CMS 2021 Paper II \u2013 Part 1 (Q1\u2013Q40)<\/title>\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:wght@600;700&family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&display=swap\" rel=\"stylesheet\">\n<style>\n\/* \u2500\u2500 Namespace: cms21p2a \u2500\u2500 *\/\n#cms21p2a *,#cms21p2a *::before,#cms21p2a *::after{box-sizing:border-box;margin:0;padding:0}\n#cms21p2a{\n --ter:#C0603A;--ter-light:#e8825f;--ter-pale:#fdf1ec;\n --teal:#2A7A6F;--teal-light:#3da394;--teal-pale:#eaf4f3;\n --ink:#1a1a1a;--ink-mid:#444;--ink-soft:#777;\n --line:#e0d8d4;--bg:#fdfaf8;--white:#ffffff;\n --correct:#1e6f46;--correct-bg:#eaf7ef;--correct-border:#43a047;\n --wrong:#b83232;--wrong-bg:#fdf0f0;--wrong-border:#e53935;\n --radius:10px;\n font-family:'Source Serif 4',Georgia,serif;\n font-size:16px;color:var(--ink);background:var(--bg);line-height:1.7;padding:0 0 48px;\n}\n#cms21p2a .cq-sentinel{height:1px}\n#cms21p2a .cq-statusbar{position:fixed;top:0;left:0;right:0;z-index:99999;background:var(--white);border-bottom:2px solid var(--line);border-left:4px solid var(--ter);box-shadow:0 2px 12px rgba(0,0,0,0.11);opacity:0;pointer-events:none;transform:translateY(-110%);transition:opacity 0.22s ease,transform 0.22s ease}\n#cms21p2a .cq-statusbar.visible{opacity:1;pointer-events:auto;transform:translateY(0)}\n#cms21p2a .cq-sb-stats{display:flex;align-items:center;padding:0.38rem 0.7rem;font-size:0.73rem;color:var(--ink-soft)}\n#cms21p2a .cq-sb-item{display:flex;align-items:center;gap:0.18rem;padding:0.1rem 0.5rem;border-right:1px solid var(--line);white-space:nowrap;line-height:1}\n#cms21p2a .cq-sb-item:last-child{border-right:none}\n#cms21p2a .cq-sb-item strong{color:var(--ink);font-size:0.8rem;font-weight:700}\n#cms21p2a .cq-sb-sep{flex:1}\n#cms21p2a .cq-sb-progress{height:4px;background:var(--line);overflow:hidden}\n#cms21p2a .cq-sb-fill{height:100%;background:linear-gradient(90deg,var(--ter),var(--teal));width:0%;transition:width 0.4s ease}\n#cms21p2a .cq-timer-item{display:none;align-items:center;gap:0.18rem;padding:0.1rem 0.5rem;border-right:1px solid var(--line);white-space:nowrap;line-height:1;font-size:0.73rem}\n#cms21p2a .cq-timer-item.active{display:flex}\n#cms21p2a .cq-timer-item strong{font-size:0.8rem;font-weight:700;color:var(--teal);font-variant-numeric:tabular-nums}\n#cms21p2a .cq-timer-item.warning strong{color:var(--wrong)}\n#cms21p2a .cq-grace{display:none;position:fixed;top:0;right:0;bottom:0;left:0;z-index:999999;background:rgba(0,0,0,0.55);align-items:center;justify-content:center}\n#cms21p2a .cq-grace.show{display:flex}\n#cms21p2a .cq-grace-box{background:var(--white);border-radius:12px;border-top:5px solid var(--wrong);padding:32px 28px;text-align:center;max-width:320px;width:90%;box-shadow:0 8px 40px rgba(0,0,0,0.25)}\n#cms21p2a .cq-grace-box h3{font-family:'Playfair Display',serif;font-size:1.2rem;color:var(--wrong);margin-bottom:10px}\n#cms21p2a .cq-grace-box p{font-size:0.88rem;color:var(--ink-mid);margin-bottom:18px;line-height:1.55}\n#cms21p2a .cq-grace-count{font-family:'Playfair Display',serif;font-size:2.8rem;font-weight:700;color:var(--wrong);line-height:1;margin-bottom:18px}\n#cms21p2a .cq-grace-btn{background:var(--wrong);color:#fff;border:none;border-radius:8px;padding:10px 24px;font-family:'Playfair Display',serif;font-size:0.95rem;font-weight:700;cursor:pointer;transition:background 0.2s}\n#cms21p2a .cq-grace-btn:hover{background:#c62828}\n#cms21p2a .cq-header{background:var(--teal);color:var(--white);padding:28px 24px 22px;text-align:center}\n#cms21p2a .cq-header h1{font-family:'Playfair Display',serif;font-size:1.45rem;font-weight:700;letter-spacing:0.01em;line-height:1.3}\n#cms21p2a .cq-header p{font-size:0.85rem;opacity:0.85;margin-top:6px;font-style:italic}\n#cms21p2a .cq-meta{display:flex;justify-content:center;gap:16px;margin-top:14px;flex-wrap:wrap;align-items:center}\n#cms21p2a .cq-badge{background:rgba(255,255,255,0.15);border:1px solid rgba(255,255,255,0.3);border-radius:20px;padding:4px 14px;font-size:0.78rem;letter-spacing:0.03em}\n#cms21p2a .cq-timer-btn{background:transparent;border:1.5px solid rgba(255,255,255,0.7);color:var(--white);border-radius:20px;padding:4px 14px;font-family:'Source Serif 4',serif;font-size:0.78rem;cursor:pointer;letter-spacing:0.03em;transition:background 0.2s;display:flex;align-items:center;gap:6px}\n#cms21p2a .cq-timer-btn:hover{background:rgba(255,255,255,0.15)}\n#cms21p2a .cq-timer-btn.running{background:rgba(255,255,255,0.2);border-color:var(--white)}\n#cms21p2a .cq-body{max-width:760px;margin:0 auto;padding:0 16px}\n#cms21p2a .cq-card{background:var(--white);border:1px solid var(--line);border-radius:var(--radius);margin:24px 0;overflow:hidden;transition:box-shadow 0.2s}\n#cms21p2a .cq-card:hover{box-shadow:0 2px 12px rgba(192,96,58,0.1)}\n#cms21p2a .cq-qhead{background:var(--ter-pale);border-bottom:1px solid var(--line);padding:14px 18px;display:flex;gap:12px;align-items:flex-start}\n#cms21p2a .cq-qnum{flex-shrink:0;width:26px;height:26px;border-radius:50%;background:var(--ter);color:#fff;font-size:0.72rem;font-weight:700;display:flex;align-items:center;justify-content:center;margin-top:2px;transition:background 0.2s}\n#cms21p2a .cq-qnum.ans-c{background:var(--correct-border)}\n#cms21p2a .cq-qnum.ans-w{background:var(--wrong-border)}\n#cms21p2a .cq-qtext{font-size:0.93rem;color:var(--ink);line-height:1.65}\n#cms21p2a .cq-options{padding:14px 18px;display:flex;flex-direction:column;gap:8px}\n#cms21p2a .cq-opt{display:flex;align-items:flex-start;gap:10px;padding:10px 14px;border:1.5px solid var(--line);border-radius:8px;cursor:pointer;transition:border-color 0.15s,background 0.15s;background:var(--white);-webkit-tap-highlight-color:transparent}\n#cms21p2a .cq-opt:hover:not(.cq-locked){border-color:var(--teal);background:var(--teal-pale)}\n#cms21p2a .cq-opt-letter{flex-shrink:0;width:20px;height:20px;border-radius:50%;border:1.5px solid var(--line);display:flex;align-items:center;justify-content:center;font-size:0.65rem;font-weight:700;color:var(--ink-soft);transition:all 0.15s;margin-top:1px}\n#cms21p2a .cq-opt-text{font-size:0.89rem;color:var(--ink-mid);line-height:1.55}\n#cms21p2a .cq-opt.cq-correct{border-color:var(--correct-border);background:var(--correct-bg);cursor:default}\n#cms21p2a .cq-opt.cq-correct .cq-opt-letter{background:var(--correct-border);border-color:var(--correct-border);color:#fff}\n#cms21p2a .cq-opt.cq-correct .cq-opt-text{color:var(--correct);font-weight:600}\n#cms21p2a .cq-opt.cq-wrong{border-color:var(--wrong-border);background:var(--wrong-bg);cursor:default}\n#cms21p2a .cq-opt.cq-wrong .cq-opt-letter{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff}\n#cms21p2a .cq-opt.cq-wrong .cq-opt-text{color:var(--wrong)}\n#cms21p2a .cq-opt.cq-dimmed{opacity:0.42;cursor:default}\n#cms21p2a .cq-opt.cq-locked{cursor:default}\n#cms21p2a .cq-explanation{display:none;background:var(--teal-pale);border-top:1px solid #b2d8d3;padding:10px 18px 12px;font-size:0.82rem;color:#1a4f49;line-height:1.62}\n#cms21p2a .cq-exp-label{font-size:0.7rem;font-weight:700;letter-spacing:0.08em;text-transform:uppercase;color:var(--teal);margin-bottom:4px}\n#cms21p2a .cq-submit-wrap{text-align:center;padding:28px 16px 8px}\n#cms21p2a .cq-btn{background:var(--teal);color:var(--white);border:none;border-radius:8px;padding:13px 36px;font-family:'Playfair Display',serif;font-size:1rem;font-weight:700;cursor:pointer;letter-spacing:0.02em;transition:background 0.2s,transform 0.1s}\n#cms21p2a .cq-btn:hover{background:var(--teal-light)}\n#cms21p2a .cq-btn:active{transform:scale(0.98)}\n#cms21p2a .cq-score{display:none;background:var(--white);border:2px solid var(--teal);border-radius:var(--radius);margin:28px 0 0;padding:28px 24px;text-align:center}\n#cms21p2a .cq-score-ring{width:110px;height:110px;border-radius:50%;background:conic-gradient(var(--teal) 0%,var(--line) 0%);display:flex;align-items:center;justify-content:center;margin:0 auto 20px;position:relative}\n#cms21p2a .cq-score-ring::before{content:'';position:absolute;width:86px;height:86px;border-radius:50%;background:var(--white)}\n#cms21p2a .cq-ring-inner{position:relative;display:flex;flex-direction:column;align-items:center;line-height:1.2}\n#cms21p2a .cq-ring-pct{font-family:'Playfair Display',serif;font-size:1.3rem;font-weight:700;color:var(--teal)}\n#cms21p2a .cq-ring-sub{font-size:0.6rem;color:var(--ink-soft);text-transform:uppercase;letter-spacing:0.05em}\n#cms21p2a .cq-score h2{font-family:'Playfair Display',serif;font-size:1.2rem;color:var(--ink);margin-bottom:8px}\n#cms21p2a .cq-net-line{font-size:1rem;color:var(--teal);font-weight:600;margin-bottom:6px}\n#cms21p2a .cq-verdict{font-size:0.85rem;color:var(--ink-soft);margin-bottom:20px}\n#cms21p2a .cq-score-bands{display:flex;justify-content:center;gap:10px;flex-wrap:wrap;font-size:0.8rem}\n#cms21p2a .cq-band{padding:4px 12px;border-radius:16px;font-weight:600}\n#cms21p2a .cq-band-c{background:var(--correct-bg);color:var(--correct)}\n#cms21p2a .cq-band-w{background:var(--wrong-bg);color:var(--wrong)}\n#cms21p2a .cq-band-s{background:var(--teal-pale);color:var(--teal)}\n#cms21p2a .cq-retry-btn{margin-top:22px;background:transparent;border:2px solid var(--teal);color:var(--teal);border-radius:8px;padding:10px 28px;font-family:'Playfair Display',serif;font-size:0.95rem;font-weight:700;cursor:pointer;transition:background 0.2s,color 0.2s}\n#cms21p2a .cq-retry-btn:hover{background:var(--teal);color:var(--white)}\n@media(max-width:480px){#cms21p2a .cq-header h1{font-size:1.15rem}#cms21p2a .cq-qtext{font-size:0.88rem}#cms21p2a .cq-opt-text{font-size:0.84rem}}\n<\/style>\n<\/head>\n<body>\n<div id=\"cms21p2a\">\n <div class=\"cq-sentinel\" id=\"cms21p2a-sentinel\"><\/div>\n <div class=\"cq-statusbar\" id=\"cms21p2a-statusbar\">\n <div class=\"cq-sb-stats\">\n <div class=\"cq-timer-item\" id=\"cms21p2a-timer-item\">\u23f1 <strong id=\"cms21p2a-timer-display\">40:00<\/strong><\/div>\n <div class=\"cq-sb-item\">\u2705 <strong id=\"cms21p2a-sc\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u274c <strong id=\"cms21p2a-sw\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u23f3 <strong id=\"cms21p2a-sr\">40<\/strong> left<\/div>\n <div class=\"cq-sb-sep\"><\/div>\n <div class=\"cq-sb-item\">Net <strong id=\"cms21p2a-sn\">0<\/strong> \/ <strong id=\"cms21p2a-sm\">160<\/strong><\/div>\n <\/div>\n <div class=\"cq-sb-progress\"><div class=\"cq-sb-fill\" id=\"cms21p2a-fill\"><\/div><\/div>\n <\/div>\n <div class=\"cq-grace\" id=\"cms21p2a-grace\">\n <div class=\"cq-grace-box\">\n <h3>Time's Up!<\/h3><p>Submitting in<\/p>\n <div class=\"cq-grace-count\" id=\"cms21p2a-grace-count\">10<\/div>\n <button class=\"cq-grace-btn\" id=\"cms21p2a-grace-now\">Submit Now<\/button>\n <\/div>\n <\/div>\n <div class=\"cq-header\">\n <h1>Combined Medical Services Examination 2021<br>Paper II \u00b7 Part 1<\/h1>\n <p>General Surgery<\/p>\n <div class=\"cq-meta\">\n <span class=\"cq-badge\">Questions 1 \u2013 40<\/span>\n <span class=\"cq-badge\">Options reshuffled<\/span>\n <button class=\"cq-timer-btn\" id=\"cms21p2a-timer-btn\">\u23f1 Start Timed Mode<\/button>\n <\/div>\n <\/div>\n <div class=\"cq-body\">\n <div id=\"cms21p2a-questions\"><\/div>\n <div class=\"cq-submit-wrap\"><button class=\"cq-btn\" id=\"cms21p2a-submit\">Submit Answers<\/button><\/div>\n <div class=\"cq-score\" id=\"cms21p2a-score\">\n <div class=\"cq-score-ring\" id=\"cms21p2a-ring\"><div class=\"cq-ring-inner\"><span class=\"cq-ring-pct\" id=\"cms21p2a-ring-pct\">0%<\/span><span class=\"cq-ring-sub\">score<\/span><\/div><\/div>\n <h2>Your Result<\/h2>\n <div class=\"cq-net-line\" id=\"cms21p2a-net-line\"><\/div>\n <div class=\"cq-verdict\" id=\"cms21p2a-verdict\"><\/div>\n <div class=\"cq-score-bands\">\n <span class=\"cq-band cq-band-c\" id=\"cms21p2a-ct-c\"><\/span>\n <span class=\"cq-band cq-band-w\" id=\"cms21p2a-ct-w\"><\/span>\n <span class=\"cq-band cq-band-s\" id=\"cms21p2a-ct-s\"><\/span>\n <\/div>\n <button class=\"cq-retry-btn\" id=\"cms21p2a-retry\">\u21ba Retry Quiz<\/button>\n <\/div>\n <\/div>\n<\/div>\n<script>\n(function(){\n 'use strict';\n const NS='cms21p2a', TOTAL=40, MAX=160, TIMER_SECS=2400, GRACE_SECS=10;\n const QUESTIONS=[\n {id:1,stem:'Which of the following are types of wound healing?\\n1. Primary Intention\\n2. Secondary Intention\\n3. Tertiary Intention\\n4. Quaternary Intention',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Wound healing types: Primary Intention (direct apposition), Secondary Intention (granulation tissue), and Tertiary Intention (delayed primary closure). Quaternary Intention is not a recognised wound healing classification.'},\n {id:2,stem:'A 50-year-old female presents with pain, swelling and redness over the left foot following trivial trauma 3 days back. The swelling is poorly localised; local tenderness and erythema are present; crepitus is absent; distal pulsations are palpable. The most likely clinical diagnosis is',correct:'Cellulitis',options:['Compartment syndrome','Cellulitis','Abscess','Fasciitis'],exp:'Poorly localised erythema with tenderness, absent crepitus (ruling out necrotising infection), and intact distal pulses (ruling out compartment syndrome) = cellulitis. Abscess would be fluctuant; fasciitis shows rapid systemic deterioration with crepitus.'},\n {id:3,stem:'Which one of the following is NOT associated with BRCA1\/BRCA2 genes?',correct:'Liver cancer',options:['Breast cancer','Ovarian cancer','Prostate cancer','Liver cancer'],exp:'BRCA1\/2 mutations are associated with breast, ovarian, prostate, and pancreatic cancer. Liver cancer (HCC) is NOT among established BRCA-associated malignancies \u2014 it is associated with hepatitis B\/C, aflatoxin, and alcohol.'},\n {id:4,stem:'The malignancy associated with Stewart-Treves syndrome is',correct:'Lymphangiosarcoma',options:['Lymphangiosarcoma','Malignant melanoma','Basal cell carcinoma','Liposarcoma'],exp:\"Stewart-Treves syndrome = lymphangiosarcoma arising in chronically lymphoedematous tissue, classically the arm following mastectomy with axillary dissection. Presents as purplish nodules in the oedematous limb. Extremely poor prognosis.\"},\n {id:5,stem:'A 60-year-old lady underwent total abdominal hysterectomy. On the 3rd postoperative day she suddenly became breathless while returning from the washroom. BP = 80\/50 mmHg. The most probable diagnosis is',correct:'Thromboembolism',options:['Postural hypotension','Secondary haemorrhage','Thromboembolism','Transient ischaemic attack'],exp:\"Day 3 post-hysterectomy: sudden breathlessness + hypotension = classic pulmonary embolism. Virchow's triad is fully satisfied. CTPA is gold standard investigation; anticoagulation is treatment.\"},\n {id:6,stem:'A 52-year-old female underwent MRM. After few years she developed lymphoedema of the ipsilateral arm. Which malignancy can develop in her arm?',correct:'Lymphangiosarcoma',options:['Lymphangiosarcoma','Malignant Melanoma','Lymphoma','Malignant fibrous histiocytoma'],exp:'Lymphangiosarcoma (Stewart-Treves syndrome) develops in chronically lymphoedematous arms post-MRM. Bluish-red nodules in the oedematous arm. Treatment: forequarter amputation or wide excision; poor prognosis.'},\n {id:7,stem:'A 60-year-old gentleman presented with brawny swelling of the submandibular region with inflammatory oedema of mouth and putrid halitosis. Most likely he is suffering from',correct:\"Ludwig's angina\",options:['Tubercular adenitis','Chronic lymphadenitis','Acute lymphadenitis',\"Ludwig's angina\"],exp:\"Ludwig's angina: rapidly spreading gangrenous cellulitis of the mouth floor and submandibular space from dental origin. Brawny swelling, airway-threatening oedema, and putrid halitosis are pathognomonic. A surgical emergency requiring early airway management.\"},\n {id:8,stem:'A 25-year-old female with previous neck irradiation presents with thyroid swelling for 6 months, clinically euthyroid. The right thyroid lobe is enlarged with ipsilateral cervical lymphadenopathy. The most probable clinical diagnosis is',correct:'Papillary carcinoma thyroid',options:['Medullary carcinoma thyroid','Papillary carcinoma thyroid','Lymphoma','Follicular carcinoma thyroid'],exp:'Papillary carcinoma: most common thyroid malignancy, strongly associated with prior neck irradiation. Young adult, euthyroid, hard nodule with early ipsilateral cervical nodal metastases. FNAC confirms. 10-year survival >90% even with nodal spread.'},\n {id:9,stem:'An infant presented with a unilateral neck swelling that was soft, cystic, partially compressible and brilliantly transilluminant. The most probable diagnosis is',correct:'Cystic Hygroma',options:['Branchial fistula','Branchial cyst','Cystic Hygroma','Thyroglossal cyst'],exp:'Cystic Hygroma (lymphatic malformation): multilocular cystic neck lesion, soft, partially compressible, and BRILLIANTLY transilluminant. Branchial cysts are not brilliantly transilluminant. Thyroglossal cyst is midline and moves with swallowing. Treatment: surgical excision or sclerotherapy.'},\n {id:10,stem:'Serum thyroglobulin level is an important tumour marker for',correct:'Papillary carcinoma thyroid',options:['Medullary carcinoma thyroid','Papillary carcinoma thyroid','Anaplastic carcinoma thyroid','Thyroid lymphoma'],exp:'Serum thyroglobulin is produced exclusively by thyroid follicular epithelium \u2014 marker for differentiated thyroid carcinoma (papillary and follicular). After total thyroidectomy + RAI, rising Tg signals recurrence. Medullary carcinoma marker = calcitonin.'},\n {id:11,stem:'A 43-year-old woman presented with serous discharge from a single duct of the nipple. She is unlikely to be suffering from',correct:'Fibrocystic disease',options:['Fibrocystic disease','Intraductal Papilloma','Duct Ectasia','Carcinoma'],exp:'Single-duct serous discharge is caused by Intraductal Papilloma (most common), Duct Ectasia, or Carcinoma. Fibrocystic disease causes multiductal bilateral intermittent discharge \u2014 it is UNLIKELY to cause unilateral single-duct serous discharge.'},\n {id:12,stem:'An 8-month-old male child is brought with recurrent episodes of screaming and drawing up of legs. He appears listless between attacks. Examination reveals emptiness in the RIF and blood-stained mucus on PR examination. The most probable clinical diagnosis is',correct:'Acute intussusception',options:['Caecal volvulus','Acute intussusception','Rectal prolapse','Midgut volvulus'],exp:\"Acute intussusception: episodic screaming, listless intervals, Dance sign (empty RIF), and redcurrant jelly stool on PR = classic presentation in an 8-month-old. Most common intestinal obstruction in infancy. Treatment: pneumatic\/hydrostatic reduction.\"},\n {id:13,stem:\"Which of the following statements regarding Ogilvie's syndrome are correct?\\n1. It presents as acute large bowel mechanical obstruction\\n2. Marked caecal dilatation is a common feature on X-ray abdomen\\n3. Caecal perforation is a well-recognised complication\\n4. Intravenous Neostigmine is used for treatment\",correct:'2, 3 and 4',options:['1, 2 and 3','2, 3 and 4','1, 2 and 4','1, 3 and 4'],exp:\"Ogilvie's syndrome is functional PARALYTIC colonic dilatation \u2014 NOT mechanical obstruction (statement 1 false). Marked caecal dilatation on AXR, caecal perforation risk, and IV Neostigmine treatment (~90% effective) are all correct. Statements 2, 3 and 4.\"},\n {id:14,stem:'Which of the following statements regarding Carcinoid tumour are correct?\\n1. Terminal ileum is the most common GI site\\n2. These tumors arise from Kulchitsky cells at the base of intestinal crypts\\n3. 5-Hydroxytryptamine is the most common vasoactive peptide produced\\n4. Serum chromogranin A is a useful marker for disease recurrence',correct:'1, 3 and 4',options:['1, 2 and 3','2, 3 and 4','1, 3 and 4','1, 2 and 4'],exp:'Carcinoid tumours: arise from Kulchitsky (enterochromaffin) cells; terminal ileum is the most common GI site; 5-HT (serotonin) is the primary vasoactive peptide; chromogranin A is the tumour marker. Per examination convention, best grouping is 1, 3 and 4.'},\n {id:15,stem:'In familial adenomatous polyposis, which of the following all are true?\\n1. Presence of >100 colorectal polyps\\n2. Positive family history\\n3. Autosomal Recessive inheritance\\n4. Genetic mutation on Chromosome 5',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'FAP: >100 colorectal polyps, positive family history, APC gene mutation on chromosome 5q21. Inheritance is AUTOSOMAL DOMINANT \u2014 not recessive (statement 3 false). Without prophylactic colectomy, CRC is virtually certain by age 40\u201350. Statements 1, 2 and 4 correct.'},\n {id:16,stem:'A 50-year-old male presents with upper abdominal pain, haematemesis, BP = 100\/70. CECT shows a large exophytic gastric tumour at the fundus. Upper GI biopsy staining for CD117 is positive. The most probable clinical diagnosis is',correct:'Gastrointestinal stromal tumor',options:['Gastric lymphoma','Gastrointestinal stromal tumor','Carcinoid tumor','Carcinoma stomach'],exp:'CD117 (c-KIT) positivity is pathognomonic for GIST (Gastrointestinal Stromal Tumour). Large exophytic gastric mass with intact overlying mucosa (submucosal origin). Arises from interstitial cells of Cajal. Treatment: surgical resection + adjuvant imatinib.'},\n {id:17,stem:'Which of the following is NOT a classical symptom of acute appendicitis?',correct:'Constipation',options:['Anorexia','Periumbilical colic','Constipation','Nausea'],exp:\"Classic appendicitis sequence: anorexia \u2192 periumbilical colic \u2192 RIF migration \u2192 nausea\/vomiting \u2192 fever. Constipation is NOT a classical symptom \u2014 it is not part of the diagnostic triad.\"},\n {id:18,stem:\"Among the extraintestinal manifestations of Crohn's disease, which one is related to disease activity?\",correct:'Eye complications (Iritis\/Uveitis)',options:['Eye complications (Iritis\/Uveitis)','Renal calculi','Primary sclerosing cholangitis','Chronic active hepatitis'],exp:\"Crohn's EIMs classified by disease activity. Activity-RELATED (flare with bowel disease): peripheral arthropathy, episcleritis, erythema nodosum, iritis\/uveitis. Activity-INDEPENDENT: axial arthropathy, PSC, pyoderma gangrenosum. Iritis\/uveitis = activity-related.\"},\n {id:19,stem:'The MELD score for end-stage liver disease includes which of the following variables?\\n1. Serum bilirubin\\n2. Serum albumin\\n3. Serum creatinine\\n4. International Normalised Ratio (INR)',correct:'1, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'MELD variables: serum bilirubin (1), serum creatinine (3), and INR (4). Serum albumin is part of Child-Pugh score, NOT MELD. MELD predicts 3-month mortality without transplant.'},\n {id:20,stem:'Which of the following statements regarding Enteric perforation are correct?\\n1. Salmonella typhi is the causative organism\\n2. Enteric perforation characteristically occurs during the third week of illness\\n3. Typhoid ulcers are placed transversely to the long axis of the gut\\n4. Terminal ileum is the most common site',correct:'1, 2 and 3',options:['1, 2 and 3','2, 3 and 4','1, 3 and 4','1, 2 and 4'],exp:\"All four statements are essentially correct. Perforations occur in the third week via Peyer's patch necrosis; typhoid ulcers run transversely; terminal ileum is the most common site. Per examination convention, answer is 1, 2 and 3.\"},\n {id:21,stem:'A 35-year-old male with known enteric fever presents with sudden generalised abdominal pain, board-like rigidity, rebound tenderness, tachycardia, and hypotension. The most likely complication is',correct:'Small bowel perforation',options:['Small bowel enteritis','Small bowel perforation','Small bowel obstruction','Cholecystitis'],exp:'Peritonitis signs + known enteric fever = small bowel perforation (most feared complication, third week). Management: emergency laparotomy, perforation repair, peritoneal lavage, continued ceftriaxone.'},\n {id:22,stem:'Which of the following are options for management of a pancreatic pseudocyst?\\n1. Pancreaticoduodenectomy\\n2. Cystogastrostomy\\n3. Percutaneous drainage\\n4. Endoscopic drainage',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:\"Pancreatic pseudocyst management: Cystogastrostomy (2), Percutaneous drainage (3), and Endoscopic drainage (4) are valid. Whipple's procedure (1) is for pancreatic head malignancy \u2014 NOT pseudocyst. Statements 2, 3 and 4 correct.\"},\n {id:23,stem:'Which of the following statements regarding hepatic adenomas are correct?\\n1. Almost exclusively in females aged 25-50 years\\n2. Associated with use of oral contraceptive pills\\n3. They do not have any malignant potential\\n4. Majority detected incidentally on imaging',correct:'1, 2 and 4',options:['1, 2 and 3','2, 3 and 4','1, 3 and 4','1, 2 and 4'],exp:'Hepatic adenomas: almost exclusively in women 25\u201350 (correct), OCP association (correct), incidentally detected (correct). They DO have malignant potential (~4\u20138% transformation) \u2014 statement 3 is FALSE. Statements 1, 2 and 4 correct.'},\n {id:24,stem:'Which of the following are probable sites for Ectopic pancreas?\\n1. Submucosa of the stomach and duodenum\\n2. Liver\\n3. Small bowel mesentery\\n4. Splenic hilum',correct:'1, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Ectopic pancreas most common sites: gastric\/duodenal submucosa (1), small bowel mesentery (3), splenic hilum (4). The LIVER is NOT a recognised common site (2 incorrect). Statements 1, 3 and 4 correct.'},\n {id:25,stem:\"Which one of the following statements regarding Cantlie's line is correct?\",correct:\"Runs between gall bladder fossa and middle hepatic vein\",options:[\"Runs between gall bladder fossa and right hepatic vein\",\"Runs between gall bladder fossa and right branch of portal vein\",\"Runs between gall bladder fossa and middle hepatic vein\",\"Runs between gall bladder fossa and left branch of portal vein\"],exp:\"Cantlie's line divides the liver into true right and left functional lobes. It runs from the gallbladder fossa anteriorly to the IVC posteriorly, passing through the MIDDLE hepatic vein \u2014 the anatomical basis for right and left hepatectomy.\"},\n {id:26,stem:'Which of the following are indications of splenectomy?\\n1. Pseudomyxoma peritonei\\n2. Trauma\\n3. Idiopathic thrombocytopenic purpura (ITP)\\n4. Hypersplenism',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Splenectomy indications: Trauma (2), ITP refractory to steroids (3), Hypersplenism (4). Pseudomyxoma peritonei requires cytoreductive surgery + HIPEC \u2014 NOT splenectomy (1 incorrect). Statements 2, 3 and 4 correct.'},\n {id:27,stem:'A 45-year-old female presents with a painless firm abdominal swelling of 10\u00d78 cm near the umbilicus. The swelling can be moved freely in a plane at right angle to the line of attachment of the mesentery. The most probable clinical diagnosis is',correct:'Mesenteric cyst',options:['Dermoid cyst','Ovarian cyst','Mesenteric cyst','Hydatid cyst'],exp:'Mesenteric cyst: moves freely at RIGHT ANGLES to the mesenteric attachment but is restricted along the mesenteric line \u2014 this characteristic restricted mobility is pathognomonic.'},\n {id:28,stem:'A 45-year-old male with known left inguinal hernia presents with acute pain, irreducible swelling, absent cough impulse, tense erythematous overlying skin, localised tenderness, tachycardia, and hypotension. The most probable diagnosis is',correct:'Strangulated hernia',options:['Obstructed hernia','Strangulated hernia','Incarcerated hernia','Irreducible hernia'],exp:'Strangulated hernia: compromised vascular supply evidenced by tense erythematous skin, localised tenderness, absent cough impulse, and systemic compromise (tachycardia, hypotension). Obstructed hernia lacks vascular compromise. Surgical emergency.'},\n {id:29,stem:\"Mayo's repair is done for\",correct:'Umbilical hernia',options:['Inguinal hernia','Femoral hernia','Umbilical hernia','Incisional hernia'],exp:\"Mayo's repair: vest-over-pants (double-breasted) fascial overlap for umbilical hernia. Bassini's and Shouldice repairs are for inguinal hernias. Femoral hernias use Lockwood or McEvedy approach.\"},\n {id:30,stem:'In Pringle Manoeuvre, clamping includes which of the following?\\n1. Common Bile Duct\\n2. Hepatic artery\\n3. Portal vein\\n4. Inferior Vena Cava',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Pringle Manoeuvre clamps the hepatoduodenal ligament containing: Common Bile Duct (1), Hepatic Artery (2), and Portal Vein (3). The IVC is retroperitoneal and NOT included. Total hepatic vascular exclusion additionally clamps the IVC.'},\n {id:31,stem:'A road traffic accident patient is conscious (GCS 14\/15), stable, with bleeding from right ear, CSF leak from nose, and bruising behind the right ear. The most probable clinical diagnosis is',correct:'Fracture of the base of skull',options:['Extradural haematoma','Fracture of the base of skull','Cerebral concussion','Traumatic subarachnoid haemorrhage'],exp:\"Basal skull fracture: CSF rhinorrhoea (anterior fossa \u2014 cribriform plate), haemotympanum\/otorrhoea (middle fossa \u2014 petrous temporal), Battle's sign (post-auricular bruising). Conscious GCS 14\/15 argues against extradural haematoma.\"},\n {id:32,stem:'The commonest organism causing Suppurative Otitis Media is',correct:'Streptococcus pneumonia',options:['Streptococcus pneumonia','Staphylococcus aureus','Acinetobacter Spp','Escherichia coli'],exp:'Streptococcus pneumoniae (Pneumococcus) is the most common organism causing acute Suppurative Otitis Media, followed by H. influenzae and Moraxella catarrhalis. First-line treatment: amoxicillin.'},\n {id:33,stem:'A road traffic accident patient has increasing restlessness, respiratory rate 26\/min, distended neck veins, tracheal deviation to the RIGHT, hyper-resonant note and absent breath sounds on the LEFT. Which statements are correct?\\n1. Most probable diagnosis is left tension pneumothorax\\n2. Immediate chest decompression using wide bore cannula in left 2nd ICS\\n3. Immediate chest X-ray should be done to confirm the diagnosis\\n4. Definitive chest tube in left 5th ICS',correct:'1, 2 and 4',options:['1, 2 and 3','2, 3 and 4','1, 3 and 4','1, 2 and 4'],exp:'Left tension pneumothorax: diagnosis is CLINICAL \u2014 do NOT wait for CXR (statement 3 false). Immediate decompression with wide bore cannula, left 2nd ICS (statement 2 correct); definitive chest drain, left 5th ICS (statement 4 correct). Statements 1, 2 and 4 correct.'},\n {id:34,stem:'Positron Emission Tomography (PET) used in preoperative staging of gastro-oesophageal tumours is to detect',correct:'Distant metastatic disease',options:['Distant metastatic disease','Extension into stomach','Local spread','Lymph node status'],exp:'PET-CT excels at detecting DISTANT METASTATIC DISEASE (liver, para-aortic nodes, bone) that would preclude curative surgery. CT and EUS are superior for local T-staging and regional N-staging. PET upstages ~10\u201315% to incurable disease.'},\n {id:35,stem:'Which of the following are correct about ectopic ureters?\\n1. They are more common in males\\n2. They drain the upper pole of kidney\\n3. They are associated with duplex ureter\\n4. They may cause incontinence',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Ectopic ureters are more common in FEMALES (statement 1 false). They drain the UPPER pole of a duplex kidney (2 correct), are associated with duplex ureter (3 correct), and may cause continuous dribbling incontinence in females (4 correct). Statements 2, 3 and 4 correct.'},\n {id:36,stem:'Which one of the following is a Nephrotoxic anaesthetic agent?',correct:'Methoxyflurane',options:['Methoxyflurane','Isoflurane','Halothane','Nitrous oxide'],exp:'Methoxyflurane is nephrotoxic due to inorganic fluoride ion release from hepatic CYP2E1 metabolism, causing dose-dependent polyuric renal failure. Halothane = hepatotoxic. Isoflurane and nitrous oxide have minimal organ toxicity.'},\n {id:37,stem:'A comatose patient after severe head injury is in neurosurgical ICU. Which parameters should ideally be maintained?\\n1. pCO2 = 4.5-5.0 kPa (33-38 mm Hg)\\n2. MAP = 80-90 mm of Hg\\n3. pO2 > 11 kPa (> 80 mm Hg)\\n4. Na+ < 130 meq\/L',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Severe TBI targets: pCO2 33\u201338 mmHg (mild hyperventilation) \u2713, MAP 80\u201390 mmHg (CPP >60 mmHg) \u2713, pO2 >80 mmHg \u2713. Hyponatraemia <130 meq\/L WORSENS cerebral oedema and must be AVOIDED (statement 4 false). Statements 1, 2 and 3 correct.'},\n {id:38,stem:'Untidy wounds are characterised by which of the following?\\n1. Crushed or avulsed tissues\\n2. Contamination wound\\n3. Devitalised tissue\\n4. No loss of tissue',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:\"Untidy wounds: crushed\/avulsed tissues (1), contamination (2), devitalised tissue (3). Statement 4 ('no loss of tissue') is FALSE \u2014 untidy wounds characteristically involve tissue damage\/loss. Statements 1, 2 and 3 correct.\"},\n {id:39,stem:'Which one of the following statements regarding the composition of common crystalloid solutions is correct?',correct:\"Hartmann's solution contains 111 meq\/L of Cl\",options:[\"Normal saline contains 100 meq\/L of Na\",\"Hartmann's solution contains 111 meq\/L of Cl\",\"Normal saline contains 130 meq\/L of Cl\",\"Hartmann's solution contains 111 meq\/L of Na\"],exp:\"Normal saline (0.9% NaCl) = 154 meq\/L Na and 154 meq\/L Cl. Hartmann's solution = 130 meq\/L Na, 111 meq\/L Cl. Therefore Hartmann's contains 111 meq\/L Cl \u2014 option (b) is correct.\"},\n {id:40,stem:'Perioperative benefit from transfusion is with a haemoglobin level of',correct:'6-8 gm\/dl',options:['< 6 gm\/dl','6-8 gm\/dl','8-10 gm\/dl','> 10 gm\/dl'],exp:'Perioperative transfusion benefit is clearly established at Hb 6\u20138 gm\/dL. Below 6: universally indicated. Above 10: generally not needed. At 8\u201310: individualised decision. Restrictive transfusion strategy (threshold ~7\u20138 gm\/dL) is now standard practice.'}\n ];\n\n const LETTERS=['A','B','C','D'];\n let userAnswers={},answered=0,shuffledOpts={};\n let timerRunning=false,timerRemaining=TIMER_SECS,timerInterval=null,graceInterval=null,quizSubmitted=false;\n\n function shuffle(arr){const a=arr.slice();for(let i=a.length-1;i>0;i--){const j=Math.floor(Math.random()*(i+1));[a[i],a[j]]=[a[j],a[i]];}return a;}\n function fmtTime(s){const m=Math.floor(s\/60),sec=s%60;return(m<10?'0':'')+m+':'+(sec<10?'0':'')+sec;}\n\n function startTimer(){\n if(timerRunning||quizSubmitted)return;timerRunning=true;\n const btn=document.getElementById(NS+'-timer-btn');\n btn.textContent='\u23f1 '+fmtTime(timerRemaining);btn.classList.add('running');\n document.getElementById(NS+'-timer-item').classList.add('active');\n timerInterval=setInterval(function(){\n timerRemaining--;\n const disp=fmtTime(timerRemaining);\n document.getElementById(NS+'-timer-display').textContent=disp;\n document.getElementById(NS+'-timer-btn').textContent='\u23f1 '+disp;\n if(timerRemaining<=300)document.getElementById(NS+'-timer-item').classList.add('warning');\n if(timerRemaining<=0){clearInterval(timerInterval);timerInterval=null;triggerGrace();}\n },1000);\n }\n function stopTimer(){if(timerInterval){clearInterval(timerInterval);timerInterval=null;}timerRunning=false;}\n function triggerGrace(){\n if(quizSubmitted)return;let count=GRACE_SECS;\n document.getElementById(NS+'-grace-count').textContent=count;\n document.getElementById(NS+'-grace').classList.add('show');\n graceInterval=setInterval(function(){count--;document.getElementById(NS+'-grace-count').textContent=count;if(count<=0){clearInterval(graceInterval);graceInterval=null;dismissGrace();showScore();}},1000);\n }\n function dismissGrace(){document.getElementById(NS+'-grace').classList.remove('show');if(graceInterval){clearInterval(graceInterval);graceInterval=null;}}\n\n function updateStats(){\n const c=Object.values(userAnswers).filter(function(v){return v==='correct';}).length;\n const w=Object.values(userAnswers).filter(function(v){return v==='wrong';}).length;\n const net=(c*4)-w;\n document.getElementById(NS+'-sc').textContent=c;\n document.getElementById(NS+'-sw').textContent=w;\n document.getElementById(NS+'-sr').textContent=TOTAL-answered;\n document.getElementById(NS+'-sn').textContent=net>=0?'+'+net:net;\n document.getElementById(NS+'-sm').textContent=MAX;\n document.getElementById(NS+'-fill').style.width=(answered\/TOTAL*100)+'%';\n }\n\n function pick(qid,oi){\n if(userAnswers[qid]!==undefined||quizSubmitted)return;\n const q=QUESTIONS.find(function(x){return x.id===qid;});\n const opts=shuffledOpts[qid],correct=opts[oi]===q.correct;\n userAnswers[qid]=correct?'correct':'wrong';answered++;\n opts.forEach(function(o,i){\n const el=document.getElementById(NS+'-o'+qid+'-'+i);\n if(o===q.correct)el.classList.add('cq-correct','cq-locked');\n else if(i===oi)el.classList.add('cq-wrong','cq-locked');\n else el.classList.add('cq-dimmed','cq-locked');\n });\n document.getElementById(NS+'-n'+qid).classList.add(correct?'ans-c':'ans-w');\n document.getElementById(NS+'-exp'+qid).style.display='block';\n updateStats();\n }\n\n function build(){\n const container=document.getElementById(NS+'-questions');\n container.innerHTML='';userAnswers={};answered=0;shuffledOpts={};\n quizSubmitted=false;timerRunning=false;timerRemaining=TIMER_SECS;\n stopTimer();dismissGrace();\n document.getElementById(NS+'-score').style.display='none';\n document.getElementById(NS+'-timer-item').classList.remove('active','warning');\n const btn=document.getElementById(NS+'-timer-btn');\n btn.textContent='\u23f1 Start Timed Mode';btn.classList.remove('running');\n document.getElementById(NS+'-timer-display').textContent=fmtTime(TIMER_SECS);\n updateStats();\n QUESTIONS.forEach(function(q){\n const opts=shuffle(q.options);shuffledOpts[q.id]=opts;\n const card=document.createElement('div');card.className='cq-card';\n card.innerHTML='<div class=\"cq-qhead\"><div class=\"cq-qnum\" id=\"'+NS+'-n'+q.id+'\">'+q.id+'<\/div><div class=\"cq-qtext\">'+q.stem.replace(\/\\n\/g,'<br>')+'<\/div><\/div>'+\n '<div class=\"cq-options\" id=\"'+NS+'-opts'+q.id+'\">'+\n opts.map(function(o,i){return '<div class=\"cq-opt\" id=\"'+NS+'-o'+q.id+'-'+i+'\" role=\"button\" tabindex=\"0\"><span class=\"cq-opt-letter\">'+LETTERS[i]+'<\/span><span class=\"cq-opt-text\">'+o+'<\/span><\/div>';}).join('')+\n '<\/div><div class=\"cq-explanation\" id=\"'+NS+'-exp'+q.id+'\"><div class=\"cq-exp-label\">Explanation<\/div>'+q.exp+'<\/div>';\n container.appendChild(card);\n opts.forEach(function(_,i){document.getElementById(NS+'-o'+q.id+'-'+i).addEventListener('click',function(){pick(q.id,i);});});\n });\n }\n\n function showScore(){\n if(quizSubmitted)return;quizSubmitted=true;stopTimer();\n document.getElementById(NS+'-timer-btn').textContent='\u23f1 Submitted';\n document.getElementById(NS+'-timer-btn').classList.remove('running');\n const c=Object.values(userAnswers).filter(function(v){return v==='correct';}).length;\n const w=Object.values(userAnswers).filter(function(v){return v==='wrong';}).length;\n const s=TOTAL-answered,net=(c*4)-w,pct=Math.max(0,Math.round((net\/MAX)*100)),disp=Math.min(100,Math.max(0,pct));\n document.getElementById(NS+'-ring').style.background='conic-gradient(var(--teal) '+disp+'%,var(--line) 0%)';\n document.getElementById(NS+'-ring-pct').textContent=pct+'%';\n document.getElementById(NS+'-net-line').textContent='Net Score: '+net+' \/ '+MAX;\n document.getElementById(NS+'-verdict').textContent=pct>=80?'Excellent \u2014 well above the qualifying threshold.':pct>=60?'Good attempt \u2014 consolidate the weaker areas.':pct>=40?'Fair \u2014 systematic revision of these topics is recommended.':'Needs significant revision across these topics.';\n document.getElementById(NS+'-ct-c').textContent='\u2705 '+c+' Correct';\n document.getElementById(NS+'-ct-w').textContent='\u274c '+w+' Wrong';\n document.getElementById(NS+'-ct-s').textContent='\u23ed '+s+' Skipped';\n const sc=document.getElementById(NS+'-score');sc.style.display='block';sc.scrollIntoView({behavior:'smooth',block:'center'});\n }\n\n function init(){\n document.getElementById(NS+'-grace-now').addEventListener('click',function(){dismissGrace();showScore();});\n document.getElementById(NS+'-timer-btn').addEventListener('click',function(){if(!timerRunning&&!quizSubmitted)startTimer();});\n document.getElementById(NS+'-submit').addEventListener('click',showScore);\n document.getElementById(NS+'-retry').addEventListener('click',function(){build();window.scrollTo({top:0,behavior:'smooth'});});\n new IntersectionObserver(function(entries){\n document.getElementById(NS+'-statusbar').classList.toggle('visible',!entries[0].isIntersecting);\n },{threshold:0}).observe(document.getElementById(NS+'-sentinel'));\n build();updateStats();\n }\n\n if(document.readyState==='loading'){document.addEventListener('DOMContentLoaded',init);}else{init();}\n})();\n<\/script>\n<\/body>\n<\/html>\n\n\n","protected":false},"excerpt":{"rendered":"<p>CMS 2021 Paper II \u2013 Part 1 (Q1\u2013Q40) \u23f1 40:00 \u2705 0 \u274c 0 \u23f3 40 left Net 0 \/ 160 Time's Up! Submitting in 10 Submit Now Combined Medical Services Examination 2021Paper II \u00b7 Part 1 General Surgery Questions 1 \u2013 40 Options reshuffled \u23f1 Start Timed Mode Submit Answers 0%score Your Result \u21ba Retry Quiz<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-36604","post","type-post","status-publish","format-standard","hentry","category-cms"],"yoast_head":"\n<title>CMS 2021 P2 Part-1 Surgery - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CMS 2021 P2 Part-1 Surgery - atsixty\" \/>\n<meta property=\"og:description\" content=\"CMS 2021 Paper II \u2013 Part 1 (Q1\u2013Q40) \u23f1 40:00 \u2705 0 \u274c 0 \u23f3 40 left Net 0 \/ 160 Time's Up! Submitting in 10 Submit Now Combined Medical Services Examination 2021Paper II \u00b7 Part 1 General Surgery Questions 1 \u2013 40 Options reshuffled \u23f1 Start Timed Mode Submit Answers 0%score Your Result \u21ba Retry Quiz\" \/>\n<meta property=\"og:url\" content=\"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/\" \/>\n<meta property=\"og:site_name\" content=\"atsixty\" \/>\n<meta property=\"article:published_time\" content=\"2026-04-17T12:09:54+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-19T12:55:05+00:00\" \/>\n<meta name=\"author\" content=\"Avi\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Avi\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\"},\"author\":{\"name\":\"Avi\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"headline\":\"CMS 2021 P2 Part-1 Surgery\",\"datePublished\":\"2026-04-17T12:09:54+00:00\",\"dateModified\":\"2026-04-19T12:55:05+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\"},\"wordCount\":51,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"articleSection\":[\"CMS\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\",\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\",\"name\":\"CMS 2021 P2 Part-1 Surgery - atsixty\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\"},\"datePublished\":\"2026-04-17T12:09:54+00:00\",\"dateModified\":\"2026-04-19T12:55:05+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/atsixty.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"CMS 2021 P2 Part-1 Surgery\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\",\"url\":\"https:\\\/\\\/atsixty.com\\\/\",\"name\":\"At Sixty\",\"description\":\"The Option Taken\",\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/atsixty.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\",\"name\":\"Avi\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"url\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"contentUrl\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"width\":200,\"height\":200,\"caption\":\"Avi\"},\"logo\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\"},\"sameAs\":[\"https:\\\/\\\/atsixty.com\"],\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/author\\\/avinaux\\\/\"}]}<\/script>\n","yoast_head_json":{"title":"CMS 2021 P2 Part-1 Surgery - atsixty","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/","og_locale":"en_US","og_type":"article","og_title":"CMS 2021 P2 Part-1 Surgery - atsixty","og_description":"CMS 2021 Paper II \u2013 Part 1 (Q1\u2013Q40) \u23f1 40:00 \u2705 0 \u274c 0 \u23f3 40 left Net 0 \/ 160 Time's Up! Submitting in 10 Submit Now Combined Medical Services Examination 2021Paper II \u00b7 Part 1 General Surgery Questions 1 \u2013 40 Options reshuffled \u23f1 Start Timed Mode Submit Answers 0%score Your Result \u21ba Retry Quiz","og_url":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/","og_site_name":"atsixty","article_published_time":"2026-04-17T12:09:54+00:00","article_modified_time":"2026-04-19T12:55:05+00:00","author":"Avi","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Avi","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/#article","isPartOf":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/"},"author":{"name":"Avi","@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"headline":"CMS 2021 P2 Part-1 Surgery","datePublished":"2026-04-17T12:09:54+00:00","dateModified":"2026-04-19T12:55:05+00:00","mainEntityOfPage":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/"},"wordCount":51,"commentCount":0,"publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"articleSection":["CMS"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/","url":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/","name":"CMS 2021 P2 Part-1 Surgery - atsixty","isPartOf":{"@id":"https:\/\/atsixty.com\/#website"},"datePublished":"2026-04-17T12:09:54+00:00","dateModified":"2026-04-19T12:55:05+00:00","breadcrumb":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/atsixty.com\/"},{"@type":"ListItem","position":2,"name":"CMS 2021 P2 Part-1 Surgery"}]},{"@type":"WebSite","@id":"https:\/\/atsixty.com\/#website","url":"https:\/\/atsixty.com\/","name":"At Sixty","description":"The Option Taken","publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/atsixty.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d","name":"Avi","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","url":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","contentUrl":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","width":200,"height":200,"caption":"Avi"},"logo":{"@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png"},"sameAs":["https:\/\/atsixty.com"],"url":"https:\/\/atsixty.com\/index.php\/author\/avinaux\/"}]}},"_links":{"self":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36604","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/comments?post=36604"}],"version-history":[{"count":2,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36604\/revisions"}],"predecessor-version":[{"id":36627,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36604\/revisions\/36627"}],"wp:attachment":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/media?parent=36604"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/categories?post=36604"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/tags?post=36604"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

{"id":36604,"date":"2026-04-17T17:39:54","date_gmt":"2026-04-17T12:09:54","guid":{"rendered":"https:\/\/atsixty.com\/?p=36604"},"modified":"2026-04-19T18:25:05","modified_gmt":"2026-04-19T12:55:05","slug":"cms-2021-p2-part-1-surgery","status":"publish","type":"post","link":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/","title":{"rendered":"CMS 2021 P2 Part-1 Surgery"},"content":{"rendered":"\n\n\n\n\n\n\n\nCMS 2021 Paper II \u2013 Part 1 (Q1\u2013Q40)<\/title>\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:wght@600;700&family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&display=swap\" rel=\"stylesheet\">\n<style>\n\/* \u2500\u2500 Namespace: cms21p2a \u2500\u2500 *\/\n#cms21p2a *,#cms21p2a *::before,#cms21p2a *::after{box-sizing:border-box;margin:0;padding:0}\n#cms21p2a{\n --ter:#C0603A;--ter-light:#e8825f;--ter-pale:#fdf1ec;\n --teal:#2A7A6F;--teal-light:#3da394;--teal-pale:#eaf4f3;\n --ink:#1a1a1a;--ink-mid:#444;--ink-soft:#777;\n --line:#e0d8d4;--bg:#fdfaf8;--white:#ffffff;\n --correct:#1e6f46;--correct-bg:#eaf7ef;--correct-border:#43a047;\n --wrong:#b83232;--wrong-bg:#fdf0f0;--wrong-border:#e53935;\n --radius:10px;\n font-family:'Source Serif 4',Georgia,serif;\n font-size:16px;color:var(--ink);background:var(--bg);line-height:1.7;padding:0 0 48px;\n}\n#cms21p2a .cq-sentinel{height:1px}\n#cms21p2a .cq-statusbar{position:fixed;top:0;left:0;right:0;z-index:99999;background:var(--white);border-bottom:2px solid var(--line);border-left:4px solid var(--ter);box-shadow:0 2px 12px rgba(0,0,0,0.11);opacity:0;pointer-events:none;transform:translateY(-110%);transition:opacity 0.22s ease,transform 0.22s ease}\n#cms21p2a .cq-statusbar.visible{opacity:1;pointer-events:auto;transform:translateY(0)}\n#cms21p2a .cq-sb-stats{display:flex;align-items:center;padding:0.38rem 0.7rem;font-size:0.73rem;color:var(--ink-soft)}\n#cms21p2a .cq-sb-item{display:flex;align-items:center;gap:0.18rem;padding:0.1rem 0.5rem;border-right:1px solid var(--line);white-space:nowrap;line-height:1}\n#cms21p2a .cq-sb-item:last-child{border-right:none}\n#cms21p2a .cq-sb-item strong{color:var(--ink);font-size:0.8rem;font-weight:700}\n#cms21p2a .cq-sb-sep{flex:1}\n#cms21p2a .cq-sb-progress{height:4px;background:var(--line);overflow:hidden}\n#cms21p2a .cq-sb-fill{height:100%;background:linear-gradient(90deg,var(--ter),var(--teal));width:0%;transition:width 0.4s ease}\n#cms21p2a .cq-timer-item{display:none;align-items:center;gap:0.18rem;padding:0.1rem 0.5rem;border-right:1px solid var(--line);white-space:nowrap;line-height:1;font-size:0.73rem}\n#cms21p2a .cq-timer-item.active{display:flex}\n#cms21p2a .cq-timer-item strong{font-size:0.8rem;font-weight:700;color:var(--teal);font-variant-numeric:tabular-nums}\n#cms21p2a .cq-timer-item.warning strong{color:var(--wrong)}\n#cms21p2a .cq-grace{display:none;position:fixed;top:0;right:0;bottom:0;left:0;z-index:999999;background:rgba(0,0,0,0.55);align-items:center;justify-content:center}\n#cms21p2a .cq-grace.show{display:flex}\n#cms21p2a .cq-grace-box{background:var(--white);border-radius:12px;border-top:5px solid var(--wrong);padding:32px 28px;text-align:center;max-width:320px;width:90%;box-shadow:0 8px 40px rgba(0,0,0,0.25)}\n#cms21p2a .cq-grace-box h3{font-family:'Playfair Display',serif;font-size:1.2rem;color:var(--wrong);margin-bottom:10px}\n#cms21p2a .cq-grace-box p{font-size:0.88rem;color:var(--ink-mid);margin-bottom:18px;line-height:1.55}\n#cms21p2a .cq-grace-count{font-family:'Playfair Display',serif;font-size:2.8rem;font-weight:700;color:var(--wrong);line-height:1;margin-bottom:18px}\n#cms21p2a .cq-grace-btn{background:var(--wrong);color:#fff;border:none;border-radius:8px;padding:10px 24px;font-family:'Playfair Display',serif;font-size:0.95rem;font-weight:700;cursor:pointer;transition:background 0.2s}\n#cms21p2a .cq-grace-btn:hover{background:#c62828}\n#cms21p2a .cq-header{background:var(--teal);color:var(--white);padding:28px 24px 22px;text-align:center}\n#cms21p2a .cq-header h1{font-family:'Playfair Display',serif;font-size:1.45rem;font-weight:700;letter-spacing:0.01em;line-height:1.3}\n#cms21p2a .cq-header p{font-size:0.85rem;opacity:0.85;margin-top:6px;font-style:italic}\n#cms21p2a .cq-meta{display:flex;justify-content:center;gap:16px;margin-top:14px;flex-wrap:wrap;align-items:center}\n#cms21p2a .cq-badge{background:rgba(255,255,255,0.15);border:1px solid rgba(255,255,255,0.3);border-radius:20px;padding:4px 14px;font-size:0.78rem;letter-spacing:0.03em}\n#cms21p2a .cq-timer-btn{background:transparent;border:1.5px solid rgba(255,255,255,0.7);color:var(--white);border-radius:20px;padding:4px 14px;font-family:'Source Serif 4',serif;font-size:0.78rem;cursor:pointer;letter-spacing:0.03em;transition:background 0.2s;display:flex;align-items:center;gap:6px}\n#cms21p2a .cq-timer-btn:hover{background:rgba(255,255,255,0.15)}\n#cms21p2a .cq-timer-btn.running{background:rgba(255,255,255,0.2);border-color:var(--white)}\n#cms21p2a .cq-body{max-width:760px;margin:0 auto;padding:0 16px}\n#cms21p2a .cq-card{background:var(--white);border:1px solid var(--line);border-radius:var(--radius);margin:24px 0;overflow:hidden;transition:box-shadow 0.2s}\n#cms21p2a .cq-card:hover{box-shadow:0 2px 12px rgba(192,96,58,0.1)}\n#cms21p2a .cq-qhead{background:var(--ter-pale);border-bottom:1px solid var(--line);padding:14px 18px;display:flex;gap:12px;align-items:flex-start}\n#cms21p2a .cq-qnum{flex-shrink:0;width:26px;height:26px;border-radius:50%;background:var(--ter);color:#fff;font-size:0.72rem;font-weight:700;display:flex;align-items:center;justify-content:center;margin-top:2px;transition:background 0.2s}\n#cms21p2a .cq-qnum.ans-c{background:var(--correct-border)}\n#cms21p2a .cq-qnum.ans-w{background:var(--wrong-border)}\n#cms21p2a .cq-qtext{font-size:0.93rem;color:var(--ink);line-height:1.65}\n#cms21p2a .cq-options{padding:14px 18px;display:flex;flex-direction:column;gap:8px}\n#cms21p2a .cq-opt{display:flex;align-items:flex-start;gap:10px;padding:10px 14px;border:1.5px solid var(--line);border-radius:8px;cursor:pointer;transition:border-color 0.15s,background 0.15s;background:var(--white);-webkit-tap-highlight-color:transparent}\n#cms21p2a .cq-opt:hover:not(.cq-locked){border-color:var(--teal);background:var(--teal-pale)}\n#cms21p2a .cq-opt-letter{flex-shrink:0;width:20px;height:20px;border-radius:50%;border:1.5px solid var(--line);display:flex;align-items:center;justify-content:center;font-size:0.65rem;font-weight:700;color:var(--ink-soft);transition:all 0.15s;margin-top:1px}\n#cms21p2a .cq-opt-text{font-size:0.89rem;color:var(--ink-mid);line-height:1.55}\n#cms21p2a .cq-opt.cq-correct{border-color:var(--correct-border);background:var(--correct-bg);cursor:default}\n#cms21p2a .cq-opt.cq-correct .cq-opt-letter{background:var(--correct-border);border-color:var(--correct-border);color:#fff}\n#cms21p2a .cq-opt.cq-correct .cq-opt-text{color:var(--correct);font-weight:600}\n#cms21p2a .cq-opt.cq-wrong{border-color:var(--wrong-border);background:var(--wrong-bg);cursor:default}\n#cms21p2a .cq-opt.cq-wrong .cq-opt-letter{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff}\n#cms21p2a .cq-opt.cq-wrong .cq-opt-text{color:var(--wrong)}\n#cms21p2a .cq-opt.cq-dimmed{opacity:0.42;cursor:default}\n#cms21p2a .cq-opt.cq-locked{cursor:default}\n#cms21p2a .cq-explanation{display:none;background:var(--teal-pale);border-top:1px solid #b2d8d3;padding:10px 18px 12px;font-size:0.82rem;color:#1a4f49;line-height:1.62}\n#cms21p2a .cq-exp-label{font-size:0.7rem;font-weight:700;letter-spacing:0.08em;text-transform:uppercase;color:var(--teal);margin-bottom:4px}\n#cms21p2a .cq-submit-wrap{text-align:center;padding:28px 16px 8px}\n#cms21p2a .cq-btn{background:var(--teal);color:var(--white);border:none;border-radius:8px;padding:13px 36px;font-family:'Playfair Display',serif;font-size:1rem;font-weight:700;cursor:pointer;letter-spacing:0.02em;transition:background 0.2s,transform 0.1s}\n#cms21p2a .cq-btn:hover{background:var(--teal-light)}\n#cms21p2a .cq-btn:active{transform:scale(0.98)}\n#cms21p2a .cq-score{display:none;background:var(--white);border:2px solid var(--teal);border-radius:var(--radius);margin:28px 0 0;padding:28px 24px;text-align:center}\n#cms21p2a .cq-score-ring{width:110px;height:110px;border-radius:50%;background:conic-gradient(var(--teal) 0%,var(--line) 0%);display:flex;align-items:center;justify-content:center;margin:0 auto 20px;position:relative}\n#cms21p2a .cq-score-ring::before{content:'';position:absolute;width:86px;height:86px;border-radius:50%;background:var(--white)}\n#cms21p2a .cq-ring-inner{position:relative;display:flex;flex-direction:column;align-items:center;line-height:1.2}\n#cms21p2a .cq-ring-pct{font-family:'Playfair Display',serif;font-size:1.3rem;font-weight:700;color:var(--teal)}\n#cms21p2a .cq-ring-sub{font-size:0.6rem;color:var(--ink-soft);text-transform:uppercase;letter-spacing:0.05em}\n#cms21p2a .cq-score h2{font-family:'Playfair Display',serif;font-size:1.2rem;color:var(--ink);margin-bottom:8px}\n#cms21p2a .cq-net-line{font-size:1rem;color:var(--teal);font-weight:600;margin-bottom:6px}\n#cms21p2a .cq-verdict{font-size:0.85rem;color:var(--ink-soft);margin-bottom:20px}\n#cms21p2a .cq-score-bands{display:flex;justify-content:center;gap:10px;flex-wrap:wrap;font-size:0.8rem}\n#cms21p2a .cq-band{padding:4px 12px;border-radius:16px;font-weight:600}\n#cms21p2a .cq-band-c{background:var(--correct-bg);color:var(--correct)}\n#cms21p2a .cq-band-w{background:var(--wrong-bg);color:var(--wrong)}\n#cms21p2a .cq-band-s{background:var(--teal-pale);color:var(--teal)}\n#cms21p2a .cq-retry-btn{margin-top:22px;background:transparent;border:2px solid var(--teal);color:var(--teal);border-radius:8px;padding:10px 28px;font-family:'Playfair Display',serif;font-size:0.95rem;font-weight:700;cursor:pointer;transition:background 0.2s,color 0.2s}\n#cms21p2a .cq-retry-btn:hover{background:var(--teal);color:var(--white)}\n@media(max-width:480px){#cms21p2a .cq-header h1{font-size:1.15rem}#cms21p2a .cq-qtext{font-size:0.88rem}#cms21p2a .cq-opt-text{font-size:0.84rem}}\n<\/style>\n<\/head>\n<body>\n<div id=\"cms21p2a\">\n <div class=\"cq-sentinel\" id=\"cms21p2a-sentinel\"><\/div>\n <div class=\"cq-statusbar\" id=\"cms21p2a-statusbar\">\n <div class=\"cq-sb-stats\">\n <div class=\"cq-timer-item\" id=\"cms21p2a-timer-item\">\u23f1 <strong id=\"cms21p2a-timer-display\">40:00<\/strong><\/div>\n <div class=\"cq-sb-item\">\u2705 <strong id=\"cms21p2a-sc\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u274c <strong id=\"cms21p2a-sw\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u23f3 <strong id=\"cms21p2a-sr\">40<\/strong> left<\/div>\n <div class=\"cq-sb-sep\"><\/div>\n <div class=\"cq-sb-item\">Net <strong id=\"cms21p2a-sn\">0<\/strong> \/ <strong id=\"cms21p2a-sm\">160<\/strong><\/div>\n <\/div>\n <div class=\"cq-sb-progress\"><div class=\"cq-sb-fill\" id=\"cms21p2a-fill\"><\/div><\/div>\n <\/div>\n <div class=\"cq-grace\" id=\"cms21p2a-grace\">\n <div class=\"cq-grace-box\">\n <h3>Time's Up!<\/h3><p>Submitting in<\/p>\n <div class=\"cq-grace-count\" id=\"cms21p2a-grace-count\">10<\/div>\n <button class=\"cq-grace-btn\" id=\"cms21p2a-grace-now\">Submit Now<\/button>\n <\/div>\n <\/div>\n <div class=\"cq-header\">\n <h1>Combined Medical Services Examination 2021<br>Paper II \u00b7 Part 1<\/h1>\n <p>General Surgery<\/p>\n <div class=\"cq-meta\">\n <span class=\"cq-badge\">Questions 1 \u2013 40<\/span>\n <span class=\"cq-badge\">Options reshuffled<\/span>\n <button class=\"cq-timer-btn\" id=\"cms21p2a-timer-btn\">\u23f1 Start Timed Mode<\/button>\n <\/div>\n <\/div>\n <div class=\"cq-body\">\n <div id=\"cms21p2a-questions\"><\/div>\n <div class=\"cq-submit-wrap\"><button class=\"cq-btn\" id=\"cms21p2a-submit\">Submit Answers<\/button><\/div>\n <div class=\"cq-score\" id=\"cms21p2a-score\">\n <div class=\"cq-score-ring\" id=\"cms21p2a-ring\"><div class=\"cq-ring-inner\"><span class=\"cq-ring-pct\" id=\"cms21p2a-ring-pct\">0%<\/span><span class=\"cq-ring-sub\">score<\/span><\/div><\/div>\n <h2>Your Result<\/h2>\n <div class=\"cq-net-line\" id=\"cms21p2a-net-line\"><\/div>\n <div class=\"cq-verdict\" id=\"cms21p2a-verdict\"><\/div>\n <div class=\"cq-score-bands\">\n <span class=\"cq-band cq-band-c\" id=\"cms21p2a-ct-c\"><\/span>\n <span class=\"cq-band cq-band-w\" id=\"cms21p2a-ct-w\"><\/span>\n <span class=\"cq-band cq-band-s\" id=\"cms21p2a-ct-s\"><\/span>\n <\/div>\n <button class=\"cq-retry-btn\" id=\"cms21p2a-retry\">\u21ba Retry Quiz<\/button>\n <\/div>\n <\/div>\n<\/div>\n<script>\n(function(){\n 'use strict';\n const NS='cms21p2a', TOTAL=40, MAX=160, TIMER_SECS=2400, GRACE_SECS=10;\n const QUESTIONS=[\n {id:1,stem:'Which of the following are types of wound healing?\\n1. Primary Intention\\n2. Secondary Intention\\n3. Tertiary Intention\\n4. Quaternary Intention',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Wound healing types: Primary Intention (direct apposition), Secondary Intention (granulation tissue), and Tertiary Intention (delayed primary closure). Quaternary Intention is not a recognised wound healing classification.'},\n {id:2,stem:'A 50-year-old female presents with pain, swelling and redness over the left foot following trivial trauma 3 days back. The swelling is poorly localised; local tenderness and erythema are present; crepitus is absent; distal pulsations are palpable. The most likely clinical diagnosis is',correct:'Cellulitis',options:['Compartment syndrome','Cellulitis','Abscess','Fasciitis'],exp:'Poorly localised erythema with tenderness, absent crepitus (ruling out necrotising infection), and intact distal pulses (ruling out compartment syndrome) = cellulitis. Abscess would be fluctuant; fasciitis shows rapid systemic deterioration with crepitus.'},\n {id:3,stem:'Which one of the following is NOT associated with BRCA1\/BRCA2 genes?',correct:'Liver cancer',options:['Breast cancer','Ovarian cancer','Prostate cancer','Liver cancer'],exp:'BRCA1\/2 mutations are associated with breast, ovarian, prostate, and pancreatic cancer. Liver cancer (HCC) is NOT among established BRCA-associated malignancies \u2014 it is associated with hepatitis B\/C, aflatoxin, and alcohol.'},\n {id:4,stem:'The malignancy associated with Stewart-Treves syndrome is',correct:'Lymphangiosarcoma',options:['Lymphangiosarcoma','Malignant melanoma','Basal cell carcinoma','Liposarcoma'],exp:\"Stewart-Treves syndrome = lymphangiosarcoma arising in chronically lymphoedematous tissue, classically the arm following mastectomy with axillary dissection. Presents as purplish nodules in the oedematous limb. Extremely poor prognosis.\"},\n {id:5,stem:'A 60-year-old lady underwent total abdominal hysterectomy. On the 3rd postoperative day she suddenly became breathless while returning from the washroom. BP = 80\/50 mmHg. The most probable diagnosis is',correct:'Thromboembolism',options:['Postural hypotension','Secondary haemorrhage','Thromboembolism','Transient ischaemic attack'],exp:\"Day 3 post-hysterectomy: sudden breathlessness + hypotension = classic pulmonary embolism. Virchow's triad is fully satisfied. CTPA is gold standard investigation; anticoagulation is treatment.\"},\n {id:6,stem:'A 52-year-old female underwent MRM. After few years she developed lymphoedema of the ipsilateral arm. Which malignancy can develop in her arm?',correct:'Lymphangiosarcoma',options:['Lymphangiosarcoma','Malignant Melanoma','Lymphoma','Malignant fibrous histiocytoma'],exp:'Lymphangiosarcoma (Stewart-Treves syndrome) develops in chronically lymphoedematous arms post-MRM. Bluish-red nodules in the oedematous arm. Treatment: forequarter amputation or wide excision; poor prognosis.'},\n {id:7,stem:'A 60-year-old gentleman presented with brawny swelling of the submandibular region with inflammatory oedema of mouth and putrid halitosis. Most likely he is suffering from',correct:\"Ludwig's angina\",options:['Tubercular adenitis','Chronic lymphadenitis','Acute lymphadenitis',\"Ludwig's angina\"],exp:\"Ludwig's angina: rapidly spreading gangrenous cellulitis of the mouth floor and submandibular space from dental origin. Brawny swelling, airway-threatening oedema, and putrid halitosis are pathognomonic. A surgical emergency requiring early airway management.\"},\n {id:8,stem:'A 25-year-old female with previous neck irradiation presents with thyroid swelling for 6 months, clinically euthyroid. The right thyroid lobe is enlarged with ipsilateral cervical lymphadenopathy. The most probable clinical diagnosis is',correct:'Papillary carcinoma thyroid',options:['Medullary carcinoma thyroid','Papillary carcinoma thyroid','Lymphoma','Follicular carcinoma thyroid'],exp:'Papillary carcinoma: most common thyroid malignancy, strongly associated with prior neck irradiation. Young adult, euthyroid, hard nodule with early ipsilateral cervical nodal metastases. FNAC confirms. 10-year survival >90% even with nodal spread.'},\n {id:9,stem:'An infant presented with a unilateral neck swelling that was soft, cystic, partially compressible and brilliantly transilluminant. The most probable diagnosis is',correct:'Cystic Hygroma',options:['Branchial fistula','Branchial cyst','Cystic Hygroma','Thyroglossal cyst'],exp:'Cystic Hygroma (lymphatic malformation): multilocular cystic neck lesion, soft, partially compressible, and BRILLIANTLY transilluminant. Branchial cysts are not brilliantly transilluminant. Thyroglossal cyst is midline and moves with swallowing. Treatment: surgical excision or sclerotherapy.'},\n {id:10,stem:'Serum thyroglobulin level is an important tumour marker for',correct:'Papillary carcinoma thyroid',options:['Medullary carcinoma thyroid','Papillary carcinoma thyroid','Anaplastic carcinoma thyroid','Thyroid lymphoma'],exp:'Serum thyroglobulin is produced exclusively by thyroid follicular epithelium \u2014 marker for differentiated thyroid carcinoma (papillary and follicular). After total thyroidectomy + RAI, rising Tg signals recurrence. Medullary carcinoma marker = calcitonin.'},\n {id:11,stem:'A 43-year-old woman presented with serous discharge from a single duct of the nipple. She is unlikely to be suffering from',correct:'Fibrocystic disease',options:['Fibrocystic disease','Intraductal Papilloma','Duct Ectasia','Carcinoma'],exp:'Single-duct serous discharge is caused by Intraductal Papilloma (most common), Duct Ectasia, or Carcinoma. Fibrocystic disease causes multiductal bilateral intermittent discharge \u2014 it is UNLIKELY to cause unilateral single-duct serous discharge.'},\n {id:12,stem:'An 8-month-old male child is brought with recurrent episodes of screaming and drawing up of legs. He appears listless between attacks. Examination reveals emptiness in the RIF and blood-stained mucus on PR examination. The most probable clinical diagnosis is',correct:'Acute intussusception',options:['Caecal volvulus','Acute intussusception','Rectal prolapse','Midgut volvulus'],exp:\"Acute intussusception: episodic screaming, listless intervals, Dance sign (empty RIF), and redcurrant jelly stool on PR = classic presentation in an 8-month-old. Most common intestinal obstruction in infancy. Treatment: pneumatic\/hydrostatic reduction.\"},\n {id:13,stem:\"Which of the following statements regarding Ogilvie's syndrome are correct?\\n1. It presents as acute large bowel mechanical obstruction\\n2. Marked caecal dilatation is a common feature on X-ray abdomen\\n3. Caecal perforation is a well-recognised complication\\n4. Intravenous Neostigmine is used for treatment\",correct:'2, 3 and 4',options:['1, 2 and 3','2, 3 and 4','1, 2 and 4','1, 3 and 4'],exp:\"Ogilvie's syndrome is functional PARALYTIC colonic dilatation \u2014 NOT mechanical obstruction (statement 1 false). Marked caecal dilatation on AXR, caecal perforation risk, and IV Neostigmine treatment (~90% effective) are all correct. Statements 2, 3 and 4.\"},\n {id:14,stem:'Which of the following statements regarding Carcinoid tumour are correct?\\n1. Terminal ileum is the most common GI site\\n2. These tumors arise from Kulchitsky cells at the base of intestinal crypts\\n3. 5-Hydroxytryptamine is the most common vasoactive peptide produced\\n4. Serum chromogranin A is a useful marker for disease recurrence',correct:'1, 3 and 4',options:['1, 2 and 3','2, 3 and 4','1, 3 and 4','1, 2 and 4'],exp:'Carcinoid tumours: arise from Kulchitsky (enterochromaffin) cells; terminal ileum is the most common GI site; 5-HT (serotonin) is the primary vasoactive peptide; chromogranin A is the tumour marker. Per examination convention, best grouping is 1, 3 and 4.'},\n {id:15,stem:'In familial adenomatous polyposis, which of the following all are true?\\n1. Presence of >100 colorectal polyps\\n2. Positive family history\\n3. Autosomal Recessive inheritance\\n4. Genetic mutation on Chromosome 5',correct:'1, 2 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'FAP: >100 colorectal polyps, positive family history, APC gene mutation on chromosome 5q21. Inheritance is AUTOSOMAL DOMINANT \u2014 not recessive (statement 3 false). Without prophylactic colectomy, CRC is virtually certain by age 40\u201350. Statements 1, 2 and 4 correct.'},\n {id:16,stem:'A 50-year-old male presents with upper abdominal pain, haematemesis, BP = 100\/70. CECT shows a large exophytic gastric tumour at the fundus. Upper GI biopsy staining for CD117 is positive. The most probable clinical diagnosis is',correct:'Gastrointestinal stromal tumor',options:['Gastric lymphoma','Gastrointestinal stromal tumor','Carcinoid tumor','Carcinoma stomach'],exp:'CD117 (c-KIT) positivity is pathognomonic for GIST (Gastrointestinal Stromal Tumour). Large exophytic gastric mass with intact overlying mucosa (submucosal origin). Arises from interstitial cells of Cajal. Treatment: surgical resection + adjuvant imatinib.'},\n {id:17,stem:'Which of the following is NOT a classical symptom of acute appendicitis?',correct:'Constipation',options:['Anorexia','Periumbilical colic','Constipation','Nausea'],exp:\"Classic appendicitis sequence: anorexia \u2192 periumbilical colic \u2192 RIF migration \u2192 nausea\/vomiting \u2192 fever. Constipation is NOT a classical symptom \u2014 it is not part of the diagnostic triad.\"},\n {id:18,stem:\"Among the extraintestinal manifestations of Crohn's disease, which one is related to disease activity?\",correct:'Eye complications (Iritis\/Uveitis)',options:['Eye complications (Iritis\/Uveitis)','Renal calculi','Primary sclerosing cholangitis','Chronic active hepatitis'],exp:\"Crohn's EIMs classified by disease activity. Activity-RELATED (flare with bowel disease): peripheral arthropathy, episcleritis, erythema nodosum, iritis\/uveitis. Activity-INDEPENDENT: axial arthropathy, PSC, pyoderma gangrenosum. Iritis\/uveitis = activity-related.\"},\n {id:19,stem:'The MELD score for end-stage liver disease includes which of the following variables?\\n1. Serum bilirubin\\n2. Serum albumin\\n3. Serum creatinine\\n4. International Normalised Ratio (INR)',correct:'1, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'MELD variables: serum bilirubin (1), serum creatinine (3), and INR (4). Serum albumin is part of Child-Pugh score, NOT MELD. MELD predicts 3-month mortality without transplant.'},\n {id:20,stem:'Which of the following statements regarding Enteric perforation are correct?\\n1. Salmonella typhi is the causative organism\\n2. Enteric perforation characteristically occurs during the third week of illness\\n3. Typhoid ulcers are placed transversely to the long axis of the gut\\n4. Terminal ileum is the most common site',correct:'1, 2 and 3',options:['1, 2 and 3','2, 3 and 4','1, 3 and 4','1, 2 and 4'],exp:\"All four statements are essentially correct. Perforations occur in the third week via Peyer's patch necrosis; typhoid ulcers run transversely; terminal ileum is the most common site. Per examination convention, answer is 1, 2 and 3.\"},\n {id:21,stem:'A 35-year-old male with known enteric fever presents with sudden generalised abdominal pain, board-like rigidity, rebound tenderness, tachycardia, and hypotension. The most likely complication is',correct:'Small bowel perforation',options:['Small bowel enteritis','Small bowel perforation','Small bowel obstruction','Cholecystitis'],exp:'Peritonitis signs + known enteric fever = small bowel perforation (most feared complication, third week). Management: emergency laparotomy, perforation repair, peritoneal lavage, continued ceftriaxone.'},\n {id:22,stem:'Which of the following are options for management of a pancreatic pseudocyst?\\n1. Pancreaticoduodenectomy\\n2. Cystogastrostomy\\n3. Percutaneous drainage\\n4. Endoscopic drainage',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:\"Pancreatic pseudocyst management: Cystogastrostomy (2), Percutaneous drainage (3), and Endoscopic drainage (4) are valid. Whipple's procedure (1) is for pancreatic head malignancy \u2014 NOT pseudocyst. Statements 2, 3 and 4 correct.\"},\n {id:23,stem:'Which of the following statements regarding hepatic adenomas are correct?\\n1. Almost exclusively in females aged 25-50 years\\n2. Associated with use of oral contraceptive pills\\n3. They do not have any malignant potential\\n4. Majority detected incidentally on imaging',correct:'1, 2 and 4',options:['1, 2 and 3','2, 3 and 4','1, 3 and 4','1, 2 and 4'],exp:'Hepatic adenomas: almost exclusively in women 25\u201350 (correct), OCP association (correct), incidentally detected (correct). They DO have malignant potential (~4\u20138% transformation) \u2014 statement 3 is FALSE. Statements 1, 2 and 4 correct.'},\n {id:24,stem:'Which of the following are probable sites for Ectopic pancreas?\\n1. Submucosa of the stomach and duodenum\\n2. Liver\\n3. Small bowel mesentery\\n4. Splenic hilum',correct:'1, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Ectopic pancreas most common sites: gastric\/duodenal submucosa (1), small bowel mesentery (3), splenic hilum (4). The LIVER is NOT a recognised common site (2 incorrect). Statements 1, 3 and 4 correct.'},\n {id:25,stem:\"Which one of the following statements regarding Cantlie's line is correct?\",correct:\"Runs between gall bladder fossa and middle hepatic vein\",options:[\"Runs between gall bladder fossa and right hepatic vein\",\"Runs between gall bladder fossa and right branch of portal vein\",\"Runs between gall bladder fossa and middle hepatic vein\",\"Runs between gall bladder fossa and left branch of portal vein\"],exp:\"Cantlie's line divides the liver into true right and left functional lobes. It runs from the gallbladder fossa anteriorly to the IVC posteriorly, passing through the MIDDLE hepatic vein \u2014 the anatomical basis for right and left hepatectomy.\"},\n {id:26,stem:'Which of the following are indications of splenectomy?\\n1. Pseudomyxoma peritonei\\n2. Trauma\\n3. Idiopathic thrombocytopenic purpura (ITP)\\n4. Hypersplenism',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Splenectomy indications: Trauma (2), ITP refractory to steroids (3), Hypersplenism (4). Pseudomyxoma peritonei requires cytoreductive surgery + HIPEC \u2014 NOT splenectomy (1 incorrect). Statements 2, 3 and 4 correct.'},\n {id:27,stem:'A 45-year-old female presents with a painless firm abdominal swelling of 10\u00d78 cm near the umbilicus. The swelling can be moved freely in a plane at right angle to the line of attachment of the mesentery. The most probable clinical diagnosis is',correct:'Mesenteric cyst',options:['Dermoid cyst','Ovarian cyst','Mesenteric cyst','Hydatid cyst'],exp:'Mesenteric cyst: moves freely at RIGHT ANGLES to the mesenteric attachment but is restricted along the mesenteric line \u2014 this characteristic restricted mobility is pathognomonic.'},\n {id:28,stem:'A 45-year-old male with known left inguinal hernia presents with acute pain, irreducible swelling, absent cough impulse, tense erythematous overlying skin, localised tenderness, tachycardia, and hypotension. The most probable diagnosis is',correct:'Strangulated hernia',options:['Obstructed hernia','Strangulated hernia','Incarcerated hernia','Irreducible hernia'],exp:'Strangulated hernia: compromised vascular supply evidenced by tense erythematous skin, localised tenderness, absent cough impulse, and systemic compromise (tachycardia, hypotension). Obstructed hernia lacks vascular compromise. Surgical emergency.'},\n {id:29,stem:\"Mayo's repair is done for\",correct:'Umbilical hernia',options:['Inguinal hernia','Femoral hernia','Umbilical hernia','Incisional hernia'],exp:\"Mayo's repair: vest-over-pants (double-breasted) fascial overlap for umbilical hernia. Bassini's and Shouldice repairs are for inguinal hernias. Femoral hernias use Lockwood or McEvedy approach.\"},\n {id:30,stem:'In Pringle Manoeuvre, clamping includes which of the following?\\n1. Common Bile Duct\\n2. Hepatic artery\\n3. Portal vein\\n4. Inferior Vena Cava',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Pringle Manoeuvre clamps the hepatoduodenal ligament containing: Common Bile Duct (1), Hepatic Artery (2), and Portal Vein (3). The IVC is retroperitoneal and NOT included. Total hepatic vascular exclusion additionally clamps the IVC.'},\n {id:31,stem:'A road traffic accident patient is conscious (GCS 14\/15), stable, with bleeding from right ear, CSF leak from nose, and bruising behind the right ear. The most probable clinical diagnosis is',correct:'Fracture of the base of skull',options:['Extradural haematoma','Fracture of the base of skull','Cerebral concussion','Traumatic subarachnoid haemorrhage'],exp:\"Basal skull fracture: CSF rhinorrhoea (anterior fossa \u2014 cribriform plate), haemotympanum\/otorrhoea (middle fossa \u2014 petrous temporal), Battle's sign (post-auricular bruising). Conscious GCS 14\/15 argues against extradural haematoma.\"},\n {id:32,stem:'The commonest organism causing Suppurative Otitis Media is',correct:'Streptococcus pneumonia',options:['Streptococcus pneumonia','Staphylococcus aureus','Acinetobacter Spp','Escherichia coli'],exp:'Streptococcus pneumoniae (Pneumococcus) is the most common organism causing acute Suppurative Otitis Media, followed by H. influenzae and Moraxella catarrhalis. First-line treatment: amoxicillin.'},\n {id:33,stem:'A road traffic accident patient has increasing restlessness, respiratory rate 26\/min, distended neck veins, tracheal deviation to the RIGHT, hyper-resonant note and absent breath sounds on the LEFT. Which statements are correct?\\n1. Most probable diagnosis is left tension pneumothorax\\n2. Immediate chest decompression using wide bore cannula in left 2nd ICS\\n3. Immediate chest X-ray should be done to confirm the diagnosis\\n4. Definitive chest tube in left 5th ICS',correct:'1, 2 and 4',options:['1, 2 and 3','2, 3 and 4','1, 3 and 4','1, 2 and 4'],exp:'Left tension pneumothorax: diagnosis is CLINICAL \u2014 do NOT wait for CXR (statement 3 false). Immediate decompression with wide bore cannula, left 2nd ICS (statement 2 correct); definitive chest drain, left 5th ICS (statement 4 correct). Statements 1, 2 and 4 correct.'},\n {id:34,stem:'Positron Emission Tomography (PET) used in preoperative staging of gastro-oesophageal tumours is to detect',correct:'Distant metastatic disease',options:['Distant metastatic disease','Extension into stomach','Local spread','Lymph node status'],exp:'PET-CT excels at detecting DISTANT METASTATIC DISEASE (liver, para-aortic nodes, bone) that would preclude curative surgery. CT and EUS are superior for local T-staging and regional N-staging. PET upstages ~10\u201315% to incurable disease.'},\n {id:35,stem:'Which of the following are correct about ectopic ureters?\\n1. They are more common in males\\n2. They drain the upper pole of kidney\\n3. They are associated with duplex ureter\\n4. They may cause incontinence',correct:'2, 3 and 4',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Ectopic ureters are more common in FEMALES (statement 1 false). They drain the UPPER pole of a duplex kidney (2 correct), are associated with duplex ureter (3 correct), and may cause continuous dribbling incontinence in females (4 correct). Statements 2, 3 and 4 correct.'},\n {id:36,stem:'Which one of the following is a Nephrotoxic anaesthetic agent?',correct:'Methoxyflurane',options:['Methoxyflurane','Isoflurane','Halothane','Nitrous oxide'],exp:'Methoxyflurane is nephrotoxic due to inorganic fluoride ion release from hepatic CYP2E1 metabolism, causing dose-dependent polyuric renal failure. Halothane = hepatotoxic. Isoflurane and nitrous oxide have minimal organ toxicity.'},\n {id:37,stem:'A comatose patient after severe head injury is in neurosurgical ICU. Which parameters should ideally be maintained?\\n1. pCO2 = 4.5-5.0 kPa (33-38 mm Hg)\\n2. MAP = 80-90 mm of Hg\\n3. pO2 > 11 kPa (> 80 mm Hg)\\n4. Na+ < 130 meq\/L',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:'Severe TBI targets: pCO2 33\u201338 mmHg (mild hyperventilation) \u2713, MAP 80\u201390 mmHg (CPP >60 mmHg) \u2713, pO2 >80 mmHg \u2713. Hyponatraemia <130 meq\/L WORSENS cerebral oedema and must be AVOIDED (statement 4 false). Statements 1, 2 and 3 correct.'},\n {id:38,stem:'Untidy wounds are characterised by which of the following?\\n1. Crushed or avulsed tissues\\n2. Contamination wound\\n3. Devitalised tissue\\n4. No loss of tissue',correct:'1, 2 and 3',options:['1, 2 and 3','1, 2 and 4','1, 3 and 4','2, 3 and 4'],exp:\"Untidy wounds: crushed\/avulsed tissues (1), contamination (2), devitalised tissue (3). Statement 4 ('no loss of tissue') is FALSE \u2014 untidy wounds characteristically involve tissue damage\/loss. Statements 1, 2 and 3 correct.\"},\n {id:39,stem:'Which one of the following statements regarding the composition of common crystalloid solutions is correct?',correct:\"Hartmann's solution contains 111 meq\/L of Cl\",options:[\"Normal saline contains 100 meq\/L of Na\",\"Hartmann's solution contains 111 meq\/L of Cl\",\"Normal saline contains 130 meq\/L of Cl\",\"Hartmann's solution contains 111 meq\/L of Na\"],exp:\"Normal saline (0.9% NaCl) = 154 meq\/L Na and 154 meq\/L Cl. Hartmann's solution = 130 meq\/L Na, 111 meq\/L Cl. Therefore Hartmann's contains 111 meq\/L Cl \u2014 option (b) is correct.\"},\n {id:40,stem:'Perioperative benefit from transfusion is with a haemoglobin level of',correct:'6-8 gm\/dl',options:['< 6 gm\/dl','6-8 gm\/dl','8-10 gm\/dl','> 10 gm\/dl'],exp:'Perioperative transfusion benefit is clearly established at Hb 6\u20138 gm\/dL. Below 6: universally indicated. Above 10: generally not needed. At 8\u201310: individualised decision. Restrictive transfusion strategy (threshold ~7\u20138 gm\/dL) is now standard practice.'}\n ];\n\n const LETTERS=['A','B','C','D'];\n let userAnswers={},answered=0,shuffledOpts={};\n let timerRunning=false,timerRemaining=TIMER_SECS,timerInterval=null,graceInterval=null,quizSubmitted=false;\n\n function shuffle(arr){const a=arr.slice();for(let i=a.length-1;i>0;i--){const j=Math.floor(Math.random()*(i+1));[a[i],a[j]]=[a[j],a[i]];}return a;}\n function fmtTime(s){const m=Math.floor(s\/60),sec=s%60;return(m<10?'0':'')+m+':'+(sec<10?'0':'')+sec;}\n\n function startTimer(){\n if(timerRunning||quizSubmitted)return;timerRunning=true;\n const btn=document.getElementById(NS+'-timer-btn');\n btn.textContent='\u23f1 '+fmtTime(timerRemaining);btn.classList.add('running');\n document.getElementById(NS+'-timer-item').classList.add('active');\n timerInterval=setInterval(function(){\n timerRemaining--;\n const disp=fmtTime(timerRemaining);\n document.getElementById(NS+'-timer-display').textContent=disp;\n document.getElementById(NS+'-timer-btn').textContent='\u23f1 '+disp;\n if(timerRemaining<=300)document.getElementById(NS+'-timer-item').classList.add('warning');\n if(timerRemaining<=0){clearInterval(timerInterval);timerInterval=null;triggerGrace();}\n },1000);\n }\n function stopTimer(){if(timerInterval){clearInterval(timerInterval);timerInterval=null;}timerRunning=false;}\n function triggerGrace(){\n if(quizSubmitted)return;let count=GRACE_SECS;\n document.getElementById(NS+'-grace-count').textContent=count;\n document.getElementById(NS+'-grace').classList.add('show');\n graceInterval=setInterval(function(){count--;document.getElementById(NS+'-grace-count').textContent=count;if(count<=0){clearInterval(graceInterval);graceInterval=null;dismissGrace();showScore();}},1000);\n }\n function dismissGrace(){document.getElementById(NS+'-grace').classList.remove('show');if(graceInterval){clearInterval(graceInterval);graceInterval=null;}}\n\n function updateStats(){\n const c=Object.values(userAnswers).filter(function(v){return v==='correct';}).length;\n const w=Object.values(userAnswers).filter(function(v){return v==='wrong';}).length;\n const net=(c*4)-w;\n document.getElementById(NS+'-sc').textContent=c;\n document.getElementById(NS+'-sw').textContent=w;\n document.getElementById(NS+'-sr').textContent=TOTAL-answered;\n document.getElementById(NS+'-sn').textContent=net>=0?'+'+net:net;\n document.getElementById(NS+'-sm').textContent=MAX;\n document.getElementById(NS+'-fill').style.width=(answered\/TOTAL*100)+'%';\n }\n\n function pick(qid,oi){\n if(userAnswers[qid]!==undefined||quizSubmitted)return;\n const q=QUESTIONS.find(function(x){return x.id===qid;});\n const opts=shuffledOpts[qid],correct=opts[oi]===q.correct;\n userAnswers[qid]=correct?'correct':'wrong';answered++;\n opts.forEach(function(o,i){\n const el=document.getElementById(NS+'-o'+qid+'-'+i);\n if(o===q.correct)el.classList.add('cq-correct','cq-locked');\n else if(i===oi)el.classList.add('cq-wrong','cq-locked');\n else el.classList.add('cq-dimmed','cq-locked');\n });\n document.getElementById(NS+'-n'+qid).classList.add(correct?'ans-c':'ans-w');\n document.getElementById(NS+'-exp'+qid).style.display='block';\n updateStats();\n }\n\n function build(){\n const container=document.getElementById(NS+'-questions');\n container.innerHTML='';userAnswers={};answered=0;shuffledOpts={};\n quizSubmitted=false;timerRunning=false;timerRemaining=TIMER_SECS;\n stopTimer();dismissGrace();\n document.getElementById(NS+'-score').style.display='none';\n document.getElementById(NS+'-timer-item').classList.remove('active','warning');\n const btn=document.getElementById(NS+'-timer-btn');\n btn.textContent='\u23f1 Start Timed Mode';btn.classList.remove('running');\n document.getElementById(NS+'-timer-display').textContent=fmtTime(TIMER_SECS);\n updateStats();\n QUESTIONS.forEach(function(q){\n const opts=shuffle(q.options);shuffledOpts[q.id]=opts;\n const card=document.createElement('div');card.className='cq-card';\n card.innerHTML='<div class=\"cq-qhead\"><div class=\"cq-qnum\" id=\"'+NS+'-n'+q.id+'\">'+q.id+'<\/div><div class=\"cq-qtext\">'+q.stem.replace(\/\\n\/g,'<br>')+'<\/div><\/div>'+\n '<div class=\"cq-options\" id=\"'+NS+'-opts'+q.id+'\">'+\n opts.map(function(o,i){return '<div class=\"cq-opt\" id=\"'+NS+'-o'+q.id+'-'+i+'\" role=\"button\" tabindex=\"0\"><span class=\"cq-opt-letter\">'+LETTERS[i]+'<\/span><span class=\"cq-opt-text\">'+o+'<\/span><\/div>';}).join('')+\n '<\/div><div class=\"cq-explanation\" id=\"'+NS+'-exp'+q.id+'\"><div class=\"cq-exp-label\">Explanation<\/div>'+q.exp+'<\/div>';\n container.appendChild(card);\n opts.forEach(function(_,i){document.getElementById(NS+'-o'+q.id+'-'+i).addEventListener('click',function(){pick(q.id,i);});});\n });\n }\n\n function showScore(){\n if(quizSubmitted)return;quizSubmitted=true;stopTimer();\n document.getElementById(NS+'-timer-btn').textContent='\u23f1 Submitted';\n document.getElementById(NS+'-timer-btn').classList.remove('running');\n const c=Object.values(userAnswers).filter(function(v){return v==='correct';}).length;\n const w=Object.values(userAnswers).filter(function(v){return v==='wrong';}).length;\n const s=TOTAL-answered,net=(c*4)-w,pct=Math.max(0,Math.round((net\/MAX)*100)),disp=Math.min(100,Math.max(0,pct));\n document.getElementById(NS+'-ring').style.background='conic-gradient(var(--teal) '+disp+'%,var(--line) 0%)';\n document.getElementById(NS+'-ring-pct').textContent=pct+'%';\n document.getElementById(NS+'-net-line').textContent='Net Score: '+net+' \/ '+MAX;\n document.getElementById(NS+'-verdict').textContent=pct>=80?'Excellent \u2014 well above the qualifying threshold.':pct>=60?'Good attempt \u2014 consolidate the weaker areas.':pct>=40?'Fair \u2014 systematic revision of these topics is recommended.':'Needs significant revision across these topics.';\n document.getElementById(NS+'-ct-c').textContent='\u2705 '+c+' Correct';\n document.getElementById(NS+'-ct-w').textContent='\u274c '+w+' Wrong';\n document.getElementById(NS+'-ct-s').textContent='\u23ed '+s+' Skipped';\n const sc=document.getElementById(NS+'-score');sc.style.display='block';sc.scrollIntoView({behavior:'smooth',block:'center'});\n }\n\n function init(){\n document.getElementById(NS+'-grace-now').addEventListener('click',function(){dismissGrace();showScore();});\n document.getElementById(NS+'-timer-btn').addEventListener('click',function(){if(!timerRunning&&!quizSubmitted)startTimer();});\n document.getElementById(NS+'-submit').addEventListener('click',showScore);\n document.getElementById(NS+'-retry').addEventListener('click',function(){build();window.scrollTo({top:0,behavior:'smooth'});});\n new IntersectionObserver(function(entries){\n document.getElementById(NS+'-statusbar').classList.toggle('visible',!entries[0].isIntersecting);\n },{threshold:0}).observe(document.getElementById(NS+'-sentinel'));\n build();updateStats();\n }\n\n if(document.readyState==='loading'){document.addEventListener('DOMContentLoaded',init);}else{init();}\n})();\n<\/script>\n<\/body>\n<\/html>\n\n\n","protected":false},"excerpt":{"rendered":"<p>CMS 2021 Paper II \u2013 Part 1 (Q1\u2013Q40) \u23f1 40:00 \u2705 0 \u274c 0 \u23f3 40 left Net 0 \/ 160 Time's Up! Submitting in 10 Submit Now Combined Medical Services Examination 2021Paper II \u00b7 Part 1 General Surgery Questions 1 \u2013 40 Options reshuffled \u23f1 Start Timed Mode Submit Answers 0%score Your Result \u21ba Retry Quiz<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-36604","post","type-post","status-publish","format-standard","hentry","category-cms"],"yoast_head":"\n<title>CMS 2021 P2 Part-1 Surgery - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CMS 2021 P2 Part-1 Surgery - atsixty\" \/>\n<meta property=\"og:description\" content=\"CMS 2021 Paper II \u2013 Part 1 (Q1\u2013Q40) \u23f1 40:00 \u2705 0 \u274c 0 \u23f3 40 left Net 0 \/ 160 Time's Up! Submitting in 10 Submit Now Combined Medical Services Examination 2021Paper II \u00b7 Part 1 General Surgery Questions 1 \u2013 40 Options reshuffled \u23f1 Start Timed Mode Submit Answers 0%score Your Result \u21ba Retry Quiz\" \/>\n<meta property=\"og:url\" content=\"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/\" \/>\n<meta property=\"og:site_name\" content=\"atsixty\" \/>\n<meta property=\"article:published_time\" content=\"2026-04-17T12:09:54+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-19T12:55:05+00:00\" \/>\n<meta name=\"author\" content=\"Avi\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Avi\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\"},\"author\":{\"name\":\"Avi\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"headline\":\"CMS 2021 P2 Part-1 Surgery\",\"datePublished\":\"2026-04-17T12:09:54+00:00\",\"dateModified\":\"2026-04-19T12:55:05+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\"},\"wordCount\":51,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"articleSection\":[\"CMS\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\",\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\",\"name\":\"CMS 2021 P2 Part-1 Surgery - atsixty\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\"},\"datePublished\":\"2026-04-17T12:09:54+00:00\",\"dateModified\":\"2026-04-19T12:55:05+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/17\\\/cms-2021-p2-part-1-surgery\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/atsixty.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"CMS 2021 P2 Part-1 Surgery\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\",\"url\":\"https:\\\/\\\/atsixty.com\\\/\",\"name\":\"At Sixty\",\"description\":\"The Option Taken\",\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/atsixty.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\",\"name\":\"Avi\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"url\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"contentUrl\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"width\":200,\"height\":200,\"caption\":\"Avi\"},\"logo\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\"},\"sameAs\":[\"https:\\\/\\\/atsixty.com\"],\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/author\\\/avinaux\\\/\"}]}<\/script>\n","yoast_head_json":{"title":"CMS 2021 P2 Part-1 Surgery - atsixty","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/","og_locale":"en_US","og_type":"article","og_title":"CMS 2021 P2 Part-1 Surgery - atsixty","og_description":"CMS 2021 Paper II \u2013 Part 1 (Q1\u2013Q40) \u23f1 40:00 \u2705 0 \u274c 0 \u23f3 40 left Net 0 \/ 160 Time's Up! Submitting in 10 Submit Now Combined Medical Services Examination 2021Paper II \u00b7 Part 1 General Surgery Questions 1 \u2013 40 Options reshuffled \u23f1 Start Timed Mode Submit Answers 0%score Your Result \u21ba Retry Quiz","og_url":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/","og_site_name":"atsixty","article_published_time":"2026-04-17T12:09:54+00:00","article_modified_time":"2026-04-19T12:55:05+00:00","author":"Avi","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Avi","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/#article","isPartOf":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/"},"author":{"name":"Avi","@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"headline":"CMS 2021 P2 Part-1 Surgery","datePublished":"2026-04-17T12:09:54+00:00","dateModified":"2026-04-19T12:55:05+00:00","mainEntityOfPage":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/"},"wordCount":51,"commentCount":0,"publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"articleSection":["CMS"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/","url":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/","name":"CMS 2021 P2 Part-1 Surgery - atsixty","isPartOf":{"@id":"https:\/\/atsixty.com\/#website"},"datePublished":"2026-04-17T12:09:54+00:00","dateModified":"2026-04-19T12:55:05+00:00","breadcrumb":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/17\/cms-2021-p2-part-1-surgery\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/atsixty.com\/"},{"@type":"ListItem","position":2,"name":"CMS 2021 P2 Part-1 Surgery"}]},{"@type":"WebSite","@id":"https:\/\/atsixty.com\/#website","url":"https:\/\/atsixty.com\/","name":"At Sixty","description":"The Option Taken","publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/atsixty.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d","name":"Avi","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","url":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","contentUrl":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","width":200,"height":200,"caption":"Avi"},"logo":{"@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png"},"sameAs":["https:\/\/atsixty.com"],"url":"https:\/\/atsixty.com\/index.php\/author\/avinaux\/"}]}},"_links":{"self":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36604","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/comments?post=36604"}],"version-history":[{"count":2,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36604\/revisions"}],"predecessor-version":[{"id":36627,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36604\/revisions\/36627"}],"wp:attachment":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/media?parent=36604"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/categories?post=36604"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/tags?post=36604"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}