MRCS May 3/52

Question 1

Describe the borders of the subclavian artery

Answer 1

1st part - origin from brachiocephalic to medial border of scalaneus ant
2nd part - posterior to scalanius ant
3rd part - lateral border of scalanius ant to lateral/inf edge of clavicle

Question 2

Borders of the 3 parts of axillary artery and the branches

Answer 2

1st part - lateral edge of clavicle to medial border of pect minor - sup. Thoracic artery
2nd part - posterior to pect minor- lateral thoracic artery and thoracoarcomial artery
3rd part - lateral edge of pec minor to lower edge of teres major- subscap art and circumflex arteries

Question 3

Where does brachial artery begin?

Answer 3

Lower edge of teres major

Question 4

Where is growth hormone made and scereted?

Answer 4

Anterior pituitary

Question 5

What are some stimulators of growthhormone release

Answer 5

Exercise, sleep, estradiol, hypoglycaemia

Question 6

how does hyperventilation affect GCS

Answer 6

hyperventilation causes hypocapnia which causes cerebral vasoconstriction and reduced blood flow

Question 7

strep pyogenes belongs to which group?

Answer 7

group A

Question 8

what is a group B strep?

Answer 8

strep agalactiae

Question 9

what is ca15-3 a marker of?

Answer 9

breast cancer

Question 10

what bacteria would someone post splenectomy be more susceptivle to?

Answer 10

N menigitides
strep pneumonia
H influenzae

Question 11

what are the mx options for AAA depending on size?

Answer 11

3-4.4cm = US surveillance annually

4. 5-5.4 = 3 monthly scans
5. 5 = vascular surgeon

Question 12

what muscles does obturator nerve innervate?

Answer 12

anterior branch: gracilis, adductor brevis, adductor longus

posterior: obturator externus, part of abductor magnus

Question 13

what ECG change is common post insertion of a swan ganz catheter?

Answer 13

RBBB that resolves after 24hr

Question 14

what is the concentration of sodium in hartmann’s solution?

Answer 14

131 mmol

Question 15

what is trash foot how does it present?

Answer 15

acute limb ischaemia after aortic surgery caused by emoblic cholesterol plaque. presented with pain, intact pulses and purple lacy discoloration of leg

Question 16

branches of abdominal aorta from most proximal

Answer 16

inferior phrenic
coeliac trunk
adrenal arteries
renal arteries
SMA
gonadal arteries
vertebral arteries
IMA
median sacral 
common iliacs

Question 17

what forms the portal vein

Answer 17

splenic vein and SMV

Question 18

segments of liver supplied by left and right portal vein?

Answer 18

right PV - segment 1 5 6 7 8

left PV - segment 1 2 3 4

Question 19

what many % of blood to liver is supplied by portal vein and how many % of oxygen?

Answer 19

75% of blood, but 50% of oxygen

Question 20

how does hypothermia cause increase bleeding risk

Answer 20

causes platelet dysfunction