| Post Name | Assistant Professor in Plastic and Reconstructive Surgery |
|---|---|
| Department | Medical Education |
| Question Paper Code | 066/2025/OL |
| Category Code | 369/2024 |
| Date of Test | 26 June 2025 |
| Exam Type | Online Examination |
| Total Questions | 100 |
1
Reconstruction of which part of the body was described in an Indian Publication, the Sanhita about 600 B.C
Answer
B. Nose
2
What are the function of skin?
Answer
D. All of the above
3
All are the options/indication for skin grafting except
Answer
D. Wound due to malignant neoplasia
4
All are the reasons for graft failure except
Answer
A. Graft placed in a vascular bed
5
All are true about Z-Plasty except
Answer
D. Z-plasty is an example of distant flap
6
All are true about flaps except
Answer
D. Flap survives by the blood supply from the bed of the wound
7
According to Mathes-Nahai classification of Muscle and musculocutaneous there are _________ types.
Answer
D. 5
8
All are true about tissue expansion except
Answer
D. In this method only local tissue can be expanded adjacent to the defect
9
All are true about liposuction except
Answer
C. Subfascial tissues can be suctioned only by this procedure
10
All are true about laser except
Answer
D. Hair removal can not be done by laser
11
All are the methods of non surgical measures of scar management except
Answer
D. Z-plasty
12
Find out wrong statements
Answer
D. Keloid regresses spontaneously
13
All of the following listed surgeries can be carried by Endoscopy except
Answer
D. Breast Reconstruction
14
All drugs listed are local anesthetic agents except
Answer
D. Succinylcholine
15
All are the techniques of Genetic analysis except
Answer
A. Elisa
16
Superficial musculoaponeurotic system (SMAS) is an extension of which of the following layers of the head and neck region?
Answer
C. Temporoparietal fascia
17
Which of the following is not a feature of leprosy of the face?
Answer
A. Dorsal jump
18
Keystone area is described as which of the following?
Answer
D. Region where nasal bone abuts upper lateral cartliage
19
Two years ago, during excision of an acoustic neuroma a patient sustained complete injury of facial nerve. Which of the following is not a feasible treatment option for this patient?
Answer
B. Ipsilateral facial nerve grafting
20
Antia-Buch procedure is used for which of the following?
Answer
D. Helical rim defect
21
Klippel Trenaunay syndrome is not associated with which of the following?
Answer
A. Arterial malformation
22
Unique feature of ameloblastoma is
Answer
D. Radiolucent multiloculated lesion
23
For bony reconstruction of mandible after oncological resection, the lateral border of the scapula is harvested based on blood vessel?
Answer
D. Circumflex scapular artery
24
As per the Santanaria and Cordiero classification of maxillectomy defect, a defect involving the removal of all six walls of the maxilla along with orbital exenteration is classified as
Answer
B. Type 3b
25
Isolated limb perfusion is a treatment modality to deliver chemotherapeutic agents to the limb. It is used in which of the following skin conditions:
Answer
A. Melanoma
26
Which of the following muscles of facial animation is innervated on its superficial aspect by the facial nerve?
Answer
A. Buccinator
27
What is the recommended age for cleft palate repair?
Answer
B. 9-12 months
28
Coronal closure pattern of Velopharynx is formed by which predominant moving component
Answer
D. Velum
29
What is the recommended age for alveolar bone grafting?
Answer
D. 6-9 years
30
Which of the following statements describe the normal occlusion?
Answer
B. Mesiobuccal cusp of maxillary first molar occludes in the buccal groove of the mandibular molar
31
Which of the following Tessier cleft extends through the nasolacrimal duct?
Answer
B. Cleft number 3
32
A patient suffered lateral impact to his nose with displacement of nasal bone on side of impact and green stick fracture of contralateral nasal bone. This type of injury is classified into following type.
Answer
B. Plane II
33
Trigonocephaly results from the premature fusion of which cranial suture?
Answer
D. Metopic
34
All of the following originate from the first pharyngeal arch except:
Answer
D. Posterior belly of the digastric
35
Which of the following structure is not formed by the medial nasal prominence?
Answer
C. Secondary palate
36
A 68-year old woman presents for facial rejuvenation with complaints of jowls and neck laxity. She is scheduled for a traditional facelift under general anesthesia. Review the following statements and indicate which of the options are TRUE? i. The posterior auricular dissection is commonly initiated using a scalpel all the way through the procedure. ii. The facelift plane is located deep to the SMAS to allow safe identification of the facial nerve branches. iii. Skin flap dissection should stay in the subcutaneous plane in the postauricular area to protect the great auricular nerve. iv. The "mesotemporalis" is a bridge of tissues containing superficial tenporal vessels and nerve branches.
Answer
C. Only iii and iv
37
With regards to the use of flaps for posterior truck reconstruction, review the following statements and indicate which of the options are TRUE. i. The trapezius muscle flap receives its dominant blood supply from the thoracodorsal artery. ii. The dorsal scapular artery performator (DSAP) is a basis for the trapezial performator flap. iii. The latissimus dorsi (LD) muscle can be used as a reverse flow flap based on intercostal vessels. iv. The parascapular flap is primarily supplied by thoracodorsal artery perforators.
Answer
B. Only ii and iii
38
A 65 year-old- female with a history of degenerative lumbar scoliosis underwent instrumented lumbar arthrodesis from L2 to L5. Two weeks postoperatively, she presents with a dehisced midline lumbar wound, exposing spinal hardware and with serous discharge. The defect measures approximately 12 × 5 cm, with undermined edges and visible instrumentation. The reconstructive plan includes the use of a parapinous muscle flap. Which of the following statements about the paraspinous muscle flap is CORRECT in this context?
Answer
C. It is commonly raised as a bipedicled flap based on segmental perforators from the intercostal arteries
39
A 27 year old woman has experienced progressive swelling in her right lower limb for 8 months, causing heaviness, discomfort and difficulty wearing shoes. Clinical examination shows non-pitting edema from foot to mid-calf, with a positive stemmer's sign. Ultrasound excluded venous thrombosis and she is referred for lymphoscintigraphy. Which of the following statements about lymphoscintigraphy (LS) for lymphedema assessemt is CORRECT?
Answer
D. LS provides both qualitative and quantitative assessement of lymphatic function
40
Which of the following statements about Magnetic Resonance Lymphangiography (MRL) in lymphedema imaging is FALSE?
Answer
A. MRL allows for real-time imaging of lymphatic vessel contractility and flow direction
41
A 48 year old woman presents to you with primary concerns of perioral wrinkling, a dull skin tone and fine rhytids around the eyes. Upon examination, she has fair skin, moderate elastosis and early signs of volume loss. You are considering a deep chemical peel as part of her therapy. Which of the following statements is CORRECT regarding preoperative planning for a deep chemical peel?
Answer
C. Patients must be psychologically prepared for a visible healing phase, including erythema and peeling lasting upto 2 weeks
42
Which of the following is a primary goal of preoperative skin preparation before a deep chemical peel?
Answer
B. To suppress melanocytes and improve epidermal and dermal condition
43
Which of the following is the MOST common early complication following facelift surgery?
Answer
C. Hematoma
44
Which of the following statements about contraindications to abdominoplasty is FALSE?
Answer
D. Body dysmorphic disorder is a relative contraindication and may be managed with counseling
45
A 52 year old woman underwent elective abdominoplasty for abdominal contouring. On postoperative day 3, she complains of swelling and pain in her left calf. On examination, her leg is warm and tender with a positive Homan's sign. Vital signs are stable, but D-dimer is elevated. Which of the following is TRUE regarding venous thromboembolism (VTE) in the context of abdominoplasty?
Answer
D. A history of prior VTE or inherited thrombophilia warrants extended chemoprophylaxis up to 4 weeks
46
Which of the following statements is TRUE regarding component dorsal hump reduction in open rhinoplasty?
Answer
C. Preservation of upper lateral cartilages during septal reduction helps maintain internal valve function
47
A 29-year-old woman presents for primary rhinoplasty. Her main concerns are poor nasal tip projection and mild asymmetry over the tip. On examination, she has moderate skin thickness and adequate lower lateral cartilage strength. Which of the following statements regarding nasal tip grafting techniques in primary rhinoplasty is TRUE?
Answer
A. Onlay grafts are placed over the alar domes and can camouflage tip irregularities
48
Which of the following statements regarding wetting solutions in liposuction is FALSE?
Answer
D. The dry technique remains a preferred method for small-volume liposuction due to simplicity
49
Which of the following is the MOST critical primary surgical endpoint for suction-assisted or power-assisted liposuction (SAL/PAL)?
Answer
C. Final contour and symmetrical pinch test in treatment site
50
A 58-year-old woman with Fitzpartrick Type IV skin and moderate photoaging (Glogau II) present with fine lines. brown spots and facial redness. She requests facial rejuvenation with minimal downtime and quick recovery. Which of the following laser or light-based interventions would be the MOST appropriate initial treatment option for this patient?
Answer
B. Fractional non-ablative laser treatment
51
Which of the following statements is TRUE regarding the role of biomechanics in wound formation in diabetic foot patients?
Answer
C. Deformity and altered food mechanics increase localized pressure, contributing to wound chronicity
52
A 23-year-old male sustains an open tibial fracture with extensive soft- tissue loss after a road traffic accident. Following skeletal stabilization and serial debridement, he is planned for free Latissimus Dorsi flap coverage of the distal third of the leg. Which of the following is the MOST important factor when selecting a recipient vessel for microvascular anastomosis in this patient?
Answer
D. Visual assessment of vessel pliability and quality of pulsatile flow
53
Which of the following statements about abdominal scars and free microvascular Transverse Rectus Abdominis (TRAM) flap planning for autologous breast reconstruction is TRUE?
Answer
D. A Pfannenstiel incision usually does not interface with key perforators for flap harvest
54
Which of the following statements regarding pre-pectoral placement of prosthetic breast implants for breast reconstruction is True?
Answer
A. A well-perfused mastectomy flap is essential for successful pre-pectoral implant placement.
55
Which of the following reconstructive techniques is MOST appropriately matched to its pressure sore location?
Answer
B. Posterior thigh fasciocutaneous flap : Ischial pressure sore
56
The labioscrotal swellings in a male embryo develop into which of the following?
Answer
B. Scrotum
57
Hypospadias results from :
Answer
B. Incomplete fusion of the urogenital folds
58
In female embryology, the paramesonephric (Mullerian) ducts develop into :
Answer
B. Fallopian tubes, uterus and upper vagina
59
A typical surgical goal of male-to-female (MTF) gender affirmation surgery is :
Answer
C. Creation of a neovagina using penile or colon tissue
60
In transgender health care, which of the following is a WPATH recommendation before undergoing genital surgery?
Answer
B. One year of continuous living in the gender role congruent with identity
61
At what week of gestation do limb buds first appear in the human embryo?
Answer
B. 4th week
62
Which signaling center is essential for anteroposterior axis formation of the limb?
Answer
B. Zone of polarizing activity (ZPA)
63
The preaxial border of the upper limb corresponds to which anatomical structure?
Answer
A. Radius
64
The carpal tunnel contains all except :
Answer
C. Flexor carpi ulnaris
65
The thenar muscles are primarily innervated by :
Answer
B. Median nerve
66
Which of the following injuries results in 'claw hand'?
Answer
C. Ulnar nerve injury
67
Which suture size is commonly used for microvascular anastomosis?
Answer
D. 10-0
68
An absolute contraindication to free flap transfer is :
Answer
B. Poor and damaged recipient vein
69
Erb's palsy results from injury to which part of the brachial plexus?
Answer
A. C5-C6
70
Brachial plexus roots emerge between which muscles?
Answer
A. Scalenus anterior and medius
71
Nerve transfer in brachial plexus repair often uses which donor nerve?
Answer
D. All of the above
72
A low-flow vascular malformation includes all except :
Answer
D. Arteriovenous malformation
73
The most effective imaging modality for vascular malformation is :
Answer
C. MRI with contrast
74
Which gene mutation is commonly associated with capillary malformations?
Answer
A. RASA1
75
Primary lymphedema of the upper limb is most commonly due to :
Answer
C. Congenital hypoplasia
76
Which artery is most commonly injured in supracondylar fractures of the humerus?
Answer
B. Brachial
77
The lateral arm flap is based on which artery?
Answer
B. Posterior radial collateral artery
78
The most commonly injured nerve in humeral shaft fractures is :
Answer
C. Radial nerve
79
Which reconstructive option is best for exposed tendons in the dorsum of hand?
Answer
B. Fasciocutaneous flap
80
Which of the following is a common complication of untreated compartment syndrome?
Answer
C. Volkmann's contracture
81
Regarding the pathophysiology of burn shock, which of the following is the key mediator of increases in microvascular permeability following thermal injury in the early post-burn phase?
Answer
B. Histamine
82
In planning nutritional support for an adult patient with a 40% Total Body Surface Area (TBSA) thermal burn, which formula predicts 24-hour energy expenditure with remarkable accuracy after the initial resuscitation phase?
Answer
D. Indirect calorimetry
83
A severely burned patient (60% TBSA) develops invasive Aspergillus fumigatus burn wound infection confirmed by biopsy and culture. The patient is hemodynamically unstable. Which systemic antifungal agent is generally considered first-line therapy for invasive aspergillosis in this critical setting?
Answer
C. Voricontazole
84
A 35-year old man sustains a high-voltage electrical injury of the right upper extremity with an entrance wound over the volar aspect of the hand. If increased compartment pressures are not adequately relieved in time, which of the following muscles is most likely to develop an ischemic contracture?
Answer
C. Flexor digitorum profundus
85
A 20-year only man is undergoing contracture release of the oral commissure when the nasal endotracheal tube is accidentally disconnected from the breathing circuit. The surgeon witnesses an unexpected flash in the operative field. The surgeon immediately stops the procedure and alerts the anaesthesiologist. Smoke and a burning odour coming out of the patient's airway are noted. Which of the following is the most appropriate next step in management?
Answer
B. Immediately remove the endotracheal tube
86
A 70-kg man is evaluated in burn unit 1 hour after sustaining deep partial - thickness burns to 50% of his total body surface area when attempting to light a firecracker. Paramedics administered 2 L of intravenous fluid during transport to burn unit. Using the Parkland formula, which of the following is the starting rate for fluid resuscitation in this patient?
Answer
D. 714 mL/hr
87
A 70-kg, 35-year-old man undergoes excision and skin grafting after sustaining total body surface area burns to over 40% of his body. Using the Curreri formula, which of the following is this patient's total daily caloric need?
Answer
B. 3350 kCal/day
88
Which of the following is the Pain assessment tool of choice in Infants and Pre-verbal children?
Answer
A. The Observer Pain Scale
89
A 35-year old man is admitted to the burn unit after sustaining superficial partial thickness burns involving 25% of the total body surface area. Medical history includes an allergy to sulfonamide. The burns area cleaned, and silver nitrate - soaked dressings are applied. Which of the following is most likely in this patient?
Answer
A. Hyponatremia
90
A 29-year-old man sustained extensive chemical burns to 30% of the total body surface area. After 12 weeks of healing, he came back for scar management. Examination shows thick hypertrophic scarring of the upper extremities and anterior torso. Which of the following is the most appropriate management?
Answer
D. Use of pressure garments
91
A 37-year-old male worker sustained burn injuries to the right hand when he fell and inadvertently immersed his hand in tar that had a temperature 260.2°C. Which of the following is the most appropriate initial management?
Answer
B. Removing the tar with butter and splinting
92
A 58-year-old male, weighing 70 kg, is admitted to the burn intensive care unit 4 hours after sustaining 65% Total Body Surface Area (TBSA) deep partial and full-thickness flame burns in an enclosed - space house fire. He was intubated at the scene due to hoarseness and carbonaceous sputum. Initial resuscitation was initiated with Lactated Ringer's solution at 4 mL/kg/% TBSA. Over the next 48 hours, despite adherence to lung-protective ventilation (VT 6mL/kg IBW, PEEP 10 cm ), his ratio deteriorates to 85 mmHg, with new bilateral fluffy infiltrates on chest radiography, consistent with severe ARDS by Berlin criteria. His central venous pressure is 12 mmHg, and urine output has been maintained at 0.6mL/kg/hr for the past 12 hours. Which of the following interventions is the most appropriate next step in managing his respiratory failure.
Answer
D. Institute prone positioning for at least 16 hours per day.
93
A 50-year-old day male with 55% TBSA flame burns is in the burn ICU, 21 days post-injury. He has been on mechanical ventilation for ARDS secondary to initial inhalation injury and has undergone multiple debridements and grafting procedures. He develops VAP and cultures reveal Multi Drug Resistant (MDR) Acinetrobacter baumannil, senisitive only to colistin and tigecycline. Despite appropriate doses of colistin, his condition deteriorates. He is now in septic shock with a MAP of 50 mmHg despite norepinephrine at 0.8 mcg/kg/min, vasopressin at 0.04 U/min, and adequate fluid resuscitation (CVP 14 mmHg, PAOP 16 mmHg, 65%). He is severely hypermetabolic, receiving high-protein, high-carbohydrate enteral nutrition. His lactate is 5.2 mmol/L. Which of the following interventions is the most appropriate next step to consider for his refractory shock?
Answer
C. Add epinephrine infusion, titrating to a MAP > 65 mmHg
94
In a mass casualty burn disaster scenario with limited resources, which patient category, would typically be assigned the LOWEST priority for immediate evacuation to a specialized burn center, assuming other injuries are not life- threatening?
Answer
C. Adults with < 10% TBSA partial-thickness burns without facial or perineal involvement
95
A 35-year-old electrician sustains a 15000V AC electrical injury with an entry point on the right palm and an exit point on the left heel. Initial resuscitation is adequate. On day 3 post-injury, he develops progressive oliguria, a serum Creatinine Kinase (CK) of 150,000 IU/L, and dark urine. Despite aggressive intravenous fluid therapy (targeting urine output > 100 mL/hr) and urine alkalization, his renal function deteriorates. Which of the following intervention, beyond continued aggressive fluid resuscitation, is most specifically indicated and potentially life-saving in this immediate scenario?
Answer
D. Urgent dialysis with consideration for Continuous Renal Replacement Therapy (CRRT)
96
Which of the following best explains the 'steal phenomenon' in free flap reconstruction?
Answer
D. Shunting of arterial blood through a low-resistance flap circuit
97
A 35-year-old male presents 10 hours after a complete guillotine amputation of his dominant right thumb at the metacarpohalangeal (MP) joint. The amputated part has been kept cool. He is heavy smoker with a 20 pack-year history. Intraoperatively, after bony fixation and extensor tendon repair, arterial anastomosis is performed, but there is no immediate reflow despite a technically sound anastomosis and absence of kinking. Which of the following is the MOST appropriate next step in management?
Answer
D. Vein graft interposition, assuming intimal damage, followed by exploration of the distal arterial tree for micro-thrombi.
98
A 30-year-old patient requires a sensate free Antero Lateral Thigh (ALT) flap for reconstruction of a large soft tissue defect on the volar aspect of the dominant forearm following a severe crush injury with segmental nerve loss of both the median and ulnar nerves (greater than 8 cm gap in each) The Lateral Femoral Cutaneous Nerve (LFCN) is identified for coaptation. Which of the following recipient nerve strategies offers the BEST potential for meaninful protective sensation and functional recovery in the reconstructed area?
Answer
A. End-to-end coaptation of the LFCN to the distal stump of the superficial radial sensory nerve, which was uninjured.
99
A 48-year-old patient undergoes a free Transverse Rectus Abdominis Myocutaneous (TRAM) flap for breast reconstruction. On postoperative day 2, the flap becomes progressively swollen, tense, and develops a violaceous hue with brisk, dark capillay refill on pinprick. An urgent surgical exploration is performed. The arterial anastomosis is patent with a strong Doppler signal. The venous anastomosis appears technically sound with no evidence of kinking, tension, or external compression, and a discernible venous Doppler signal is present, though perhaps less robust than baseline. No hematoma is found. Despite these findings, the flap congestion persists. Which of the following is the MOST appropriate next step in management?
Answer
C. Perform a second, more distal venous anastomosis (supercharging / super- drainage) to an available recipient vein, if technically feasible.
100
A 70-year-old patient with a long history of diffuse systemic sclerosis (seleroderma) and sever Raynaud's phenomenon requires reconstruction of a non- healing ulcer with exposed tibia (8 cm x 5 cm) following minor trauma. Previous attempts at skin grafting have failed. Her peripheral pulses are diminished but Dopplerable. She has digital pitted scarring and early acro-osteolysis. Which of the following factors poses the GREATEST challenge to successful free tissue transfer in this patient and what is the MOST critical perioperative adjustment to mitigate this?
Answer
C. Challenge : Microvascular disease and vasopastic tendency of recipient vessels : Mitigation : Recipient vessel selection as proximal as possible, avoidance of vasoconstrictive agents (e.g., epinephrine in local anesthetic), and maintenance of aggressive perioperative vasodilation
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