MBBS Surgery and Clinical Medicine 2 — Questions and Answers
Question 1: The 'Rule of Nines' is used in burns assessment — what percentage of body surface area does the anterior trunk represent?
- 9%
- 18% (Correct answer)
- 27%
- 36%
Correct answer: 18%
In the Rule of Nines, the anterior trunk accounts for 18% of total body surface area (TBSA), equal to the posterior trunk.
Question 2: Which scoring system is used to assess the severity of acute pancreatitis at 48 hours?
- Child-Pugh score
- APACHE II score
- Ranson's criteria (Correct answer)
- MELD score
Correct answer: Ranson's criteria
Ranson's criteria evaluate 5 parameters at admission and 6 more at 48 hours; a score ≥3 indicates severe pancreatitis with increased morbidity and mortality.
Question 3: What is the most common cause of small bowel obstruction in adults?
- Hernias
- Tumors
- Adhesions from previous surgery (Correct answer)
- Crohn's disease
Correct answer: Adhesions from previous surgery
Post-operative intraperitoneal adhesions account for approximately 60–75% of all small bowel obstruction cases in adults.
Question 4: Which nerve is at greatest risk during a thyroidectomy due to its proximity to the inferior thyroid artery?
- Superior laryngeal nerve (external branch)
- Hypoglossal nerve
- Recurrent laryngeal nerve (Correct answer)
- Glossopharyngeal nerve
Correct answer: Recurrent laryngeal nerve
The recurrent laryngeal nerve runs close to the inferior thyroid artery and the tracheo-esophageal groove; injury causes hoarseness or vocal cord paralysis.
Question 5: A patient presents with acute limb ischemia — which of the 6 Ps is NOT part of the classic presentation?
- Pain
- Pallor
- Pulselessness
- Pruritus (Correct answer)
Correct answer: Pruritus
The 6 Ps of acute limb ischemia are: Pain, Pallor, Pulselessness, Paresthesia, Paralysis, and Perishing cold (poikilothermia) — pruritus is not included.
Question 6: Which type of shock is characterized by high cardiac output and low systemic vascular resistance?
- Hypovolemic shock
- Cardiogenic shock
- Obstructive shock
- Distributive (septic) shock (Correct answer)
Correct answer: Distributive (septic) shock
Distributive shock (classically septic shock) features massive vasodilation (low SVR) with a compensatory high cardiac output ('warm shock') in early stages.
MBBS Surgery and Clinical Medicine 2
The 'Rule of Nines' is used in burns assessment — what percentage of body surface area does the anterior trunk represent?