MBBS Surgery and Clinical Medicine 1 — Questions and Answers
Question 1: Which Glasgow Coma Scale (GCS) score indicates severe traumatic brain injury?
- 13–15
- 9–12
- 8 or below (Correct answer)
- 5–7
Correct answer: 8 or below
A GCS score of 8 or below defines severe TBI; endotracheal intubation is generally indicated at this level to protect the airway.
Question 2: What is the Charcot's triad of acute cholangitis?
- Fever, jaundice, and right upper quadrant pain (Correct answer)
- Fever, nausea, and epigastric pain
- Jaundice, dark urine, and pale stools
- Right upper quadrant pain, Murphy's sign, and leukocytosis
Correct answer: Fever, jaundice, and right upper quadrant pain
Charcot's triad of acute cholangitis consists of fever (rigors), jaundice, and right upper quadrant pain, caused by biliary obstruction with ascending infection.
Question 3: In ATLS (Advanced Trauma Life Support), what is the first priority in the primary survey?
- Breathing and ventilation
- Circulation and hemorrhage control
- Airway maintenance with cervical spine protection (Correct answer)
- Disability (neurological status)
Correct answer: Airway maintenance with cervical spine protection
The ATLS primary survey follows the ABCDE sequence: Airway (with C-spine protection) is always assessed and managed first.
Question 4: Which suture material is most appropriate for closing the abdominal fascia (linea alba) in a midline laparotomy?
- Chromic catgut (absorbable)
- Polypropylene (non-absorbable monofilament) (Correct answer)
- Silk (non-absorbable braided)
- Rapid-absorbing polyglactin
Correct answer: Polypropylene (non-absorbable monofilament)
Polypropylene (Prolene) or slowly absorbable sutures like PDS are preferred for fascial closure due to their prolonged tensile strength reducing wound dehiscence risk.
Question 5: Which clinical sign is pathognomonic of a tension pneumothorax?
- Dullness to percussion on the affected side
- Tracheal deviation away from the affected side with absent breath sounds (Correct answer)
- Bilateral decreased breath sounds
- Subcutaneous emphysema alone
Correct answer: Tracheal deviation away from the affected side with absent breath sounds
Tension pneumothorax classically causes tracheal deviation to the contralateral side, absent breath sounds on the affected side, and hemodynamic compromise.
Question 6: Which investigation is considered the gold standard for diagnosing deep vein thrombosis (DVT)?
- D-dimer blood test
- CT pulmonary angiography
- Contrast venography (Correct answer)
- Compression ultrasonography
Correct answer: Contrast venography
Contrast venography remains the gold standard for DVT diagnosis, though duplex compression ultrasonography is the preferred first-line investigation due to its non-invasive nature.
MBBS Surgery and Clinical Medicine 1
Which Glasgow Coma Scale (GCS) score indicates severe traumatic brain injury?