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MRCS > new part A 2020 > Flashcards

new part A 2020 Flashcards

1
Q

Surface marking of the femoral artery?

A

Mid-inguinal point

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2
Q

Content of the adductor canal in order?

A

from lateral to medial: a continuation of the apex of the femoral triangle.
Laterally: Lateral cutaneous nerve of the thigh, femoral nerve, Femoral artery, femoral vein.

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3
Q

Discuss Femoral triangle

A

It is medially bound by the adductor longus, laterally sartorius, superiorly inguinal ligament, floor is pectinus.

Content L to M: Nerve, artery, vein, lacunar ligament.

Femoral sheathe contains all the above except the lacunar ligament because it is medial. in the female contains Cloquet’s node (also Rosenmuller’s node)

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4
Q

Mid inguinal point Vs mid point of inguinal ligament?

A

Mid inguinal point is from ASIS to the pubic symphsis, this gives the landmark inferiorly to the femoral artery.

Mid point of inguinal ligament is lateral compared to the former(ASIS to pubic tubercle). this represents inferiorly the landmark of the femoral nerve and the deep inguinal ring.

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5
Q

Conn’s syndrome Vs Addison disease?

A

Addisons: Adrenal insufficiency
Conns: Hyperaldosteronism.

Adrenal insuficieny / Addison:
Not enough cortisol, glucocorticoids, mineralcorticoids, not enough aldosterone -> Hyponat, Hyperkal, Increased ACTH due to lack of adrenal activity, hence increased melanin. Low BP, low mood, Hypercalcaemia from Reduced GFR due to lower volume.

Conns/ Hyperaldosteronism: Opposite of Addisons. Hypernat, hypokal, hypocal, hypomag. Not too much aldo, high BP.

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6
Q

Papillary thyroid Ca. What do you know about it?

A

80-85% of all thyroid Ca.
Spread via Lymphatics
Psamomma bodies.
Orphan anni cells.

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7
Q

Tell me about otitis media.

A

Common in paeds.
Strep pneumo, strep pyogens, staph aureus, H. Influenzae.

Dural venous thrombophlebitis posterior to the ear of the mastoid air cells.

Mastoid air cells are part of the temporal bone.

When tX, first line is Abx, exploratory is reserved is resistant.

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8
Q

Tell me the 12 CN Nerves.

A

CN I: Olfactory nerve
CN II: Optic nerve
CN III: Oculomotor nerve
CN IV: Trochlear nerve
CN V: Trigeminal nerve (First ph. pouch) V1 opthalmic, V2 Max, V3 Mand
CN VI: Abducens nerve
CN VII: Facial nerve (2nd Ph. pouch)
CN VIII: Vestibulocochlear n.
CN IX: Glossopharyngeal n. (3rd Ph. pouch)
CN X: Vagus Nerve (4th Ph. pouch)
CN XI: Accessory Nerve
CN XII: Hypoglossal Nerve

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9
Q

Foramen rotundum contents and which bone

A

Max nerve, V2
opening in the greater wing Sphenoidal bone.
Anterio-medial to foraman ovale.
it connects the middle cranial fossa to the pterygopalatine fossa.

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10
Q

Foraman ovale content

A

Mandibular nerve
motor root of the trigeminal nerve
accessory meningeal artery
lesser petrosal nerve
emissary vein

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11
Q

Foraman spinosum content

A

Middle meningeal artery
Middle meningeal vein
Maybe also nervus spinosus

Posterior lateral to ovale.

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12
Q

Hypoglossal nerve. Tell me what you know

A

Hypoglossal nerve.
Innervates the intrinsic muscles of the tongue.
Lesions cause ipsilateral deviations
Runs through the hypoglossal canal located in the occipital bone medially and superiorly to the occipital condyles.

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13
Q

CN X. Tell me about it.

A

Vagus nerve.
From the 4th Ph. Pouch.
Innervates the palate. Ipsilateral deviations to the site of lesion.
Travels through the jugular foramen.

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14
Q

Hassall’s corpuscles

A

Anterior mediastinum, also called thymic corpuscles found in thymus.

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15
Q

What muscle opens the jaw?

A

Lateral Ptreygoid

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16
Q

Muscles of mastication

A

Masster, temporalis, medial and lateral pterygoid

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17
Q

Buccinator muscle function?

A

Tightens the cheeks and presses them against the teeth while chewing.

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18
Q

List common organisms causes necrotising fasciitis

A

Psudomonas aerugoniosa _____G-ve, rod, sweet/grape smell
Clostridium perf. ____G+ve rod
E.coli ____G-ve rod
MRSA ____G+ve rod

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19
Q

Post splenectomy vaccines?

A

H.influenza type B
N. meningiditis
Strep pneumoniae

(ALL encapsulated)

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20
Q

which H.Influenza is encapsulated?

A

H. influenza B is encapsulated, A is not

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21
Q

Deep peroneal nerve root

A

L4-S2

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22
Q

Cholecystokinin (CKK) function?

A

Relaxes sphincter of Oddi.
Contracts gall bladder
Constricts pyloric sphincter
Inhibits appetite by acting on hypothalamus

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23
Q

Lynch syndrome

A

Autosomal dominant due to mismatch repair gene defect/ Part of the HNPCC. Associated with Endometrial, ovarian, colorectal. and other genitourinary tumors
Histologically likely to be mucinous and likely to be right sided.
strong genetic history

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24
Q

Hodgkins lymphoma

A

Reed sternberg cells (Bi-lobed nucleated B lymphocytes).
subMandibular node swelling.
Night sweats.
Fever

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25
Q

AML

A

Auer rod

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26
Q

Sarcoidosis histology

A

Non-caseating granuloma

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27
Q

TB histology

A

Caesating granuloma with central necrosis

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28
Q

Respiratory accessory muscles

A

Scalene muscles and sternocleidomastoid

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29
Q

Celiac trunk arises at which level

A

T12

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30
Q

Paired bilateral aortic arteries branches

A

T12- inferior phrenic arteries, middle suprarenal arteries
L1/L2: RENAL ARTERIES
L2: gonadal arteries

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31
Q

4 Parasympathetic cranial ganglion

A

Ciliary, Otic, submandibular and pterygopalatine. stellate is sympathetic

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32
Q

Kaposi sarcoma associated with which disease

A

HHV-8, common with HIV, appears as a purple lesion on the mucosa or skin or internally.

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33
Q

Urachus dervied from ?

A

Allantois

34
Q

Lumbar cistern anatomical level?

A

L1/L2 extending to S2

35
Q

Midgut to hindgut transition point?

A

Proximal two thirds to distal third of the transverse colon

36
Q

foregut to midgut transition point

A

Half way boundary at D2

37
Q

First aortic arch?

A

Maxillary artery

38
Q

second aortic arch

A

pharyngeal artery and stapedial artery

39
Q

third aortic arch

A

common carotid and internal carotid

40
Q

4th aortic arch

A

R subclavian on the R side and aortic arch on the L

41
Q

6TH AORTIC ARCH

A

R & L pulmonary arteries

42
Q

Medullary thyroid carcinoma

A

Amyloid deposition in 80%
Part of MEN 2
cancer of the parafollicular cells
raised calcitonin levels

43
Q

antecubital fossa anatomy

A

Medially: lateral border of pronator teres
Laterally: medial border of brachioradialis
Floor is proximally brachialis and distally by supinator.
Roof is skin and fascia of bicipital aponeurosis which arises from biceps brachii.
Biceps brachii tendon is the most lateral border and medially is the brachial artery and median nerve.
Medial cubital vein is above the aponeurosis and below the skin

44
Q

Hodgkins vs non-Hodgkins features?

A

NHL is systemic lymphadenopathy, HL is localized lymph nodes

45
Q

Medial arch of the foot anatomy

A

Made from the tibilias posterior inserts into the navicular tuberosity and base of the medial cuneiform. Travels through the tarsal tunnel

46
Q

Tarsal tunnel anatomy

A

Anterior to posterior: Post. tibial tendn, flexor digitorum longus, post tibial artery, vein, nerve and flexor hallucis longus tendon.

Flexor retinaculum.
Tarsal tunnel is posterior to medial mall. and anterior to it is the great saphenous vein.

47
Q

features of pulmonary sarcoidosis

A

Bilateral hilar lymphadenopathy
raised ACE levels
SOB

48
Q

How does Gastrin work?

A

Binds to enterochromaffin cells by binding to CCK but does not bind directly to histamine cells

49
Q

NICE guidelines for CT within 8 hrs for head injuries criteria?

A

Age of 65 years or older
history of bleeding disorder
>30 minutes of retrograde amnesia
dangerous mechanism of injury

50
Q

Post op infection time

A

After 72 hrs

51
Q

where is potassium excreted in the nephron

A

Collecting ducts

52
Q

most common location for urinary calculi to impact

A

VUJ

53
Q

cat scratch disease ?

A

Bartonella henselae from cat saliva

54
Q

Lyme disease

A

B.BURGDORFERI. EXODUS TIC
ERYTHEMA MIGRANS
BULLS EYE LESION
Causes heart block

55
Q

VACTERL

A

vertebral defect, anal atresia, cardiac defect, tracheo-oesophageal fistula, renal anomaly and limb anomalies

56
Q

Solitary nucleus function and location

A

Antero medial on the medulla oblongata

Purely sensory:

Taste sensation from the tongue via chorda tympani of CN7
sensory info from the middle ear
chemoreceptors in the carotid body
baroreceptors in the aortic body.

57
Q

Embryonic structure that forms nucleus pulposus

A

Notochord

58
Q

Carotid sheath anatomy ?

A

medial: common carotid artery, internal carotid artery, Vagus nerve, internal jugular vein.
at C3-C4 the common carotid bifurcates to the external carotid.
Oesophagus is medial to the carotid sheath
Vagus nerve is posterior lateral to the common carotid artery.
Lobes of the thyroid are anterior to the sheath

59
Q

Fluid maintenance in children

A

100ml/kg/24hr for the first 10kgs of the body weight
50 ml/kg/24hr for the next 10kgs of the body weight
20 ml/kg//24hr for the remainder weight

60
Q

which foramen does the facial nerve leave the skull

A

Stylomastoid foramen

61
Q

Aspirate in gout

A

Negative birefringent needle shaped crystals

62
Q

Which vessels originates from the right ventricle and drains into the right atrium

A

Anterior cardiac vein

63
Q

Which vein drains the inferior surface of the heart and drains into the coronary sinus?

A

Middle cardiac vein

64
Q

Where does the hypoglossal nerve exit the skull?

A

Superior and medial to each occipital condyle

65
Q

Hip extensor muscles?

A

Gluteus maximus
Hamstrings ( Semitendinosus, semimembranosus and biceps femoris)
Adductor magnus

66
Q

Function of the gluteus medius?

A

Primary abductor of hip. Posterior portion causes hip extension and external rotation

67
Q

Classify Salmonella, and give relation to orthopaedics

A

Encapsulated Gram negative rod. common cause of osteomyelitis in patients with sickle cell anaemia because of serial splenic infarct causing splenic dysfunction

68
Q

On bimanual examination what is felt anteriorly to the vagina?

A

Base of the bladder

69
Q

what is the level of luschka joint

A

C3 to T1

70
Q

Which organism appears on Ziehl-Neelsen and Lowenstein-Jensen?

A

Mycobacterium TB

71
Q

what is the most influential factor on prognosis of breast cancer?

A

Nodal involvement, the more nodes involved the lesser the prognosis

72
Q

Duration of analgesia of lidocaine?

A

90 mins

73
Q

Antagonist of benzodiazepines and GABA agonist

A

Flumazenil

74
Q

Duration of bupivacaine?

A

6-8 hours

75
Q

Diabetic develops swelling and abscess after tooth extraction. Pus is oozing from the affected gum. Swab shows anaerobic Gram positive bacterium?

A

Actinomyces israelii, produces yellow sulfur granules.
DM causes immunodeficiency

76
Q

Which of the following structures forms from the second pharyngeal arch?

A

Muscles of facial expression

77
Q

Expected ECG findings in isolated obstruction of the circumflex coronary artery?

A

I and V5-V6

78
Q

patient with traumatic brain injury, CT shows isolated contusion in a deep brain region. BP is 88/56 mmHg, HR 100bpm, temperature is 40.5 degrees. Plasma sodium is 121. What area of the brain is most likely affected?

A

Hypothalamus

79
Q

Deep posterior compartment of leg content?

A

Popliteus, tibialis posterior, flexor hallucis longus and flexor digitorium longus.
innervated by tibial nerve

80
Q

Superficial posterior compartment of leg content?

A

Gastrocnemius, soleus and plantaris, innervated by tibial nerve

81
Q

Lateral compartment of leg?

A

Peroneus longus and brevis, innervated superficial peroneal nerve

82
Q

Anterior compartment content of leg?

A

tibialis anterior, extensor hallucis longus, extensor digitorum and peroneus tertius. innervated by deep peroneal nerve

MRCS (4 decks)

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