General Surgery

Question 1

Is a direct inguinal hernia medial or lateral to the artery

Answer 1

medial

Question 2

Is a indirect inguinal hernia medial or lateral to the artery

Answer 2

lateral

Question 3

What is indirect inguinal hernia caused by

Answer 3

Patent processus vaginalis

Question 4

What is direct inguinal hernia caused by

Answer 4

Breakdown of transverfacialis

Question 5

What is the commonest presentation an indirect inguinal hernia?

Answer 5

lateral to the artery

Congenital in a young body

Question 6

Indications for surgery in diverticulitis?

Answer 6

Hinchey III - IV
Unstable patient
Immunocompromised
Complications: perf, abscess, fistula, obstruction, hemorrhage, cant rule out colon cancer, failed medical mx

Question 7

What is the inheritance of familial adenomatous polyposis?

Answer 7

Dominant autosomal

Question 8

Commonest cause of spontaneous unilateral bloody nipple discharge?

Answer 8

Intraductal papilloma

Question 9

Risk factors for Breast Ca?

Answer 9

Age > 40 
Female 
FHx breast Ca 
Nulliparous 
First pregnancy > 30 
Young Menarche 
Late Menopause 
> 5 yrs HRT, > 10 years OCP 
BRACA 1/2, obesity

Question 10

Good prognosis for breast cancer?

Answer 10

< 2cm 
ER +ve 
Node neg 
Mucious 
Grade 1

Question 11

Bad prognosis for breast cancer?

Answer 11

Her2Neu +ve 
ER -ve 
Positive margins 
Lymphovascular invasion 
Epidermal inclusion cyst 
> 5cm 
Grade III

Question 12

Side effects of HEUR2New Hormone (zumab)?

Answer 12

HF

Question 13

In which patients do you use SERMS?

Answer 13

Premenopausal

Question 14

Example of SERMS?

Answer 14

Tamoxifen/Raloxifen

Question 15

Side effects of SERMS?

Answer 15

Hot flush
DVT
Endometrial cancer

Question 16

What are SERMS protective against?

Answer 16

Osteoporosis

Question 17

How does tamoxifen work? Antagonist/Agonist effect?

Answer 17

Antagonist at breast

Agonist at bone/uterus

Question 18

In which patients do you use aromatase inhibitors?

Answer 18

Postmenopausal