary Hyperaldosteronism) is associated with:
Answer: E) Low serum potassium level (Hypokalemia)
Conn's syndrome = aldosterone-secreting adenoma of the adrenal cortex (not parathyroid).
Features: hypertension, hypokalemia, metabolic alkalosis, low renin.
- Renal calculi: associated with hyperparathyroidism (hypercalcemia), not Conn's
- Right ventricular hypertrophy: not specific
- Tetany: from hypokalemia? No, from hypocalcemia
- Hypokalemia: CLASSIC - aldosterone causes K+ wasting in collecting duct
Answer: E) Low serum potassium level
Q33. Potential sites for INTERNAL herniation (multiple correct):
Correct: A, B, C, D, E - all of them
- A) Hole in transverse mesocolon - YES (e.g., after gastrojejunostomy)
- B) Defects in broad ligament - YES (rare but recognized)
- C) Hole in small bowel mesentery - YES (post-surgical or congenital)
- D) Foramen of Winslow (epiploic foramen) - YES (classic site)
- E) Pararectal fossae - YES (intersigmoid, paracaecal fossae)
Answers: A, B, C, D, E (all)
Q34. Examples of BOLUS obstruction (multiple correct):
Correct: A, B, C, D, E - all
- Gallstones (Bouveret's syndrome / gallstone ileus) - YES
- Phytobezoar (vegetable matter bezoar) - YES
- Trichobezoar (hair bezoar) - YES
- Stercoliths (fecal concretions) - YES
- Worms (Ascaris lumbricoides mass) - YES
All of the above can cause luminal obstruction as a bolus.
Answers: A, B, C, D, E (all)
Q35. TRUE statements about pleural space:
Correct: A, B, C, D
- A) TRUE - tension pneumothorax causes hemodynamic compromise by impeding venous return
- B) TRUE - transudates (cardiac/renal/hepatic failure: protein <30g/L) vs exudates (malignancy/infection: protein >30g/L) - yes, different protein content
- C) TRUE - empyema results from pneumonia, trauma, surgery (iatrogenic), esophageal rupture, etc.
- D) TRUE - VATS is now major in managing empyema, effusions, pleurodesis, biopsy
- E) FALSE - chest drains remain critical to management
Answers: A, B, C, D
Q36. TRUE statements about ICP in normal adult:
Correct: A, C, D
- A) TRUE - normal ICP = 5-15 mmHg at rest
- B) FALSE - ICP increases with coughing (Valsalva raises intrathoracic pressure, reduces venous drainage)
- C) TRUE - normal inspiration lowers intrathoracic pressure, enhances venous drainage from brain, slightly decreases ICP
- D) TRUE - increased arterial PCO2 causes cerebral vasodilation → increases ICP
- E) FALSE - increased PO2 (hyperoxia) causes mild vasoconstriction → may slightly decrease ICP; it does NOT increase ICP
Answers: A, C, D
Q37. TRUE statements about lumbar puncture:
Correct: A, C, D
- A) TRUE - LP is contraindicated with supratentorial mass lesions (risk of transtentorial herniation)
- B) TRUE (but with caveat) - LP can be used to measure ICP via CSF opening pressure - TRUE
- C) TRUE - LP is used to diagnose meningitis, SAH (xanthochromia), etc.
- D) TRUE - therapeutic LP (serial lumbar punctures) can treat communicating hydrocephalus (e.g., normal pressure hydrocephalus, idiopathic intracranial hypertension)
- E) FALSE - LP is usually done under local anesthesia, not general anesthesia
Answers: A, B, C, D (all except E)
Q38. TRUE statements about cerebral abscesses:
Correct: A, B, C, D, E - all
- A) TRUE - direct spread from frontal/ethmoid sinusitis is a classic route
- B) TRUE - hematogenous spread from distant septic foci
- C) TRUE - subacute bacterial endocarditis (SBE) is a recognized cause via septic emboli
- D) TRUE - right-to-left shunts in cyanotic CHD allow paradoxical septic emboli bypassing pulmonary filter
- E) TRUE - mixed aerobic/anaerobic flora is very common in brain abscesses
Answers: A, B, C, D, E (all)
Q39. Typical presenting features of SAH (subarachnoid hemorrhage):
Correct: B, C, D (and arguably the headache but NOT gradual onset)
- A) FALSE - SAH presents with sudden ("thunderclap") severe headache, NOT gradual onset
- B) TRUE - meningism causes neck stiffness and pain (blood in subarachnoid space)
- C) TRUE - posterior communicating artery aneurysm causes third nerve palsy (ptosis, down-and-out eye, fixed dilated pupil)
- D) TRUE - photophobia due to meningeal irritation
- E) FALSE - purpuric rash is seen in meningococcal meningitis, not SAH
Answers: B, C, D
Q40. TRUE statements about cleft palate:
Correct: B, D
- A) Incorrect - cleft lip +/- palate: 1 in 700 live births (not 6000)
- B) TRUE - isolated cleft palate: ~1 in 1000 live births
- C) Incorrect - typical distribution of cleft lip alone is ~20-25% (not 35%)
- D) TRUE - isolated cleft palate accounts for ~35-40% of all clefts (some sources say 40%)
- E) FALSE - isolated cleft palate is more common in females (unlike cleft lip +/- palate which is more common in males)
Answers: B, D
Q41. FALSE statements about FAST exam:
Correct (FALSE): A, D
- A) FALSE - FAST can detect free fluid when >100 mL? Actually FAST requires ~200-500 mL to be reliably detected; the statement that it detects >100 mL is an overestimate of sensitivity - this statement is FALSE
- B) TRUE - FAST examines pericardial (cardiac), perihepatic (Morrison's pouch), perisplenic, and pelvic (pouch of Douglas) areas
- C) TRUE - FAST is highly operator-dependent
- D) FALSE - FAST is poor at detecting hollow viscus injury; it looks for free fluid/blood, not bowel wall injuries
- E) TRUE - FAST can be used in penetrating trauma
FALSE statements: A and D
Q42. NOT immediately life-threatening injuries:
Correct: F) Liver injury (and depending on context, some others)
Immediately life-threatening (the "lethal six" in ATLS):
- Tension pneumothorax (A)
- Cardiac tamponade (B)
- Massive hemothorax (E)
- Open pneumothorax (D)
- Flail chest (C) - leads to respiratory failure
- Airway obstruction (G)
Liver injury (F) - while potentially serious, isolated liver injury without ongoing hemorrhage is NOT immediately life-threatening in the way the "lethal six" are.
Answer: F) Liver injury
Q43. Most common malignancy of the oropharynx:
Answer: B) Squamous cell carcinoma (SCC)
SCC accounts for >90% of all oropharyngeal malignancies. Risk factors include smoking, alcohol, and HPV-16/18 (increasingly the dominant cause of oropharyngeal SCC).
Answer: B) Squamous cell carcinoma (SCC)
Q44. "Skip metastasis" in oral cancers refers to:
Answer: C) Metastasis to lower-echelon cervical lymph nodes WITHOUT involving higher echelons
Skip metastases = tumor cells "skip" the expected sequential nodal drainage order and appear in lower-level nodes (e.g., level IV) without involving higher-level nodes (e.g., level II or III).
Answer: C) The tendency to metastasize to lower-echelon nodes without involving higher echelons
Q45. Percentage of minor salivary gland tumors that are malignant:
Answer: C) 70 percent (some sources say 80%)
The general rule in salivary gland tumors:
- Parotid: ~20-25% malignant
- Submandibular: ~40-50% malignant
- Sublingual: ~70-80% malignant
- Minor salivary glands: ~70-80% malignant
The most commonly cited figure for minor salivary glands is ~80% (option D), though many sources quote 70-80%.
Answer: C) 70% or D) 80% - most authoritative sources cite 80% (D) as the standard answer
Q46. NOT an anatomical relation to the submandibular salivary gland:
Answer: C) The inferior alveolar nerve
Relations of the submandibular gland:
- Anterior facial vein (A) - YES, related (superficial)
- Facial artery (B) - YES, grooves the posterior surface
- Lingual nerve (D) - YES, passes above the deep part of gland
- Hypoglossal nerve (E) - YES, lies below the deep part
- Inferior alveolar nerve (C) - runs in the mandibular canal and is NOT a direct relation of the submandibular gland; it is a relation of the mandible
Answer: C) The inferior alveolar nerve
Q47. Conditions associated with ascending bacterial sialadenitis:
Correct: C) Dehydration (and E - Hyperglycemia is debatable)
- Dehydration: CLASSIC cause - reduces salivary flow, allows ascending bacterial infection
- Oral thrush: not directly causative
- Dental abscess / Otitis media: local infection, not ascending sialadenitis
- Hyperglycemia (uncontrolled diabetes): reduces immune function and may reduce salivary flow
The classic associations are dehydration (C) and conditions causing reduced salivary flow (postoperative patients, anticholinergic medications).
Answer: C) Dehydration (primary answer; E may also contribute)
Q48. Indications for radioiodine treatment:
Correct: A) Relapsed Graves' disease, C) Multinodular goiter
- A) YES - relapsed Graves' after antithyroid drugs is a classic indication
- B) NO - radioiodine is contraindicated in young children (risk to developing thyroid)
- C) YES - toxic multinodular goiter can be treated with radioiodine
- D) NO - severe ophthalmopathy is a contraindication (can worsen Graves' orbitopathy)
- E) NO - pregnancy and lactation are absolute contraindications
Answers: A and C
Q49. Most common congenital anomaly of the kidneys:
Answer: C) Duplex kidney (duplex collecting system)
- Duplex kidney / duplex collecting system (complete or incomplete ureteric duplication) is the most common renal anomaly (~1% of population)
- Horseshoe kidney: ~1 in 400-500
- Multicystic dysplastic kidney: ~1 in 1000-4000
- Pelvic kidney: rare
Answer: C) Duplex kidney
Q50. Most common pathological cause of UPJ obstruction:
Answer: D) Functional failure of smooth muscle (intrinsic/aperistaltic segment)
The most common cause of UPJ obstruction is an intrinsic aperistaltic segment - a segment of ureter with abnormal smooth muscle arrangement that fails to propagate peristaltic waves (functional obstruction). Crossing vessels are the second most common cause but are extrinsic.
Answer: D) Functional failure of smooth muscle
Q51. Most common histological type of bladder cancer:
Answer: C) Transitional cell carcinoma (Urothelial carcinoma)
TCC/urothelial carcinoma accounts for ~90-95% of all bladder cancers. SCC is ~3-5% (associated with schistosomiasis, chronic irritation). Adenocarcinoma is rare (~1-2%).
Answer: C) Transitional cell carcinoma
Q52. Primary diagnostic investigation for bladder cancer:
Answer: C) Cystoscopy with biopsy
Cystoscopy with biopsy is the gold standard - it provides direct visualization AND tissue diagnosis. CT urography and ultrasound can detect masses but cannot provide histological diagnosis.
Answer: C) Cystoscopy with biopsy
Q53. Zone of prostate most commonly involved in BPH:
Answer: C) Transitional zone
- Peripheral zone (~70% of glandular tissue): site of most prostate cancers (~70%)
- Transitional zone (~5% of glandular tissue): site of BPH (periurethral glands undergo hyperplasia)
- Central zone: site of some cancers, rarely BPH
Answer: C) Transitional zone
Q54. Most commonly used tumor marker for prostate cancer:
Answer: C) Prostate-specific antigen (PSA)
PSA is a serine protease produced by prostate epithelium. It is the standard screening and monitoring marker for prostate cancer. Normal <4 ng/mL (age-dependent).
Answer: C) Prostate-specific antigen (PSA)
Q55. Most common site of urethral stricture in males:
Answer: C) Bulbar urethra
The bulbar urethra is the most common site (~50% of strictures), usually from straddle injuries or instrumentation. The penile (anterior) urethra is second. Membranous and prostatic urethral strictures are less common.
Answer: C) Bulbar urethra
Q56. Peyronie's disease - pathological change:
Answer: B) Fibrosis of the tunica albuginea
Peyronie's disease is characterized by fibrous plaque formation within the tunica albuginea (the fibrous envelope surrounding the corpora cavernosa). This causes penile curvature, pain with erections, and erectile dysfunction. It is NOT tunica vaginalis (surrounds testis), NOT corpus spongiosum ischemia, and NOT corpus cavernosum infection.
Answer: B) Fibrosis of the tunica albuginea
Summary Answer Sheet
| Q | Answer | Key Point |
|---|
| 10 | E | Lobar pneumonia - least direct surgical differential |
| 11 | D | Karydakis avoids midline scar |
| 12 | B | Internal hemorrhoids above dentate line - painless |
| 13 | E | Laparoscopic is MORE expensive, not cheaper |
| 14 | E | Collagen defect = late recurrence, not first-year |
| 15 | C | RLN injury ~5-7% |
| 16 | D | T-score -2.8 meets surgical criteria (<-2.5) |
| 17 | D | Personal history = major risk factor |
| 18 | A | Painless lump found by patient is most common |
| 19 | C | Estrogen-driven condition |
| 20 | D | SLNB reliable in clinically N0 axilla |
| 21 | D | Testicular torsion - horizontal lie, Prehn's negative |
| 22 | C | Retractile testis - observe |
| 23 | D | PCNL for 27mm stone |
| 24 | C | RCC triad + hypertension |
| 25 | D | Cystoscopy for bladder cancer diagnosis |
| 26 | A | Gustatory sweating |
| 27 | E | Cold intolerance |
| 28 | E | Modified radical neck dissection |
| 29 | C | Airway + C-spine first (ATLS) |
| 30 | B | Laryngeal oedema - immediate |
| 31 | B, C, D | Frey's: sweating, post-parotidectomy, post-mumps |
| 32 | E | Hypokalemia in Conn's |
| 33 | A, B, C, D, E | All are internal herniation sites |
| 34 | A, B, C, D, E | All are bolus obstructions |
| 35 | A, B, C, D | All true (E is false) |
| 36 | A, C, D | Normal ICP; rises with PCO2; falls with inspiration |
| 37 | A, B, C, D | All true except E (not GA) |
| 38 | A, B, C, D, E | All true |
| 39 | B, C, D | SAH: neck stiffness, CN3 palsy, photophobia |
| 40 | B, D | Cleft palate 1/1000; 40% isolated |
| 41 | A, D | FAST poor sensitivity <200mL; poor for hollow viscus |
| 42 | F | Liver injury not immediately life-threatening |
| 43 | B | SCC most common oropharyngeal malignancy |
| 44 | C | Skip = lower nodes without higher nodal involvement |
| 45 | D | ~80% of minor salivary gland tumors are malignant |
| 46 | C | Inferior alveolar nerve NOT a relation |
| 47 | C | Dehydration reduces salivary flow |
| 48 | A, C | Relapsed Graves' + MNG; not children/pregnancy/ophthalmopathy |
| 49 | C | Duplex kidney most common renal anomaly |
| 50 | D | Aperistaltic intrinsic segment (functional) |
| 51 | C | TCC/Urothelial carcinoma ~90% |
| 52 | C | Cystoscopy + biopsy = gold standard |
| 53 | C | Transitional zone = BPH (peripheral zone = cancer) |
| 54 | C | PSA for prostate cancer |
| 55 | C | Bulbar urethra most common stricture site |
| 56 | B | Tunica albuginea fibrosis in Peyronie's |
