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UPSC CMS Surgery - Colorectal, Peritoneal & Abdominal Wall
Attempt UPSC CMS Surgery - Colorectal, Peritoneal & Abdominal Wall under real exam conditions. Features timed computer-based test interface, textbook explanations, and detailed subject rank analytics.
Duration
15 Mins
Countdown timer with review palette.
Marking Scheme
+4.00 / -1.00
Exact negative marking as per official exam rules.
Textbook Citations
Harrison & Bailey
Standard medical textbook solution references.
Target Exam
UPSC CMS
Official paper pattern & syllabus coverage.
📝 Sample Question Preview from UPSC CMS Surgery - Colorectal, Peritoneal & Abdominal Wall
Below is a preview of sample questions included in this mock test. Launch the live simulator to attempt the complete test.
Question 1
A 68-year-old male presents with a 6-month history of increasing difficulty in defecation, passage of dark red blood mixed with stool, and a 10 kg weight loss. Colonoscopy reveals a circumferential, friable mass at 10 cm from the anal verge. Biopsy confirms moderately differentiated adenocarcinoma. Staging CT scan shows thickening of the rectal wall with perirectal fat stranding and a single enlarged mesorectal lymph node (1.5 cm) without distant metastases. Carcinoembryonic antigen (CEA) level is 8 ng/mL. What is the most appropriate initial management strategy?
A. Anterior resection with total mesorectal excision (TME) followed by adjuvant chemotherapy.
B. Long-course neoadjuvant chemoradiotherapy followed by interval rest and then anterior resection with TME.
C. Abdominoperineal resection (APR) with TME due to the low-lying nature of the tumor.
D. Transanal endoscopic microsurgery (TEM) followed by close surveillance.
Textbook Explanation Highlight:
This patient presents with locally advanced rectal cancer (likely cT3N1M0 based on the circumferential mass, perirectal fat stranding, and enlarged mesorectal lymph node). For such tumors, especially those in the mid-to-low rectum (10 cm from the ana...
Question 2
A 45-year-old male presents with sudden onset severe crampy abdominal pain, nausea, and obstipation for 24 hours. He has a history of abdominal surgery for appendicitis 15 years ago. On examination, the abdomen is distended, tympanitic, and tender to palpation, with high-pitched bowel sounds. Plain abdominal X-ray shows multiple dilated loops of small bowel with air-fluid levels and absence of gas in the colon. Which of the following is the most definitive immediate diagnostic and therapeutic step?
A. Nasogastric tube decompression and intravenous fluids.
B. CT abdomen with oral and intravenous contrast.
C. Water-soluble contrast enema.
D. Urgent exploratory laparotomy.
Textbook Explanation Highlight:
This clinical presentation is highly suggestive of small bowel obstruction, likely due to adhesions given the prior abdominal surgery. While nasogastric tube decompression and IV fluids (Option a) are crucial initial supportive measures, they are not...
Question 3
A 72-year-old male with a history of chronic constipation and diverticulosis presents to the emergency department with acute onset severe left lower quadrant abdominal pain, fever (38.5°C), and leukocytosis (16,000/µL). Physical examination reveals localized tenderness and guarding in the left iliac fossa. A CT scan of the abdomen and pelvis is performed, which shows thickening of the sigmoid colon wall, pericolic fat stranding, and a localized collection of 3 cm adjacent to the inflamed diverticulum. There is no free air or distant abscess. What is the most appropriate initial management?
A. Immediate surgical resection of the affected colon.
B. Broad-spectrum intravenous antibiotics and percutaneous drainage of the collection.
C. Oral antibiotics and a clear liquid diet.
D. Laparoscopic lavage and drainage.
Textbook Explanation Highlight:
This patient presents with acute complicated diverticulitis, specifically Hinchey Stage II (pericolic or retroperitoneal abscess). For a localized abscess of 3 cm without evidence of generalized peritonitis, sepsis, or perforation, the initial manage...
Question 4
A 55-year-old female presents with a several-month history of increasing abdominal distension, early satiety, and vague abdominal discomfort. Physical examination reveals ascites and a palpable, irregular pelvic mass. CA-125 is significantly elevated. A CT scan shows extensive peritoneal carcinomatosis with an ovarian mass and omental caking. She is otherwise hemodynamically stable. What is the most appropriate initial management approach?
A. Palliative chemotherapy alone.
B. Neoadjuvant chemotherapy followed by interval debulking surgery.
C. Primary cytoreductive surgery followed by adjuvant chemotherapy.
D. Diagnostic laparoscopy with biopsy and then palliative care discussion.
Textbook Explanation Highlight:
This patient presents with advanced ovarian cancer (Stage III/IV) characterized by extensive peritoneal carcinomatosis and omental caking, making primary optimal cytoreduction difficult or impossible. In such cases, neoadjuvant chemotherapy (NACT) is...
Question 5
A 30-year-old male presents with a painless, gradually enlarging bulge in his right groin that becomes more prominent with coughing and straining. On examination, the bulge is reducible and descends into the scrotum. It is felt to originate superior and lateral to the pubic tubercle. A diagnosis of indirect inguinal hernia is made. During surgical repair, what is the most critical anatomical landmark to identify and protect to prevent iatrogenic injury?
A. Inferior epigastric artery and vein.
B. Ilioinguinal nerve.
C. Genital branch of the genitofemoral nerve.
D. Deep inguinal ring.
Textbook Explanation Highlight:
The inferior epigastric artery and vein are the most critical anatomical landmarks during inguinal hernia repair, particularly for distinguishing direct from indirect hernias (indirect hernias are lateral to these vessels, direct hernias are medial)....