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Question and Answers of TNPSC Exam for Assistant Surgeons, held on October 16th, 2005

Series A : 151 to 200

151 The following are diseases for which extended sickness benefit is payable for 309 days under the ESI Act, except
a Hemiplegia

b Hemolytic Anaqemia
c Chronic Renal failure

d Tuberculosis
Reference Page 619,620 Park, 18th edition
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152 The following are the complications of measles, except
a Orchitis

b Diarrhoea
c Pneumonia

d Otitis Media
Reference Page 126 Park, 18th edition
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153 Presumptive treatment for Malaria is given to
a persons who travel to Malaria endemic area

b all fever cases
c fever cases showing typical symptoms of Malaria

d persons who are positive for Malarial parasites
Reference Park, 18th edition Pages 208 and 258
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154 Which of the following statements about the characteristics of Tardive Dyskinesia is true ?
a It is more common in men than women

b It includes abnormal movements of Tongue
c It occurs more often in treatment using clozepin than other Antipsychotics

d It usually occurs within 3 months of beginning of drug treatment
Reference : Harrison 15th Edition Chapter 363 and KDT, 5th edition Page 398,
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155 Conventional anti-psychotics can cause
a Hyperprolactinemia

b Gynaecomastia
c Sexual dysfunction

d All of these
Reference : KDT, 5th edition Page 397,

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156 All of the following may be effective in treating ADHD child, except
a Methyl phenydate hydrochlorine

b Chlorpromazine
c Phenobarbitone

d Dextroamphetamine sulphate
Reference : Nelson 15th Edition Chapter 27 and Tripathi (see the adverse effects of Phenobarbitone)

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157 Oral rehydrating salt contains
a 15 gm/Litre of glucose

b 20 gm/Litre of glucose
c 25 gm/Litre of glucose

d 30 gm/Litre of glucose
Reference Park, 18th edition Page 179
No need for confusion. 12 gms is NOT given in any of the choices
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158 What is the commonest organism responsible for neonatal meningitis ?
a Haemophilus influezae

b E.Coli
c Meningococci

d none of these
Reference : Nelson 15th Edition Chapter 98.1

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159 Cholera is characterised by all, except
a Effortless vomitting

b Painful watery ( Rice water ) stools
c Hypotension

d Acute Renal Failure
Reference : Page 18th edition Page 178, Nelson 15th Edition Chap 185 and Ananthanarayanan 7th Edition Page 308

* Copious effortless vomiting

* painless watery diarrhoea
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160 In a patient with fever for 4 days, typhoid can be confirmed by
a Positive widal

b Positive blood culture
c Leucocytosis

d Raised ESR
Reference : Ananthanarayanan 7th Edition Page 297

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161 All are true of parathion poisoning, except
a decrease in true cholinesterase level

b respiratory depression common
c pupil constricted

d opiates ideal for convulsions
Reference : Reddy 17th Edition Page 409 and KDT, 5th edition , Page 91,
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162 Complications of Mitral Stenosis include all, except
a Acute left ventricular failure

b Pulmonary apoplexy
c Pneumonia

d Infective endocarditis
Reference Page 1555, Braunwald Text Book of Cardiology
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163 In India for Rheumatic fever all are present, except
a Sydenham's chorea

b Erythema Marginatum
c Arthralgia

d Raised C reactive proteins
Reference : Harrison 15th edition Chapter 57,235 and O.P.Ghai, 5th edition Page 277,
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164 In Atrial fibrillatiion all are true, except
a Varying internsity of first heart sound

b Precipitation or Aggravation of existing CCF
c Pulse deficit rarely

d Embolic manifestations
Reference Harrison, 15th edition Page 1295,  and Braunwald Chapter 45
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165 All are features of pulmonary hypertension, except
a Early diastolic murmur

b Ejection click
c Canon vein in jugulars

d Prominent palpable pulmonary artery pulsations over chest
Reference Page 1812, Braunwald Text Book of Cardiology  and Golwalia Chapter 8 Pages 247 and 287

Refer Golwalia before you argue on this question
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166 Coarctation of Aorta is associated with all, except
a Hypertension in lower limbs

b Turner's syndrome
c Biscuspid aortic valves

d Polycystic kidney
Reference Harrison, 15 th edition Chapter 234
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167 All are true of methyl alcohol poisoning, except
a occurs in groups of persons

b toxic effects due to acetaldehyde
c causes blurring of vision d treatment is with ethyl alcohol
Reference : KDT, 5th edition Page 354,
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168 Streptokinase therapy is contraindicated in all, except
a Allergic reaction

b Second dose within six months
c Recent surgery

d Age above 50 years
Reference : Tripathi 5th Edition page 571 and Harrison, 15th edition Page 1392,
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169 Pulmonary hypertension occurs in ail, except
a Ostium secondum septal defect

b Patent dectus asteriosus
c Fallot's tetralogy

d Mitral incompetence
Reference : Harrison 15th Edition Chapter 234 and O.P.Ghai, 5th edition Page 310,
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170 All are true of opening snap in mitral stenosis, except
a It is absent when valve is calcified

b occurs before II sound
c heard all over precordium

d ringing quality
Reference : Golwalia 8th edition Page 283 and Harrison, 15 th edition Page 1295,

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171 Regularly irregular pulse occurs in
a Sinus arrhythmias

b II degree heart block
c Multifocal extrasystoles

d None of these
Reference : Mathew 1st edition Page 272

Note that 2nd choice cannot be ruled out
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172 Pleural effusion protein analysis less than 2 gms occurs in
a Meig's syndrome

b Pulmonary infarction
c Malignancy

d Pneumonia
Reference : No need to discuss this question. Consider this as wrong for you

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173 Beta-Blockers are contraindicated in hypertension management when associatd with
a Congestive cardiac failure

b Renal failure
c Liver failure

d All of these
Reference : tripathi 5th Edition Page 127, 508, 516

No "hard" evidence for other choices.

Adverse effects and Contraindications of Propanolol.

1. Accentuates myocardial insufficiency

2. Bradycardia

3. COPD - worsened

4. Prinzmetal's angina exacerabated

5. Carbohydrate tolerance impaired in Prediabetics

6. Altered plasma lipid profile

7. Upon Abrupt withdrawal - rebound hypertension

8. Partial and Complete heart block

9. Tiredness and reduced capacity

10. Cold hands and feet

Contraindications of beta blockers.

1. LVF

2. Bradycardia, Conduction defects

3. Asthma, PVD

4. Diabetic or Borderline Glucose intolerance

5. Abnormal lipid profile

6. Requirement of optimum physical and mental activity

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174 Palmar Erythema is associated with
a Thyrotoxicosis

b Pregnancy
c Liver disorders

d All of them
Reference : Golwalia 8th edition page 181

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175 All are true of impotence, except
a In India psychogenic causes are rare

b Diabetes impotence is common
c It occurs as the side effect of drug therpy of hypertension

d Papaverine improves the condition in some
Reference Page 133, 137, Ahuja, 5th edition
Psychogenic impotence is exploited by the "lodge doctors"
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176 The initial treatment for pre-eclampsia consists of
a Modified bed rest

b Salt restricted diet
c Antihypertensive drugs

d Sedatives
Reference Page 242, Dutta, 5th edition
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177 Which of the following factors is most important in stimulating fetal growth ?
a Insulin

b Growth hormone
c Cortisol

d Human placental lactogen
Reference : Dutta Obs 4th Edition Page 303

Please refer to 2003 Paper in TargetPG TNPSC Book
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178 Wound infections observed within the first 2 days after Caesarean delivery are usually caused by
a Streptococci

b Clostridia
c Staphylococci

d Bacteroides
Answer : a Streptococci

Reference : Williams 21st Edition, page 673, 674, 678

Clostridia cause late infection (Williams)

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179 Maternal convulsions have been associated with which of the following fetal heart rate patterns ?
a Early decelerations

b Variable decelerations
c Prolonged decelerations

d Accelerations
Reference : Williams 21st Edition Page 345

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180 The Marshall-Marchetti Krantz operation is a procedure done to correct
a chronic retention of urine

b stress incontinence
c urge incontinence

d vesicovaginal fistula
Reference Page 362, Dutta (Gynaec), 2nd edition
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181 At the time of curettage for suspected endometrial carcinoma, the uterus is perforated with a sound. The treatment would be
a Conservative

b Immediate laparotomy and hysterectomy
c Laparoscopy and closure of perforation

d Immediatye chemotherapy
Reference : Jeffcoat 5th Edition pages 248 and 249 and Gynaec Dutta 2nd Edition Page 517

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182 Hysterosalpingogram is useful in the diagnosis of all the following conditions, except
a Cervical incompetence

b Tuberculous endometritis
c Asherman's syndrome

d Scar integrity in previous LSLC

Answer :  b Tuberculous endometritis
Reference Page 518, Dutta (Gynaec), 2nd edition, Pg : 350, Dutta (OBS), 5th edition and Shaw 11th Edition Page 548
Indications of HSG (Hysterosalphingography)

1. To test the patency of tubes in infertility

2. To test the patency of tubes following tuboplasty and to evalutate the result of tuboplasty post operatively

3. To confirm diagnosis of secondary abdominal pregnancy

4. To diagnose cervical incompetence

5. To detect uterine malformation in recurrent midtrimester abortion

6. To identify translocated IUCD - whether intrauterine or extrauterine

7. To detect uterine abnormality such as fibroid polyps in menorrhagia septate and bicornuate uterus in habitual abortion, and in Asherman's Syndrome

8. To study the internal os in habitual abortion

Contraindications of HSG (Hysterosalphingography)

1. Presence of Pelvic Infection

2. Suspected Genital Tract Tuberculosis

3. Suspected Pregnancy

4. Post-ovulatory phase of menstruation

5. Iodine sensitivity

Note : We have changed the answer from (d) to (b)

However we are still not sure how HSG will be useful in Condition (d)

Though HSG "should not be done for a suspected case" of Genital TB, but HSG "is useful in the diagnosis"... This statement is similar to " Crepitus should not be elicited in cases of fracture, but crepitus is useful in the diagnosis of fracture"

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183 The LH surge precedes ovulation by
a 12 hours

b 24 - 36 hours
c 48 hours

d 60 - 72 hours
Reference Page 20, Dutta, 5th edition
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184 Post-Caesarean pregnancy should be
a delivered by repeat Caesarean section

b should have a vaginal delivery
c an instituitional delivery

d none of these
Reference Page 351, Dutta, 5th edition
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185 Primi gravida is seen in the first trimester with primary pulmonary hypertension. You will advise
a Medical termiantion of pregnancy

b Hospitalization
c Outpatient treatment

d Angiography
Reference Page 298, Dutta, 5th edition and Williams 21st Edition Page 1194.

First Hospitalise and evaluate. Then you can go for Outpatient treatment or MTP
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186 In a twin pregnancy Caesarean section is indicated in
a Abruptio plaacentae

b Acute polyhydramnios
c When first fetus presents as transverse lie

d All of these
Reference Still : Dutta Obs 4th Edition Page 225
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187 If a woman c/o bleeding per vaginum with history of two months amenorrhoea, one should think of
a Threatened abortion

b Ectopic pregnancy
c Metropathia haemorrhagica

d All of these
Reference : Obs Dutta 4th Edition Page 197

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188 Red degeneration of fibroid is associated with
a Pregnancy

b Aseptic infarction
c Thrombosis

d Leukocytosis
Reference : Gyn Dutta 4th Edition Page 252

No Arguments please !!

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189 Which of the following is not an indication for classical Caesarean ?
a Carcinoma cervix

b Cervical fibroid
c Vestcovaginal fistula repaired previously

d classical Caesarean previously
Reference : Wiliams 21st Edition Pages 551 and 552
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190 Dananol is not useful in
a Amenorrhoea

b Infertility
c Endometriosis

d Fibroadenoma breast
Reference Tripathi 5th Edition Page 271
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191 Couvelatre uterus is seen in
a Placenta Previa

b Vasa Previa
c Abruptio placentae

d All of these
Reference Dutta, 5th edition Page 269,
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192 Maternal syphilis is associated with abortion at
a Early first trimester

b Second trimester
c IUD

d None of these
Reference Dutta, 5th edition Page 310,
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193 Physiological oedema of pregnancy is best treated with the following :
a Crepe bandage

b Diuretics
c Rest

d Salt restricted diet
Reference Dutta, 4th edition Page 54
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194 Aminocentesis is indicated in all, except
a alpha Foetoprotein study

b Breech
c Chromosomal study

d Foetal maturity
Reference Dutta, 4th edition Page 117
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195 Neutrophil examination can indicate sex from
a number of lobes

b presence of drumstick
c nature of granules

d size of cell
Reference : Shaw 11th Edition Page 94
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196 Commonest cause for decubitus ulcer in prolapse uterus is
a Infection

b Injury
c Conjestion

d Malignancy
Reference : Gyn Dutta 2nd Edition Page 193
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197 Myomectomy is done in a patient to conserve
a Reproductive function

b Menstrual function
c Feminity

d none of these
Reference : Dutta (Gynaec), 2nd edition Page 258,
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198 Condom is used in the following, except
a Following vasectomy

b Treatment of STD
c Immunological infertility

d Asherman's syndrome`
Reference : Gyn Dutta 2nd Edition Page 420

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199 Ovulation inducing drugs include the following, except
a Clomiphene citrate

b Human menopausal gonadotrophin
c follicle stimulating hormone

d Progesterone
Reference Dutta (Gynaec), 2nd edition , Page 225,
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200 Diagnosis of vesicular mole can be made confidently by
a Clinical examination

b X-ray
c HCG levels

d Ultrasound
Reference : Dutta Obs 4th Edition Page 209

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