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MRCS Clinical Conditions Flashcards

1
Q

What is the most common tumour of anterior mediastinum?

A

Thymoma

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2
Q

Investigation of choice for achiles tendon rupture?

A

US or MRI

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3
Q

What test is diagnostic of Achilles tendon rupture? What is it

A

Thompson test - squeeze posterior calf, doesn’t plantarflex = positive result

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4
Q

Mammogram shows coarse linear branching calcification. Dx?

A

Comedo type DCIS

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5
Q

Which 2 kidney stones are radiopaque?

A

Calcium oxalate
Calcium phosphate

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6
Q

Which 2 kidney stones are radiolucent?

A

Uric acid
Indinavir

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7
Q

Which kidney stone is partially radiolucent?

A

Cystine

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8
Q

What are the 2 types of cartilagenous joints? Examples of each?

A

Primary- 2 bones joined by hyaline cartilage e.g. growing bones or in costochondral joints and first chondrosternal joint
Secondary - 2 bones joined by fibrocartilage **midline e.g. manubriosternal, pubic symphysis, xiphisternum, interverterbal joints

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9
Q

Which type of cartilagenous joints are found in midline? What are they?

A

Secondary cartilagenous- 2 bones joined by fibrocartilage

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10
Q

Twisting injury, immediate pain, delayed swelling and knee locking. Dx?

A

Meniscus injury

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11
Q

Greasy surface plus keratin plugs. Diagnosis?

A

Seb K

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12
Q

Most common parotid tumour? Features

A

Benign pleomorphic adenoma
Slow growing, can recur, needs excising
Can become malignant

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13
Q

What is Warthins tumour otherwise known as?

A

Benign papillary cystadenoma

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14
Q

What is the most common bilateral parotid tumour?

A

Warthins

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15
Q

Which common parotid tumour can become malignant?

A

Pleomorphic adenoma

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16
Q

What is most common parotid tumour in kids?

A

Haemangioma

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17
Q

Which malignant parotid cancer is associated most with perineural spread?

A

Adenoid cystic carcinoma

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18
Q

Management of benign vs malignant parotid tumours?

A

Benign - superficial parotidectomy
Malignant- radical excision

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19
Q

What is the most common type of renal stone? Main RF?

A

Calcium oxalate
High calcium

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20
Q

Which renal stone precipitates in acidic urine? Main RF for these?

A

Uric acid stones
High uric acid - e.g. cancer

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21
Q

Which is the main radio lucent renal stonse?

A

Uric acid
Xanthine

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22
Q

Which renal stones are semi opaque? Ground glass. What do they contain

A

Cysteine stones
Contain sulfur

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23
Q

Which renal stone is formed in alkali urine and seen in RTA 1 and 3?

A

Calcium phosphate

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24
Q

What is the most radio dense renal stone?

A

Calcium phosphate

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25
What is the treatment of choice for staghorn calculi or renal stones over 2cm?
PCNL
26
Which stones are suitable for ESWL?
5-10mm ureteric or renal stones, some larger renal stones
27
Characteristics of superficial epidermal burns?
Red, moist skin, blanches
28
Characteristics of superficial epidermal burns?
Red, moist skin, blanches
29
Characteristics of superficial partial thickness burns?
Pale and dry, blistery, blanches
30
Characteristics of deep partial thickness burns?
Red mottled and non blanching skin
31
What depth of burn must be at least if skin non blanching?
Deep partial thickness
32
Characteristics of full thickness burns?
Dry leathery hard skin that doesn't blanch
33
What is the most accurate way of measuring SA burns in kids?
Lund Bronder chart
34
Describe Wallaces rule of 9s?
Arm = 4.5% front and back (x2) Leg = 9% front and back (x2) Trunk = 9% x 4 Head = 4.5% front and back Perineum is 1% Palm is roughly 0.8%
35
Parkland formula for first and next 24 hours?
2 x SA x weight over first 24, 1/2 in fjrst 8 hours Then 1.5 x SA x weight over next 24
36
In adults and kids what is cut off for needing fluid as per parkland?
15% SA in adults, 10% in kids At least partial thickness
37
How is fluid formula different for electrical burns?
4 x SA x kg rather than 2
38
What is adequate UO for adults vs kids in burns?
At least 0.5 ml per kg per hour in adults 1 in kids
39
Which thyroid Ca commonly metastases via lymph?
Papillary
40
What cells characterise medullary thyroid Ca?
Parafollicular c cells of neural crest origin
41
Which thyroid Ca is notoriously not radio iodine sensitive?
Medullary
42
Which thyroid Ca doesn't usually need resection?
Lymphoma
43
Which thyroid Ca usually metastasises via blood?
Follicular
44
What scans can be used to localise parathyroid adenomas?
US in combo with sestamibi (MIBI radionucleotide)
45
What infarction causes AV node ischaemia - be specific and also where it arises?
RCA - posterior IV artery, AV nodal branch. Arises in ant coronary sinus
46
What bit of adrenal hypertrophies in Cushings?
Zona fasciculata
47
What is piriformis syndrome?
Entrapment neuropathy of sciatic nerve causing radicular pain and paraesthesia
48
From which muscle does sciatic nerve emerge under? Entrapment syndrome?
Piriformis Piriformis syndrome
49
Which nerve emerge over piriformis? Innervated muscles?
Superior gluteal nerve Gluteus medius and minimus
50
Nerve roots of superior gluteal nerve?
L4-S1
51
Inferior gluteal nerve innervates?
Gluteus maximus
52
Once thawed, when does FFP have to be used within? What about overall fridgd ztorage time?
24 hours 36 months total
53
Most common pathogen causing bacterial flexor tenosynovitis?
S aureus
54
Ewings sarcoma is diagnosed based on what? Radiology and biopsy
Lytic destruction with onion skin appearance, usually diaphyseal in LLs of teenagers Small round blue cells on biopsy
55
What condition is suggested by onion skin appearance lytic lesion and pain swelling in teenage lower limb long bone?
Ewings sarcoma
56
What is a chondroblastoma?
Benign epiphyseal tumour
57
What do you do if DDH suspected in newborn? Why?
US at 4 to 6 weeks to reduce inappropriate splinting, as many lax capsules tighten by then
58
Why does radial nerve injury in spiral groove of humerus leave elbow extension ok?
Triceps branch originates higher up
59
What is the emegency treatment of hereditsry angiodema?
FFP to replace C1 esterase inhibitor
60
Why is ferrous sulphate better than ferric?
Dissolves better in water
61
Where is most body iron stored?
Hb
62
How are displaced intracapsular fractures in young people managed?
Fixation - emergency e.g. Dhs
63
MUST fracture?
Monteggia- proximal ulna fracture with superior/prox radial head dislocation
64
GRIP fracture?
Galeazzi- radial fracture with inferior radio ulnar dislocation
65
CD arm fractjre?
Colles - dorsal angulation, fall on outstretched hand
66
Smiths fracture?
Reverse colles - fall on flexed hand, volar angulation of segment
67
Barton fracture? BC
Distal radial fracture with radioCarpal joint dislocation
68
Main MALT gastric lymphoma association and therefore first treatment measure for local disease?
H pylori therefore eradicate
69
Minimal size for aystmpomtatic AAA intervention?
Over 5.5 cm
70
What is PEEP useful for? Specific example?
Diffuse processes to keep Airways open - e.g. ARDS
71
Best method of investigating microcalcification on mammography?
Core biospy
72
Majority of hip dislocations are what? How do they look? Nerve at risk?
Posteiror due to trauma Sciatic nerve palsy Shortened adducted and internally rotated
73
Diagnosis of Hirschprungs is confirmed by?
Absence of ganglia in submuvosa of rectum
74
What acid base disturbance can be caused by over administration of NaCL?
Hyperchkoraemic metabolic acidosis
75
Haemophilia A causes prologned what?
APTT
76
Management of pregnancy associated CTS?
Conservative initially e.g. wrist splint as most resolve after pregnancy
77
What investigation is best breast imaging in women under 35?
US
78
Incision for open appendicectomy?
Lanz
79
VWD is what inheritance?
AD
80
Lichen planus is a RF for what?
Oral cancer
81
Which is more common in trauma - intra or extraperitoneal bladder rupture? How are these repaired
Extra 2 layer technique, absorbable sutures
82
MEN2a? 2b?
Medullary thyroid Ca Phaeochromocytoma Parathyroid hyperplasia 2b is this but with marfans and neuromas, no parathyroid
83
Men1?
Pituitary tumour Parathyroid hyperplasia Pancreatic - insulinoma/ZES
84
What neck swelling classically gets big/painful after URTI?
Branchial cyst
85
How does PTH increase Ca?
Increases hydroxylatkon of 25 hydroxy vit D to 1 25 dehydr vit D In turn increases intestinal absortpion of Ca
86
What cells release PTH?
Chief cells of parathyroid
87
What investigation is most sensitive for heart transplant rejection?
Heart biopsy
88
A central lumbar disc herniation at a given spinal level e.g. L3/4 will affect which nerve?
One below - transiting E.g. L4
89
A lateral disc prolapse will get which nerve?
Exiting nerve e.g. at L3/4 would be L3 nerve

MRCS- physiology + surgery (32 decks)

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