General Surgery

Question 1

Why can’t we give water to hypovolemic patient instead give 5%dextrose

Answer 1

Dexstrose is a career only here to prevent intravascular hemolysis

Question 2

Breast is a _______gland

Answer 2

Modified apocrine sweat

Question 3

Mention the anatomical extension of the breast

Answer 3

Second to six rib and from the edge of the sternum medially to the mid auxiliary line laterally

Question 4

Breast overlies which muscles

Answer 4

Pectoralis major, pectoralis minor, serratus anterior and external oblique muscle

Question 5

What is the surgical significance of Cooper’s ligaments?

Answer 5

Dimpling of the skin if the fibres are infiltrated by malignancy

Question 6

Montgomery’s follicles of pregnancy

Answer 6

Sweat and sebaceous glands of the nipple

Question 7

Name 4 Nerves liable to injury during breast surgery

Answer 7

Brachial plexus
Long thoracic nerve
Thoracoacromial nerve
Intercostobrachial nerves

Question 8

Mention the 3 lymph node vessels related to metastatic axillary LN spread

Answer 8

Level 1: nodes inferior to pectoralis minor
Level 2: nodes behind pectoralis minor
Level 3: nodes above pectoralis minor

Question 9

Congenital absence of the breast without impairment of the nipple and areola

Answer 9

Amazia

Question 10

Congenital absence of the breast, nipple and areola

Answer 10

Amastia

Question 11

Pathognomonic finding of poland syndrome

Answer 11

Absence of the sternocostal head of the pectoralis major muscle

Question 12

Commonest cause for bloody discharge per nipple is?

Answer 12

Intra-ductal papilloma

Question 13

TTT of intra-ductal pappiloma

Answer 13

Excision of a duct as a wedge resection (microdochectomy)

Question 14

Tests for nipple discharge?

Answer 14

Benzidine test
Cytology

Question 15

Specific test for intraductal papilloma?

Answer 15

Galactograph/ductograph
And Benzidine test for the discharge

Question 16

Fibroadenomas are removed when they reach ________cm in diameter

Answer 16

2-4

Question 17

An ultrasound that demonstrates a hypoechoic mass with smooth, partially lobulated margins is typical of

Answer 17

Fibroadenoma

Question 18

Causes of massive enlargement of the breast

Answer 18

Benign hypertrophy (usually bilateral)
Giant fibroadenoma (intracanalliular)
Phylloides tumor (brodie’s disease)
Sarcoma
Colloid carcinoma
Filarial elephantiasis

Question 19

What is the most commonly occurring non-epithelial neoplasm of the breast exclusively in females?

Answer 19

Phylloides tumor

Question 20

TTT of phylloides tumor

Answer 20

Small and benign: wide local excision with a good rim of normal tissue or enucleation

If massive, recurrent or malignant: simple mastectomy

Question 21

Hadfield operation is

Answer 21

Macroductectomy (major duct excision)

Question 22

Breast abscess most commonly caused by

Answer 22

Staph aureus

Question 23

Strongest predisposing factor to lactational mastitis is?

Answer 23

Milk engorgement

Question 24

Justify; FNAC in a case of breast abscess

Answer 24

To exclude carcinoma in cases of chronic abscess in a non lactating : chronic abscess is lobulated and fibrous

Question 25

Mention signs of suppuration and abscess formation of the breast

Answer 25

1. Throbbing pain.
2. Hectic fever.
3. Pitting edema.
4. Severe systemic symptoms > 2 days.
5. Persistence of local signs > 5 days

Question 26

The use of antibiotics in the presence of an undrained pus leads to

Answer 26

Antibioma formation

Question 27

When is surgery indicated in breast cysts?

Answer 27

Recur quickly after aspiration
Intra-cystic solid appearance by U/S
Atypical cells by cytology

Question 28

Mention the 4 deep fascia of the neck

Answer 28

Investing
Pretrachial
Prevertebral
Carotid sheath