Important MCQ’s in Git for Neet SS Surgery

Q1. A 44-year-old man comes to the outpatient department of a tertiary care center with complaints of burning micturition, high-grade fever, and back pain for 2 weeks and 3 episodes of vomiting last night. He also has a history of multiple episodes of painful micturition in the past. On examination, he has a fever of 101 °F (38.3 C), blood pressure of 130/80 mmHg, and pulse rate is 90/minute. He has costovertebral angle tenderness. Based on the history and examination findings, what is the patient most likely suffering from?

1. Inguinal Hernia

2. Acute Cystitis

3. Lumbar spinal stenosis

4. Pyelonephritis

Ans 4) Pyelonephritis 

Also read: Colonic Infections: Etiology, Clinical Features, Risk Factors

Q2. A 65-year-old man male presents with frequent episodes of urination and feeling of incomplete voiding after urination. He does not have any burning micturition. His blood pressure is 135/90 mmHg, his temperature is 98 F, and his pulse rate is 85/min. Physical exam including a digital rectal exam is performed. It reveals a non-tender and smoothly enlarged prostate. Urinalysis shows 0 RBCs/HPF, very few pus cells, and no casts. What is the most likely diagnosis?

1. Prostate cancer

2. Benign prostatic hyperplasia (BPH)

3. Bladder cancer

4. Urinary tract infection (UTI)

Ans. 2) Benign prostatic hyperplasia (BPH)

Q3. A 7-year-old boy presents with recurrent urinary tract infections and incontinence. His physical examination is unremarkable. Which of the following imaging modalities would be the most appropriate for further evaluation of the urinary tract? 

1. Computed Tomography (CT)

2. Magnetic Resonance Imaging (MRI)

3. Ultrasound

4. Voiding Cystourethrogram (VCUG)

Ans. 4) Voiding Cystourethrogram (VCUG) 

Q4. A 20-year-old boy presented to the Emergency Department of the hospital with a complaint of blood in his urine and painful micturition for 10 hours. He has a history of falling on a metal beam while playing football 12 hours ago. On examination, there was swelling of the scrotum and lower anterior abdominal wall and bruising of the perineal region. After doing the initial investigation, a diagnosis was made and a management plan was also discussed. What structure is most likely to be injured in this patient? 

1. Ureter

2. Bladder

3. Spongy urethra

4. Membranous urethra

 Ans. 3) Spongy urethra

Also read: Mesentery and Omentum: Surgical POV

Q5. A 55-year-old man presents with a 4cm renal mass and suspected renal cell carcinoma. Which of the following indications would be the most appropriate for a laparoscopic nephrectomy in this case? 

1. Large renal mass

2. Advanced renal cell carcinoma

3. Complex renal cyst

4. Renal trauma 

Ans. 1) Large renal mass

Q6. A 32-year-old woman presents in her third trimester of pregnancy with symptoms of urethral stricture. Which of the following options would be the most appropriate management for urethral stricture in this case? 

1. Observation only

2. Urethral dilation

3. Urethrotomy

4. Urethral reconstruction 

Ans. 2) Urethral dilation

Q7. A 13-year-old female presents to the clinic due to fever, left renal pain and vomiting for 2 days. She also reports dysuria and urgency. She is given appropriate treatment, but she fails to improve. The clinician advised renal radionucleotide imaging. Which of the following is the preferred radionucleotide agent for this patient? 

1. ^99mTc-Dimercaptosuccinic Acid (DMSA)

2. ^99mTc-(CO₃) Tricarbonylnitriloacetic Acid (NTA)

3. ^99mTc-_L,L- and _D,_D-Ethylenedicysteine (EC)

4. ⁵¹Cr-Ethylenediaminetetraacetic Acid (EDTA) 

Ans. 1) ^99mTc-Dimercaptosuccinic Acid (DMSA)

Also read: Gastric Lesions : Gastric Bezoar

Q8. A 67-year-old man visits his doctor due to frequent urination, dysuria, and blood in his urine. Over the past three months, he has also lost 4.5 kg (10 lb) of weight and has been experiencing greater than normal weariness. He smoked one pack each day for 40 years until quitting two years ago. Urine analysis reveals 3+ blood. A biopsy is performed when a cystoscopy reveals an unruly tumour on the bladder wall. Which of the following histologic findings would suggest a poor chance of survival? 

1. Dysplastic cell extending into lamina propria

2. Nests of atypical cells in the urothelium

3. Disordered urothelium lined with papillary fronds

4. Friable urothelium with ulcerations

Ans. 1) Dysplastic cell extending into lamina propria 

Q9. A 42-year-old man with a history of type 1 diabetes mellitus visits the office because he frequently has unconscious urination. He has been having trouble establishing and sustaining a urine stream for the past few months. He has experienced two cases of nocturnal enuresis in the past three weeks, as well as several instances of uncontrollable daytime urination without any sense of a full bladder. Along with gastroparesis, he also has chronic renal disease. He doesn't drink or smoke. Which of the following extra results would this patient be most likely to have? 

1. Enlarged prostate on rectal examination

2. Increased postvoid residual volume

3. Loss of sensation in the perineal area

4. Lower extremity hyperreflexia

Ans. 2) Increased postvoid residual volume

Q10. A 45-year-old man complains of frequent urination and discomfort while urinating. He reports that he must go to the bathroom immediately after finishing his last urination. He has no significant past medical history and is not on any medications. What is the most likely cause of his symptoms? 

1. Bladder cancer

2. Urinary tract infection

3. Detrusor overactivity

4. Stress urinary incontinence 

Ans. 3) Detrusor overactivity

Q11. A 50-year-old man presents with difficulty initiating urination and frequent urination. Which of the following statements best describes the innervation of the bladder? 

1. The sympathetic nervous system innervates the bladder

2. The parasympathetic nervous system innervates the bladder

3. The bladder is innervated by both the sympathetic and parasympathetic nervous system

4. Any nervous system does not innervate the bladder 

Ans. 3) The bladder is innervated by both the sympathetic and parasympathetic nervous system

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Q12. A 72-year-old male presented in emergency with the passage of painless blood while urinating and urinary urgency for 2 days. He has a 30-pack-year smoking history. The cystoscopy image shows multiple pedunculated tumours at the trigone of the bladder with an area of oedematous, dilated blood vessels. Which of the following is the most probable carcinoma of the bladder? 

1. Non-muscle-invasive bladder cancer

2. Invasive bladder cancer

3. Carcinoma in situ

4. Non-muscle-invasive bladder cancer with carcinoma in situ

 Ans. 4) Non-muscle-invasive bladder cancer with carcinoma in situ

Q13. A 76-year-old male presented in the emergency with painless bleeding during urination and urinary frequency for 2 days. His cystoscopy and non-contrast CT or MRI scan explain the bladder carcinoma with T3N2M0 staging status. What is the best management modality for this patient? 

1. Radical cystectomy

2. Partial cystectomy

3. Transurethral resection of the tumour

4. Salvage cystectomy, radiotherapy and chemotherapy 

Ans. 1) Radical cystectomy 

Q14. A 35-year-old woman presented to the outpatient surgical department with complaints of passing urine involuntarily and having difficulty voiding the urine for about 3 months. Her past medical history was significant for autoimmune disease. Investigations revealed that her disease had damaged the myelin sheath of the spinal nerves. Which of the following nerve levels are most likely to be damaged in the patient's urinary symptoms?

1. S2-S3

2. L2-L4

3. T1-T12

4. C2-C3 

Ans. 1) S2-S3 

Also read: Understanding Carcinoma of the Stomach

Q15. A 70-year-old male patient presents to the outpatient department with complaints of urinary frequency, urinary urgency, nocturia and urge incontinence. The patient also had a neurological condition in which there is dopamine deficiency and increased cholinergic activity in the corpus striatum. His CT scan revealed no abnormality in the spinal cord, and ultrasound for kidneys, ureters, and bladder is also unremarkable. From which one of the following conditions is the patient suffering? 

1. Detrusor hyperreflexia and urethral sphincter bradykinesia

2. Detrusor areflexia with urethral sphincter hyperkinesia

3. Detrusor sphincter dyssynergia-detrusor hyperreflexia

4. Detrusor areflexia

Ans. 1) Detrusor hyperreflexia and urethral sphincter bradykinesia

Hope you found this blog helpful for your GIT, Hepatobiliary and Pancreatic Surgery preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.