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MRCS
| Question | Answer |
|---|---|
| What is the floor of the inguinal canal? | Inguinal ligament |
| Which rotator cuff muscle inserts onto the lesser tubercle? | Subscapularis, the rest insert on the lesser tubercle |
| Where does the long head of triceps insert? | Infraglenoid tubercle of the scapula |
| Which zones are affected in a)prostrate cancer b)BPH? | a)peripheral zone, b)transitional zone |
| Which muscles are innervated by the obturator nerve? | Gracillis, adductor brevis, adductor longus, obturator externus, part of adductor magnus |
| What is the inferior border of the epiploic foramen? | First part of duodenum |
| Which nerve supplies pectineus? | Femoral nerve |
| Where would uterine tumours spread to? | Internal iliac nodes |
| Which nerve supplies cricothyroid? | External laryngeal nerve |
| What measures FEV1? | Spirometry |
| Which sterile technique kills all organisms including TB, viruses and heat resistant spores? | Autoclave |
| Which sterilisation technique would be used to clean sutures and single use items? | Ethylene oxide |
| Which method would be used for cleaning large amounts of items such as syringes or catheters? | Gamma radiation |
| What method is used to clean endoscopes? | 2% glutaraldehyde |
| What sort of bilirubin builds up in Gilbert's Syndrome? | Unconjugated |
| What factors increase bone resorption? | Glutocorticoids, androgens, TSHm prostaglandins, PTH |
| Which muscle abducts the true vocal cords? | Posterior cricoarytenoids |
| Where do most branchical cysts originate from? | 2nd branchical cleft- 75% |
| What is a cancer marker for breast cancer? | Ca 15-3 |
| Which chemo drug works by causing non classical alkylation causing cross linking of DNA strands | Cisplatin C, Carboplatin |
| Which chemo drugs are antimetabolites and interfere with purine/pyrimidine synthesis and interfere with DNA synthesis? | Methotrexate, 5FU, Gemcitabine |
| Which chemo drug is an anthracycline and intercalates DNA strands | Doxorubicin |
| Whcih chemo drug acts by inhibiting mitosis and preventing spindle formation? | Vincristine |
| Which chemo drug inhibits mitosis through stabilisation of microtubules? | Docetaxel, Paditaxel |
| Which chemo drug inhibits topoisemerase I | Irintecan |
| Which facial fracture features: epistaxis, crepitus, severs tooth part of maxilla from upper maxilla | Le Fort I |
| Which facial fracture affects the middle part of the face? | Le Fort II |
| Which facial fracture extends into the anterior fossa via the superior orbital margins? | Le Fort III |
| Flexes the elbow | C5 |
| Extends the wrist | C6 |
| Extends the elbow | C7 |
| Flexes the fingers | C8 |
| Flexes the hip | L2 |
| Extends the knee | L3 |
| Dorsifelxes the foot | L4 |
| Wiggles the toes | L5 |
| Which fracture causes blow out of C1-usually caused by axial loading | Jefferson # |
| Which # is of the proximal ulna with dislocation of the radial head. Usually caused by fall on forced pronation or forearm, or direct blow to back of the upper forearm? | Monteggia |
| Which # is caused by a fall on the hand causing # to the radial shaft and dislocation of the distal ulna | Galeazzi |
| Where do gluteus medius and minimus insert? | Lateral side of greater trochanter |
| Where does the psoas muscle insert? | Lesser trochanter |
| Where do the external rotators of the hip attach? | Lateral side of the greater trochanter |
| Where does gluteus maximus insert? | Gluteral tuberosity of the femus |
| How much cardiac output does the skin receive? | 9% |
| What is the commonest benign tumour? | Leiomyoma |
| Which chromosome is bladder cancer associated with? | 9 |
| Damage to which nerve would cause drooling of saliva and drooping of corner of mouth? | Marginal mandibular branch of facial nerve |
| Where do the inferior parathyroid glands develop from? | 3rd pharyngeal pouch, superior develop from 4th |
| Injury to the radial nerve at the axilla, would cause... | Loss of elbow extension, loss of wrist extension and loss of finger extension |
| Injury to the radial nerve at the spiral groove would cause.... | only loss of wrist and finger extension. Elbow extension would be preserved |
| Which artery supplies the levator scapulae, rhomboids, and trapezius? | Dorsal scapular |
| Where are the areas of oesophageal constriction? | Cricopharyngeal sphincter 15cm, aortic arch 22cm, left main bronchus 27cm |
| A patient presents with bleeding from the posterior gastric wall, which vessel is involed? | Splenic artery |
| What causes Kerr's sign on the left? | Splenic rupture |
| What crosses the ureter at the pevicuteric junction? | Vas deferens or broad ligament of the uterus |
| What is the most common type of hypospadiasis? | Glandular hypospadiasis (1 in 300) |
| What measures the extrinsic pathway? | Prothrombin Time, usually 1-13 seconds, prolonged by Warfarin, Liver disease and DIC |
| What measures the intrinsic pathway? | APTT, usually 35 seconds, prolonged by haemophillia A&B, Heparin and DIC |
| When should tamoxifen be stopped pre op? | 4 weeks |
| Which factors does heparin inhibit? | IIa, IXa, Xa, XIIa |
| Which muscle relaxant is used for rapid tracheal intubation? | Suxamethonium |
| Which vitamin is involved in collagen cross linking? | B6 |
| Which vitamin is involved in hydroxylation of proline and lysine? | C |
| What is the risk of getting the following post needlestick injury? Hep B, Hep C, HIV | 30%, 3%, 0.3% |
| Which dressing is good for exudating wounds? | Aquacel |
| Which scan is used for? Thyroid Parathyorid HPB Myocardial perfusion | Iodine 12B Technetium sestamic HIDA Thallium 20 |
| What is the most abundant cell? | Neutrophil |
| What is the largest leukocyte? | Monocyte |
| What is the normal CVP? | 8-12 mmHg |
| Where is a central chemoreceptor and what does it do? | Detects changes in pH/CO2 crossing the BBB |
| What do peripheral chemoreceptors detect? | Changes in PaO2, carotid body via CNIX, aoritc arch via vagus |
| Which fibres transmit acute sharp pain? | A, C fibres transmit slow chronic pain |
| Where do A fibres terminate? | Lamina 1 and 5 in the dorsal horn |
| Where do C fibres terminate? | Lamina 2&3 in the substantia gelatinosa |
| What does afferent vasoconstriction cause? | Reduced GFR and glomerular plasma flow |
| What does efferent arteriolar vasoconstriction cause? | Increased GFR |
| What are the differences between endotoxin and exotoxin? | Endotoxin remains within cell wall of bacteria, exotoxins are actively secreted by bacterium |
| Which inotrope activates beta recptors and increases intracellular camp? | Adrenaline |
| Which inotrope affects predominantly B1 and HR and increases force of contraction? | Dobutamine |
| Which inotrope increases SVR? | Noradrenaline |
| Which trope increases cardiac relaxation? | Lusitropes |
| Which deficiency is linked with bacterial infections? | C3 |
| Which complement deficiency is linked with recurrent neisseria infections? | C5-8 |
| What are examples of exotoxins? | Gram +ve bacteria like clostridium |
| What are examples of enterotxins? | Staph A, E Coli |
| Which herpes virus is linked with a)EBV, b)CMV? | a:4, b:5 |
| Where would giardia lamblia accumulate? | Duodenum |
| Where does cryptosporidium lodge? | Brush border of villi |
| Which antigens are on all platelets and nucleated cells? | Class I Class II are on all dendritic cells, macrophages, b lymphocytes and activated T cells |
| Which interlukin stimulates proliferation of B and T cells? | 2 |
| Which interleukin promotes differentiation of CD4 and B cells | 4 |
| Which interleukin stimulates activation of eosinophils | 5 |
| Which disease as antibodies against parietal cells? | Atrophic gastritis |
| What is anti-centromere associated with? | CREST syndrome |
| What is Anti Scl 70 associated with? | Scleroderma |
| Where are indirect hernias in relation to the inferior epigastric vessels? | Lateral |
| What are the boundaries of calot's triangle? | Superior-inferior edge of the liver, lateral- cystic duct, medial- common hepatic duct |
| Where does the aortic arch end | T4 |
| Where does SCC arise from? | Stratum spinosum and epidermal appendage. Needs a 4mm margin to be clear and 6mm if high risk |
| What are the 4 steps of skin graft healing? | Adherence, plasmatic imbition, revascularisation, maturation |
| What forms the lateral wall of the femoral triangle? | Sartorius |
| What symptoms is campylorbacter jejuni associated with? | Severe abdominal pain and diarrhoea |
| Where is most dietary iron absorbed? | Duodenum |
| What is mcKeown's procedure? | Total oesophagectomy |
| What runs medially to the pars flaccida? | Chorda tympani |
| Which study would use relative risk? | Cohort study |
| Which study would use odd's ratio? | Case-control |
| Which muscle relaxant can cause malignant hyperthermia? | Suxamthonium |
| What is the most posterior structure at the hilum of the right kidney? | Ureter |
| What are psammonal bodies? | Clusters of microcalcification mainly seen in papillary carcinoma |
| Which bacteria stain purple? | Gram +ve |
| Which bacteria have LPS in outer membrane? | Gram -ve |
| Which fibres lead to contraction at the apex before the base? | Purkinje |
| What does the cystic artery arise from? | right hepatic |
| Which cells produce VIP? | Pancreatic D |
| What are the contents of the cavernous sinus? | ICA, CN VI, blood |
| Which nerve provides parasympathetic innervation to the parotid salivery gland? | Glossopharyngeal via auriculotemporal |
| When is fusion of the ilium, ischium and pubis at the acetabulum complete? | 23 years |
| What can the kidneys generate bicarbonate from? | Glutamine |
| What is the volume capactiy of the gallbladder? | 50ml |
| Where is 70% sodium reabsorbed? | PCT, 20% ascending loop of henle, 10% DCT |
| What is the left gastroepiploic artery a branch of? | Splenic |
| What is the most radiodense stone? | Calcium phosphate |
| What is the commonest cause of filarisis? | W. Bancrofti |
| Which cranial nerves carry parasympathetic finres? | X, IX, VII, III (1973) |
| What are the main flaps used in BKA? | Skew flaps or Burgess long posterior flap |
| Which type of amputation preserves the patella?? | Gritti stokes |
| What is Hadfield's procedure? | Total duct excision |
| What is Mondor's disease? | Superficial thrombophlebitis of s/c veins of the chest |
| Which antibodies are elevated in Grave's disease? | Thyroid receptor |
| Which antibodies are elevated in hypothyroidism? | Thyroid peroxidase |
| Which thyroid tumour is TSH dependent? | Papillary and follicular |
| Which ligament prevents abduction above the knee? | Medial collateral |
| Which technique analyses DNA? | Southern Blotting |
| Which technique uses mRNA as the target nucleic acid? | Northern Blotting |
| Which technique analyses proteins seprated by electrophoresis? | Western Blotting |
| Which heart sound coincides with QRS complex? | 1st |
| When would you see high numbers of Auer Rods? | AML |
| Which cells in the adrenal medulla release adrenaline? | Chromaffin |
| Which nerve wraps around Wharton's Duct? | Lingual |
| What promotes gastrin release? | Distended stomach |
| Whait is released by S cells in the upper small intestine and reduces gastric acid? | Secretin |
| What inhibits gastric acid and pepsinogin? | VIP |
| What stimulates bile and pancreatic juice production? | Secretin |
| What is the commonest cause of infrarenal outflow obstruction? | Posterior urethral valves |
| Which suture lasts up to 3 months? | PDS |
| How is biliary atresia managed? | Roux en Y portojejunostomy aka Kasai Procedure |
| What lesion causes Erb's palsy? | c5, c6 |
| Which virus is linked with anal cancer? | HPV 16 |
| Which stoma is formed after low anterior resection? | Loop ileostomy |
| Which stoma is formed after large bowel obstruction? | Loop colostomy |
| Which stoma is formed after subtotal colectomy? | End ileostomy |
| How is blood stained nipple discharge managed? | Microdochectomy |
| What is the substrate for renin? | Angiotensinogen |
| What skin graft would be used for a full thickness burn? | Split thickness graft |
| When would trans metartarsal amputation be indicated? | Diabetic gangrene |
| Where does the axillary artery become the brachial? | Lower border of teres minor |
| Which artery stenosis causes intermittent claudication? | Superficial femoral |
| Aortoiliac disease is treated with which bypass?- presents with buttock and hip pain | Aortobifemoral |
| Which bypass would be used in isolated external iliac disease? | Ileofemoral bypass |
| If only one iliac artery is blocked and the pt is unfit for abdominal surgery which graft is used? | Fem-fem crossover graft, if both arteries are occluded then axilofemoral graft |
| What causes horseshoe kidney? | The kidneys fuse at the infeior pole and fail to ascend |
| Which embryological structure becomes the functioning kidney? | Metanephros |
| Where do the bladder and urethra descend from? | urogential sinus |
| Which cells produce mullerian inhibitory substance? | Sertoli Cells, this causes regression of the parameseonephric ducts |
| What is the most common malignant brain tumour in children? | Medulloblastoma |
| Which hernia occurs with the appendix within the inguinal hernia sac? | Amyand's |
| Where do the Vas Deferens develop fron? | Mesonephric ducts |
| What is a remnant of allantois? | Urachus |
| Where does the male urethra develop from? | Cloaca |
| Where is the internal iliac artery in relation to the ureter and vein? | Ureter is anterior, the vein lies posterio |
| Where does the body of the uterus drain? | Iliac lymph nodes |
| Where is the isthmus of the thyrpid? | 2nd-4th tracheal rings |
| Where is oesophageal opening in the diaphragm? | t10 in the right crus |
| Where is the vena cava opening in the oesophagus? | Central tendon T8 |
| What is the function of the femoral canal? | Allows expansion of the femoral vein |
| What does an orbital floor fracture cause? | Enophthalamos and diplopia |
| What does the Hawkin's test test? | Subacromial impingement |
| What does Jobe's test test? | Suprapsintaus injury |
| What is the equation for cerebral perfusion pressure? | CPP=MAP-ICP |
| What happens to SVR in septic shock? | Reduces it due to increased bacterial exotoxins causing peripheral vasodilatation |
| What is the arterial supply to the prostate? | Inferior vesical artery |
| Where does the uterine artery run? | Base of broad ligament, it is branch of the internal iliac |
| Where are the roots of the brachial plexus? | Between scalene anterior and medius |
| What is a typicial chemo regime in breast ca? | Cyclophosphamide, methotrexate, 5FU |
| What is the gold standard for detecting renal calculi? | CT urogram |
| What is the risk of repeat MI if operation is 3-6 months after a MI? | 6% |
| Which test is used for autoclaving efficacy? | Bowie-Dick |
| How many sections are in the WHO checklist? | 3 |
| Where does the SVC enter the right atrium? | Behind right C3 |
| How much tibia is required to fit a prosthesis? | At least 8 cm |
| What is the protien count of CSF compared to plasma? | 0.5% |
| When does the diaphragm form? | 9-2 weeks |
| Which nerve is at risk during submandibular duct ligation? | Lingual |
| What level is the ureteropelvic junction? | L2 |
| Herniation of which disc affects dorsiflexion? | L4/5 |
| Herniation of which disc affects plantarflexion and decreased ankle jerk? | Lf/21 |
| Where do oesophageal veins drain? | Azygous veins |
| Which ligament is in direct contact with the vertebral foramen? | Ligamentum flavum |
| Where does the dural sac end? | S2 |
| What is the action of latissimus dorsi? | Adduction and medical rotation of the humerus |
| What level in adults is lumbar puncture performed at? | L4/5 |
| Where do the external genitalia drain? | Superficial inguinal nodes |
| Which arteries are within the spermatic cord? | Cremasteric, tesitular, artery to vas |
| What forms the trauma triad of death? | Hypothermia, coagulopathy, metabolic acidosis |
| Where is the larynx in children, adults | C3-4, C4-5 |
| Which nerves are parasympathetic? | CNIII, CN VII, CN IX, CN X, S2-s4 |
| Which receptor is noradrenaline more potent than isoprenaline? | alpha, but vice versa at beta |
| What is sensitivity? | Measure of true positives |
| What is specificity? | Measure of true negatives |
| Which neurotransmitter is usually released at post ganglionic sympathetic endings? | Noradrenaline, at eccrine sweat glands it is ACh |
| Which hormone does bronchial cancer produce? | Calcitonin |
| Which hormones are produced by testicular teratomas? | BHCg, thyroxine, AFP |
| Which nerve is anterior to the lung root? | Phrenic |
| Which necrosis occurs post MI? | Coagulative |
| What level does the azygous drain into the SVC? | T4 |
| Where does the thoracic duct drain? | Confluence Left jugular and subclavian veins |
| What toxin does E.coli 0157 produce? | Enterotoxin |
| What signifies active or chronic hep b? | S antigen |
| Which antigen signifies active replication and high infectivity of hep B? | e antigen |
| What is the proper name of chinese liver fluke? | Clonorchic Sinesis |
| Which bacteria produce hyalurinidase? | S.Aureus, S. Pyogenes, C. Perfringenes |
| Which stage of the cell cycle are cells not actively replicating? | G1 |
| Which toxin in tobacco is associated with bronchogenic ca? | Napthylamine |
| What is compliance? | Change in volume for a given change in pressure |
| How quickly does the exudative phase develop in ARDS? | 30 minutes, characterised by interstitial oedema, alveolar haemorrhage, the oedema leads to alveolar collapse |
| What is the main site of absroption of amino acids and lipids? | Ileum |
| What are the features of the jejunum compared to ileum? | Thicker wall, more vasculare, more circular folds, fewer lymph aggregates |
| Where does the cystic artery arise from? | Right hepatic artery |
| Which amino acids are a major stimulant for gastric secretion? | Phenylalanie and tyrosine |
| What does the portal vein develop from? | Vitteline venous plexus |
| Where are 90% of bile salts absorbed? | terminal ileum |
| What is the lateral coticospinal column responsible for? | Motor function |
| What is the posterior spinal column responsible for? | Position, vibration, and deep pressure sensation |
| What are the features of spinal shock? | Paralysis, hypotonia, areflexia |
| Which ligament is affected in Jefferson's fracture? | Transverse ligament rupture |
| Which herniation causes Cushing's Triad? | Cerebellar tonsil |
| Which artery supplies the sciatic nerve? | Inferior gluteal |
| What does the Y waveform on JVP show? | Ventricular filling |
| What is at risk in axillar node clearance? | Thoracodorsal trunk |
| Which organisms are lactose fermenting? | E.Coli, Klebsiella |
| What causes amoebiasis? | Entmceba histolytica |
| Which nerve supplies sensation to the inferior part of the ear? | C3- greater auricular nerve |
| What are the strap muscles? | Sternohyoid, thyrohyoid, styrohyoid, omohyoid |
| Which dermatome is the shoulder tip? | C4 |
| What are the nerve roots of the musculocutaneous nerve and what does it supply? | C5-C7, corachobrachialis, bicpeps brachia, brachialis |
| Which nerve root is damaged in Klumpke's palsy? | T1 |
| Where is the radial nerve in relation to the axillary artery? | Posterior to it |
| What are iodine dressings used for? | Infection/ exudative wounds |
| What is the risk of CBD injury in cholecystectomy? | 0.5% |
| What are the features of neurogenic shock? | Bradycardia, warm peripheries, no response to fluids |
| Where does anterior tongue cancer spread? | submental, submandibular, deep cervical nodes |
| Where does posterior tongue cancer spread? | bilaterally to lymph nodes |
| Which hormone is increased in the menopause? | FSH |
| What is the medial border of the femoral canal? | Adductor longus |
| What is the lateral border of the femoral canal? | Sartorius |
| What is the superior border of the femoral canal? | Inguinal ligament |
| Which bone cell does PTH directly act on? | Osteoblasts |
| Where are Brunner's glands located? | Submucosa of the duodenum |
| What are the roots of the ankle reflex? | S1, S2 |
| What does LMWH inhibit? | Factor Xa |
| What is the management of recurrent duct ectasia? | Total duct excision |
| What is normal cerebral blood flow? | 55ml/minute for every 100 gram of brain tissue. Ischaemia occurs when it falls below 20ml/min |
| What is Sistrunk's procedure? | Excision of thyroglossal cyst |
| Which nerve injury causes difficulty in vocal pitch? | Superior laryngeal |
| Diphonia and dysphagia is caused by injury to which nerve? | Unilateral inferior laryngeal nerve |
| What can be used to treat GI parasitic worms? | Mebendazole |
| Which enzyme activates trypsinogen? | Enterokinase |
| What is the most commonly displaced carpal bone? | Lunate |
| Which receptor does dobutamine bind? | B1 |
| Which stain is used in amyloidosis? | Congo-Red-stains apple green |
| What would deficiency in production of J Chain produce? | Decreased serum IgA and IgM |
| Which virus causes myocarditis? | Coxsackie B |
| Which nerve is secreto-motor to the lacrimal gland? | Facial |
| Which organism produces urease which can form staghorn calculi? | Proteus mirabilis |
| What is contained in the lienorenal ligamanet? | Splenic artey and tail of pancreas |
| Which virus can complicate blood transfusion? | CMV |
| Which chromosomes are involved in Hirschspring disease? | 10 and 13 |
| What is the function of quadratus lumborum? | Pulls the ribcage inferiorly and lateral flexion |
| What structures are posterior to the medial malleolus? | Tibialis posterior Flexor digitorum longus Posterior Tibial artery Tibial nerve Flexor hallicus longus |
| What is Barton's fracture? | Distal radius fracture with radiocarpal dislocation |
| What aDDucts the vocal cord? | Lateral cricoarytenoid |
| Which vessel may be encountered during tracheostomy? | Anterior jugular vein |
| What forms the posterior wall of the femoral canal? | Pectineal |
| Where is the vomiting centre located? | Medulla oblongata |
| How is anatomical dead space measured? | Fowler's Method |
| Which structure is most posterior at the lung root? | Vagus nerve |
| Which cells indicate follicular cancer? | Hurtle Cell tumours |
| What causes Lynch syndrome? | Microsatellite instability of DNA repair genes |
| What is the neurotransmitter for Purkinje neurons? | GABA |
| What does ondansetron block? | CTZ in postrema |
| Which tendon lies closest to hamate in the carpal tunnel | FDP |
| Which finger does not have palmar interosseous? | Middle finger |
| Which muscle is penetrated by the parotid duct? | Buccinator |
| Which sinus empties into the IIJV? | Sigmoid |
| What is the terminal branch of the inferior alveolar nerve? | Mental |
| How do you treat insulinoma? | Enucleation of the lesion |
| What is a Hangman's fracture? | Traumatic spondylothesis of C2 on C3 |
| What is medial epicondylitis aka? | Golfer's elbow |
| Which part of the urethra is the narrowest? | Membranous |
| How should you investigate a neonate with bilious vomiting? | Upper GI contrast study |
| How would a ureteric stone <2cm be managed? | Lithotripsy |
| What innervates the long head of biceps femoris? | Branch of sciatic nerve |
| What innervates the shorthead of biceps femoris? | Common fibular branch of the peroneal nerve |
| Which drain would be used post mastectomy? | REdivac suction drain |
| Which artery supplies Broca's area? | Middle cerebral artery |
| Where does the prostate gland drain? | Internal iliac nodes |
| What innervates the prostate? | Inferior hypogastric plexus |
| What is the main pancreatic duct aka? | Wirsing's duct |
| What is the accessory pancreatic duct aka? | Santorini duct |
| What nerve supplies sensation to the suprapubic skin? | Illiohypogastric |
| Which tongue papilla grip food? | Fuliform |
| Which tongue pailla tastse sweet/salty food? | Fungiform |
| Which tongue pailla detect sour tastes | folate |
| Which vein arises in the anatomical snuff box? | Cephalic vein |
| Where does the submandibular duct lie? | Between mylohyoid and hypoglossus. It opens into the floor of the mouth adjacent to the frenulum |
| Where does the tongue develop from? | 1st and 3rd branchial arch |
| What does PTH do? | Increases calcium from bone and kidney, increases vit d |
| What does neutrophils produce? | Hydrogen peroxide |
| Which nerve supplies aBDuctor pollicis longus? | Posterior interosseous nerve |
| What nerve supplies aBDuctor pollicis brevis? | Median nerve |
| When does the descending colon become sigmoid? | L3,L4 |
| What attaches periosteum to bone? | Sharpey's fascia |
| Where does the vagus nerve leave the medulla? | At the olivary nucleus and inferior to the cerebellar peduncle |
| What are the layers of the scrotum? | Skin Dartos External spermic fascia Cremasteric muscle and fascia Internal spermatic fascia Tunica Vaginalis |
| What is the initial mangement of congenital talipes equinovarus? | Ponsetti method- serial casting |
| What supplies the anterior digastric muscle? | Mylohyoid nerve |
| What supplies the posterior digastric muscle? | Facial nerve |
| What induces satiety? | Leptin |
| What induces hunger? | Grehlin |
| Where does the trigeminal nerve originate? | Pons |
| What is the lateral border of the adductor canal? | Vastus medialis |
| How long can you store FFP? | 36 months |
| What are the contents of the adductor canal? | Saphenous nerve, superficial branch of femoral |
| Which nerve innervates the nail bed of the index finger? | Median nerve |
| Which ligament seprates the IV discs from the spinal cord? | Posterior longitudinal ligament |
| Where does the posterior ethmoidal sinus drain? | Superior meatus |
| Where do the frontal and anterior ethmoidal cells drain? | Infundibulum of the middle meatus |
| Where do the maxillary sinus and middle ehtmoidal cells open? | Middle meatus |
| What are the features of O'Danaghue's unhappy triad? | Tear ACL Tear MCL Meniscal tear |
| What is the most radiosensitive testicular tumour? | Seminoma |
| What is normal portal vein pressure? | 5-10mmHg, portal HTN develops at 12mmHg |
| How much does 1gram nitrogen loss equate to lean muscle loss? | 36 gram |
| What vein does the basillic drain into? | Axillary |
| Which cells are affected by poliomyelitis? | Anterior horn cells= lower motor neurone palsy |
| Which anaesthetic is used in brier's block? | Prilocaine |
| Which anaesthetic is used in spinals/epidurals? | Bupivacaine |
| What dermatome signifies inguinal ligament? | T12 |
| Which hormone is responsible for ion exchange in the salivary glands? | aldosterone |
| Which structure is deepest in the popliteal fossa? | Popliteal artery |
| Which muscles insert onto the superior medial tibial shaft? | Sartorius, gracilis, semitendinous |
| What nerve can be compressed by anterior dislocation of lunate? | Median nerve |
| Which stain identifies toxoplasmosis gonadii? | Giemsa |
| Which vitamin deficiency can cause bladder calculi? | A- causes desquamation which causes nidus formation |
| Which kidney infection causes alkaline urine? | Proteus |
| Which hormone do small cell lung cancers produce? | ACTH |
| Which oepration is used for ingrown toenails? | Zadik's |
| Which muscles flex the hip? | Sartorius Tensa fascia latae Rectus femoris Iliopsaos Pectineus |
| What is normal pulmonary artery wedge pressure? | 18mmHg |
| What group is strep pyogenes in? | Lancefield group A |
| What can be used to monitor follicular cnacer? | Thyroglobulin |
| What is used to monitor medullary cancer? | Calcitonin |
| Which level is the xiphoid process? | T7 |
| Which clotting factor forms a complex with tissue factor? | 8 |
| What position is used for nephrectomy? | Lateral decubitus position |
| What is vital capacity? | Volume of air that is expelled from max inspiration to max expiration |
| Which reflex prevents overinflation of the lungs? | Hering-Breuer reflex |
| When does renal autoregulation fail? | SBP <80mmHg |
| What is most common toxin from cat bite? | Paseurella multicida |
| What is most common pathogen in THR infection? | Staph epidermidis |
| What supplies the first web space in the hand? | Superficial radial nerve |
| What innervates pronator quadratus? | Anterior interosseous nerve |
| What forms the medial wall of the axilla? | Serratus anterior |
| What is afterload? | MEasure of tension in the left ventricular wall during systole |
| What is the anterior border of the epiploic foramen? | Portal vein |
| What is transmitted by the anterior spinothalamic tract? | Crude touch |
| What is Jenkin's rule | Length of suture if 4 times the length of the wound |
| How does picolax work? | It is magnesium sulphate, stimulates release of CCK which promotes intestinal motility |
| What are the pro-inflammatory cytokines that also cause pyrexia? | TNF-a, IL-1, IL-6, IL-8 |
| Which fascia covers the sacrum and coccyx? | Waldeyer's |
| Which procedure can be used for adult hydrocele? | Jaboulay/Lord's |
| What is the management of pleiomorphic adenoma? | Superifical parotidectomy |
| Which amputation uses skew flaps? | BKA |
| How would you mangafe obstructed infected calculi? | Broad spectur abx, percutaneous nephrostomy |
| What forms the roof of the adductor canal? | Sartorius |
| What forms the posterior wall of the adductor canal? | Adductor longus and magnus |
| What is the resting muscle membrane potential? | -90 |
| What is the commonest presentation of ulcerative colitis? | Priaprism |
| Which artery winds around midshaft of the humerus? | Brachial artery |
| Which cells form the primary callous in #healing? | Osteoblasts |
| What condition happens post cardiac surgery? | Acute mediastinitis |
| What is the incidence of cleft lip and palate? | 1 in 600 live briths |
| What is Parotid duct known as? | Stenson's duct, opens adjacent to 2nd molar teeth, mainly serous saline fluid |
| What is likely to have developed if patient becomes suddenly anuric post transplant? | Renal artery thrombosis |
| What forms the roof of the inguinal canal? | Conjoint tendon |
| What forms the posterior wall of the inguinal canal? | Transversalis fascia |
| What forms the anterior wall of the inguinal canal? | External oblique aponeurosis |
| What forms the floor of the inguinal canal? | Inguinal ligament |
| What is first line for varicose veins? | Endothermal ablations |
| What is a congential cause of lymphoderma? | Milroy's disease |
| What are the features of aortoliac obstruction? | Claudication in both buttocks, thighs, calves |
| What are the features of iliac obstruction? | Unilateral claudication in thigh, calf and buttocks, bruit over iliac regions, unilateral absence of femoral and distal pulses |
| What are the features of femoropopliteal obstruction? | Unilateral calf claudication, palpable femoral pulse, absent unilateral distal pulse |
| At McBurnley's point, which structure is encountered first in dissection? | External oblique aponeurosis |
| Where does the cervix drain? | Internal iliac nodes |
| Where is water mainly absorbed? | Jejunum |
| what marks junction between duodenum and pylorus? | Vein of Mayo |
| What is normal inspiratory reserve volume? | 3000ml |
| which foramen connects the 2 lateral ventricles with the 3rd ventricle? | Foramen of Munro |
| What causes ACL damage? | Twisting of slightly flexed knee- netball- pop sounds |
| What causes MCL damage? | Blow to lateral aspect of knee |
| Posterolateral disc protrusion causes/// | nerve root pain and sciatica |
| Where are level I breast nodes? | Lateral to pectoralis minor |
| Where are level II breast nodes? | Behind pectoralis minor |
| Where are level III breast nodes? | Medial to pectoralis minor |
| How does UV light act as antimicrobial? | Causes formation of pyrimidine dimers |
| Which nerve is likely to be injured after deep laceration to the thenar eminence? | Recurrent branch of median |
| Which nerve is tested by Froment's test? | Anterior interosseous nerve |
| What is the most common testicular cancer in maldescended testis? | Seminoma |
| What is the commonest cause of blood stained nipple discharge? | Intraductal papilloma |
| What is the intrabdominal pressure in critically ill patients? | 5-7 mmHg |
| Where is zinc mainly absorbed? | duodenum and jejunum |
| What are the contents of the right atrium? | Fossa ovalis, opening of coronary sinus, crista terminalis, musculi pectinati |
| Which muscles tenses the vocal folds? | Cricothyroid |
| How does HIV establish persistance? | Antigenic variation |
| Which clotting pathway is affected by haemophillia A | Intrinsic |
| Which amino acid produces nitric oxide? | Arginine |
| What syndrome is posterior cricoid tumour associated with? | Plummer Vinson |
| Where is the primary visual cortex located? | Brodmann area 17 |
| What is the oldest part of the brain? | Limbic system |
| Which artery supplies ACL? | Middle geniculate artery |
| Which nerve carries fibres for lacrimation? | Greater petrosal |
| Which renal stones are radiolucent? | Urate, xanthine |
| Which immunoglobulin is first secreted in infection? | IgM |
| Which IL stimulates production of eosinophils? | IL-5 |
| where is the Meissner's plexus? | Submucosa |
| Which abx inhibit DNA synthesis? | Quinolones |
| Which cells are the main source of IL-12? | B cells |
| What does tranexamic acid inhibit? | Plasmin |
| What does string sign of Kantor represent? | Narrowing of the terminal ileum |
| When is AP resection indicated? | Cancer <4cm from anal verge |
| Which graft has the best patency? | Above knee anastomosis using long saphenous vein |
| where does the upper anus drain? | internal iliac nodes, supplied by superior rectal artery and vein |
| Where does the inferior anus drain? | Superficial inguinal nodea |
| What is Goodsall's rule for posterior fistula? | Always have internal opening at 6 oclock- curved tract |
| Which repair is preferred for herniaS? | Tension free Lichenstein rather than sutured shouldice |
| What is the repair for paraumbilical hernias? | Mayo repair |
| Which hernia passes through linea semiluminaris/ | Spigelian |
| What is factor II aka? | Prothrombin |
| What is HbcAG a marker of? | Ineffectivity |
| What effect do prostaglandins have on renal flow? | Increase renal blood flow and GFR? |
| Where is fat mainly absorbed? | Proximal small intestine |
| Which chromosome is the APC gene found? | Chromosome 5 |
| What is the main method intracellular pH is regulated? | Cytoplasmic proteins |
| What are non absorbable sutures? | Polyprolene, silk, nylon, pvdf, steel |
| What is the commonest germ cell testicular cancer? | seminoma |
| What is marantaric endocarditis aka? | non bacterial thrombotic endocarditis |
| What is dartos fascia a continuation of? | scarper's fascia |
| What is gluconeogenesis? | Formation of glucose from non carbohydrate sources-glycerol, lactate, amino acids |
| Which nerve is involved in Frey's syndrome post parotidectomy? | Auriculotemporal |
| What are the features of spermatocele? | Fluid filled cyst at the upper pole of the testis |
| What does specific gravity test? | Concentration |
| What lies in the retrovesical space in men? | Seminal vesicles |
| What are the effects of thyroxine? | Increases tissue oxygen consumption Stimulates protein synthesis Decreases plasma cholesterol Causes a net reduction in lipid stores |
| What is the treatment for thyroid storm? | Intravenous hydration Intravenous propranolol Propylthiouracil and sodium iodide |
| When could a HCW infected with Hep B perform procedures? | 1. e-antigen negative 2. Baseline viral load less than 105 geq/ml and 3. Viral load should fall below 103 geq/ml while taking antiviral therapy |
| What is the minimum amount of Hep B vaccine required? | 3 doses |
| What colour can propofol turn urine? | Green |
| What is the treatment for malignant hyperthermia? | Dantrolene |
| What is the most prominent extracellular ion | Sodium |
| What is the most prominent intracellular ion | potassium |
| What does calcitonin do? | Calcitonin acts to oppose PTH, so causing increased renal excretion and reduces bone resorption |
| What is the most common cause of vasodilatory shock? | Sepsis |
| What is the absolute maximum pressure of a tourniquet? | 350mmHg |
| What are the lowest effective tourniquet pressures in arm and leg? | Use the lowest effective pressure 100 mmHg over systolic BP for arm !50 mmHg over systolic BP for leg |
| What are the main symptoms of fat embolism? | Petechiae, hypoxaemia, confusion |
| What is the mechanism of Basiliximab ? | immunosuppression induction agent. |
| Which drugs are calcineurin inhibitors? | cyclosporine and tacrolimus. These agents both inhibit calcineurin, an important enzyme in the T-cell activation pathway. |
| What are the side effects of calcineurin inhibitors? | nephrotoxic. chronic allograft nephropathy and graft loss. narrow therapeutic -blood levels must be monitored. neurotoxicity, htn, hyperlipidaemia and glucose intolerance. New-onset diabetes- tacrolimus Cyclosporine -hirsuitism &gingival hyperplasia. |
| What are the side effects of antimetabolites? | The most important side effect of azathioprine and mycophenolate mofetil is bone marrow suppression, and the full blood count must be monitored. |
| What are the features of cell mediated acute rejection? | Peritubular infiltration with monocytes and foamy macrophages |
| What are the features of Chronic allograft nephropathy? | Interstitial fibrosis with arteriolar smooth muscle hypertroph |
| What is an Orthotopic graft? | Implanted in the position of the native organ/tissue |
| What is an Heterotopic graft? | Implanted in a position different from the native organ/tissue |
| Which solution is used to preserve the kidneys? | Marshall’s solution (Soltran™) |
| Which solution is used to preserve abdominal organs? | University of Wisconsion solution (ViaSpan™ |
| Non-absorbable skin closure | 3-0 polyprolene |
| What are the stages of wound healing? | Haemostasis (Day 1) Inflammation (Days 1-7) Proliferation (Days 3-21) Remodelling (Day 14-12 months) |
| What is the spring ligament? | The spring ligament or plantar calcaneonavicular ligament, is a support for the medial longitudinal arch on which the head of the talus rests. It is a major restraint preventing the head of the talus moving medially and collapsing inferiorly. |
| Rupture of which tendon causes flat foot deformity? | Rupture of tibialis posterior tendon leads to a severe secondary flat foot deformity. |
| Which clotting factor stabilises fibrin? | Factor XIII |
| What forms the anterolateral border of the adductor canal? | Vastus medialis |
| Which vertebrae are predominantly coronal? | thoracic |
| Where is the internal venous plexus of the spine? | Extradural fat |
| What is the role of FSH in men? | Stimulates synthesis of androgen binding protein |
| Which muscle is crucial to hindfoot position? | Tibialis posterior |
| What is a tributary of IJV? | Middle thyroid vein |
| What percentage of gallstones can be seen on plain xray? | 15% |
| What can increase renal blood flow and GFR? | Prostaglandins |
| What percentage of developing breast cancer do people with BRCA1 have? | 50% by age of 50 |
| Where is the fossa navcularis in the penis? | Small dilatation in the distal penile urethra |
| What are features of Men2a? | Medullary thyroid cancer, phaecochromocytoma and parathyorif hyperplasia |
| Who should have BRCA testing? | Women <35 with triple negative breast cancer |
| Which fracture is associated with posterior hip dislocation? | acetabulum |
| What is Liddle syndrome? | Rare AD, hypokalaemia and hypertension, unrestrained sodium reabsorption |
| What is the ophthalmic artery a branch of? | Internal carotid artery |
| What is the best test for acromegaly? | Oral glucose tolerance with GH levels |
| What is the first heart sound? | Closing AV valves |
| How does calcitonin work? | Inhibits bone resorption by inhibiting osteoclasts. |
| What is the action of co-amoxiclav? | Inhibits cell wall synthesis |
| what is the most common cause of epididyitis in children? | e.coli |
| Where is the aortic apperture? | Behind the median arcuate ligament. In the mid-line. |
| What is the course of the thoracic duct? | The thoracic duct extends from L2 to the root of the neck & lies immediately posterior to the esophagus & may be injured while mobilizing the esophagus in the neck. |
| Which muscle is the main extensor of the hip? | Gluteus maximus |
| Where does quadriceps femoris insert? | Tibial tuberosity |
| Which muscles inserts on the base of the 5th metatarsal? | Peroneus brevis |
| What are the 3 components of the femoral sheath? | 1. The medial is called the femoral canal. 2. The middle contains the femoral vein. 3. The lateral contains the femoral artery. |
| What are the components of Hunter's canal? | 1. Femoral artery & vein. 2. Saphenous nerve. 3. Nerve to vastus medialis |
| What does the sphenoid bone contain? | The optic foramen, superior orbital fissure, foramen rotundum, ovale & spinosum. |
| What is the arterial supply of the adrenal glands? | 1. Superior supra-renal from inferior phrenic artery. 2. Middle supra-renal from abdominal aorta. 3. Inferior supra-renal from renal artery |
| Which nerve transmits pain from anal fissure? | inferior rectal nerve |
| Which cell type is increased in patients with hydatid cysts? | Eosinophils |
| What is the most abundant immunoglobulin? | IgG |
| Which complement activates membrane attack complex? | C5b |
| What can pass through the blood brain barrier? | 1. Lipid-soluble substances (O2, Co2, ethanol & steroid hormones). 2. Substances having transport systems (sugars & some amino acids). 3. Serotonin (5HT). |
| What is the management of testicular tumours? | orchidectomy via an inguinal approach. This allows high ligation of the testicular vessels and avoids exposure of another lymphatic field to the tumour. |
| Where are the greatest proportion of musculi pectinati found? | right atrium |
| What is the treatment for intestinal malrotation? | Ladd's procedure |
| hich of the structures separates the subclavian artery and vein? | Anterior scalene muscle |
| A 6 day old child is suspected of having a malrotation and requires urgent abdominal exploration. What is the most appropriate surgical approach? | Transverse supra umbilical abdominal incision |
| A 32 male presents with a swollen RTscrotum which has developed over 3 weeks after being kicked in the groin area. There is a non tense swelling of the right scrotum and the underlying testis cannot be easily palpated. What is the most likely diagnosis? | Hydrocele |
| Which of these nerves passes through the greater and lesser sciatic foramina? | Pudendal nerve Internal pudendal artery Nerve to obturator internus |
| Which lung cancer is more common in non smokers?? | adenocarcinoma |
| How does a patent urachus present? | umbilical urinary discharge |
| At which of the following levels does the inferior thyroid artery enter the thyroid gland? | C6 |
| What is the arterial blood supply to the lacrimal apparatus? | Ophthalmic artery |
| Which of structures lies posterior to the femoral nerve in the femoral triangle? | iliacus |
| Where do lesions below the dentate line drain? | Lesions distal to the dentate line drain to the inguinal nodes. |
| From which structre is the tunica vaginalis derived from? | The tunica vaginalis is derived from peritoneum, it secretes the fluid that fills the hydrocele cavity. |
| What is the reciprocal of absolute risk reduction? | Number needed to treat |
| What is the sensory nerve supply to the angle of the jaw? | Greater auricular nerve (C2-C3) |
| Which of the fascial layers will be divided during the surgical approach to the axilla? | Clavipectoral fascia |
| A 25 year old man is undergoing respiratory spirometry. He takes a maximal inspiration and maximally exhales. Which of the following measurements will best illustrate this process? | Vital capacity |
| A 17-year-old girl presents with a swelling over her right knee. Movements of her knee are restricted. A plain x-ray of the affected site shows multiple lytic and lucent lesions with clearly defined borders. What is the most likely diagnosis? | OSteoclastoma |
| What is the largest branch of the brachial artery? | Profunda brachii artery |
| A 38 year old lady is due to undergo a parathyroidectomy for hyperparathyroidism. At operation the inferior parathyroid gland is identified as being enlarged. A vessel is located adjacent to the gland laterally. This vessel is most likely to be the: | Common carotid artery |
| A 23 year old man presents with blunt abdominal trauma and a splenic bleed is suspected. He is commenced on an infusion of tranexamic acid. Which of the following best describes its mechanism of action? | Inhibition of plasmin |
| Which of the following muscles inserts onto the lesser tuberostiy of the the humerus? | Subscapularis |
| Approximately what proportion of salivary secretions is provided by the submandibular glands? | 70% |
| Which nerve wraps around Wharton's Duct? | Lingual nerve wraps around Wharton's duct. |
| Which of the following nerves conveys sensory information from the laryngeal mucosa? | Laryngeal branches of the vagus |
| What is the function of sartorius? | Flexor of the hip and knee, slight abducts the thigh and rotates it laterally It assists with medial rotation of the tibia on the femur. For example it would play a pivotal role in placing the right heel onto the left knee |
| Which of the following structures passes through the quadrangular space near the humeral head? | Axillary nerve |
| A 22 year old lady presents with symptoms and signs of hyperthyroidism. Her diagnostic work up results in a diagnosis of Graves disease. Which of the following best describes the pathophysiology of the condition? | Formation of IgG antibodies to the TSH receptors on the thyroid gland |
| What is omphalitis? | This condition consists of infection of the umbilicus with Staph a. may spread rapidly through the umbilical vessels in neonates with a risk of portal pyaemia, and portal vein thrombosis. |
| Which of the following structures separates the ulnar artery from the median nerve? | Pronator teres |
| How is aanatomical dead space measured? | Anatomical dead space is measured by helium dilution |
| Which nerve supplies abductor pollicis longus? | radial nerve |
| Which of the following structures separates the posterior cruciate ligament from the popliteal artery? | Popliteus tendon |
| Brown tumours of bone are associated with which of the following? | Hyperparathyroidism |
| Through which of the following foramina does the genital branch of the genitofemoral nerve exit t | Deep inguinal ring |
| In which electrosurgical mode is the electrode held away from the tissue, where the current utilises a low amplitude and high voltage? | fukgration |
| How long will it take for the serum PTH levels to fall if the functioning adenoma has been successfully removed?he abdominal cavity? | 10 minutes |
| A 56 year old man is left impotent following an abdomino-perineal excision of the colon and rectum. What is the most likely explanation? | Damage to the hypogastric plexus during mobilisation of the inferior mesenteric artery |
| What do central chemoreceptors respond to? | Central chemoreceptors: Respond to increased H+ in BRAIN INTERSTITIAL FLUID to increase ventilation. |
| A 54 year old lady has her serum calcium measured. Assuming her renal function is normal, what proportion of calcium filtered at the glomerulus will be reabsorbed by the renal tubules? | 95% |
| What causes glucagon release? | Glucagon is a protein comprised of a single polypeptide chain. Produced by alpha cells of pancreatic islets of Langerhans in response to hypoglycaemia and amino acids. It increases plasma glucose and ketones. |
| What is the main component of colloid in the thyroid gland? | thyroglobulin |
| Which of the following stimulates prolactin release or action? | Thyrotropin releasing hormone |
| A 39 year old lady has recurrent attacks of biliary colic. What is the approximate volume of bile to enter the duodenum per 24 hours? | 500ml |
| Which one of the following would cause a rise in the carbon monoxide transfer factor (TLCO)? | Pulmonary haemorrhage |
| Which receptor does noradrenaline mainly bind to? | a1 |
| Which of the following is responsible for the rapid depolarisation phase of the myocardial action potential? | Rapid sodium influx |
| Which ligament keeps the head of the radius connected to the radial notch of the ulna? | Annular (orbicular) ligament |
| At which of the following vertebral body levels does the common carotid artery typically bifurcate into the external and internal carotid arteries? | c4 |
| A 19 year old man is playing rugby when he suddenly notices a severe pain at the posterolateral aspect of his right thigh. Which of the following muscle groups is most likely to have been injured? | Long head of biceps femoris |
| Which of the following overlies the outer muscular layer of the intrathoracic oesophagus? | Loose connective tissue |
| Which nerve lies medially on the thyroid gland, in the groove between the oesophagus and trachea? | Recurrent laryngeal nerve |
| Which of the following nerve roots contribute nerve fibres to the ansa cervicalis? | c1,c2,c3 |
| A 23 year old lady is undergoing a trendelenberg procedure for varicose veins. During the dissection of the saphenofemoral junction, which of the structures listed below is most liable to injury? | The deep external pudendal artery runs under the long saphenous vein close to its origin and may be injured. |
| A 28 year old man has a pleomorphic adenoma and the decision is made to resect this surgically. Which of the following structures is least likely to be encountered during surgical resection of the parotid gland? | Mandibular nerve |
| Which of the nerves listed below is at greatest risk of injury with a laceration to the upper lateral margin of the popliteal fossa? | Common peroneal nerve |
| What supplies the posterior scalp? | C2,C3` |
| n inspecting the caecum, which of the following structures is most likely to be identified at the point at which all the tenia coli converge? | Appendix base |
| A 36 year old male is admitted for elective surgery for a lymph node biopsy in the supraclavicular region. Post operatively the patient has difficulty shrugging his left shoulder. What is the most likely reason? | Accessory nerve lesion |
| Which cranial nerve supplies the motor fibres of styloglossus? | The hypoglossal nerve supplies motor innervation to all extrinsic and intrinsic muscles of the tongue. The only possible exception to this is palatoglossus, which is jointly innervated by the vagus and accessory nerves. |
| What is the normal angle between the femoral neck and the femoral shaft? | 130 |
| Which of the following bones is related to the cuboid's distal articular surface? | 5th metatarsal |
| Which of the following nerves is responsible for the innervation of the posterior belly of the digastric muscle? | Facial nerve |
| A 19 year old man undergoes an open inguinal hernia repair. The cord is mobilised and the deep inguinal ring identified. Which of the following structures forms its lateral wall? | Transversalis fascis |
| What is the lymphatic drainage of the membranous urethra? | Internal iliac nodes |
| In a patient with an ectopic kidney where is the adrenal gland most likely to be located? | In its usual position |
| Which cranial nerve provides general sensation to the anterior two thirds of the tongue? | Trigeminal |
| When performing minor surgery in the scalp, which of the following regions is considered a danger area as regards spread of infection into the CNS? | Loose areolar tissue |
| Which of the following structures are at risk of direct injury following a fracture dislocation of the femoral condyles? | Popliteal artery |
| An 82 year old lady presents with a carcinoma of the caecum. Approximately what proportion of patients presenting with this diagnosis will have synchronous lesions? | 5% |
| Which of the following is a recognised tributary of the retromandibular vein? | Maxillary vein |
| mydriasis and diminished direct response to light shone into the affected eye. The consensual response is preserved when light is shone into the unaffected eye. Which of the cranial nerves listed below is responsible for this? | Optic nerve |
| A 28 year old man presents with hypertension and haematuria. Haematological investigations show polycythaemia but otherwise no abnormality. CT scanning shows a left renal mass. What is the most likely cause? | Renal adenocarcinoma |
| A 63 year old man is undergoing a right pneumonectomy for carcinoma of the bronchus. As the surgeons approach the root of the lung, which structure will lie most posteriorly (in the anatomical plane)? | Vagus nerve |
| A 43 year old lady is undergoing an axillary node clearance for breast cancer. The nodal disease is bulky. During clearance of the level 3 nodes there is suddenly brisk haemorrhage. The most likely vessel responsible is: | Thoracoacromial artery |
| A 22 year old is found to have bilateral acoustic neuromas. Which of the disorders listed below is most likely to be present? | Neurofibromatosis Type II |
| Which of the following fingers is not a point of attachment for the palmar interossei? | Middle finger |
| He is well for several months and then develops symptoms of palpitations and facial flushing. Which of the following diagnostic markers should be requested? | Urinary 5-Hydroxyindoleacetic acid measurements |
| A 33 year old man sustains an injury to his forearm and wrist. When examined in clinic he is unable to adduct his thumb. What is the most likely underlying nerve lesion? | Deep branch of the ulnar nerve |
| A 6 year old sustains a supracondylar fracture of the distal humerus. There are concerns that the radial nerve may have been injured. What is the relationship of the radial nerve to the humerus at this point? | Anterolateral |
| Which of the following structures does not pass anterior to the lateral malleolus? | Peroneus brevis |
| A neonate is noted to have colonic obstruction, what is the most likely cause? | Meconium plugs |
| A 4 year old boy is brought to the clinic by his mother. He has a swelling in his right hemiscrotum. On examination, it transilluminates brilliantly. What is the best course of action? | Division of the patent processus vaginalis via an inguinal approach |
| A 16 year old man sustains a basal skull fracture and is suspected of having CSF rhinorrhoea. Which of the following laboratory tests would most accurately identify whether CSF is present or not? | Beta 2 transferrin assay |
| What proportion of patients presenting for cholecystectomy for treatment of biliary colic due to gallstones will have stones in the common bile duct? | 10% |
| Which of the following has the greatest impact on the positive predictive value of a test? | Prevalence |
| During an open Watsons Fundoplication, the inferior pole of the spleen is injured causing troublesome bleeding. What is the best course of action? | Use of argon plasma coagulation system |
| A 72 year old lady has a 4cm basal cell carcinoma excised from her right cheek. There is a rhomboid defect measuring 4cm by 4cm. What is the best option for managing the wound? | Full thickness skin graft |
| A 6 year old boy presents with symptoms of recurrent pruritus ani. On examination, there is evidence of a small worm like structure protruding from the anus. What is the most likely infective organism? | Enterobius vermicularis |
| A 68 year old women with previous rheumatic fever is admitted with pyrexia of unknown origin. Her blood cultures are unhelpful but transoesophageal echocardiography reveals vegetations on the mitral valve. Infectionis most likely? | Staph viridans |
| A cohort study is being designed to look at the relationship between smoking and breast cancer. What is the usual outcome measure in a cohort study? | Relative risk |
| What type of virus is Hepatitis B? | Double stranded DNA virus |
| What is the commonest cause of an amoebic liver abscess? | Entamoeba histolytica |
| A 56 year old lady is admitted with colicky abdominal pain. A plain x-ray is performed. Which of the following should not show fluid levels on a plain abdominal film? | descending colon |
| A 55 year old man has multiple stones of varying size located within the renal pelvis. What is the most appropriate course of action? | Arrange a percutaneous nephrolithotomy |
| A 28 year old man presents with a recurrent inguinal hernia on the left side of his abdomen and a newly diagnosed inguinal hernia on the right side. What is the best course of action? | Laparoscopic hernia repairs are specifically indicated where there are bilateral hernias or recurrence of a previous open repair. |
Created by:
laylag