MRCS Recalls Sept 2017 (Part 1) Flashcards

1
Q

1- A 25 years old athlete came with a single rib fracture. He is in pain, but he is vitally stable. What is the most appropriate management?
A. Chest drain
B. Admission, observation and analgesia
C. Analgesia and discharge
D. Infiltration of wound with 5% bupivacaine
E. None of the above

A

C. Analgesia and discharge

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2
Q

2- A 59 years old COPD patient came with a rib fracture. X-ray was done with no hemo or pneumothorax detected, but the patient is in pain. What is the most appropriate management?
A. Chest drain
B. Admission, observation and analgesia
C. Analgesia and discharge
D. Infiltration of wound with 5% bupivacaine
E. None of the above

A

B. Admission, observation and analgesia

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3
Q

3- A 33 years old man suffered a RTA resulting in rib fracture. Examination revealed a BP of 110/70 and pulse rate of 88 with mild dyspnea. Chest Xray revealed left sided pneumothorax. What is the most appropriate management?
A. Chest drain
B. Admission, observation and analgesia
C. Analgesia and discharge
D. Infiltration of wound with 5% bupivacaine
E. None of the above

A

A. Chest drain

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4
Q

4- An 80 years old self dependent female sustained an intracapsular neck of femur fracture. The hip is internally rotated with pain on the greater trochanter. What is the appropriate management?
A. Hemiarthroplasty
B. Internal fixation
C. Open reduction and external fixation
D. Total hip replacement
E. Fixation with DHS

A

D. Total hip replacement

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5
Q

5- A known case of breast cancer suffered subtrochanteric fracture of femur after a car accident. What is the appropriate management?
A. Hemiarthroplasty
B. Internal fixation
C. Open reduction and external fixation
D. Cast

A

B. Internal fixation

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6
Q

6- A 40 years old male is injured during a rugby game resulting in a displaced subcapital fracture of femur. What is the most appropriate treatment?
A. Hemiarthroplasty
B. Internal fixation
C. Open reduction and external fixation
D. Traction
E. Closed reduction and cast

A

B. Internal fixation

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7
Q

7- A 12 years old boy presented to ortho clinic with an Xray revealing an osteoid forming tumor in
lower femur associated with soft tissue mass. He has a positive family history of Paget’s disease of bone. What is the likely diagnosis?
A. Osteosarcoma
B. Ewing sarcoma
C. Osteoclastoma
D. Benign bone cyst
E. None of the above

A

A. Osteosarcoma

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8
Q

8- A 35 years old man, just returned from Bangladesh, presented with bloody diarrhea and lower abdominal pain. Mucosa appeared severely distorted on sigmoidoscopy. What is the most likely cause?
A. Entamoeba histolytica
B. Ulcerative colitis
C. Campylobacter
D. Hepatitis A
E. Enterobius vermicularis

A

A. Entamoeba histolytica

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9
Q

9- A patient had a 24-hour duration colicky pain and diarrhea after eating barbecued chicken. Which organism causes this condition?
A. Staph aureus
B. E coli
C. Campylobacter
D. S. pyogenes
E. None of the above

A

C. Campylobacter

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10
Q

10- Which is the spinal root for plantar flexion?
A. L5
B. L4
C. L3
D. S1
E. S2

A

D. S1

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11
Q

11- A 23 years old patient was admitted after falling on his outstretched hand. His examination revealed that his thumb is adducted with lost sensation over the palmar aspect of the thumb. What is the most accepted cause of this injury?
A. Hook of hamate fracture
B. Distal radial fracture
C. lunate dislocation.
D. Scaphoid fracture
E. Montagea fracture

A

C. lunate dislocation.

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12
Q

12- A 12 years old child presented after a trauma to his wrist. Xray is normal and he was discharged. He is now presenting back after one week with severe pain at anatomical snuff box. What is the likely diagnosis?
A. Lunate dislocation
B. Scaphoid fracture
C. Fracture distal ulna
D. Carpal tunnel syndrome
E. None of the above

A

B. Scaphoid fracture

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13
Q

13- A 42 years old man sustained a trauma to his left upper limb. On examination there is weakness of intrinsic hand muscles with numbness over the medial aspect of the arm. What is the affected structure?
A. Lower trunk brachial plexus
B. Middle trunk of plexus
C. Median nerve
D. Ulnar nerve
E. Upper trunk of brachial plexus

A

A. Lower trunk brachial plexus

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14
Q

14- A patient suffered an injury to his thumb finger while gardening. He is now complaining of a fluctuant swelling in the palp space of his thumb. What is the causative organism?
A. Streptococcus pyogenes
B. Klebsiella
C. Staphylococcus aureus
D. Pseudomonas
E. MRSA

A

C. Staphylococcus aureus

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15
Q

15- A 53 years old female had a prosthetic valve replacement 2 years ago. He is now presenting with fever and palpitation. What is the causative organism?
A. Streptococcus pyogenes
B. Staphylococcus epidermides
C. Staphylococcus aureus
D. Pseudomonas
E. MRSA

A

B. Staphylococcus epidermides

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16
Q

16- A 34 years old athlete sustained a twisting knee injury while training. Next day, he presented with swollen knee and positive tap test. He is unable to fully extend his knee. What is the likely diagnosis?
A. Anterior cruciate ligament injury
B. Posterior cruciate ligament injury
C. Medial collateral ligament injury
D. Medial meniscal tear
E. Loose body

A

D. Medial meniscal tear

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17
Q

17- A 34 years old athlete sustained a knee injury while playing football. On examination, there is positive vulgus stress test. What is the likely diagnosis?
A. Anterior cruciate ligament injury
B. Posterior cruciate ligament injury
C. Medial collateral ligament injury
D. Medial meniscal tear
E. Loose body

A

C. Medial collateral ligament injury

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18
Q

18- A 7-year-old baby was brought by his mother after she noticed that he has evident limping with pain in his left hip. She denies any history of trauma. What is the most accurate diagnosis?
A. Perthes disease
B. Slipped upper femoral epiphysis
C. Developmental dysplasia of the hip
D. Septic arthritis
E. Osteoarthritis

A

A. Perthes disease

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19
Q

19- A 12 years old overweight child presented with obvious limping and limited internal rotation. He denies any history of trauma. What is the most accurate diagnosis?
A. Perthes disease
B. Slipped upper femoral epiphysis
C. Developmental dysplasia of the hip
D. Septic arthritis
E. Osteoarthritis

A

B. Slipped upper femoral epiphysis

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20
Q

20- A 24 years old man developed a painful scrotal swelling after long periods of standing which disappears on supine position. What is the most likely diagnosis?
A. Varicocele
B. Hydrocele
C. Inguinal hernia
D. Sperm granuloma
E. Spermatocele

A

A. Varicocele

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21
Q

21- A 25 years old man just returned from Bangladesh when he developed painless jaundice, anorexia and vomiting. What is the most likely cause?
A. Campylobacter
B. Ascaris
C. Hepatitis A
D. Hepatitis C
E. HIV

A

C. Hepatitis A

22
Q

22- External urethral sphincter is supplied by which nerve root?
A. L5,S1
B. S2,3,4
C. S3,4,5
D. L4,5
E. None of the above

A

B. S2,3,4

23
Q

23- A 42 years old pregnant lady developed incontinence after delivery. What is the nerve responsible for that?
A. Genitofemoral nerve
B. Internal pudendal nerve
C. Nerve to obturator internus
D. Sciatic nerve
E. None of the above

A

B. Internal pudendal nerve

24
Q

24- A 71 years old man with a history of cervical osteoarthritis is now presenting with numbness in his upper limb. What is the most suitable investigation?
A. CT scan
B. MRI
C. Bone scan
D. Neck Xray
E. None of the above

A

B. MRI

25
Q

25- The best investigation for a suspected complex supracondylar fracture of humerus is:
A. CT scan
B. MRI
C. Bone scan
D. Xray
E. None of the above

A

A. CT scan

26
Q

26- What is the medial border of femoral hernial sack?
A. Pectineal ligament
B. Inguinal ligament
C. Femoral vein
D. Lacunar ligament
E. None of the above

A

D. Lacunar ligament

27
Q

27- A 26 years old man presents to the ED with extensive bleeding from his arm after sustaining a glass injury. On examination there’s a 7 cm transverse laceration across the anterior aspect of his elbow. On exploring the cubital fossa, you expect the brachial artery to be:
A. Anterior to the median nerve.
B. Lateral to the biceps tendon
C. Lateral to the median nerve.
D. Medial to the median nerve.
E. Superficial to the bicipital aponeurosis.

A

C. Lateral to the median nerve.

28
Q

28- A 52-year-old man is found to have multiple myeloma. What skull X-ray appearances would be characteristic?
A. Diffuse thickening of the calvarium
B. Hair on end appearance.
C. Multiple fractures
D. Multiple osteolytic lesions
E. Multiple osteosclerotic lesions

A

D. Multiple osteolytic lesions

29
Q

29- A patient has symptoms of painful arc of shoulder abduction between (60-120) degrees What’s the most likely underlying diagnosis?
A. Frozen shoulder
B. Calcific tendinitis
C. Dislocated shoulder
D. Supraspinatus tendinitis
E. Occupational pain

A

D. Supraspinatus tendinitis

30
Q

30- A patient cannot perform opposition of thumb after a wrist injury. What is the most affected nerve? A. Recurrent median nerve
B. Deep ulnar nerve
C. Superficial ulnar nerve
D. Palmar median nerve
E. None of the above

A

A. Recurrent median nerve

31
Q

31- A 42 years old diabetic undergone appendicectomy for a complicated appendicitis. 7 days later, the wound appeared erythematous with yellow granules discharging. What is the most likely cause?
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Actinomycosis
D. Bacteroides
E. Pseudomonas

A

C. Actinomycosis

32
Q

32- What is the normal epithelial lining of the urinary bladder?
A. Stratified squamous cell
B. Transitional cell
C. Columnar cell
D. Non-stratified squamous cell
E. None of the above

A

B. Transitional cell

33
Q

33- During recovery from varicose veins surgery, a 35 years old woman complains of weakness of dorsiflexion of the ankle. Physical examination reveals absent sensation over the dorsum of the foot. Which of the following nerves is most likely injured?
A. Common peroneal nerve
B. Deep peroneal nerve
C. Saphenous nerve
D. Superficial peroneal nerve
E. Sural nerve

A

A. Common peroneal nerve

34
Q

34- A 36-year-old man falls on his outstretched right hand. Examination reveals tenderness in the anatomical snuffbox. Which of the following tendons forms a boundary of the anatomical snuffbox?
A. Abductor pollicis brevis
B. Extensor carpi radialis brevis
C. Extensor carpi radialis longus
D. Extensor indicis
E. Extensor pollicis longus

A

E. Extensor pollicis longus

35
Q

35- A patient presented with fracture of tibia and above knee cast was applied. He later presented with loss of foot eversion. Which of the following areas will have paresthesia?
A. Dorsum of foot except 1st web space
B. Lateral border of foot
C. 1st web space
D. Medial border of foot
E. Sole of the foot.

A

A. Dorsum of foot except 1st web space

36
Q

36- A 20 years old man with history of a pinned midtarsal fracture 7 years ago is now presenting with tarsal pain at the site of fracture. Xray would likely show:
A. Osteoarthritis
B. Rheumatoid arthritis
C. Malunion
D. Nonunion
E. Avascular necrosis

A

A. Osteoarthritis

37
Q

37- A 32 years old patient presented with recurrent loin to groin pain. Xray revealed multiple radio opaque stones. Analysis confirmed Ca oxalate stones. What is the most likely cause of this condition cause?
A. Hyperparathyroidism
B. Familial hyperoxaluria
C. Urinary tract infection
D. Hypoparathyroidism
E. None of the above

A

B. Familial hyperoxaluria

38
Q

38- A patient had upper limb injury. During examination, Sensation was intact with prominent claw hand, what is the level of nerve injury?
A. Radial nerve injury at the axilla
B. Ulnar nerve injury at the wrist
C. Median nerve injury at the cubital fossa
D. Ulnar nerve injury at the elbow
E. None of the above

A

B. Ulnar nerve injury at the wrist

39
Q

39- A man developed loss of sensation at first web space of the left foot after a complicated fracture management. What is the mostly affected nerve?
A. Deep peroneal nerve
B. Common peroneal nerve
C. Superficial peroneal nerve
D. Tibial nerve
E. Sural nerve

A

A. Deep peroneal nerve

40
Q

40- Following saphenous vein striping, a man developed loss of sensation over the lateral aspect of the foot. what is the most likely nerve to be injured?
A. Saphenous nerve
B. Tibial nerve
C. Superficial peroneal nerve
D. Sural nerve
E. None of the above

A

D. Sural nerve

41
Q

41- A 53 years old man developed loss of hip abduction after a hip surgery. What is the most likely cause?
A. Common peroneal (fibular) component of sciatic
B. Inferior gluteal nerve
C. Pudendal nerve
D. Superior gluteal nerve injury
E. Femoral nerve

A

D. Superior gluteal nerve injury

42
Q

42- A 49 years old female patient presented with a tingling and pins sensation in her hands. She mentions that she drops objects from her hands. What is the appropriate treatment?
A. Fasciotomy
B. Release trigger finger
C. Carpal tunnel release
D. Steroids
E. None of the above

A

C. Carpal tunnel release

43
Q

43- Posterior leg compartment syndrome can be diagnosed by passive pain on:
A. Hallux flexion
B. Hallux extension
C. Ankle planter flexion
D. Eversion

A

B. Hallux extension

44
Q

44- A 36-year-old butcher injures his left hand with a knife, suffering a deep laceration on the palmar aspect of the ring phalanx. On examination he’s unable to flex DIP, which tendon is likely to have been injured?
A. Flexor carpi facialis
B. Flexor carpi radialis
C. Flexor digitorum profundus
D. Flexor digitorum superficialis
E. Flexor indicis

A

C. Flexor digitorum profundus

45
Q

45- A 14 years old adolescent suddenly developed a painful scrotum after a football game. On examination, his testis is tender with lost cremasteric reflex. What is the most accurate treatment?
A. Fixation orchidopexy
B. Testicular doppler
C. Ligation of processus vaginalis
D. Medical treatment
E. Call urologist

A

A. Fixation orchidopexy

46
Q

46- A 49 years old man reported that he neglected his desire to urinate due to stressful condition. After the situation passed, he felt no desire to urinate. On examination, he has abdominal tenderness and distension with an empty foley catheter. What is the most accepted cause?
A. Blocked catheter
B. Hypovolemia
C. Bladder diverticulum
D. Ureteric stone
E. Bladder rupture

A

E. Bladder rupture

47
Q

47- A child known with sickle cell anemia experienced hip pain with high grade fever and TLC of 16 and ESR up to 66. What is the most likely underlying organism?
A. Staphylococcus aureus
B. Streptococcus pneumonia
C. Salmonella
D. Neisseria meningitis
E. None of the above

A

C. Salmonella

48
Q

48- A 51 years old female with claustrophobia and metallic valve sustained a trauma to her shoulder after a fall. How to investigate?
A. CT
B. MRI
C. Xray
D. PET scan
E. USG

A

C. Xray

49
Q

49- A patient developed loss of finger extension and mild affection of wrist extension with no sensory loss. What is the affected nerve?
A. Posterior interosseus nerve
B. Anterior interosseus nerve
C. Median nerve
D. Radial nerve
E. Ulnar nerve

A

A. Posterior interosseus nerve

50
Q

50- A patient had painful defecation. On examination the doctor noticed a painful fluctuant swelling near the anus. He undergone perianal abscess incision and drainage. Several days later the wound became shocked severely infected with bad odour and blackish discoloration. What is the possible diagnosis?
A. Perianal abscess
B. Necrotizing fasciitis
C. Erysipelas
D. Anthrax
E. Cellulitis

A

B. Necrotizing fasciitis