Surgical

Question 1

What is mesenteric adenitis?

Answer 1

Self-limiting inflammation of mesenteric lymph nodes, mimicking appendicitis.

Question 2

Most common pathogen in mesenteric adenitis?

Answer 2

Yersinia enterocolitica.

Question 3

Key ultrasound finding in mesenteric adenitis?

Answer 3

Enlarged lymph nodes and ileal wall thickening >3mm over >5cm.

Question 4

What is Meckel’s diverticulum?

Answer 4

A true diverticulum of the ileum, remnant of vitellointestinal duct.

Question 5

Rule of 2s in Meckel’s diverticulum?

Answer 5

2% population, 2 inches long, 2 feet from ileocaecal valve, 2 types ectopic tissue, 2% symptomatic.

Question 6

Most common symptom of Meckel’s diverticulum?

Answer 6

Painless severe rectal bleeding.

Question 7

Best test to diagnose Meckel’s diverticulum?

Answer 7

Technetium-99m pertechnetate scan.

Question 8

Cause of inguinal hernia and hydrocoele?

Answer 8

Patent processus vaginalis.

Question 9

Management of reducible inguinal hernia?

Answer 9

Elective herniotomy.

Question 10

Management of hydrocoele persisting after age 2?

Answer 10

Herniotomy with hydrocoele drainage.

Question 11

What is a key complication of untreated inguinal hernia?

Answer 11

Incarceration and testicular atrophy.

Question 12

What is undescended testis?

Answer 12

Testis not located in the scrotum; may be undescended, ectopic, retractile or absent.

Question 13

Management of undescended testis after 1 year?

Answer 13

Orchidopexy between 6–18 months.

Question 14

Imaging method for bilateral impalpable testes?

Answer 14

Laparoscopy.

Question 15

Risk of malignancy in undescended testis?

Answer 15

22x higher than normal.

Question 16

What is testicular torsion?

Answer 16

Twisting of spermatic cord leading to ischemia; surgical emergency.

Question 17

Time window for testicular torsion salvage?

Answer 17

Within 6 hours.

Question 18

Most common age for intravaginal torsion?

Answer 18

10–14 years.

Question 19

Key clinical signs of testicular torsion?

Answer 19

Sudden pain, high-riding testis, absent cremasteric reflex.

Question 20

Management of uncertain acute scrotum?

Answer 20

Immediate surgical exploration.

Question 21

Common causes of acute scrotum?

Answer 21

Torsion, epididymitis, incarcerated hernia, trauma.

Question 22

Common signs of epididymo-orchitis?

Answer 22

Gradual pain, fever, tender epididymis, dysuria.

Question 23

Cause of epididymo-orchitis in children?

Answer 23

Reflux of infected urine, mumps, STI.

Question 24

What is phimosis?

Answer 24

Preputial stenosis or fibrosis causing obstructive symptoms.

Question 25

Indication for circumcision in phimosis?

Answer 25

Recurrent balanoposthitis or urinary symptoms.

Question 26

What is BXO?

Answer 26

Balanitis xerotica obliterans; chronic inflammation causing fibrosis.

Question 27

Management of BXO?

Answer 27

Circumcision ± meatotomy.

Question 28

What is intestinal malrotation?

Answer 28

Congenital abnormal rotation and fixation of the bowel.

Question 29

Most feared complication of malrotation?

Answer 29

Midgut volvulus.

Question 30

Common presentation of midgut volvulus?

Answer 30

Bilious vomiting and abdominal distension.

Question 31

Best imaging for malrotation?

Answer 31

Barium meal showing DJ flexure on right.

Question 32

What is the Ladd procedure?

Answer 32

Surgical reduction of volvulus and division of Ladd’s bands.

Question 33

What is Hirschsprung disease?

Answer 33

Absence of ganglion cells in distal colon due to neural crest migration failure.

Question 34

Gold standard diagnosis of Hirschsprung disease?

Answer 34

Rectal suction biopsy.

Question 35

Classic neonatal sign of Hirschsprung disease?

Answer 35

Failure to pass meconium within 24 hours.

Question 36

Key rectal exam finding in Hirschsprung disease?

Answer 36

Empty rectum with explosive discharge after finger withdrawal.

Question 37

Common complication of Hirschsprung disease?

Answer 37

Enterocolitis.

Question 38

Treatment of Hirschsprung disease?

Answer 38

Surgical resection with pull-through procedure.

Question 39

Differentiate Hirschsprung from functional constipation?

Answer 39

Onset in infancy, delayed meconium, tight anal tone in Hirschsprung.

Question 40

What is intussusception?

Answer 40

Telescoping of one bowel segment into another.

Question 41

Peak age of intussusception?

Answer 41

6–9 months.

Question 42

Classic triad of intussusception?

Answer 42

Colicky pain, red currant jelly stools, sausage mass.

Question 43

Common site of intussusception?

Answer 43

Ileo-colic junction.

Question 44

Most common cause of intussusception?

Answer 44

Hypertrophied Peyer’s patches.

Question 45

Best imaging for intussusception?

Answer 45

Ultrasound showing target or doughnut sign.

Question 46

First-line treatment for intussusception?

Answer 46

Air or hydrostatic enema.

Question 47

Surgical indication in intussusception?

Answer 47

Failed enema, peritonitis, or perforation.

Question 48

Recurrence risk of intussusception?

Answer 48

1–2%.

Question 49

Severe complication of intussusception?

Answer 49

Bowel ischemia or gangrene.

Question 50

Typical X-ray finding in intussusception?

Answer 50

Gasless abdomen, distended small bowel.