NEET SS Surgery Clinical Questions

Q1. A 26-year-old female patient presents with a history of recurrent urinary tract infections and ultrasonography revealing multiple renal calculi. The patient reports pain in the abdomen and back, and physical examination shows tenderness in the right flank. The patient's medical history is significant for a recent urinary tract infection that was treated with antibiotics. The laboratory tests show elevated levels of white blood cells and red blood cells in the urine. The patient is suspected to have a kidney stone, and the physician orders further investigations to determine the type of stone. Based on the clinical presentation, which of the following options is the most likely type of stone in this patient?

1. Calcium Oxalate
2. Uric Acid
3. Struvite
4. Cystine

Correct Answer 3: Struvite

Q2. A 55-year-old male presents with abdominal pain and distension at the gastric region associated with vomiting for 2 months. He has a 10-year-pack smoking history. To evaluate the underlying cause, endoscopy and CT of the abdomen and pelvis are recommended. The diagnosed gastric tumor invades muscularis propria, with the 4-5 regional lymph nodes involved and no distant metastasis. What is the TNM staging of gastric carcinoma in this case?

1. T2N3M0
2. T1N3M0
3. T2N2M0
4. T3N1M1

Correct Option C: T2N2M0

Q3. A 52-year-old male presents with gross hematuria, flank pain, and a palpable mass in the right upper quadrant. He has a history of heavy tobacco use and occupational exposure to chemicals. Physical examination reveals a non-tender, mobile mass in the right upper quadrant. Laboratory investigations show anaemia (haemoglobin: 10.5 g/dL), elevated liver enzymes (aspartate transaminase: 72 U/L; alanine transaminase: 58 U/L), and normal renal function. A computed tomography (CT) scan of the abdomen demonstrates a 10 cm solid mass in the right kidney with areas of necrosis and invasion into the renal vein. Biopsy of the mass is taken and histopathological examination reveals the following features: tubulopapillary pattern, often with cells taking a columnar pattern with a hobnail appearance, presence of mucinous material, and desmoplastic stroma. Based on this information, which of the following is the most likely diagnosis in this patient?

1. Renal cell carcinoma (clear cell type)
2. Transitional cell carcinoma of the renal pelvis
3. Collecting duct carcinoma (CDC)
4. Renal oncocytoma

Correct Option C: Collecting duct carcinoma (CDC)

Q4. A 40-year-old male patient is brought to the emergency department after a fall from a height. He has multiple small fractures of the ribs on the right side and alarge laceration on the right chest. A chest x-ray reveals a small pneumothorax, and a CT scan shows a right lung contusion. What is the most appropriate management for this patient?

1. Immediate surgical repair
2. Insertion of a chest tube and observation
3. Insertion of a chest tube and administration of high-flow oxygen
4. Observation and discharge with follow-up imaging

Correct Option B: Insertion of a chest tube and observation

Q5.  A 30-year-old man who had been experiencing significant epigastric pain and vomiting for three hours prior arrives at the emergency room. He describes a six-month history of persistent epigastric discomfort that occurred almost daily and was treated with antacids. Upon closer inspection, he appears to be perspiring and stiff. The patient's vital signs show a temperature of 100°F, a blood pressure reading of 100/60 mmHg, a heart rate of 110/min, and a respiration rate of 12/min. The rest of his examination indicated a noticeably painful and stiff abdomen as well as reduced bowel noises. Pneumoperitoneum is seen on an abdominal film and a chest x-ray. Which of the following is the most likely diagnosis?

1. Small-bowel obstruction
2. Perforated colon carcinoma
3. Perforated duodenal ulcer
4. Perforated gastric ulcer

Correct Option C: Perforated duodenal ulcer

Q6. A 55-year-old man presents with nonspecific complaints regarding gastrointestinal symptoms. A diagnosis of gastric lymphoma is made after further examination and investigations. The patient's CT scan shows multiple lymphadenopathies and no evidence of distant metastasis. Which of the following is the most appropriate treatment for this patient?

1. Chemotherapy and radiotherapy
2. Surgery and adjuvant Chemotherapy
3. Chemotherapy alone
4. Surgery alone

 Correct Option A: Chemotherapy and radiotherapy

Q7. A 40-year-old male presented to the clinic with the complaint of a buried penis. He is morbidly obese with a BMI of 40 Kg/m2. What should be the main surgical technique for this patient?

1. Panniculectomy
2. Phalloplasty
3. Orchiectomy
4. Testicular prosthesis implantation

Correct Option A: Panniculectomy

Q7. Which of the following is the treatment for the skin condition shown in the image below?

1. Topical retinoid
2. Topical corticosteroids
3. Oral isotretinoin
4. Topical brimonidine

Correct Option A: Topical retinoid

Q8. A 71-year-old male presents with increased frequency of urination, weak urine flow, and difficulty initiating urination. Upon further evaluation, benign prostatic hyperplasia (BPH) is diagnosed. During embryonic development, the urogenital sinus gives rise to several structures, including the prostate gland. Which specific region of the urogenital sinus is responsible for developing the epithelial component of the prostate gland?

1. Sinus tubercle
2. Sinus membrane
3. Sinus prostaticus
4. Sinus spongiosum

Correct Option C: Sinus prostaticus

Q9. A 63-year-old man is referred from the dermatology outdoors to the surgical outdoors with a complaint of a non-healing wound near the lower lip, as shown in the picture below. The patient has been a professional wildlife photographer for 25 years. He has a 22-year smoking history. Which of the following is the most likely diagnosis?

1. Squamous cell carcinoma
2. Basal cell carcinoma
3. Malignant melanoma
4. Actinic keratosis

Correct Option A: Squamous cell carcinoma

Q10. An adult male, aged 54, arrives at the emergency department with acute epigastric pain and hematemesis. He has no relevant medical history, is not taking any medications, and denies recent use of NSAIDs or alcohol. Physical Examination shows a blood pressure of 90/60 mmHg, a pulse rate of 110 beats/minute, and a pale appearance. An upper GI Endoscopy reveals a small arterial branch arising from the gastric submucosa with active bleeding. What would be the best course of action for managing this patient?

1. Endoscopic therapy with epinephrine injection
2. Endoscopic therapy with hemoclip placement
3. Surgical intervention with gastrectomy
4. Conservative management with proton pump inhibitors

Correct Option B: Endoscopic therapy with hemoclip placement.

Q11. A 55-year-old man presents to the clinic complaining of severe hot flashes significantly affecting his quality of life. After a thorough evaluation, the clinician determines that he is affected by prostate cancer and is being treated with androgen deprivation therapy (ADT). Which of the following is considered the most effective preventive therapy for severe hot flashes in men?

1. Oral medroxyprogesterone
2. Oral testosterone replacement therapy
3. Oral finasteride
4. Oral metformin

Correct Option A: Oral medroxyprogesterone

Q12. A 4-month-old baby is brought to the surgeon by his mother with a triangular-shaped head deformity. The baby has a narrow and pointed forehead. He also has hypotelorism. His head CT scan is ordered, showing premature closure of the cranial sutures (the image is given below). Which of the following craniosynostosis types is the patient suffering from?

1. Plagiocephaly
2. Brachycephaly
3. Trigonocephaly
4. Scaphocephaly

Correct Option C: Trigonocephaly

Q13. A 45-year-old male with a past medical history of poorly controlled diabetes mellitus and hyperlipidemia presents with bloating, post-prandial fullness, vomiting and weight loss from the last 4 months. General physical and abdominal examination is unremarkable. Examination of the nervous system indicates autonomic dysfunction. Which one of the following investigations is most diagnostic for gastroparesis?

1. CT/MR Enterography
2. A barium follow-through
3. Gastric Emptying Scintigraphy
4. Upper GI endoscopy

Correct Option C: Gastric Emptying Scintigraphy

Q14. A 65-year-old man presents with lower urinary tract obstruction symptoms caused by benign prostate hyperplasia (BPH). He is concerned about potential side effects and the procedure's recovery time. He is hesitant about being hospitalized. Which of the following options would be the most appropriate for treating BPH in this case?

1. Transurethral Resection of the Prostate (TURP)
2. Open Prostatectomy
3. Transurethral Needle Ablation (TUNA)
4. Watchful Waiting

Correct Option C: Transurethral Needle Ablation (TUNA)

Q15. An 80-year-old maid has been admitted to the surgical department to evaluate an abdominal mass. He also complains of weight loss after extensive workup, and a pancreatic carcinoma diagnosis is made. Which of the following is the most common presenting symptom of periampullary carcinoma of the pancreas?

1. Jaundice
2. Weight loss
3. Nausea
4. Abdominal pain

Correct Option A: Jaundice

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