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MRCS Part A > MRCS Clinical Conditions > Flashcards

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
Q

What is the treatment of choice for staghorn calculi or renal stones over 2cm?

A

PCNL

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26
Q

Which stones are suitable for ESWL?

A

5-10mm ureteric or renal stones, some larger renal stones

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27
Q

Characteristics of superficial epidermal burns?

A

Red, moist skin, blanches

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28
Q

Characteristics of superficial epidermal burns?

A

Red, moist skin, blanches

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29
Q

Characteristics of superficial partial thickness burns?

A

Pale and dry, blistery, blanches

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30
Q

Characteristics of deep partial thickness burns?

A

Red mottled and non blanching skin

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31
Q

What depth of burn must be at least if skin non blanching?

A

Deep partial thickness

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32
Q

Characteristics of full thickness burns?

A

Dry leathery hard skin that doesn’t blanch

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33
Q

What is the most accurate way of measuring SA burns in kids?

A

Lund Bronder chart

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34
Q

Describe Wallaces rule of 9s?

A 
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%
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35
Q

Parkland formula for first and next 24 hours?

A

2 x SA x weight over first 24, 1/2 in fjrst 8 hours

Then 1.5 x SA x weight over next 24

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36
Q

In adults and kids what is cut off for needing fluid as per parkland?

A

15% SA in adults, 10% in kids

At least partial thickness

37
Q

How is fluid formula different for electrical burns?

A

4 x SA x kg rather than 2

38
Q

What is adequate UO for adults vs kids in burns?

A

At least 0.5 ml per kg per hour in adults

1 in kids

39
Q

Which thyroid Ca commonly metastases via lymph?

A

Papillary

40
Q

What cells characterise medullary thyroid Ca?

A

Parafollicular c cells of neural crest origin

41
Q

Which thyroid Ca is notoriously not radio iodine sensitive?

A

Medullary

42
Q

Which thyroid Ca doesn’t usually need resection?

A

Lymphoma

43
Q

Which thyroid Ca usually metastasises via blood?

A

Follicular

44
Q

What scans can be used to localise parathyroid adenomas?

A

US in combo with sestamibi (MIBI radionucleotide)

45
Q

What infarction causes AV node ischaemia - be specific and also where it arises?

A

RCA - posterior IV artery, AV nodal branch. Arises in ant coronary sinus

46
Q

What bit of adrenal hypertrophies in Cushings?

A

Zona fasciculata

47
Q

What is piriformis syndrome?

A

Entrapment neuropathy of sciatic nerve causing radicular pain and paraesthesia

48
Q

From which muscle does sciatic nerve emerge under? Entrapment syndrome?

A

Piriformis

Piriformis syndrome

49
Q

Which nerve emerge over piriformis? Innervated muscles?

A

Superior gluteal nerve

Gluteus medius and minimus

50
Q

Nerve roots of superior gluteal nerve?

A

L4-S1

51
Q

Inferior gluteal nerve innervates?

A

Gluteus maximus

52
Q

Once thawed, when does FFP have to be used within? What about overall fridgd ztorage time?

A

24 hours

36 months total

53
Q

Most common pathogen causing bacterial flexor tenosynovitis?

A

S aureus

54
Q

Ewings sarcoma is diagnosed based on what? Radiology and biopsy

A

Lytic destruction with onion skin appearance, usually diaphyseal in LLs of teenagers
Small round blue cells on biopsy

55
Q

What condition is suggested by onion skin appearance lytic lesion and pain swelling in teenage lower limb long bone?

A

Ewings sarcoma

56
Q

What is a chondroblastoma?

A

Benign epiphyseal tumour

57
Q

What do you do if DDH suspected in newborn? Why?

A

US at 4 to 6 weeks to reduce inappropriate splinting, as many lax capsules tighten by then

58
Q

Why does radial nerve injury in spiral groove of humerus leave elbow extension ok?

A

Triceps branch originates higher up

59
Q

What is the emegency treatment of hereditsry angiodema?

A

FFP to replace C1 esterase inhibitor

60
Q

Why is ferrous sulphate better than ferric?

A

Dissolves better in water

61
Q

Where is most body iron stored?

A

Hb

62
Q

How are displaced intracapsular fractures in young people managed?

A

Fixation - emergency e.g. Dhs

63
Q

MUST fracture?

A

Monteggia- proximal ulna fracture with superior/prox radial head dislocation

64
Q

GRIP fracture?

A

Galeazzi- radial fracture with inferior radio ulnar dislocation

65
Q

CD arm fractjre?

A

Colles - dorsal angulation, fall on outstretched hand

66
Q

Smiths fracture?

A

Reverse colles - fall on flexed hand, volar angulation of segment

67
Q

Barton fracture? BC

A

Distal radial fracture with radioCarpal joint dislocation

68
Q

Main MALT gastric lymphoma association and therefore first treatment measure for local disease?

A

H pylori therefore eradicate

69
Q

Minimal size for aystmpomtatic AAA intervention?

A

Over 5.5 cm

70
Q

What is PEEP useful for? Specific example?

A

Diffuse processes to keep Airways open - e.g. ARDS

71
Q

Best method of investigating microcalcification on mammography?

A

Core biospy

72
Q

Majority of hip dislocations are what? How do they look? Nerve at risk?

A

Posteiror due to trauma
Sciatic nerve palsy
Shortened adducted and internally rotated

73
Q

Diagnosis of Hirschprungs is confirmed by?

A

Absence of ganglia in submuvosa of rectum

74
Q

What acid base disturbance can be caused by over administration of NaCL?

A

Hyperchkoraemic metabolic acidosis

75
Q

Haemophilia A causes prologned what?

A

APTT

76
Q

Management of pregnancy associated CTS?

A

Conservative initially e.g. wrist splint as most resolve after pregnancy

77
Q

What investigation is best breast imaging in women under 35?

A

US

78
Q

Incision for open appendicectomy?

A

Lanz

79
Q

VWD is what inheritance?

A

AD

80
Q

Lichen planus is a RF for what?

A

Oral cancer

81
Q

Which is more common in trauma - intra or extraperitoneal bladder rupture? How are these repaired

A

Extra

2 layer technique, absorbable sutures

82
Q

MEN2a? 2b?

A

Medullary thyroid Ca
Phaeochromocytoma
Parathyroid hyperplasia
2b is this but with marfans and neuromas, no parathyroid

83
Q

Men1?

A

Pituitary tumour
Parathyroid hyperplasia
Pancreatic - insulinoma/ZES

84
Q

What neck swelling classically gets big/painful after URTI?

A

Branchial cyst

85
Q

How does PTH increase Ca?

A

Increases hydroxylatkon of 25 hydroxy vit D to 1 25 dehydr vit D
In turn increases intestinal absortpion of Ca

86
Q

What cells release PTH?

A

Chief cells of parathyroid

87
Q

What investigation is most sensitive for heart transplant rejection?

A

Heart biopsy

88
Q

A central lumbar disc herniation at a given spinal level e.g. L3/4 will affect which nerve?

A

One below - transiting

E.g. L4

89
Q

A lateral disc prolapse will get which nerve?

A

Exiting nerve e.g. at L3/4 would be L3 nerve

MRCS Part A (7 decks)

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