Surgery MCQs for AMC Part 1 Exam

ByAMC Wise

Surgical disorders are a critical component of medical knowledge, and mastering them is essential for success in AMC Part 1 exam. Whether you’re a medical student or a healthcare professional looking to face the CAT MCQ exam, this curated collection of multiple-choice questions (MCQs) on surgical disorders is designed to provide you with a comprehensive and efficient study aid.

These MCQs are specifically crafted to test your diagnosis skills on various surgical conditions and will give you a general overview on the topics you need to study for AMC Part 1.

Question 2001

A 42-year-old female presents to the clinic with muscle cramps, tingling sensations in her fingers and toes, and an overall feeling of weakness. She reports a history of thyroid surgery six months ago, where her thyroid gland was removed due to hyperthyroidism. What is the most likely diagnosis for her current symptoms?

  • A) Hypothyroidism
  • B) Hypoparathyroidism
  • C) Hyperparathyroidism
  • D) Graves’ disease
  • E) Addison’s disease

Answer: B) Hypoparathyroidism

Hypoparathyroidism is the most likely diagnosis for the patient’s symptoms. After thyroid surgery, damage or removal of the parathyroid glands, which regulate calcium levels in the body, can occur.

In this case, the patient’s low calcium levels (hypocalcemia) and high phosphate levels results in a disrupted calcium-phosphate balance, leading to muscle cramps, tingling sensations, and weakness.

Hypothyroidism (A) typically presents with different symptoms related to low thyroid hormone levels. Hyperparathyroidism (C) would lead to elevated calcium levels and does not fit the clinical picture. Graves’ disease (D) is a condition of hyperthyroidism, not hypoparathyroidism, and Addison’s disease (E) is unrelated to calcium and phosphate regulation.

Question 2002

A 45-year-old female presents to you with complaints of unintentional weight loss, palpitations, heat intolerance, and tremors. Physical examination reveals proptosis, a diffuse, non-tender goiter, and fine tremors of the hands. Laboratory tests show very low levels of thyroid-stimulating hormone (TSH). What is the most likely diagnosis?

  • A) Hypothyroidism
  • B) Hashimoto’s thyroiditis
  • C) Graves’ disease
  • D) Thyroid adenoma
  • E) Thyroid cancer

Answer: C) Graves’ disease

This patient’s symptoms, including weight loss, palpitations, heat intolerance, tremors, proptosis (exophthalmos), and laboratory findings of very low TSH, are indicative of Graves’ disease.

Graves’ disease is an autoimmune thyroid disorder characterized by the production of autoantibodies (thyroid-stimulating immunoglobulins) that stimulate the thyroid gland, leading to excess production of thyroid hormones. This results in hyperthyroidism and the classic clinical features described in the patient. Treatment options include antithyroid medications, radioactive iodine therapy, and surgical thyroidectomy.

Question 2003

A 60-year-old male presents to his primary care physician with complaints of dysphagia, unintentional weight loss, and progressive difficulty in swallowing both solids and liquids. He denies any significant heartburn or regurgitation. Physical examination reveals no abnormal findings. An upper endoscopy is performed, showing an irregular, ulcerated mass in the distal esophagus. Which of the following is the most appropriate next step in managing this patient?

  • A) Initiate proton pump inhibitor (PPI) therapy
  • B) Refer for surgical resection
  • C) Esophageal stenting
  • D) Prescribe high-dose oral corticosteroids
  • E) Review in 3 months

Answer: B) Refer for surgical resection

The patient’s presentation with dysphagia, unintentional weight loss, and an irregular, ulcerated mass in the distal esophagus suggests advanced esophageal cancer. The most appropriate next step in managing this patient is to refer for surgical resection, which is often the primary treatment modality for localized esophageal cancer. Surgical resection offers the best chance for cure in this scenario.

Question 2004

A 55-year-old male smoker with a history of hypertension and hyperlipidemia presents to his primary care physician with complaints of pain and cramping in his right calf that occurs during walking and is relieved with rest. He describes the pain as aching and cramping and notes that it consistently occurs after walking a few blocks. Physical examination reveals diminished pulses in the right lower extremity. Which of the following is the most likely diagnosis?

  • A) Deep vein thrombosis
  • B) Osteoarthritis
  • C) Gout
  • D) Peripheral neuropathy
  • E) Intermittent claudication

Answer: E) Intermittent claudication

The patient’s presentation of pain and cramping in the right calf that occurs with walking and is relieved with rest is characteristic of intermittent claudication. This symptom is indicative of peripheral arterial disease (PAD) and is typically caused by atherosclerosis, which leads to reduced blood flow to the lower extremities during physical activity.

Risk factors such as smoking, hypertension, and hyperlipidemia are consistent with the development of atherosclerotic disease. Physical examination finding of diminished pulses support the diagnosis of intermittent claudication.

Question 2005

A 65-year-old male presents to his urologist with complaints of urinary frequency, nocturia, and a weak urinary stream. He has a past medical history of hypertension and type 2 diabetes, both of which are well-controlled with medication. Digital rectal examination (DRE) reveals a nodule on the posterior surface of the prostate gland. A serum prostate-specific antigen (PSA) test is performed, and the result comes back elevated. Which of the following is the most appropriate next step in managing this patient?

  • A) Initiate treatment with alpha-blockers
  • B) Perform a transrectal ultrasound (TRUS)-guided biopsy of the prostate
  • C) Monitor PSA levels annually
  • D) Prescribe a 5-alpha reductase inhibitor
  • E) Order a bone scan to evaluate for metastases

Answer: B) Perform a transrectal ultrasound (TRUS)-guided biopsy of the prostate

The patient’s presentation with urinary symptoms, an abnormal DRE finding (prostate nodule), and an elevated PSA level raises suspicion for prostate cancer. The most appropriate next step in managing this patient is to perform a transrectal ultrasound (TRUS)-guided biopsy of the prostate. This biopsy is the definitive method for diagnosing or ruling out prostate cancer and is indicated when there are concerning clinical findings, such as an elevated PSA and abnormal DRE.

Question 2006

A 40-year-old male presents to the emergency department with severe abdominal pain that radiates to his back. He reports a history of heavy alcohol consumption over the past several years. On physical examination, he appears acutely ill and in distress. His abdomen is tender to palpation, and there is guarding and rigidity in the epigastric region. Laboratory tests show elevated serum amylase and lipase levels. What is the most likely diagnosis in this case?

  • A) Peptic ulcer disease
  • B) Acute appendicitis
  • C) Acute pancreatitis
  • D) Crohn’s disease
  • E) Intestinal obstruction

Answer: C) Acute pancreatitis

The patient’s presentation of severe epigastric pain radiating to the back, along with a history of heavy alcohol consumption, is highly suggestive of acute pancreatitis. Elevated serum amylase and lipase levels are consistent with this diagnosis.

Question 2007

A 30-year-old female presents with a painless, soft, and non-tender lump on the dorsum of her wrist. She reports that the lump has been slowly increasing in size over the past several months. On examination, the mass is mobile, located just proximal to the wrist joint, and is transilluminated when a penlight is placed against it. What is the most likely diagnosis?

  • A) Ganglion
  • B) Lipoma
  • C) Carpal tunnel syndrome
  • D) Rheumatoid arthritis
  • E) Dupuytren’s contracture

Answer: A) Ganglion

The patient’s presentation of a painless, soft, and non-tender lump on the dorsum of the wrist that is mobile and transilluminates when a penlight is applied is characteristic of a ganglion cyst. Ganglion cysts are benign, fluid-filled cysts that commonly arise near joints, particularly on the wrists and hands. They are often associated with joint or tendon sheath irritation. The characteristic appearance and location of the mass, along with its behavior on examination, are highly suggestive of a ganglion.

Question 2008

A 45-year-old female presents to the emergency department with sudden-onset right upper quadrant abdominal pain that radiates to the back. She describes the pain as severe and colicky, and it began shortly after she consumed a fatty meal. Physical examination reveals tenderness in the right upper quadrant, but there is no fever or jaundice. Laboratory tests, including liver function tests and complete blood count, are within normal limits. What is the most likely diagnosis in this case?

  • A) Acute pancreatitis
  • B) Cholecystitis
  • C) Peptic ulcer disease
  • D) Biliary colic
  • E) Appendicitis

Answer: D) Biliary colic

The patient’s presentation of sudden-onset right upper quadrant abdominal pain that radiates to the back, especially after consuming a fatty meal, is characteristic of biliary colic. Biliary colic typically occurs due to the temporary obstruction of the cystic duct by a gallstone, leading to intermittent, crampy, and severe pain.

Unlike cholecystitis, which is associated with gallbladder inflammation and often presents with fever and signs of infection, biliary colic does not typically cause fever or significant laboratory abnormalities. This presentation is highly suggestive of biliary colic.

Question 2009

A 20-year-old male presents to the emergency department with a 12-hour history of abdominal pain that initially began around the umbilicus but has since migrated to the right lower quadrant. He describes the pain as constant and progressively worsening. On physical examination, there is tenderness and guarding in the right lower quadrant, as well as rebound tenderness. Laboratory tests show an elevated white blood cell count. What is the most likely diagnosis in this case?

  • A) Gastroenteritis
  • B) Kidney stone
  • C) Appendicitis
  • D) Diverticulitis
  • E) Ovarian torsion

Answer: C) Appendicitis

The patient’s presentation of abdominal pain that initially starts around the umbilicus and migrates to the right lower quadrant, along with tenderness, guarding, and rebound tenderness in the right lower quadrant, is highly indicative of appendicitis.

Appendicitis is characterized by inflammation of the appendix and is associated with localized abdominal pain, often accompanied by fever and an elevated white blood cell count. The migration of pain from the periumbilical area to the right lower quadrant, along with the physical examination findings, strongly suggest appendicitis as the most likely diagnosis in this case.

Question 2010

A 35-year-old female presents to the emergency department with severe, colicky right lower abdominal pain that radiates to the groin. She describes the pain as excruciating and intermittent. She also reports nausea and vomiting. On physical examination, she is in distress and has tenderness in the right lower quadrant. There is no fever, and her urine dipstick is positive for blood. What is the most likely diagnosis in this case?

  • A) Acute appendicitis
  • B) Ovarian torsion
  • C) Ureteric colic (renal colic)
  • D) Gastroenteritis
  • E) Ectopic pregnancy

Answer: C) Ureteric colic (renal colic)

The patient’s presentation of severe, colicky abdominal pain that radiates to the groin, along with associated nausea and vomiting, is characteristic of ureteric colic, also known as renal colic. Ureteric colic typically occurs due to the passage of a kidney stone through the ureter, causing intense, intermittent pain.

References

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