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SurgeryUrology
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Q1469. Intra-operatively, the gallbladder is grossly distended with dense adhesions in Calot’s triangle. There is a stone in the common bile duct, and during dissection the CBD is inadvertently torn, resulting in bile leakage. The surgeon is not experienced in advanced laparoscopic biliary surgery. What is the most appropriate next step in management?

A.Switch to ERCP and stenting
B.Convert to open surgery and perform CBD repair with T-tube placement
C.Close the tear laparoscopically and insert an intra-abdominal drain
D.Continue laparoscopically and complete cholecystectomy later

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SurgeryGeneral Surgery
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Q1473. spinal anesthesia. During the procedure, glycine is used as the irrigating fluid. After 50 minutes of resection, the patient develops restlessness, headache, nausea, vomiting, bradycardia, hypotension, and confusion. ECG shows prolonged QT interval, and serum sodium is 118 mEq/L. What is the most appropriate immediate management?

A.Abort surgery and give hypertonic saline
B.Change irrigation fluid from glycine to normal saline
C.Stop the procedure and give furosemide
D.Continue surgery and restrict fluids

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SurgeryGeneral Surgery
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Q1480. A 5-year-old woman presents with a painless thyroid swelling in the right lobe. Fine-needle aspiration suggests follicular neoplasm. She is planned for thyroid surgery. The surgeon wants to identify any extra-thyroidal tissue or distant spread before surgery. Which is the most appropriate investigation for this purpose?

A.MRI neck
B.Ultrasound neck
C.Iodine-131 isotope scan
D.PET scan

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SurgeryGI Surgery
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Q1564. A Truck driver presents with a single genital ulcer noticed incidentally. The lesion is painless, has a clean base with indurated margins, and is associated with non-tender inguinal lymphadenopathy. There is no fever or systemic illness. What is the most likely diagnosis?

A.Aphthous ulcer
B.Oral TB
C.Primary syphilis
D.Effusion with hernia

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