April 2017 Recalls MRCS A

1. What was that thumb abduction with hand on table answer:I cant remember maybe EPL
2. what about injury in axilla and numbness in lat forarm:C6
3. source of blood during lumbar puncture ?lumber venous plx
4. type of femur fracture in the
5. child who was hit from side ?tranvese/olique/greenstick/spiral
6. Womnan with mx # same options
7. Tibial twisted-spiral# same
8. Child radial #
9. Pt e prolonged catheter this frank hematuria and w loss :regional transional ca,diffuse transitional
ca/scc/intstisial cystitis
10. Cyst in breast aspirated cytology free what next? I wrote bx, but the asnwer is dischage
11. There was melonoma in situ removed.? Discharge
12. One was audit of process
13. Second I wrote clinical audit but I cant remember the Q.
14. pt e breast cancer and metastatic disease come e hypotonia:hyper ca
15. After vericose vein surgery numbness dorsum of foot which nerve damaged: saphenos
16. Ttt of post op phelbitis: bandiage
17. Pt e antithrombin 3 Def and dvt : I choosed short duration heparin but the correct answer was Warfarin life long
18. Rx for recurrent pulm edema :V.C filter
19. Surface anatomy of IJV ??? From lobe if the ear to sternal edge of clavicle
20. Ulnar nerve , artery relation upper or lower forarm: ulnar to ulnar art.
21. There was this question about GCS. Patient localizes pain , open eye to pain and sounds whats the GCS ? I chose
9 as no option of 8 in answer choices(I awkwardly calcute it wrong !)
22. Peronial hematoma and lower abd hematoma, rupture bladder,bulbar,[Link] urethra ing.
23. with leg flexion at 30degree and moves lateral after trauma I chose.. medial colateral injury
24. Then a man hit by car when viewed from above left tibia lie posterior i chose pcl
25. Sciatic nerve injury what other movement not possible: extention of hip
26. 6 yrs Child e sudden hip pain: perthis
27. Oh there was a question u operating parathyroid and find nodule in thyroid what to do i chose thyroidectomy(
icant remmber the Qs and answer!)
28. Hemithyroidectomy for papillary 0.5cm nodule
29. Total thyroidectomy or medullary CA
30. Anexity adrenaline released from endings or gland ??gland
31. Inj to the dorsal root ganglia???sensoey,motor,sympathetic ,parasympathetic,all of above
32. The one with cervical subcutaneous emphysema. Esophageal rupture :Ix of choice:contrast study,CXR
33. Ejection systolic murmur with pulmonary edema ; aortic calcification
34. Ascending or descending limb Ascendig loop for furacmide
35. Then there was this methylsomething thiazide where did that act : dct
36. pt had pancreatitis thin hyperpara .. inv what next ?? Thyroid ?Petutary? Adrenals
37. Factor which doesnt cause colon ca. Chrons, alcohol,smoking,diverticulitis
38. Was it gout or oa ? Golfer with first metatarsophalangeal joint xray showed decreased space and alsub chondral
cyst: Rh [Link],Gout
39. Man used opoid then constipation; painful fresh bleeding
40. Then was about prostate lymphatics internal iliac
41. Testis lymphatics: para aortic
42. Scrotum: transverse inguinal
43. Pt e vien graft 16 month ago then stenosis pathophysiology: Fibrosis, thrombosis or intimal hyperplasia
44. Nerve to upper sctotum and penis ?? ileoinginal
45. Which artery anurysn compressed renal vein:SMA
46. ant relation to rt adrenal gland:IVC
47. Portal vein drainsTo splenic Then splenic and SMV unite... IVC
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48. Q about pt e head injury on IPPV ,at the 5 day techypnea and hypoxia ???? What to do CPAp CXR?/ tracheotomy
/swangang cathI / Cxr
49. Other q pt start weaning in icu??? Same options above,, CPAP /tracheotomy
50. Patient underwent operation for IBD complicated by infection...now developed diarrhea...i pseudomembranous
colitis
51. Esophageal perfiration type of feeding :TPN
52. Staged ediphagectomy:PEG
53. Perforated appendix organism? [Link]?
54. Bilious vomting ,scaphoid abdomen And dudenal atresia
55. 9 month What was in child with rt upper quadrant mass empty rectum and vomiting ? Valvolis?
56. There was a child with family history of cystic fibrosis, meconium ileus?
57. And then there was child vomiting with Distended abdomen And meconium plug was renoved after 3 days by
suppository- hirschprung
58. Test for Addison des? ? short synacthen
59. Spleen rupture without trauma, Ebv
60. study comparing fluid requirements? after burn in male n females...most patient had small values and some
larger values...what test to apply? Mann whittney/paired /unpaired t test /chi sequare?
61. Case pt have 5 unite blood then bleeding profile: decr pltls ,normal ptt, incr INR , inc fibroplastin norm fibrinogen
products: I choose DIC bcoz I don’t know the others �
62. intrinsic pathway?factor 9
63. (Ascending Lymphangitis) creeping redness around vessels caused after thorne/gardening? Strep pyogenes or
clostridium perfringenes,staph saprophyticus
64. Root of transmesion of mrca in some surgical ward 5 pt infected? Inhalation, contact(I choose contact?)
65. Renal mass on USS do CT scan,MRI,IVU
66. 15x9 cm lesion deep fascia,what to do: excision bx,inscion bx ,core bx
67. That liver accumulation prussian blue:iron
68. Pt e history of FAP and colectomy done 30 yr ago now he came e jundice pale stool and vomiting: [Link]
69. Melanoma suspected 1cm; Excise with 2cm margin?
70. Patient 6 days post-op burn surgery with hiccups n abdominal distension...soft abdomen.. Acute gastric
dilatation
71. Forhead mass pt itch cause bleeding follwed by incr in size during 1 yr: bcc,scc,fibroadenoma
72. Which is the first immunologic cell in rosethorn and infl: Neutophil
73. what does warming reduce levels of? TSH,ACTH,oxitocine,vasoprisin
74. Mediastinal mass with keratin and flat cells :seq cell ca
75. Hyponatraemia in man post op with glucose fluids? Was it stress response or excess lack of sodium containing
fluids,extra fluid admition
76. Heat loss intra op by convection
77. Lung ca brain mets given dexa,paracetol,morphine
78. Marathon runner sudden death; SAH
79. Noturia ,thirsty - FBG:5 glucose then post prandial 2 hr was 7 – normoglycemia,impaied glucose tolerece test
,DM,[Link]
80. What the hell do we give to pregnant lady with megaloblastic macrocytic: B12 first,folate
81. What about gastric acid secretion reduced by: Protaglandin E2,ADP,
82. What drug is a precursor to noradrenaline? dopamine
83. Duct papilloma proplimatuc : duct excion
84. Post mastoidectomy loss of tast:chora tympany
85. Follicular with bony mets
86. Papillary with cervical lymph nodes
87. Then facial nerve - second arch
88. Pleuroperitoneal memberane for diaphramatic hernia
89. Surgeon clamped the lesser onentum structures which is at direct risk of injury:ivc, Common bile duct,IVC
90. J waves in hypothermia
91. Exostrophy bladder. Dorsal surface opening of meatus
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92. Nerves at risk Of injury surgical approaches:
93. medial ankle ; Saphenous
94. distal femur:tibial
95. During hip arthroplasty surgeon note Artery run in superior border of pectenius ms ? Sup gluteal artery
96. clamped unbiblical cord ,which will not carry oxigintated blood to the hrt? Ductus venosis,hepatic
artery,umbilical artery
97. Pulm stenosis for tof
98. Burn question with oedema, hypoalbumin
99. For onion peel: Ewing sacoma
100. Aortic dissection.. ascending or descending ? Ascinding
101. thoracoacromial for deltopectoral groove
102. Common peroneal for dorsum of foot loss and dorsiflexion loss?
103. Smoking and microscopic was transitional cell ca
104. And egyptian farmer heamaturia was squamous cell ca
105. And the lft with raised amylase and ggt alcoholic panc
106. one was conus medullaris compression ...L1/L2
107. There was a uterus ligmsmet question/Transverse perineal muscles
108. Pfenen – arcuate,rectus ms rt,liba alba,[Link] appon.
109. Median inscion:Linea alba
110. Inguinal:Ext obliques
111. Dartos in subcutaneous
112. Cremastic muscle - int oblique
113. Osteoporosis question NormoCa
114. Psycholosis,increase ca,tsh low then stopmefication return to normal( milk alkali synd,vit d
toxicity,hyperthyroidism)
115. Keloid scar: ntralitional steroid
116. Median and brachial; Lat ant medial
117. X-ray failed to show scaphoid fracture...what next? Mri or ct scan? Or bone scan?
118. Parathyroid adenoma - technetium sestimibi?
119. extraintenstinal features of crohns except: polyarteritis?
120. There was a question about low potassium, high creatinine, scarred small kidneys? Atn, polycystic, chronic
pyelonephritis,etc
121. There was rcc for hg 18.3
122. Cause of AAA ?? Htn ,artheroma , marfan,arthrosclerosis
123. Efferent arteiole vasoconsrricted by AT-2 i think
124. Pcwp 20= pul oedema
125. Pcwp 11= ARDS
126. High riding prostate.... Membranous
127. Pineal hematoma+ excessive collection....bladder
128. Cushing... Hypok
129. Metabolic acidosis... Hyperk
130. Wide qrs... Hyperk
131. The aortic valve replacement drop in hr and bp?its block, temponade
132. Gall bladder stone?bile pigment
133. Sickle cell disease +bone pain+pneumonia agent:I wrote stept pn
134. Pneumonia in ventilated... [Link] pn
135. Damage to 3.5 finger sensation :median
136. Guys there was a question about achllis tendon ruptute what was the test ? I chose Simmons squeeze
137. What do they clean plastic syringes with? Radiation
138. What abt collection when patient lying supine: Hepatorenal pouch of morisons,oaracolic gutter
139. Acute abd oain ,absolute constiopation,55yrs old abd x ray shows Small n large bowel Air fluid level:
colorectal Ca,adhisions,vololus
140. Tricuspid closes - isovolumetric contraction?
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141. Pathophysiology ARDS: Reduced diffusio
142. Techy cardia chest pain: Decreased diastolic interval
143. Tricuspid closes - isovolumetric contraction?
144. Vital capacity
145. eggs at anal verge: Mebendazole or metronida?
146. Cleft palate posterior to incisive foramen due to? Malunion of maxillary n nasal prominences?i choose
palatine shelved
147. There was a q about multiple lytic lessions in pelvis? It was multiple myeloma
148. *eosinophil q, type 1 hypersensitive?
149. *carcinoid,octreotide?
150. Hassal corpuscles: yes thymoma...
151. Gout, needle shaped negative under scope
152. Breslow depth less than 1mm good prognosis?
153. There melonoma in situ excised with 1 cm margin . Education of delf exam
154. chemo...only that sounded reasonable for metastatic breast Ca....
155. Vesicoureteric stone at?tanverse process L5( idid spinus process�)
156. best prognosis in breast ca:Er+ve
157. Something to do with infection spreading to brain/inner ear was it sigmoid sinus/Inner ear or what?sigmoid
sinus
158. Brown sequard
159. little's area of nose artery? Sphenopalatine
160. anterior wall of the heart ? Mostly made of rv n ra
161. rt Coronary a arise .arise from post surface of [Link] from ant surface .lei in post Interventricular groove
.arise inf to aorta from sinus(Rt coronary ... ant surface-Lt coronary ... post surface)
162. Depolarizing neuromuscular blocker... suxamethonium
163. Cervical sinus from what branchial cleft?2nd
164. Cleft palate post to inscive foramin what developmental anomaly?palatine shelves
165. Insertion of ureter in bladder:post
166. Thoraco acromial a injured in deltopectoral groove
167. Second q ant to which part of vertebra ureter insertion
168. Q asking about poas major(T12-L5)
169. Realtion of ulnar artery ana ulnar nerve in wrist(ulnar to ulnar)
170. Ant surface of heart formed by what
171. Nerve lesion in hernia operation cause parathesia at top of scrotum and base of penis
172. Ant relation to rt adrenal gland
173. Ewing sarcoma onion�
174. The 4 cases about mechanism of injury
175. Green stick fracture
176. 2 cases wara b3d bilateral lung opacity in the 2 cases but pulmonary wedge pr is high in one of them I
choose for one pulmonary embolism ARDS
177. Artery in epistaxis
178. Q about osteomalacia
179. Q about multiple myeloma
180. After the nurse cut the umbilical cord which of the following will not contain oxygenated blood any more
Ductus arteriosus- ductus venosus-portal v -umblical a-hepatic ar
181. Invetsigation for boerhaave syndrome
182. This first senario was AAA with low PAWP one post op
183. The second was following pancreatectomy a 3days later low PAWP
184. MEN1 pituitary
185. Medullary ca Tx
186. Follicular Ca Tx
187. Addison > hyperkalemia
188. TB medication adrenal crisis
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189. Recurrent PE venacava filter
190. Thrombin 3 deficincy
191. Anasthesisa of pupic , scrotum following hernirophy
192. Impaired OGTT
193. cAMP decrease gastric acid production
194. Noradrenaline septic shock
195. Three audit q came in first paper
196. Then about 6 cases asking about electrolytes
197. 2 Q parkland formula
198. Preganglionic neurotransmitter - i marked ach
199. Resting potential of skilital ms maintained by(Na,K,Ca,Cl)
200. 60 yr old man e itchy and painless yellowish discularation
201. The question was asking about tuberclin test type of hypersensitivity as I remember: Type 4,T cell mediated
202. Invest oesophageal rupture???baruim salaow
203. Deud ulcer:GD art.
204. Dumping
205. Hip extension due to semitendinosus
206. There was Q about ulcer deep to it swelling contain keratinized skin calcium and bone What is the
pathology:scc
207. Premature baby with inguinal tender swelling.. direct hernia, indirect, femoral, testis torsion, inguinal
lymphadenitis?
208. St segment depression in inferior leads:inf MI
209. A severe COPD patient receiving high flow oxygen became drowsy...?acute resp failure
210. Predominant cells in granumola/tb...macrophages
211. Wide qrs ....hyperkalemia
212. High jejunal fistula? Electrolyte imbalance
213. A sever copd with peritonitis,He was metabolic acidosis due to peritonitis
214. Organism that causes diverticular abscess in adults..
215. patient presented with knee pain and operted in his left knee after 24 hour he develop chest pain and
hemoptysis shortness of breathing what underline heamtalogical predispose to his s presentation???
Anemia,Thrombocytosis,Thrombocytopenia,NeutrophilIi
216. Extended match question;Hyperkalemia,Hypokalemia,Hypercalcemia,Hypocalcemia:
217. 1_wide qrs on ECG
218. 2_absent p wave long QT interval
219. 3_high jujenial fistula
220. 4_cushing syndrome
221. 5_corrected metabolic acidosis
222. Tension [Link]
223. Sings of elevated ICP No history of any truma and morning headache nausia moring bilateral papiloedema
:frontal glioma ,chronic subdural bleeding,subarachnoid hg
224. Most common cause of hydrocephalus:[Link] ,[Link] ,luska,aquidecut
225. which sensation lost on the thumb and lateral side of distal forearm........answer was post interosseus or
radial??
226. Penut inhalation :rt lowe pole
227. +ve pleural pr in :valsalva
228. Medial border to femoral canal:lacunar
229. Pt in sheet fawzia:metabolic acidosis due to pertonitis
230. Not happen in crhons :poly artritis
231. Swelling of whole arm after exercising how to investigate :selective axillar ar angiogram,duplex,uls?
232. Atrial deporalzation: p wave
233. Spinal acessory post triangle neck
234. Pulm arts come from 6th arch
235. Doesiflexion L5
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236. Qs about Pulm valve lt 2nd intercostal space?
237. Pips decrease preload
238. S3=perianal region
239. There is q about chrons disease then have watery diarrhea:hypokalemia

Another collection
1. a patient with renal failure has Hyperparathyroidism - what kind of changes to gland- hyperplasia, hypertrophy,
metaplasia
2. Waddling gait: nerve— Sup Gluteal, Inf. Gluteal
3. Ulnar nerve relation in wrist.. Ulnar to Ulnar artery
4. Brachial artery to median nerve relation-LAM
5. Ureterovesicular junction: bony landmark on xray: Ischial spine
6. leg twitching during bladder surgery, nerve: Obturator
7. left renal vein thrombosis— anterior relation of vein—SMA,
8. right renal gland relations: IVC
9. T5 vertebra crush fracture; relations, azygos, arch of aorta,
10. st elevation lead II III aVF-Inf wall MI
11. origin of right Coronary
12. lateral border of clavicle, exposure of axially artery- which arterial branch is anterior
13. 1st web space nerve supply: deep peroneal
14. test used for comparing results of treatment: paired t test, Unpaired t test
15. dumping syndrome path-physiology : hypoglycaemia,
16. dorsal foot surface numbness+ foot drop, which nerve damage: Common peroneal,
17. weakness in arm flexion and numbness in lateral forearm, nerve damage: MC
18. Pterion bones: Perietal,
19. Littles area: source of bleeding
20. ureter insertion in bladder, Lateral wall, posterior wall
21. damage to what structure during Pringle’s manouver : IVC, CBD
22. Direct hernia: medial to Inf epigastric vessels,
23. Femoral hernia medial border of canal Lacunar ligament
24. Dartos muscle scrotum: superficial to superfacial fascia
25. MEN 1A; Parathyroid, pancreas: what else: pituitary
26. fullness, SOB after meal in patient had trauma: Diaphragmatic rupture
27. 21 year old man collapses and dies on post mortem—subarachnoid hemorrhage
28. lacrimal gland ganglion: pterigopalatine
29. numbness on tongue after dental procedure: Lingual nerve
30. Post aaa repair patient breathless: CWP >18 LVF
31. Patient breathless CWP <18 ARDS
32. rib fracture, difficult to ventilate: Tension Pneumothorax
33. 6 year old male limping: Perthes, Slipped femoral head
34. rapidly growing tumour: keratoacanthoma
35. bloody nipple discharge 24 year old female: intraductal papilloma
36. metabolic alkalosis: NG aspiration
37. lymphatic drainage: ovaries: para aortic
38. testis: para aortic
39. scrotum: superficial inguinal
40. prostate: internal iliac
41. premature neonate: right groin tender, irreducible swelling- indirect hernia
42. copd patient: unconscious after oxygen
43. bleeding from lumber puncture: epidural veins, posterior spinal arteries
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44. cases of AAA; Atherosclerosis
45. Blocked Fem-distal bypass .. neo intimal hyperplasia
46. fluid in which part in supine patient: right parabolic gutter
47. wound infection: neutrophil infiltration
48. inulin: filters, neither absorbed or excreted
49. method of heat loss from open abdomen: evaporation, convection
50. perforated appendix organism: E coli
51. bendroflumethiazide MOA: Distal convoluted tubule
52. which factor is intrinsic pathway: x
53. recurrent PE with anticoagulation: IVC filter
54. PE in stable patient Rx: LMWH
55. investigation for Mesenteric ischemia: CT, Mesenteric angio
56. stroke patient investigation: duplex, head CT
57. left arm Axially vein thrombosis: Duplex
58. parkland formula: 70 kg patient 50% burn: 14 L
59. Parkland formula 90 kg patient, one leg and perineal burn
60. sudden pain in leg : thompson test
61. trauma leg: tibia posterior at 90 degree: posterior cruciate
62. Excessive lateral movement: medial collateral
63. inguinal hernia repair, numbness scrotum: genital branch of genitofemoral
64. hydrocephalus: blockage at what level, aqueduct, luschka
65. xray - hyoid bone
66. abdominal layer crossed: upper midline: linea alba
67. Pfennesital: rectus sheath
68. inguinal hernia: Ext: oblique
69. damage to nerves: humerus posterior approach: radial
70. posterior approach tom distal femur: tibial
71. Medial approach to ankle: Sephanous
72. shinning nodule on the face: BCC
73. polycythemia with renal mass: adenocarcinoma
74. barrets oesophaugus : adenocarcinoma
75. septic shock: decreased PVR, Output Increased HR
76. chest infection in sickle cell disease organism: Sterp pyogenes
77. leg weakness : artery involved: MCA, ACA
78. mass alterier thigh: biopsy, core,
79. bleeding nipple : duct excision
80. oestrogen +ive metastatic breast ca: rx: chemo,
81. numbness lateral deltoid: axillary
82. pain with shoulder movement : supraspinatous tendinitis
83. branchial cyst: which arch
84. 14 year old, leg swelling ewing sarcoma
85. delay in discharge summary: audit
86. confidential information review
87. flexion of thumb: decor policies longs
88. scaphoid fracture: after X-ray what test, MRI, CT
89. foreign body in a childL right lower lobe
90. landmark for IJV
91. stiffness in the back: ankylosing spondylitis
92. cushing syndrome: hypokalemia, hyperkalemia
93. high output jejunal fistula-hypo hyper kalemia
94. boney mets, myeloma cells: plasma
95. bleeding duodennal ulcer: gastroduodenal artery
96. enter point of in thorax of thoracic duct: t12
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97. opioid use and constipation bleeding pattern, painful defecation and fresh blood
98. bladder cancer: Egyptian guy : SCC
99. lady with prolonged catheter: TCC, SCC
100. filling defect in bladder: TCC
101. itching in jaundice: bile salts
102. aDH mechanism of action
103. post phlebitis syndrome rx: compression bandage
104. rya showing joint space narrowing in 1st metatarsophalgeal joint: ?gout
105. types of fracture: spiral
106. transverse
107. oblique
108. greenstick
109. Psoas major origin:
110. Index finger dermatome: c7
111. Palmar surface of hand thumb, index and middle finger: median nerve
112. post gastrerectomy dizziness: Dumping syndrome
113. post esophagectomy feeding: NGT, PEG