MRCS Recalls Jan 2017 (Part 2) Flashcards
1
Q
- 60-year-old man presents with a short history of pain in the right cheek and right upper teeth Maxillary sinus infection is diagnosed. This sinus is particularly prone to infection because of?
A. absence of Celia on the epithelium lining the sinus
B. closeness of the sinus to the nasal cavity
C. poor blood supply
D. Position of the sinus ostium high on the medial wall
E. relationship of the front teeth to the floor of the sinus
A
D. Position of the sinus ostium high on the medial wall
2
Q
- A 60-yr-old patient with Small ulcer on tip of nose, a lesion was excised from ear few months ago& -diagnosed as BCC, what is your diagnosis:
A. BCC
B. SCC
C. Keratoacanthoma
D. Herpes labialis
E. metastatic
A
A. BCC
3
Q
- An elderly patient with an Ulcer painless on lower lip with no cervical LNs enlarged. What is your diagnosis?
A. SCC
B. Keratoacanthoma
C. Herpes labialis
D. BCC
E. Metastatic
A
D. BCC
4
Q
- A patient with a groin mass, when examined an abnormal growth found under big toenail with discoloration, what is your diagnosis about groin mass?
A. ВСС
B. metastatic
C. Malignant melanoma
D. SCC
E. Keratoacanthoma
A
B. metastatic
5
Q
- A patient with malignant melanoma. what is the best prognostic factor ?
A. .5 mm Breslow thickness
B. Free margins
C. No lymph nodes involved
D. No distant spread
E. No mitotic figures
A
A. .5 mm Breslow thickness
6
Q
- A patient with anal cancer below the dentate line. Lymphatic spread to :
A. Iliac nodes
B. Superficial horizontal inguinal nodes
C. Superficial vertical inguinal nodes
D. Deep inguinal nodes
E. Para-aortic nodes
A
B. Superficial horizontal inguinal nodes
7
Q
- Lymphatic drainage of cervix
A. Internal iliac
B. Superficial vertical inguinal
C. Deep inguinal
D. Superficial horizontal inguinal
E. Para-aortic
A
A. Internal iliac
8
Q
- Lymphatic drainage of ovaries ?
A. Iliac nodes
B. Superficial horizontal inguinal nodes
C. Superficial vertical inguinal nodes
D. Deep inguinal nodes
E. Para-aortic nodes
A
E. Para-aortic nodes
9
Q
- Neonate presented with repeated vomiting and diagnosed as malrotation. Gut rotation occur around which structure ?
A. coeliac axis
B. IMA
C. portal vein
D. SMA
E. Celiac trunk
A
D. SMA
10
Q
- If Uncinate process split & formed annual pancreas, it can cause obstruction of which structure ?
A. Gall bladder
B. 1st part of duodenum
C. 2nd part of duodenum
D. 3rd part of duodenum
E. 4th part of duodenum
A
C. 2nd part of duodenum
11
Q
- Which structure lies anterior to Head of pancreas ?
A. pylorus
B. portal vein
C. hepatic artery
D. common bile duct
E. IVC
A
A. pylorus
12
Q
- Calot’s triangle medial boundary :
A. hepatic artery
B. cystic duct
C. cystic artery
D. common bile duct
E. hepatic duct
A
E. hepatic duct
13
Q
- Posterior duodenal penetration occurred & massive bleeding developed. What is the artery involved?
A. Gastroduodenal artery
B. gastroepiploic
C. SMA
D. IMA
E. Portal vein
A
A. Gastroduodenal artery
14
Q
- Congenital diaphragmatic hernia in which intestine in chest baby. part of diaphragm involved is developed from
A. left pleuroperitoneal membrane
B. right pleuroperitoneal membrane
C. septum transversum
D. hiatal opening
E. none of the above
A
A. left pleuroperitoneal membrane
15
Q
- Flail chest, no pneumothorax but pain on inspiration Management plan ?
A. Infiltration by 2% lignocaine
B. Infiltration by 1% or 0.5 bupivacaine
C. chest drains with suction
D. chest drains without suction
E. none of the above
A
A. Infiltration by 2% lignocaine
16
Q
- Which structure is not posterior relation of kidney?
A. iliacus
B. Psoas
C. Quadrates lumborum
D. Tranversalis muscle
E. diaphragm
A
A. iliacus
17
Q
- Rectal bleeding, on colonoscopy found bleeding from sigmoid colon, artery involved ?
A. inferior rectal
B. left colic
C. middle colic
D. right colic
E. ileocolic
A
B. left colic
18
Q
- Neonate, with meconium-stained front of diaper :
A. patent urachus
B. patent Vitello intestinal
C. patent ductus venosus
D. patent ductus arteriosus
E. none of the above
A
B. patent Vitello intestinal
19
Q
- A 5-yr-old boy with abdominal pain on examination there Right iliac fossa mass on U/S there is Sausage shaped appearance :
A. intussusceptions
B. Malrotation of bowel
C. Volvulus
D. Pyloric stenosis
E. Duodenal atresia
A
A. intussusceptions
20
Q
- A 3-yr-old Boy, brought with Cherry red mass protruding from anus :
A. bleeding hemorrhoid
B. juvenile polyp
C. intussusceptions
D. Pyloric stenosis
E. Duodenal atresia
A
B. juvenile polyp
21
Q
- A 6-months-old Baby brought with abdominal pain, bilious vomiting. On examination scaphoid abdomen. Dx :
A. volvulus
B. duodenal atresia
C. congenital hypertrophic pyloric stenosis
D. juvenile polyp
E. Ileal atresia
A
A. volvulus
22
Q
- Bullet lateral to rectus abdominis at right subcostal region, which structure injured ?
A. Gallbladder
B. liver
C. spleen
D. kidney
E. none of the above
A
A. Gallbladder
23
Q
- Manubriosternal angle level structure behind
A. arch meets descending aorta
B. Rt atrium
C. Trachea started
D. Innominate veins make SVC
E. None of the above
A
D. Innominate veins make SVC
24
Q
- In adult. Esophagus pierced the diaphragm at which distance from the incisors in cm :
A. 72
B. 27
C. 40
D. 15
E. 35
A
C. 40
25
Q
- Aortic opening at which vertebral level ?
A. T1O
B. L2
C. T12
D. T9
E. L1
A
C. T12
26
Q
- Maintenance Fluid in the postoperative period
A. 1 L of 0.9 % saline plus 1.5 L. of 4 % dextrose/0.18 % saline
B. 1 L of 0.9 % saline plus 1.5 L of 5 % dextrose
C. 1 L of 0.9 % saline plus 1.5 L of Hartmann’s solution
D. 2 L of 0.9% saline
E. 2 L of 4 % dextrose/0,18 % saline
A
E. 2 L of 4 % dextrose/0,18 % saline
27
Q
- Fluid resuscitation in trauma patient best initially :
A. Normal saline.
B. Fresh frozen plasma
C. Packed RBCS
D. Dextrose 5%
E. None of the above
A
A. Normal saline.
28
Q
- Pulmonary embolism ECG finding :
A. A ST elevation in LI & aVF
B. T Wave inversion v1-v3
C. Prolonged PR interval
D. Short QT interval
E. Wide QRS
A
B. T Wave inversion v1-v3
29
Q
- Sternum fracture, what structure will be damaged?
A. Right atrium
B. Right ventricle
C. Esophagus
D. Trachea
E. None of the above
A
B. Right ventricle
30
Q
- 5% burn on torso full thickness, what is your management?
A. full thickness graft
B. split thickness graft
C. fasciotomy
D. flap
E. none of the above
A
B. split thickness graft
31
Q
- Full arm superficial burns, blistering. How to manage?
A. keep open
B. occlusive dressing
C. full thickness graft
D. flap
E. None of the above
A
A. keep open
32
Q
- A 28-year-old man is comatose, from head injuries, on the neurosurgical intensive care unit. He is recovering well and should be extubated soon.
A. Nil by mouth and intravenous fluids alone
B. Intravenous fluids and sips orally
C. Total parenteral nutrition
D. Nasogastric feeding
E. PEG tube feeding
A
D. Nasogastric feeding
33
Q
- Postoperative patient who is recently getting restless. Urine output chat is tabulated hourly as 80 ml / 80ml/ 80 ml /0ml/ 0ml/ 0ml in last 5 hours. what is the cause?
A. Blocked Catheter
B. Hypovolemia
C. Neurogenic shock
D. Oliguria
E. None of the above
A
A. Blocked Catheter
34
Q
- Gastric fundus cancer lymphatic spread, where to search for lymphatic spread ?
A. Celiac
B. paraaortic
C. Superior mesenteric
D. Portal
E. Inguinal
A
A. Celiac
35
Q
- Patient with abdominal pain and Ca 3.7mmol/l (normal2-2.5mmol/l). management :
A. Calcium gluconate
B. I.V saline infusion
C. Zoledronates
D. Pamidronates
E. None of the above
A
B. I.V saline infusion
36
Q
- A 26-year-old man is having a stereotactic frame fitted to his skull prior to radiosurgery on a cerebral arteriovenous malformation. Four pins secure the frame tightly through the scalp to the outer table of the skull, two anteriorly, two posteriorly. On insertion of one of the-posterior pins, arterial hemorrhage is encountered. Which artery is most likely to have been punctured?
A. The ascending pharyngeal artery
B. The middle meningeal artery
C. The occipital artery
D. The posterior cerebral artery
E. The posterior communicating artery
A
C. The occipital artery
37
Q
- Pancost tumor which nerve is affected
A. T1
B. C8
C. C7
D. C5
E. None of the above
A
A. T1
38
Q
- A child swallowed a coin where will it stuck ?
A. At T4
B. cricopharyngeal sphincter
C. thyroid prominence
D. at level of aorta
E. none of the above
A
B. cricopharyngeal sphincter
39
Q
- Appendix pain started in paraumbilical region, because it shares the same level of dermatome which is
A. T8
B. Τ10
C. T12
D. LI
E. L3
A
B. Τ10
40
Q
- 45 years old suffered from lower lip numbness and muscle of mastication affection, which nerve is affected?
A. Facial nerve
B. Mandibular of trigeminal
C. Lingual nerve
D. Chorda tympani
E. Glossopharyngeal
A
B. Mandibular of trigeminal
41
Q
- A 60-year-old woman with breast carcinoma complains of difficulty chewing her food and is found to have numbness of the lower lip on one side. CT scanning shows a small metastatic lesion affecting the bony skull base on. The same side as the lip numbness. Which foramen is the most likely to involve?
A. Foramen caecum
B. Foramen magnum
C. Foramen ovale
D. Foramen rotundum
E. Foramen spinosum
A
C. Foramen ovale
42
Q
- Middle meningeal artery passes through which foramina?
A. Foramen of ovale
B. Foramen rotundum
C. Foramen spinosum
D. Foramen lacerum
E. Foramen magnum
A
C. Foramen spinosum
43
Q
- 45 years old suffered from nystagmus and ataxia. Artery affected :
A. middle meningeal artery
B. PICA
C. MCA
D. ACA
E. Ophthalmic artery
A
B. PICA
44
Q
- Spastic Lower limb paralysis artery affected :
A. PICA
B. Middle meningeal artery
C. ACA
D. MCA
E. Ophthalmic artery
A
C. ACA
45
Q
- Sympathetic relay on which part at spinal cord :
A. Anterior horn
B. Dorsal horn
C. lateral horn
D. medial horn
E. none of the above
A
C. lateral horn
46
Q
- A 61 years old patient presented with recurrent gastric pain and diagnosed as gastric outlet obstruction. Which electrolyte or ABG disturbance affects that patient?
A. Metabolic Alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Hyperkalemia
E. Hyperchloremia
A
A. Metabolic Alkalosis
47
Q
- Pulmonary embolism cause which abnormality: A. respiratory alkalosis
B. Metabolic acidosis
C. Metabolic alkalosis
D. Respiratory acidosis
E. None of the above
A
A. respiratory alkalosis
48
Q
- A patient with hypovolemia symptom .Which compartment of body fluid affected?
A. Decreased extracellular volume
B. Increased interstitial volume
C. increase intracellular volume
D. no change in fluids
E. increase transcellular fluid
A
A. Decreased extracellular volume
49
Q
- A patient with tension pneumothorax symptoms. What compromises his cardio-pulmonary status ?
A. Increased venous return caused decreased cardiac output
B. Unaffected venous return cause decreased cardiac output
C. Decreased venous return cause decreased cardiac output
D. Unaffected venous return nor cardiac output
E. None of the above
A
C. Decreased venous return cause decreased cardiac output
50
Q
- INR deranged with underlying liver problem came for bleeding. Treatment?
A. Stop Warfarin then give Human prothrombin complex + Vit K
B. Stop Warfarin then give Vit K + FFP
C. Stop warfarin and give oral vitamin K
D. Stop warfarin and give FFP
E. Stop warfarin only
A
C. Stop warfarin and give oral vitamin K
