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MRCS Part A 25th jan 2011 : recall

concentrate in clinical anatomy and orthopedic


time is only ur enemy especially in paper 1
no calculation no long questions
paper1:
1-tredelenburg sign , which muscle tested Gluteus medius and minimus
2-fall on out stretch hand result compartment and parathesia on median nerve
distribution, disslocation of lunate.
3-Posterior perforating duodenal ulcer bleeder?gastroduodenal artery
4- loss of sensation on medial aspect of arm , root value T1
5-pt hitten by hard subject in head violent , sagittal sinus
6-muscle of thumb and palm supply by ulnar nerve
7- test pt hand while palm on table he cant touch paper by thumb, lesion of ext polic
8- lymph drainage of cervix, to internal & ext illic
9- pt feel numbness on medial aspect of leg following varicose vein surgery,
saphenous nerve
10-knee joint injury about 4 question
11-structures in deltopectoral fossa during dissection
12-nerve found during operating injuinal hernia
13-nerve injured during submandibular gland surgery (Hypoglossal nerve, Lingual,
Marginal mandibular)
14-lateral and third ventricle dilated where site of obstruction (Sylvia)
15-PDA formed from which aortic arch in embryo 6th arch
16-blood supply of desending colon
17- nerve supply to anal canal
18- branchs of trigiminal nerve & excit foramen for each one
19-lymph drainage of anal squamous cell carcinoma (Sup Inguinal)
20-gall bladder the most distinct part identified during surgery

21-hip joint movment muscle action in ext. rotation


22-dermatoum of lateral aspect of forarm C6
23-medistinal biopsy
24- hemisection of spinal cord , sensartion modilities loss
25-injury during maxillofascial surgrey lead to loss sensation over ant. 2/3 of tongue
(lingual nerve)
26-fracture of medial epicondyle which muscle of forarm not affected
27-collection of crainal nerves and its actions
28-neck surgery lead to horseness of voice , unilateral recurrnt
29-pt felt pain in calf muscle , the level of vascular occlusion is?
30- pleural tapping in mid axillary line, 7-9th
31-branch of internal iliac and its supply.Superior gluteal nerve supplies
32- epidural Lumbar puncture, structures pierced, level,Post. longitudinal
ligament
33- during TURB using dithermy stimulate which nerve that cause twitching
34-portal vein formed by union of ? bhind ,
35- pt loss sensation over web space of big toe, which nerve affected (Deep Fibular?)
36- sternocledomastoid mass in the middle
37- man with groin mass
38- baby with inguinal mass
39-player injury ,Anterior cruciate ligament prevents Ant. dislocation of tibia,
40- coronary circulation
41-surounding testis tunica albuginea
42-fall from horse injury to structure behind Scalenus anterior.
43- Ovale Transmits Mandibular Nerve,Rotundum Transmits Maxillary Nerve
44- sprinting duirng playing football --> pain and post of the thigh. later severe pain

and the lat side of the knee. unable to extend knee dt pain. what is the tendon being
involve?
--> tendon of biceps femoris
45-a knife penetrate the left of the sternal angle fthe rib with pt normal air entery ,
tachycardic,
46-IN surgical ICU, with flial chest intubated pt develop breathelessness need
increase ventalation pressure ,o2 drop to 70% . what is the most common cause
47- vitamin play role in ,, A , B12
48- extracellular fluid osmolality equal to osmolarity in which part of tubule loop of
Henle in pt taken lasix?
49-Angiotensin II, pt with sec HTN taken enlapril
50- TSH, T4, T3 level in gravies , ttt recurennce hyperthyroidism taken thyroxin, in
hashimioto in medullary cell carcinoma
51-protein c deficinancy affect factor and cycle of coagulation

MRCS part A 8 Jan 13


some of the questions:
1- Supination of the arm --> C6
2- Claw hand --> T1 lesion
3- what effect of ulnar nerve injury on the thumb movement --> loss of
adduction
4- Left line of the heart on CXR what does it belong to (Rt Atrium, Rt
ventricle, Lt atrium or ventricle)?
5-Stap injury to Rt side lateral to the sternum what will injure
(Hemizygus v., IVC, Rt atrium, Rt ventricle)
6- Lung function in COPD --> reduced RV (I think this is the correct
answer)
7- Which mucle affected in the 4th cranial n injury to the eye, patient
can't look down specially on coming down the stairs. can't remember
8- patient on warfarin what will it disturb --> 2, 7, 9, 10
9- Most common cause of OM in children --> H Influenza (not sure)
10- Lyning of the bladder transitional
11- Most common cause of mesenteric ischemia --> embolism
12- In pancreatitis necrosis happen due to (lipase or amylase or other
enzymes)? is it Lipase

13- Chiled spine level for LP below L2/3


14- Lost sensation side of tongue what nerve lingual(Trigeminal)
15- numb lower lip after tooth extraction what nerve inferior alveolar
nerve
16- normal anion gap acidosis (don't remember rest of question but
couldn't find renal a stenosis or pancreatic fistula among the answers)
17- Child with symptoms of inguinal hernia when at school only ? reason
(Gubernaculum, or the other embriological structures for the development
in this area)
18- on repairing the inguinal hernia which muscle is disected?
19- Chushings response --> increased BP, increases RR low HR but did
not mention the pulse pressure
20-few about tumor markers can't remember
21- fluids for burns?
22- polyps in a rectum of someone with spots around the mouth mostly
Peut Jughers what type of polyps --> ? adenomatous
23- Antiphospholipid
24- wound healing
25- acute inflammation --> neutophils
26- COPD --> chronic Resp acidosis
27-fluid over load vs PE cant remember the question
28- the local effect of Lidocaine when injected
29-Chap with head injury GCS 15 initially then 11 with dilated pupil ?
site of injury.
30- GCS score, moaning, pointing at pain, opening eyes to pain
31- latix allergy --> type I
32- What other matching is improtant in transplant apart from ABO --> I
wrote HLA DR not sure if Rhesus
33- which tendon posterior to lateral maleolus --> Perneous (fibular)
longus
34- N. injury lost dorsiflexion and lost sensation over first toe web -->
deep fibular nerve injury
35-femoral ring medially--> lacunar ligament
36- lost sensation lateral leg what is the mechanism of injury --> tibial
fracture (sural n) others were not related or very high or low
37- A registrar PR a patient 4 cm he felt something laterally what
anatomical stucture is it?
38-Hassall cells --> thymus
39- what is anterior to renal artery --> renal v
40- on opening the poplitial fossa what is the first structure --> tibial n.
41- lymphatic drainage of the scrotum--> superficial inguinal LN
42- Lymphatic drainage of the tetsticles --> Lumbar paraortic LN
43- Anterior surface of the hear --> ? Rt atrium

44- Transpyloric plane --> L1


45- where is the commonest site for collection of fluid in the abdo after
perf. appendix.
46- lateral posterior approach operation to fix radial head fracture what
nerve injured on loosing sensation medial part of hand +/- little and ring
fingers movements --> Ulnar n injury
47- Renin product --> Angiotensin I
48- Stomas --> End colostomy, or others including Hartman's
49-Increased ACTH after trauma
50-Anal Ca--> Human papiloma V
51-EBV --> lymphoma
52-factors that increase gastric acidity --> vagal stimulation, Gastrin,
Histamin
53-Factor that help Gastrin --> Histamine
54-Dark GB stones on opening the GB --> ? Bile salts
55-Type of cell change in Barret's -> metaplasia Squamous columnar
56-patient with winging scapula --> Serratus ant. muscle
few questions
1.ear discharge with 40db hearing loss- cholesteatoma
2.ear pain relieved after discharge coming from ear- AOM
3.ear discharge with long standing itching around ear
4.discharge from sinus anterior to tragus in a child -> Otitis externa
5.inv. of choice in a man with thyroid nodule - FNAC
6.treatment of medullary carc. of thyroid - total thyroidectomy
7.treatment in man with pappilary carc. of thyroid of less than 0.5cms
with no lymphnodes - hemithyroidectomy
8.treatment of upper ureteric obstruction with .07mm stone and
hydronephrosis and fever
9.treatment of 1cm ureteric stone with no hydronephrosis- ESWL
10.bloody discharge from single duct of breast - pappiloma
11.creamy discharge with no cytology - duct ectasia
12.patient on warfarin with few atypical cells on aspiration of breast cyst
13.young female with no mass or cyst but discomfort -?fibroadenos
14. tethewring of breast skin- carcinoma
15.fibroadenoma
16.child with pathological # of femoral shaft with abdo. pain and mass
17.child with skin nodule and brown spots with similar history in sibling neurofibroma
18.soft swellin at back with rubbing at exam preparations strap - lipome
19.one on infected sebaceous cyst
20.diabetic with loss of sensation on dorsum of foot with pulsation felt in

the same limb -neuropathy


21.pfannensteil incision
22.upper midline abdo. incision
23.rheumatoid lady day1 postop with hypotension and low sodium and
high pottasium with long term steroids - adrenal insufficiency
24.hoarse voice after carotid enarterctomy
25.epispadiasis
26.5weeks history of liver failure with raised inr and deranged lfts
27.osteomyelitis in sickle cell anaemia
28.infection from eating watercresses
29.child with pruritis ani
30.lactating mother with big cyst -galactocele
31.presenting feature for left side ca. colon
32.26yr. female with sudden collapse and pain to right shoulder ruptured ectopic/ovarian cyst torsion

few more questions


1.rupture of FDP
2.child with elbow fracture - median nerve
3.child with haemarthrosis and similar family history- haemophilia
4.head injury with dilated pupils -parasympathetic/sympathetic damage
5.postop long term nutrition in pt. with jejunum of 5cms _ total parenteral
nutrition or some fortified diet
6.post op nutrition for oesiphagectomy patient
7.post head injury pt. nutrition
8.penile cancer with multiple small wart like lesions
9.21 year old caucasian with splenomegaly - infectious mononucleosis
10.19 year caucasian girl with gall stones -spherocytosis
11.most common cause of mesentric infarction embolism/thrombosis/venous thrombosis
12.right gastroepiploic artery is a branch of GDA

1.post op fluid replacement -2litres dext. with 1litre saline


2.problem with basilar artery obstruction - visual problems
3.perianal abscess treatment - incision
4.first treatment for acute fissure -medical treatment
5.non reducible piles- haemmorhoidectomy
6.thromboprophylaxis in pt. with h/o cancer has undergone joint
replacement
7.thromboprophylaxis in pt. with PVD has gone AK amputation

8.antibodies to which cells in pernicious anaemia


9.good prognosis in ca. breast -her2 receptor absence/oestrogen +/--10.acute rejection in transplantation- t cells
11.endocarditis in lady with very old mitral valve replacement which
organism Strep
12.changes in osteoarthritis- cyst,erosion of cartilage,fibrosis
13.development dysplasia of hip
14.slipped subcapital femoral epiphysis
15.effect of moderate exercise on alveolar Po2 & Pco2
16.effect of pulmonary embolism on alveolar Po2 & Pco2
17.effect of rest on alveolar Po2 & Pco2
18.brown sequard syndrome leads to
19.50 yr. old with new malabsorbtion - ?adult onset coeliac disease
20.patient with vomiting tell his electrolyte changes
21.what you feel posterolaterally on PR examination
22.electrolyte change in patient with diarrhoea and soft mass on PR exam
23.nerve supplying adductors is stimulated during TURP OBTURATOR NERVE
24.level of conus medullaris in child -L 2/3
25.foreign body lands in which bronchus -right inferior
26.parasternal R side penetrating chest wound will damage what
27.spinal artery damaged in repair of thoracic aorta
28.tibia sagging behind on lateral xray of knee - PCL tear
29.footballer with knee injury with valgus stress test +ve and minimal
knee effusion- MCL injury
30.effect of osteoporosis on calcium level in blood
31.immediate treatment of hypercalcemia - iv fluids
32.patient with refractory hypertension - VMA levels increased
33.5yr. survival in dikes B cancer - 70 %

few more to go
1.old man with absent pulses distal to femoral with ulcer over calfarterial ischaemia
2.old lady with ulcer over medial malleolus and staining of skin around it
- DVT
3.artery causing ischaemia of colon beyond splenic flexure - anterior
branch of aorta arising at L3
4.decreased urine output 12 hours after surgery- cortisol or vasopressin
5.best to measure GFR - inulin
6.child comes back to # clinic with wrist pain after 1week as he was
cleared of any lower end radius fracture- scaphoid fracture

7.testicular pain after vasectomy-sperm granuloma /spermatocele


8.lady with progressing jaundice over 3months and weight loss- ca.
pancreas
9.treatment for localised ca. pancreas-pancreatoduodenectomy
10.treatment for grade 4 ca. pancreas- endoscopic stenting or MRI
stenting
11.nerve supply of sternocleidomastoid-accesor spinal
12.dysphagia with no relaxation at all of lower esophageal sphincter on
manometric studies
13.progressive dysphagia with history of gastroesophageal reflux for 3-4
years
14.neck abscess in adult with tonsil and uvula moved to centre
15.neck abscess in child with drooling and difficulty in moving neck
16.27 yr. old with testicular swelling- carcinoma
17.80yr old with scrotal swelling from groin not transilluminatinginguinal hernia
18.patient died after discharged from ED after road accident with
treatment for chest pain - rupture aorta
19.continuation of pericardioperitoneal cavities in child.give diagnosis
20.10 yr. old h/o nidtarsal fracture comes with pain in midfootosteoarthritis

Few more questions


1.how to identify C-2 vertebra on X-ray
2.porcine skin graft
3.allograft
4.kidney transplant from identical twin- isograft
5.skin grafting - autograft
6.hodgkins with worse prognosis
7.paraneoplastic syndrome secreting ACTH

A 65 year old man is admitted for a below knee amputation. He is taking


digoxin. Clinically the patient has an irregularly irregular pulse. What
would you expect to see when you examine the jugular venous pressure?
Answer abscent a wave
Jugular venous pressure
Absent a waves = Atrial fibrillation

Large a waves = Any cause of right ventricular hypertrophy, tricuspid


stenosis
Cannon waves (extra large a waves) = Complete heart block
Prominent v waves = Tricuspid regurgitation
Slow y descent = Tricuspid stenosis, right atrial myxoma
Steep y descent = Right ventricular failure, constrictive pericarditis,
tricuspid regurgitation

A 43 year old man presents with haemoptysis and is diagnosed as having


tuberculosis. Which of the cell types listed below will usually internalise
the tubercule bacullis?
Answer : Macrophages

Questions from paper 2 Part A 8 Jan 13


1- Organism for Hydatid liver disease --> Echinococcus
2- Pruritis ani in a child --> Enterobious Vermicularis
3- Mother and her children with pruritis ani was diagnosed wrongly by
GP --> ? salmonilla
4- fibroadenoma
5- creamy nipple discharge
6- Galactocele
7- bone lesion and fracture in a child ? Osteoid sarcoma
8- Primary sclerosing cholangitis in a patient with UC
9- Gilbert Syndrome
10- localised pancreatic Ca with no spread --> ? local excision
11- pancreatic Ca with liver mets--> ? pancreaticodudenectomy and
removal of any obvious tumor
12- Calcitonin --> Medullary Ca --> treatment Total thyridectomy
13- well capsulated papillary Ca in one lope --> I answered total
thyridectomy but was not sure if the correct answer is Hemi
14- Raised Ca, raised Alk phosphate and low Phosphate --> Pri
Hyperparathyroidism
15- low TSH and raised T3 AND T4 --> Pri Hyperthyroidism
16- child with dislocated elbow --> signs of ulnar nerve injury
17- Direct inguinal hernia
18- Spighelian hernia
19- Knee injury --> medical collateral ligament injury
20- Knee injury --> PCL
21- Child with nasal bleed and other symptoms --> naso-something tumor

22- ear infection --> AOM


23- Kidney stone 7mm in the ureter --> ? Uretri=olithiotomy (not sure)
24- kidney stone in the PUJ --> wave distruction
25- sigmoid valvulous
26- bloody diarrohea, with anal fistula --> Crohn's/UC
27- Lt abdo pain, chronic --> what type of stool ? dark blood
28- Child with symptom of intussusseption --> Jelly stool
29- Lady with calcium 3.7 initial managment --> IV fluids I wrote
Bisphosphonate which is usually the treament when Ca >3 BUT I think I
am wrong it is not the initial treatment, fluids first if not improved give
Bis
30- po op hoarsness of voice which nerve (recurrent laryngial nerve not
among the answers) ? Vagal
31- Patient for sigmoid colectomy what post op anticoag prophylaxis -->
LMWH + stockings?
32- below knee amputation for gangreen got worse after operation and
extended --> ? infection
33- after amputation distal leg got swollen ?
34- patient with IHD and peripheral vaascular disease what anticoag
prophylaxis--> ? LMWH only ?

MRCS Exam 11/09/2012 mcqs


Questions I can recall:
pt with high Ca and high pth...primary hyperthyroidism
which muscle initiates abduction of shoulder...supraspinatus
which structure will be in left 5th intercostal space...right ventricle
principle support of uterus... transverse muscles/facia
in elbow brachial art relation to median n...lat
which process enhances ingestion of bacterias...opsonisation
after splenectomy...leucocytosis
anatomical snuffbox border...apb
one question with nerve injuries...answers were ulnar and another with
low trunk brachial plexus inj
lymph drainage of scrotum, testes and prostate
testicular swelling in children...epidydimal cyst, torsion of morgagni,
hydrocele, seminoma, idiopatic scrotal swelling
medullary thyroid ca...calcitonin
thyroid test interpretationfor thyrotoxicosis, hypothyroidism, medullary
ca, pt after thyroidectomy with and without suspection of mts
pt with high co2, high bicarbonate, low o2

another question about spinal problems...one was disc prolapse, spina


biffida occulta, ankylosing spondilytis
few questions regarding s1 dermotome
pt with
pancreatic tumours...answers were insulinoma, glucagonoma
in pheochromacytoma...vanillilmandelic acid in urine
skin lesions...seborrhoic keratosis, dermatofibroma, few others cannot
recall
one with reynauds fenomenon
breast lesions...duct ectasy, subareolar abscess, ductal ca, pagets
child with walkig problems...development dysplasia, slipped upper
femoral epiphysis, septic arthritis
pt after laparoscopic cholecyctectomy with bile leaking from drain dg and
another one with pancreatic head ca who failed ercp next stage of mg
antibiotic prophylaxis questions cannot recall exactly but one was gas
gangrene
pathogen responsible for process again few questions one was surgeon
after working with clean wound, perianal lesion, insect bite
opposite of relative risk.,.... numbers needed to -treat
-sensitivity
- DDH..
-SCFE
-SEPTIC Arthritis
-perthes
-NERVE supply of pernieum
-pulmonary artery branchial arch
-nucleolus pulposes causing disc prolapse
-pt with stiff back and limited expansion.... anklyosing spondilitis
- p with prominent sacrum spondylolithesis
-stupid question about blood groups
-MCL
-mm tear

lumber puncture - 1st structure


femoral blood sampling land mark
compartment syndrome
hip extensor

the last emq regarding men with gynaecomastia. dg


function of iliopsoas..
which structure will be injured during chest drainage through 5th
intercostal on midaxillary line..
which nerve is in the posterior triangle of the neck...spinal accessory
nerve was the answer
transpyloric plane level...l1
pt with loss of anal tone with conus medullaris compression which
dermatome will be affected...s2 s3 s4
3questions on gcs calculation...one was no motor no sensor no verbal so
answer was 3. another one 14.
questions regarding ankle brachial pressure...the db one was the one >1
ulcers and arterial ds 0,2 chronic venous ischaemia 0.7 and one more
can't recall
one q regarding assosiations of polyarteriitis nodosa...
question about sinoatrial node
another one which structure can be auscultated on 2nd spaceleft sternal
border...pulmonary valve

A 10 year old boy is with symptoms of right knee pain. for the past 3
months and the pain typically lasts for several hours. On examination he
walks with an antalgic gait and has apparent right leg shortening
Perthes
structure medial to femoral hernia
Lacunar lig

MRCS 2012 sept part A


part a paper 2
patient travel to zembabwi fever nausea
patient underwent op possibly decrease immunity
+ pneumonitis
options
CMV

hBv
c
d
a
hiv
if u know answer?


Some neuro q-
---man with some eye sign . Diplopia--o/e 3rd n 6th CN palsy with forehead
paraesthesia - the ans will be cavernous sinus lession but i put something else .
Same que is in passmedicine.

-

70 yr old man with hemiballism, better when asleep - shoud be subthamic


nucleaus but i don't remeber if it was in the ans because i ticked red
nucleaus again wrong sob sob..
-upper limb ' weak abductor pollicis longus or brevis with decreased
sensation of index finger -- ? Ans
- another diplopia que - that was recurrent episode of self limiting
diplopia. O/e ptosis and some other eye movement problem well i don't
recall the ans for this i think MS/ MD was among them.
-headache +vomiting for 2/7, low BP on presentation . I think there was 3
nerve palsy again - ?. Could it be pituatary apoplexy well no recall of ans i
think imight have done wrong
-some limb weakness with post hypotension - GBS ( i think somebody
already mentioned this Q
-homonemous quadrantonopia one

-obese lady with headahce, false localising signs , high BP abt 169 sys-?
IICH

-galactorrperoa with hogh prolactin - which drug - ?? Metoclopramide--
pharma though

-HIV cerebral involvement what will differentiate cryptococcus frm
toxoplasmosis-- ?? I put CT but the CT finding might be similar in both so
wonder what was the ans.

upper limb ' weak abductor pollicis longus or brevis with decreased sensation of
index finger -- Sensory Loss In C6 Dermatomes+Abductor Pollaces Weak
night pain ,relieved by shaking arm etc
?
A C6 Entrapment Neuropathy
B carpal tunal syndrome
C thoracic outlet syndrome
D cervical rib
E oat cell carcinoma

1. Rx for chlamidia in pregnancy - erythromyci



2. HIV pt with CD count 300- start HAART
3. Ix to confirm post bowel surgery bile acid ind diarrhoea-?? Sehcat
4. young pt with RA-lower limb - sensory loss dorsum of foot with weak
dorsiflexion - ?? mono
5. A patient with partial third and fourth nerve palsy right with absent
sensations on ipsilateral forehead..site of lesion..midbrain, orbit,
cavernous sinus, brainstem ???
6. cystic fibrosis which chromosome Cftr Gene In Cystic Fibrosis-Code For
Amino Acid
7. lady with neck pain post fall in past ..some arm weekness

8. asthma next treatment - IgE level given prednisolone
9. SE of fenesteride gynaecomastia
10. middle age guy with recurrent ulcers on OGD while on Max dose PPI-
next IX-?? Gastrin level

11. prone to miscarriega- AB - anti b2 glycoprotein.
12. light reception photopsin
13. UC- goblet cell depletion
14. Papules And Vesicles On Extensors With Itching : Dermatitis
Herpatiformis
15. Polygonal Voilaciouse Papules Then Plaque Eruptions : Lichen Planus
16. Picture Of Jaundice Hepatospenomagaly With Lymphnode Malaria Or
Hiv Seroconversion (Ip Was 4 Month But Pt Have Lyphadenopathy So I
Choose Hiv Sero Conversion
17. Sumatriptan 5ht1a Agonist
18. Infective Endocarditis By Staph.Aureus: Penicillin Allergic So Answer
Would Be Vancomycin
19. Tpo Positive + Goiter +Tsh Low =Grave Ds ?????
20. Thyroid Carcinoma Causing Laryngeal N Palsy stridor
Anaplastic Carcinoma
21. Sick Euthyroid Syndrome (Patient In Intensive Care Unit)
Tsh n T3 Low T4 low
22. Skin Lesion Voilaciouce Pruritic Lesion On Leg
23. Porphyria Cutis Tarda
24. Hyper Prolactaemia Drug Metaclopromide
25. One Male Having Rta Compressive Myelopathy Level T4 But After Few
Month Level Go Up To T2 Cause Post Traumatic Syrinx ,Compression
Increase.....
26. Malaria Prophylaxis With Ho Seizure Atovaquine +Proguinil
27. Also Post-Transplant Lymphoproliferative Disorders Caused By-----
Ebv

28. One Case Hyperbilurubinaemia Gilbert Syndrome

29. 50 Shipyard Worker A Case Of Sever Left Plueral Effusion Also Calcific
Pleural Plaqes , Fever , Pleural Sample Exudate Lymphocytes 60% With

2% Methothelial Cells ----------- Tb Or Methothelioma ( I Am More With Tb


As Methoselial Cells Only Exclude Tb If More Than 5% And Dosent
Indicate Methothelioma Also Pleural Plaqes Is Not Premalignant, Also
Fever .)
30. A Case Of Shills Fever After 6 Monthes Returning From West Africa ---
Malaria Ovale

31. .A Case Of Post Mi Artery-Stemi V1 - V2 ----- Circumflex (In 15%
Postdesending)
32. A Case 2 Days H/O Headach & Visual Loss With Paracentral colour
Scotma ? Ms

33. One Case Like Face Upper limb,Lower limb Muscle weakness &
Wasting With Increase DTR ?Mnd

34. A Question Recurrent Weakness, Sudden Fall Down But No Loss Of
Conceousness- cataplexy
35. One Case Old Age But Presented Like Ms eye squint
36. elder female with suicide attempt: embarassed after sum medical
intervention: highest risk of suicide with in 2 weeks : most probably 65
years of age ?? --------- alcohol???
37. Iron Poisoning-Treatment There Is A Q About Iron Poisining 24 Hours
After With Sever Manifestations I Guess ------- Desferrioxamine
38. Acut Monoarthritis Aspiration wrist
39. Arthritis Conjunctivitis Clear Urithal Discharge Travelling +
--Reactive Arthritis

40. Recurunt Urticaria Treatment Antihistamin,Steroid Renitidin
41. Ch articaria eye oedema
42. Post Mi Lip Sweeling Angioedema Like Due Prindopril

43. Fsgs- 24 urine 0.9 gm Proteinuria Treatment Ramipril
44. 20 male proteinuria minimal change??
45. Most Common Eye Feature Of Wernickes Encephalopathy
Option Ophthalmoplasia Nystagmus,
46. Post-Splenectomy -->howel joly
47. Sle Is Membranous Gn (Stage 5) Because Of The Nephrosis
48. Achalasia Investigation-Manometry

49. It Was Alcoholic Liver Disease Due To High Gama Gt And In Nash Ast
To Alt Ratio Is Typically Less Than One, Which In This Case Is More Than
1....Plus It Is Not Associated With Gama Gt
50. Gastrin Inceased By-Peptide

51. Ankylosin which chromosome 6
52. Ondensteron Site Of Action-Medula

53. Enzyme up to 10 Day Post Mi----Ldh
54. Hocm- B Myosin heavy chain

55. Turner Syndome +Intestinal Obstruction?? Intussus/Crohn Ds



56. Pitz jugar s- AD
57. Inflamatory bowel s invest ----C-rp
58. Metaanalysis----Forest Graph???
59. Age & Bp Variables- ? Scatered Graph
60. Mody Most Common glucokinase
61. Hb E, beta Thalacaemia Trait@ Thala Major 25%?
62. Lmwh----Factor X / anti t3 ???
63. Yonge Lady S2 Loud ----Sob Syncope--Family Ho --Pah
64. Homocysteinuria- Reduced Activity Of Cystathione Betasynthase.
65. Post renal transplant 4 years With Reduced 25 Dihydroxy Vit D,
Increased Pth normal c.CA normal kidney -Secondary And Tertiary
Hyperparathyroidism ??

66. Live Attenuated Vaccine- Yellow Fever
67. Neisseria Gonorrhea- Aerobic Diplococcus- Male Urethritis

68. To exclude Cushings- Overnight Dexamethasone Suppression Test
69. Essential Tremor- Family History+ - Propanalol

70. Specificity= 890/950
71. Acute Episode Of Hematemesis- Terlipressin
72. Long Term Prophylaxis For Gi Bleed- Propanalol

73. Angiodysplasia- aortic stenosis

74. . Extrinsic Allergic Alveolitis- Hay
75. Restless Leg Syndrome- Ropinirole

76. Clopidogrel- Adp Agonists
77. Allergic Reaction Following Food Intake Trypase
78. Pda- Collapsing Pulse
79. Depression- Early Morning Wakening/ suicidal thougts
80. For The Contact With Afb +Ev TB Mantox Test then Cxr
81. Recent Immigration From Uganda With Multiple Hypopigmented
Areas And Reduced Sensation - Leprosy.

82. Uti Treatment In Hosp After 3 Days Becomes Agitated - Delirium.

83. Nodular Lesion On temporal telangectasic Face With Pearly Margine
=?Bcc= -Biopsy true cut ??
84. Lower Zone Fibrosis =Asbestosis
85. Decrease Kco Methotrexate Pneumonitis
86. Increase Kco Pulmonay Hemorrage

87. Recurrent Oral +Srotal Ucer =En= Becets Ds
88. Hypercalcaemia------ Thiazide
89. Best Evidence =Metanalysis


90. Face desease statistic paired t test
91. Intention To Treat- All Included
92. Methadon -Sudden Death -Long Qt Syndrome
93. Schizophrenia Vs cannabis one
94. teenage with hallucinosis and sum other complaint: inatke of alcohol
100 units and regular cannbinoid user: on examination: oriented with
tym, place: cannabinoid psychosis or alcoholic but alcohol withdrawal can
give hallucinosis not by itself ?? paranoid schizo she have auditory third
party persecutory i thnk it is 1 rank symptoms?? -----------
Schizophrenia???
95. Asymptomatic Ealy Latent Syphlis pregnant Treatment- Penicilin
96. Post Temporal Lobe Surgery -Homonemous Qudrintonopea
97. Sensory Loss In C6 index finger Dermatomes+Abductor Pollaces
Weak ? C6 Entrapment Neuropathy
98. Pain shoulder then lmnl in UL Post Viral Neuralgic Amyotrophy
99. Choria-Caudate Nu

100. Lady Bmi 40 Short Neck Hypoxia Leg Edema=Osa/Obesity
Hypoventilation Syndrome
101. Becet Ds Lg Sweeling=Dvt

102. Myoclonus--Doc Clonazipam/Valproat

103. Rhabdomylysis Responsible =Simvastatin

104. Lady Polyurea +Polydipsia With High Blood Na + High Blood Osmolality
+Urine Na Less Then +==?Diabetic Incipidus
=mangement ?Oral Desmopressin .Fluid Restriction
105. Hyponateremia mild hyperkalemia high urine NA -----Addison
106. Azothiopurin Befor Start Test -----Tioprine mt
107. Digoxin Loading Dose --half life
108. Salbutamol Oral Vs Inhalar High Bioavailibility ????
109. Complete heart block + Inf Mi 2 hours +Stable pulse 50 appropriate
immediate action=Pci
110. Post Alteplase Bleeding ---Ffp, Prothrombin Complex??
111. Paroxism svt- not distressed return to sinus after vagal manage Definate
Treatment vagal manover or flecainide
112. Lyme Ds Treatment Penicilline Allergy-Doxycy
113. Csf finding Vial Meningitis
114. Cause Of Wide Qrs During Exercise Test- In Wpw Syndrome-? Increase
Refractory Of Accessory Pathway???
115. Paget Ds With Mri + Bone Pain Nsaids\Bisphosphonates
116. Cisplatin -Side Effect-Peripheral Neuropathy/?
117. 2 Sd above the mean =95%
118. Female With Primary Amenorrhoea +Virulising= Congenital Adrenal
Hyperplasia=Investigation-17 Oh Progesterone

119. Acute Mania---lithium Or haloperidol


120. RA pt rec UTI on methotrexate Apastic Anemia -Trimethoprim ??
121. Myelofibrosis-Tear Drop Cell

122. Diabetic Pt With Hypokalaemia Hyperchloramic Acidosis-Renal Tubular
Acidosis
123. In transplanted PT A Non Responding Pt Of Febrile Neutropenia 4 days ???
Candida Fungemia
124. Tronchataric Bursitis
?/
125. After 3 days of Treatment Of Temporal Artitis neutrophilia Steroid Induced
Leucocystois
126. Rest Less Leg.. Ropironole..
127. Abdo Pain And Tenesmus Rectal Exam Normal
Sigmoidoscopy//Colonoscopy
128. Heart Failure Already On Furosemide, Ace, B. Blocker, Aspirin To Optimise
Add Spironolactone
129. Pancreas Ca Treated With Chemo - Monitor Tumour Marker Ca 19.9
130. Woman With T2dm And Copd Exacerbation, Lactate Normal, Abg Ph 7.30,
Pco2 10, Po2 9, H+ 50 - Acute On Chronic Resp Acidosis.
131. Advanced liver d raised creat , urine NA below 5 off diuretic Hepatorenal
$ pathogenesis ----------renal vascular vasoconstriction
132. Man previous MI done CATH 4 monthes mottled skin levido reticularis -----
cholesterol emboli
133. Woman With Recurrent Collapse And Wt Gain low c peptide ---- - Insulin
Overuse.
134. Treatment Of Choice replace Sod Valproate to Lamotrigine.. ?? Ans
135. Locked In Syndrome Lesion In man Has Vertical Gaze Paralysis Plus
Quadriplegia . Can Not Wake Up After Intubation What Is Teh Cause? ------ Pons?
(Ventral Pons)
136. Lady Develops Abdominal Pain Followed By Loc And Developes Lip
Smacking And Staring Where Is Lesion? ----- Temporal
137. 18 Yr Female Running Behind Bus Sudden Death Girl Running After Bus,
There Was No Option As Prolonged Qt Interval, There Was Only Arythmia,
Seizure, Vasovagal, Cardiogenic...So It Would Be Cardiogenic..-----------.Hocm
Cardiodenic Syncope
138. Vt Drud Contraindicated.. Verapamil
139. P53= Cell Cycle Delays/Apoptosis
140. Stressed Lady Recently Stopped All Meds ? Diazepalm Withdrawel/
Thyrotoxicosis
141. Pulmonary Surfactant-------phospholipid
142. Osteoporosis In Males-Testosterone
143. Oral+Genital Ulcers-Behcets

144. Cryoglobulinemia-Hep C
145. Hereditory Angioedema-,Ci Esterase, C4 Level In Between Attacks
146. Fragile x chromosome female carier -------------- 50%
147. Ifosfamide-Mesna To Prevent H Cystitis
148. No Surgery For Ca Lung If ------------- vocal cord Paralysis

149. Pulm Emb-CTPA


150. Burkitts lymphoma- Tumor Lysis Syn
151. Rh Arthritis -------------Anti Cyclic Citrullinated Abs-
152. Amiodarone-K Channel
153. Factor 5 Leiden-Activated Protein C
154. Strep Bovis bacterimia-Colorectal Ca
155. A male with hemoptysis and renal failure..renal biopsy shows cresentic
glomerulonephritis with linear igG deposition...which antibody to order to
confirm diagnosis. -----------------------Anti-Gbm

156. Stag Horn Calculi- Composition Mg Ammm Phosphate
157. anorexia nervosa hypokalemia refeeding syndrome what to look for next ---
-----hypophosphatemia
158. Pcp treatment -----------cotrimexazole
159. Traveler shocked 88/50 what to do next ------------isotonic saline
160. young male recurrent hemoptysis upper lope lung collapse -----------
carcinoid tumor
161. swollen knee xray chondrcalcinosis sterile- pseudogout
162. 5 attacks of gout in 12 monthes ------------------allopurinanol
163. Young female RA to start methotrexate --------------contraception
164. increasing dyspnea, low transer factor- emphysema
165. toxoplasmosis from Cryptococcus in HIV ------------Ct scan mass effect????
166. A 72 yr old man with acute mono ocular visual loss. On exam pale optic disk
in affected eye..diagnosis...-0--------- giant cell artiritis,
167. A patient with sudden onset occipital headche and vomiting..on exam has
gcs 15, and neck stiffness..ct brain normal...next investigation...-----------.csf
168. What does a codon encode...--------------------------- aminoacid
169. Patient on LAnsoprazole X 2yrs, decreased platelet 15000 and
megarkaryocyte in peripheral smear Dx: ITP
170. young lady ans can be vasovagal as recovery was very rapid
171. female patient with difficulty climbing stairs weekness of proximal and
distal muscles of limbs no sensory deficit deep tendon reflexes absent and
postural drop in blood pressure --------------------GB $
172. A hypothyroid female on thyroxin with adequate control suffers MI..she is
thrombolysed and discharged on aspirin, clopidogrel, simvastatin, ferrous sulfate,
ramipril,.. 6 weeks later she comes back with increased TSH..which drug has
interacted with thyroxin...----------iron sulphate
173. Spontaneous pneumothorax scenario...xray shows 3.5 cm pneumothorax in
left lateral side...mangement...------------- needle thoracocentesis?????
174. which food product has the maximum amount of calories/kg?? Ans: white
wheat
175. giant v wave and systolic murmur? Ventr pre excitation Ans: Ebstein
anomaly
176. old male gait disturbance ataxia few hours deterioration conscious bilateral
planter bp rises 190/100 ---------------herniation brain stem
177. What causes pul vasodilatn in healthy adult? Ans: Postracyclin
178. another diplopia que - that was recurrent episode of self limiting diplopia.
O/e ptosis and some other eye movement problem well i don't recall the ans for
this i think MS/ MD was among them.

179. Complete heart block-------------------rt coronary artery


180. Abdominal pain, bleeding--------------------------ulcerative colitis
181. Febril neutropenia what first ----------------broad spectrum antibiotics
182. dm, no family history, bmi high : mechanism insulin resistance and weight
loss ----------increased catecholamine??????
183. A question about somatization syndrome

184. 45 year old female tlc 100 000 splenomegaly ---------------chronic myloid
leukemia
185. Guillan Barre syndrome: check VITAL CAPACITY.
186. Albumin low, total protein high _ myeloma -------------plasma protein
electrophoresis).
187. Young femal have completed chemotheraby 6 monthes ago presented with
hip pain--------------avascular necrosis of the hip

188. A case of hemolytic uremic syndrome (low platelet and raised creat post
diarrhea)----------------- E coli O157:H7
190. Chances of inherting cystic fibrosis
191. Strep. Pneumonia- most common cause of pneumonia
192. Tuberculosis mediated by- T cells.
193. Boy e recurrent abscess and family hx of a cousin who died of a chest
infectio---------------------------- neutrophil defect
194. Addisons best test- short syncathen test
195. Ptyriasis versiclour man came from vacation

Mrcs part a april 2012


1. Warm peripheries..Septic shock
2. NA in septic shock
3. Immediate response to blood losssympathetic response
4. Angiotensin II vasoconstriction
5. Response to shock..renin angiotensin system
6. Hypovolemic shock
7. Septic shock
8. Neurogenic shock
9. Latex allergy
10. Stroke volume.70 ml/min
11. Paired t test
12. Unpaired t test
13. Out come audit
14. Structure audit
15. Process audit
16. audit

17. Intussuception
18. Juvenile rectal polyp
19. Anal fissure
20. Inflammatory bowel disease
21. Unilateral cleft lip.maxillary process and median nasal process
22. Posterior urethral valves
23. Urethral stricture
24. Bladder cancer
25. Proteus.renal stone
26. Glomerulonephritis
27. Pre renal failure
28. 75 kg, 22% burns5 to 7 L/24 hours electrolyte containing fluid
29. 85 kg, 19% burns5 to 7 l/24 hours electrolyte containg fluid
30. Full thickness bur..split thickness graft
31. Basal cell ca.advancement flap
32. Wound debridement and closure
33. Wound debridement and secondary intention healing
34. Necrositing fasciitis
35. Hirudinitis suppurativa
36. Clostridial myonecrosis
37. Serum calcium high, phoapous high, pth high, renal
failure..Teritiary hyperparathyroidism
38. Pth function.activation of 1,25 hydroxy calciferol
39. Conn syndrome.hypervolumia
40. Adrenal 1.5 cm mass.nonfunctioning adrenal adenoma
41. Lactic acidanaerobic glycolysis
42. Metabolic alkalosis..nasogastric aspirate
43. Metabolic acidosis.DKA
44. COPD. Respiratory acidosis
45. COPD.respiratory acidosis
46. COPD..type 2 respiratory failure
47. Pulmonary embolism.respiratory alkalosis
48. Increased fev1 and fvcCOPD/asthma/fibrosing
alveolitis/bronchiectasis/pte
49. Lung volume on spirometry Maximum inspiration to maximum
expirationMaximum voluntary ventilation
50. During CPB, axillary artery exposurestructure not seenaxillary
lymphnoodes/
51. Left internal thoracic artery branch of subclavian artery..immediate
branch at origin
52. Hemopneumothorax drainage5th ics mid axillary line
53. Pericardial tamponade drainage..no answer
54. Type of lung cancer in heavy smoker, hilar mass, massive mediastinal

nodal mass, histologically.small cell ca


55. Chronic smoker.bronchial metaplasisreversible nonstratified
squamous epithelium
56. Peutz jaughers syndrome
57. Familial adenomatous polyposis
58. Colonic polyp is due
to..apoptosis/calcification/degeneration/metaplasia/dysplasia
59. Testicular mass, normal tumor markers, histology.classic
seminoma
60. Testicular injury, painless testicular mass, left supraclavicular
node..seminoma
61. Brest cancer tumor markerno answer
62. Testicular malignant teratoma tumor markerafp
63. Metastatic colon cancer tumor marker..cea
64. Hepatocellular cancerafp
65. Rectal cancer 11 cm from anal verge.anterior resection
66. Peritonitis due to perfoarated diverticular disease.hartman
operation
67. Testicular descentgobernaculam
68. Testicular torsion
69. Neonatal hydrocele.processus vaginalis
70. Anal intra epithelial neoplasia
71. Cancer at anal verge.inguinal lymphnodes
72. Aortic aneurysm near SMA pushing LRV

- ICD insertion site- man with heamopneumothx, immediate
management man with cardiac temponade(site of
pericardiocentesis??)

-aortic hiatus level

- sportsman sudden death, Intra cerebral hge whats the type?
SAhge

- Gunshot injury back of distal thigh, what is most lateral
structure Pop fossa?

- A man sudden GCS 15, head injury GCS 8 later, coma, rt sided
pupil fixed.- extradural rt or lt?

- A man poor straem urine, sense of incomplete evacuation for

last 6month, H/O UTI featuring urethral pus 4yrs back- dx


BEP/urethral stenosis?

- Injury of nerve- posterior humerus approach, ankle medial
approach, SSV popliteal approach

- raised rounded lesion at face.

- tumor marker- teratoma, HCC, Melanoma, rectum, breast

- Doppler in various types of vericose veins 4themes were
there, i think one of the tricky questions

- smoker, mechanism of ca in lung- irreversible damage to
tissue?

- esopagus barrets lower part- type of histology

- Ca esophagus upper 2/3 part type of hisyology -> Squamous

- 8cm Incision from deltopectoral groove to midline which
structure will not injure- ax art/ P.major/Br.plx trunk/cephalic
v./shoulder joint capsule

- hematuria, lesion at distal femur- wheres the lesion?

- frank hematuria hemoglobin 18.8 other parameters ok- dx

- corrected ca high, PTH high- dx?

- wt loss, hot intolerance, fine tremor TFT features

- Medullary carcinoma urinary marker

- fibroadenoma

- green thick discharge for 4months no other lesion
specifically- dx

- Submandibular gland excision which nerve injured? Ligual
(sensory) Hypoglossyal (motor)

- Proteus infection in urine which will be dx.



- Intention tremor, cogwheel rigidity, flaccid paralysis lesion
site

- winged scapula, which muscle involved- Serratus anterior

- injnury to shoulder cant shrug which nerve? Accessory

- 12 yr old girl knee pain, no other findings, hip is externally
rotated when knee is flexed - dx?

- old man do cycling comfortably, but find difficulty downstair
going. dx

- AAA where is the defect?-intimal collagen or elastin?
Adventitial collagen or elastin?

- Audit type? Structure audit, outcome audit, incidence audit
another was there I forgot

- Paired t test, unpaired t test, man whitney u 2 questions there
I marked both of them paired t test

- Median nerve relation at arm.

- Cut injury front of elbow joint which most lateral structure
will be injured?

- Alcoholic, hematemesis, OGD shows erythematous lesion
lower part esophagus Dx?

- Dispnoea, tachycardia after vomiting dx?

- Alcoholic, hematemesis DxI think it was varices

- Jaundice can be czed by- HIV, HPB, HBV? Most eziest question

- GCS was 15, now 8 pupil rt side dilated, poor reponse to light
what investigation next ----- CT/ CPP?

- Pt. with confusion, weakness rt side what investigation next --

--- CT/ CPP?


- Morphine acts on which receptor? (central and peripheral) -
causes analgesia, miosis, decreased gut motility

- Pt with pain, swelling of thyroid gland, dx

- Pt with wt loss, CXR shows shadows hilar area, cervical
lymphadenopathydx

- One question of resp, alkalosis..

- A baby with hydronephrosis, uremia present dx posterior
urethtral valve?

- A pt with ACEi pre op, now urine output10ml last 2hrs what
will be next plan-stop ACEi/ fluid challenge/ furosemide?

- 2 questions from one chart thyroid-----thyroid bilat weakness
another one I forgot

- A girl with smell of ketone body

- Pancreatic ca diagnosed, stool fixed to commode , not
removed with flush which enz problem? Lipase

- 2themes from breast

- Shock feature hypovolaemia, cardiogenic, septic, neurogenic

- Post op pt @ ITU 6 units BT done, platelet count 40 others ok
DIC?

- Homonimous hemianopia wheres the lesion.

- Pituitary lesion what will be effect? 2alternate questions
were.

- Root value of urethral sphincter?

- Lumber punctute --- S1, S2, S3, S4, S5 can somebody please
clearly remember the question please?

- Renal vein lt. side will obstacled by one of the arterial


structure infront what was that?

- One man with RTA apparently stable, collapsed at A&E after
catheter done latex hypersensitivity?

- CXR shows a metallic prosthesis behind sternum what was
that? Aortic valve, mitral valve, tricuspid valve?

- Which structure is not behind rt kidney? Transverses. Abd?

- ABPIresting pain 1 theme and man can walk upto 500-600
meter then pain what will be the index <0.4/ 0.4-0.6/0.6-
0.8/>1

- Skin graft theme---- dog bite to nose damaged away----
another theme was 6 cm wide lacerated wound at scalp ---
another theme was 1cm woung leg ---advancement flap, leave
it for2ndary, primary closure

- Which fluid is most electrolytes reach? Hartmanns?
- Burn fluid management 2 theme but they didnt give any clue
to calculate % of burn I just answered it with guess work

- A boy 10 years failure to thrive, wt loss, bloody diarrhea, ---
inflammatory bowel diseae/ intussuss/meckels/

- A boy pain ful defeacation, few drop blood on the pan,,,, anul
fissure..

- A boy 6 yrs, parents found, strawberry color strurture coming
out thru anus after defeacation dx?

- Movable carcinoma, 6cm from anal vergeAR or reposition
proctocolectomy which will be the ans? I gave ARbut I think
ans will be the2nd one..

- Wkness of elbow extention, sensation loss over 1st digit
dorsum which nerve involve?

- Loss of sensation over hypothenar eminence, medial 1 and
half finger h/o injury at lower Humerus at childhood, which

nerve involved?

- Sjogrens syndrome, pleomorphic, warthins 3themes

- CXR shows lower esophageal narrowing, h/o dysphagia
ocaasional, chest pain 24 yrs. Achalasia?

- Facial muscle from which branchial arch?

- A baby boy with inguinal small swelling 4cm, swells up day
time but reduced at night when he lie down no other
symptoms persistant p.vaginalis?

- A women swelling pain lateral to pubic tubercle.

- Weakness front of thigh unable to extend knee..

- Lateral side thigh an area of around a palm size which nerve
involved

- A women after child birth by NVD which nerve is injured to
cause wkness of anal sphincter forced her to experience stool
incontinence?

- After birth cleft lip rt upper lip what is the defect?

- To check whether its UMNL or LMNL after facial palsy what
the doctor ask the pt to do?

- To test the posterior compartment muscle of leg ask the pt to
do what? Eversion of foot/ invertion

- RTA open fracture of proximal radiaus ulna, complaining pain
and numbness of forearm---what to do fasciotomy/ ORIF/
skeletal traction/Ex fix

- RTA fractute humerus open fracture what to do? fasciotomy/
ORIF/ skeletal traction/Ex fix


- Akle planter flexion root value

- Which term used to indicate the prognosis is bad of a breast


carcinoma- size/ grade/ LN involvement/ ER positive

- Which are in direct contact of Navicular bone?

- Old man 65 yrs.. playing , sudden pain at calf muscle.
Squeezing of calf muscle cz passive planter flexion of ankle
joint where is the defect?

- While playing sudden pain at calf.may be rupture backers
cyst will be the ans.

- while playing pain at back of thigh unable to flex knee joint----
biceps femoris injury/
semimembranosus/semitendinosus/gracilis

- Pain at buttock, impotence where is the block: both common
iliac / common iliac/ ext iliac/ IIA

- 3theme from breast ca

-A man on warin, unconscious... INR 2.1 Dx... cerebral hge

- Hernia operation scrotal numbness, which nerve involve?

- Caecal mass theme 3

- Injury at wrist, hand placed on the table, thumb cannot be
make abduct 90degree on the hand. Which muscle is
involved.... opponens?

- Scaphoid bone blood supply

1) lumbar canal stenosis- old man with pain limbs on walking,
bicycling he feels alright----this was also repeated in theme in
emq

2) morphine acts on mu receptors

3) theme on dysphagia- old lady with burning chest ,more at
night ,feels ok on sitting upright, x ray shows stricture lower

oesophagus-- achalasia, gerd, ca oesophagus, hiatus hernia,


motility disorder

4) drug of choice for carcinoid syndrome-- octreotide,
somatostatin etc

5)s themes on thyroid pathology- 1)a specimen with oxyphil
cells and scanty throid colloid and another with numerous
lymphocytes
lumbar cistern termination : s2
While playing sudden pain at calf.+ve homan sign ....DVT

UMNL or LMNL after facial palsy ..... upper brows
winged scapula, which muscle involved.... serratus ant.
Audit
Structure The availability and organisation of resources and
personnel.
Process The activities undertaken, that is, what is done with the
services resources.

Outcome The effect of the activities on the health/well-being of the service


user, that is,
changes for the individual which can be attributed to the clinical intervention
they received.

MRCS part A September 2011


questions:
1- Appearance of skull Xray in MM: Lytic lesions
2- High Ca, High ALP, normal PO4 : 1ry hyperparathyroidism
3-Artery liable to injury during ligation at SFJ (I did it wrong, but I think
the correct answer is superficial external pudendal a)
4- Lesion at anal verge, what is the LNs involved
5- Lytic metastatic bone lesion, what is most probable primary :breast
6-pathology associated with Crohn's disease :granulomatous
inflammation.
7- Cells forming giant cells: macrophage
8- Colorectal Ca going through to mesentry with 2 LNs involved : Duke
C
9- Pancreatic tumor with groin and buttock rash seen at dermatology :
glucagonoma
10- Athlete died during footbal game: ?intercerbral Hge/? subarachnoid

hge
11-artery involved with patient coming with leg weakness: ? ACA
12- tendon involved in anatomical snuff box: extensor pollicis brevis
13- Patient with enlarged lateral and 3rd ventricles: stenosis at aquecuct
of Sylvius.
14- Thyroid carcinoma with cervical LNs metastasis: papillary thyroid
CA.
15- Intracranial bleeding with unilateral dilated fixed pupil: trantentorial
herniation.
16- Deprssed skull fracture at vertex, which vein involved : SSS
17- Nerve injured in posterior triangle of the neck: spinal accessory N.
18- Golf player had blow to the face, probable EO muscle injury, which
investigation: US
19- Inhaled FB, where it will settle: right lower lobe
20- Nerves supplying anal sphincter: S2,3,4
21- Catheterizing a male, what is the tightest part: membranous urethra
22- perinural parotid tumour: ?pleomorphic adenoma
23- Slim tall pregnant lady with chest pain: ? aortic dissection (probable
Marfan syndrome)
24- prgnant lady with shock: ? acute massive PE
25- pregnant lady with pleuritic chest pain, haemoptysis: ? pulmonary
infarction
26- 19 years old boy post appendecectomy, poor UOP: 500 mls gelo
27- Post stroke gentleman, day 7, not eating: consider PEG tube
28- daily requirment post op patient: 1 L saline+ 1.5 L hartmann's
29- 45 years old gentlema, known Barrett's oes, high grade dysplasia : ?
for oesophagectomy
30- Advanced Ca oes with solitar liver met:? stent
31- A lady with known iron defeciency and dysphagia oes varices
32- young lady, chest pain, normal ECG and enzymes: oes spasm
33- Newborn, respiratory distress, trachea shifted, displaced cardiac apex:
? congenital diaphragmatic hernia
34-Newborn, cyanotic, improves with crying: ? subglottic stenosis
35- Newborn, unable to pass NG, air in stomach: congenital oes atresia
with tracheo-oes fistula.
36- embryonic origin of right and left pul arteries.
37- Tumour marker for medullary thyroid CA: calcitonin
38- Tumour marker for pheochromocytoma: VMA
39- Prolonged constipation, LIF pain, fever: diverticulitis
40- Drug used in ITU , important in septic shock: noradrenaline
41- Post thyroidectomy teacher, unable to sing: unilateral external
laryngeal N injury
42- Vomitting, abdo pain, swelling at reversal of colostomy site:

obstructed incisional hernia


43- Pfannenstiel incision, which layer divided: ? rectus sheath
44- Upper midline incision, which layer divided: linea alba
45- Bullet going through junction of linea semilunaris and costal margin
on right side, which structure injured: GB
46- Structure at medial part of femoral ring: lacunar lig
47- pu;sating neck swelling, confirmed by angio: carotid a aneurysm
48- Enlarged tender liver, multiple lesions, calcification: ? hydatid
disease
49- 11 years old child, painful scrotal 3 mm swelling, separated from
testis: torsion hydatid of Morgagni
50- Man acute scrotum, oedematous, tender hemiscrotum: ? testicular
torsion
51- big painless scrotal swelling: hydrocele
52- painless swelling above testis: ?epidydimal cyst
53- 26 years old male, rapidly growing swelling within testis: ? testicular
tumor
54- site of ectopic testis: ? base of penis
55- footballer with twisting injury and tenderness just proximal to medial
part of knee joint: ? medial collateral lig injury
56- structure felt in PV anteriorly at level fo cervix:? dome of bladder/ ?
base of bladder
57- Artery injured in upper chest wall below clavicle: ? thoracoacromial
a.

1- Structure liable to injury during fibulectomy: ?peroneal artery
2- Recoprical of absolute risk: ?number needed to treat
3- Sensitivity definition
4- Difference between control and experiment: ?absolute risk
5- Type of fracture in child: ?greenstick
6- Type of fracture in twisting injury of tibia: ?spiral
7- Type of fracture in femur after car accident: I did it oblique
(but I think correct answer is transverse)
8- Type of fracture in metastatic/osteoporotic
bone: ?transverse
9- Hyperechoic lesion in liver: ?hemangioma
10- Cirrhotic and hep C liver: hepatocellular carcinoma
11- Another liver lesion (cant remember its
description): ?metastases
12- Newborn with cyanosis, improves with crying: ?choanal
atresia

13- Post thyroidectomy unable to cough and clear throat:


superior laryngeal n
14- Neck swelling that appeared before infront of
sternomastoid: branchial cyst
15- Neck swelling at base of neck, transilluminates in infant:
cystic hygroma
16- Neck swelling moves sideways but not up and
down: ?carotid body tumor
17- A boy with septic arthritis in paper 1
18- Theme in paper 2, (I think it was first question on paper)
one of them had avascular necrosis and other had SUFE?

Organism causing tonsillitis: S. Pneumoniae
Organism causing sinusitis (facial pain and post nasal drip) : S
Pneumoniae
Patient with lymphedema and infection: what organism?
Perianal abscess organism? E coli
Breast abscess organism? Staph
Organism causing infection with dead tissue and cripitus: C
perfringens
Gangrene of hallux (3 themes) cant remember them
Management of ulcer ... one with bed sores of the heel:
conservative or is it debridement (can anyone remember the
other 2?)
Parasitic infestations, one patient with ova at anal verge:
mebendazole ... another patient with ova and cysts in faeces:
metronidazole
Determinant of cranial blood flow in a patient with low
GCS: ?intracranial pressure
First response to hge: ?baroreceptors
First substance that would directly cause vasoconstriction: Ag
II (some of my colleagues say that rennin causes VC?)