Let’s Collect MRCS ​Sept 2020 ​Recalls

Here together
((Please use Ctrl+F for finding any question before adding ))
This Recall File Prepared with Love from Selfless Surgeons Believed
in passing Knowledge From all over the world
Master The MRCS Part A Study Group
Specially
Dr Haya Green​ ​Dr Subodh Paudel​ ​Dr B-kram Thapa​ ​Dr Nafees Ahmed
And the whole group team refined revised and recalled many of those Questions with love
You too when you finish your exam pass your knowledge for next generations
Together we can With the Grace of God . DrBishoy

1. Alcoholic pt with heart failure,ataxia,peripheral neuropathy.

Deficiency of which vitamin?
A.Thiamine
B. Cobalamin
C. Vitamin b6
2. Mechanism of action of Botulinum toxin​?
A. Blockade of Acetylcholine
B. Blockade of sodium channels
C. Blockade of calcium channels

3. 24 yr old Pt presents with breast lump ,aspiration to dryness ,

shows clear fluid with no malignancy .what Ix to do next?
A- No further follow up
B- core biopsy
C- measure urine estrogen
D culture of fluid

4. 2 days of knee pain, no fever, WCC normal. Definative dx by​:

a-.xray
 b- Arthroscopy
c-ESR
d-Synovial joint aspiration
e-ultrasound

5. 13 years old obese boy, hip pain... ​slipped capital femoral

epiphysis

6. internal carotid artery. One is true:​ gives ophthalmic a.

7. In organ Transplantion what else should be checked beside

ABO matching:
A-HLA DR
B-HLA B27

8. Local anesthetic lidocaine acts by blocking which channels:

- Na
-k
-ca

9. 70 yrs female after total hip arthroplasty the removed head

examined. What changes do you expect.regarding
​Osteoporosis- bone density and bone mineralization
A.normal mineralization and reduced bone density
B. Reduced mineralization and reduced bone density
C.Normal bone density and normal mineralization
D.increased mineralization and increased bone density

10. young patient , with osteolytic tumour in the diaphysis . This

tumour has onion peel apearance on oxray with soft tissue
component?
 a-​ewings
B-osteosarcoma

11. 6 years old hip pain and unable to bear wieght ... ​perthes

12. 1yo boy with hx of vomitings since birth, failure to thrive dx​:
a-Duodenal atresia,
b-pylori stenosis

13. Which true about vit.K ?

A- gastrectomy cause deficiency
B- broad spectrum antibiotics
C- overdose cause bleeding
D- Affect platelet function

14. Target INR of warfarin therapy in a patient with superficial

femoral thrombosis
A- 1-2
B- 2-3
C-3-4

15. Patient with ptosis and tingling in medial side of

forearm.where is the lesion which nerve root?​.(Horner)
A T1
B C8

16. pt admitted for cholecystectomy found to be MRSA carrier.

What antibiotic to give.?
A- oral vanco
b- mupirocin nasal
C.I/V Teicoplanin
17. -injury in index finger by hammer. What anaesthesia to give.
A- digital block(ring block)
B-Biers block
C-Median
D-Ulnar
E-Radial

18. Clawing less marked in last two digits, no sensory loss at the
dorsum of those digits
A- u. N in wrist
B- u. N at elbow
C- Ulnar Nerve injury in forearm
D- Radial nerve
E- Median nerve

19. Why maxillary sinusitis is common?

a Abscence of cilia
B. Related to lateral wall of the nose
C.high located ostium
D. Relation with the front upper teeth as the floor
E.

20. -pt with hx of talus fixation by wire came . Ten years later
presents with severe pain. Cause?
A- posttraumatic OA
B-malunion
c-aVn
D NON UNION

21. Cranial nerve 11 exit the skull through?

22. A large meningioma with feeding vessel was middle
meningeal, dilated, whc foramen affected: ?
A. Jugular foramen
B. Foramen spinosum
C. Stylomastoid foramen

23. Incoherent speech which territorial cerebral a.?

a-ACA
B-PCA
C-MCA

24. Child with ear pain which subsided with ear discharge shows
hemophilis influenza
A- Acute otitis media
B- cholesteatoma
C- Otitis externa

25. Renin substrate?

A. Angiotensin
B. Aldosterone
C. Angiotensinogen
D. ACE
E. ADH

26. Weakness of grip with ulnar deviation of wrist after stab injury
to forearm..which nerve?

27. Type of bladder epithelium? BIOPSY TAKEN FROM

SUPERFICIAL LAYER OF BLADDER
​A-COLUMNAR
​ B SQUAMOUS
C TRANSITIONAL
28. What type of graft using porcine skin after burn
A. allograft
B.xenograft
C.isograft

29. Cause of rectovaginal fistula in neonate?

A IMPROPER DIVISION OF CLOACAL SEPTUM

30. Child, with burn on the forearm with blistering, pain and
increased sensitivity. Management?
A- occlusive covering
B-leave uncovered
C- fasciotomy
D- escharotomy
E-

31. Thyroid swelling with pulsating frontal bone lesion

a- follicular
B- papillary

32. Swelling ant neck in between upper and lower third of

sternomastoid
a-brachial cyst
b-thyroid
c-dermoid

33. Thyroid swelling developing / enlarging in 3 months period.

No other data available?I guess they are asking which rapidly
growing ?
A- Anaplastic carcinoma
B- Follicular
C- papillary
 D- MNG
E-Lymphoma

34. 1cm nasal skin,cartilage and muscle injury. management?

A-local flap
B-free flap
C-primary closure
D-delayed primary closure
E-

35. 26 yr old, 3cm nodule papillary thyroid cancer in the right

lobe, no lymphnodes. Managemt?
A-subtotal thyroidectomy
B-total thyroidectomy
C-hemithyroidectomy
D- RADIOACTIVE IODINE
E

36. Suspected compartment syndrome.Most appropriate

management?
A-four compartment decompression
B- assess pulse
C-give analgesic and reassess
D-compartment pressure measurement
E

37. Least reliable sign for Compartment syndrome?

A-Absent pulse
B- altered sensation
 C-excessive pain to injury
D- increased pressure in manometry
E-

38. RTA, pain in LL and lower abdomen ,. hypotensive,

tachycardic.conscious and talking.gcs not mentioned Initial mx?
A- massive haemorrhage protocol
B- platelet transfusion
C-tracheal intubation
D-O positive transfusion
E-

39. Drunk with vomiting then crepitus in neck

a-mallory weis
b- rupture oesophagus

40. Cord affection of index and lateral FA and thumb sensation

lost​.
a-C6
b-C7
c-C5

41. 1 month old child Polyhydramnios in pregnancy. the neonate

with vomiting failure to thrive recurrent chest infections
a-​(Tracheo-osophageal fistula
b-Biliary Atresia
c-Malrotation of small gut

42. Ant Pituitary removed..Without hormonal supplements what

will be affected?
a--Insulin
b--Thyroid
c--Parathy
d-Adh

43. Crohns disese, recurrent mutiple anal fistula with

transphincteric abcess. Management?
A-loose seton
B-proctocolectomy
C-panproctocolectomy and reconstruction
D-proctocolectomy and stoma

44. Ischiorectal abscess boundary

A.Medial To pudendal canal
B. Lateral to pudendal canal

45. Patient with chest trauma..intubated ventillated and became

hypoxic.What is the cause?

a-Tension Pneumothorax
b-Tamponade
c-Shock

46. Peanut inhaled by child..lodge to which site of the lung?

a-​rt lower lobe no
b-rt upper
c-lt main bronchus
d-left upper

47. Post carcinoid appendectomy ..with metastatic symptoms..

what to use.
a.Octreotide
B. terlipressin
48. A teacher underwent total thyroidectmy complains she can
not raise her voice loudly?
A- SLN
B-RLN
C-EDEMA
D- Hematoma
E-tracheomalacia

49. RTA, in ER team after log rolling, Patient then become

hypoxic 80% o2
a--endotracheal tube displaced
b- embolism
c-tension pneumo
d-Spinal injury

50. Female with 2nd child birth prolonged labour something

coming..which nerve affected?
a-Pudendal nerve

51. pt with just axillary and inguinal lymphadenopathy no other

LN involvment
a-( hodgkin,
b- non hodgkin,
c-reactive LDs,
d-cat scratch disease!

52. Multiple neck and inguinal LN..with some non

caseating/caseatin granuloma.
a-HL
b-NHL
 c-TB

53. heterotropic mucosa causing pain and bleeding . what is the

site ?
A-stomach
B- pancreas
C-COLON
D-liver
e-

54. Tall slim woman with sudden severe chest pain father died at
47 yrs..with chest pain?
A- Aortic dissection.
B Atherosclerosis
C. panic attack

55. Patient complaing of poluria at night FBG 5mmol 2HPP 7.5

mmol?
A- DM
b-Impaired
c-Diabetes Insipidus
d-normoglycaemia

56. Pt with firm thyroid nodule with hypothyroidism(features

suggestive of Hashimoto)
What is the most distinctive investigation
a-Antibodies
b-FNAC
c-Thyroid hormones

57. Closure of tricuspid valve in which phase of cardiac cycle?

A-isometric contraction
B-isometric relaxation
C- mid systolic
D-mid diastolic

58. Posterior approach to distal femur, risk of nerve being

injured:
a-Tibial n,
b-lateral cutaneous

59. Patient recurrent PE on iv heparin . mx?

A- ivc filter
B-warfarin for life
C- warfarin 3 months
D-warfarin 6 months
E-

60. Female with decreased Ca and phosphate and invceased PTH

and alk phos..Cause?

61. Pt with pain upper abdomen with radiation to back..Lesion in head

of pancrease Liver mets With CBD dilatation..
a -Stent..
b-Whipples
c-Cystojejunostomy

62. 25 year old lady with a firm. Lobulated, mobile breast mass
which is located in the center of her breast. What is the likely
diagnosis?
A. Fibroadenoma
B. Breast cyst
 c-Intraductal papilloma

63. Ischemic dry gangrene of the toe with occlusion in

femoropopliteal artey with run off from post tibial a. INITIAL
MANAGEMENT
A-amputate the toe
B-Mid foot amputation
C-below knee amputation
D-femoro popliteal bypass
E-ANGIOPLASTY

64. You have collected data of 87 children's sodium and urea

level before anaesthesia to study if anaesthesia has an adverse
effect on dehydration. You matched them with normal limits.
How can you test the validity of ur study?
1) paired t test
2 unpaired t test.
3) Whitney tes

65. Causes of unilateral cleft lip?

A-medial nasal process
B-lateral nasal process
C. Palatal shelves

See

66. Cause of cleft palate posterior to the incisive foramen?

A- failure of develop of primary palate
B- palatal shelves
67. . Effect of patent ductus arteriosus?blood direction
A. Shunt to pulmonary artery
B. Shunt to Rt atrium
C. Shunt to aorta

68. Scrotal lymphatic drainage?

A- medial horizontal superficial inguinal
B- vertical superficial inguinal
C- deep inguinal

69. A PATIENT PRESENTS WITH TINGLING ANS PARASTHESIA

IN THUMB INDEX AND MIDDLE FINGER?
A- fracture scaphoid
B- lunate #
C-hamate
D- triquetrium
E-styloid of radius

70. A man with dysuria and scrotal pain, testis normal:

a-Epididymitis
B-hydrocele
c- torsion

71. 6yo boy with bilious vomitings, abdominal pain dx:

a- testicular torsion,
b- incarcerated inguinal hernia

72. What is the muscle group that will be in contracture after a

lesion affecting the spine between lumbar and sacral region
a-(planter flexion-
b-foot eversion
c- knee dorsiflexion
 d- adductors-hip flexors)

73. Blood in Lumbar puncture sample source​: venous

74. Which ligament for mobilizing the spleen from post

abd.wall..? ​lienorenal

75. Factory worker, liver mass with high vinyl chloride?

Angiosarcoma of liver

76. After 3rd lower molar tooth surgery with infra alveolar
anesthesia, patient cannot feel the ipsilateral half of his tongue?
A-lingual n
B- mental n
C-infra-alveolar n

77. 6L of NS infused..electrolyte abnormality

A.Hyperchloraemic acidosis
B.Hypokalemic àlkalosis

78. A Pt with vomitings, weight loss, and succussion splash:

Abgs showed ?
a-​hypokalemia alkalosis,
b- acidosis

79. Solution with the highest concentration of chloride?

A. 0.9 NS
B. B.hartman
C. dextrose
D. 4.2% Sodium bicarbonate
80. During vaginal examination, at the end of female cervix what
is felt 10 cm anteriorly?
a-bladder dome
b-bladder base
c- URETER
d- FUNDUS OF UTERUS

81. After TURP, confusion cause?

A. Hyponatremia
B. Hypokalemia
C. Hypochloraemia

82. DRE posterolateraly felt at 4cm from anal verge?

a-sacrospinous ligament
b-Puborectalis
C. Seminal vesicles

83. 1cm renal stone with no hydronephrosis and normal renal

function?
1- eswl
2-Ureteroscopic litho.
3- nephrostomy

84. After ligation of IMA.. Blood supply to anastomosis after left

hemicolectomy?
-MIddle colic a
85. Which is not present in posterior mediastinum?
A-azygos vein
B-esophagus
C-thoracic duct
D-sympathetic chain
E-vertebra

86. Bee sting initial management?

a​-im adrenaline
b- iv adrenaline
c- iv histamine

87. Pharyngeal pouch forms in between which two muscles?

Cricopharyngeus and thyropharyngeus

88. 70 yrs with history of constipation presented with left iliac

fossa pain . Dx?
A-​diverticulitis
b - cancer

89. Lady with inguinal and femoral lymph nodes. Spotting of

blood in her under wear?
a-vulva
b-cervix

90. Axis of rotation of the gut?

1-vitelline artery
2-SMA
3-IMA
 91. Uterine support? ​All are ligaments except one muscle that was
the ans

92. Acute pain in shoulder. Difficulty in abduction after 1 year in

sweeper?
1- suprapinatus tendinitis
2- rotator cuff tear
3.Adhesive capsulitis

93. Relation of brachial to median nerve in antecubital fossa

94. Question about vertebral a all true except?

A.closely related to vagus
B.enter the skull thru foramen ovale
C.pass through foramen transversarium of c6

95. Horizontal Incision made at deltopectoral groove. Which of

these will not found:
A- medial cord of brachial plexus
B. axillary vien
C.Thoraco-acromial artery
D. pectoralis minor insertion
E- pectoralis major

96. cavitating lesion at the apex of the lung with

lumphadenopathy and malignant cell on biopsy?
A- SCC LUNG
B-Adenocarcinoma lung
C- small cell carcinoma lung
D- Tuberculosis
E-sarcoidosis
I
97. Ulcer on the cheek with pearly white raised egdes and
telangectasia?
 A- bcc
B-scc
C-melanoma

98. Dark greenish discharge with no lump in breast.​.

a-Papilloma
b-Ectasia
c-Ca

99. Heavy smoker, alcoholic, bleeding ulcer on the side of the

tongue?
A-leukoplakia
B-carcinoma
C-SCC
D-

100. Traumatic periorbital redness sever enough, he couldnot

open eyes).. Malocclusion of the jaw, separation of the teeth?
A-fracture maxilla
B-fracture nasal bone
C- fracture zygomatic bone
D-nasoethmoid
E-mandible

101. Young, trauma, fracture 4th rib, xray done after 3hours show
no hemo oe pneumothorax, patient in severe pain
A. Oral analgesia
B. Chest tube insertion
C. Infiltration of bupivacaine

102. Old bronchitic patient,same trauma 4th rib fracture xray after
1 hour show no hemo or pneumo thorax​.

A- admission and analgesia

B- phenol intercostal block
 C-chest tube
D-internal fixation of the rib
E- discharge/ morphine i cant remember

103. Rugby tussel with sudden collapse..regain

counciousness..then deteriorate GCS 10/15cause
A. EDH
B. SDH

104. Head injury with pupilary dilatation and non reactive..opposite

4mm and reactive what is the cause ?​ A.transtentorial herniation

105. Head injury with fixed pupil? Cause of fixed pupil?

A.Compression on oculomotor nerve
B Sympathetic nerves

106. Artery branching at superior aspect of pyriformis and passing

forwards?
a-sup gluteal
b-inf gluteal

107. Post colectomy, ulcer in heel(1.5cm diameter).

Managementm?
A-​dressing,
b- flap,
c- graft,
d-delayed closure
108.

109. Anterolateral approach to THR nerve injury causing waddling

gait?
A.Sup Gluteal N
 B.Inferior Gluteal N

110. Blood transfusion..Irritable with corrected prolonged QT and

T-wave inversion.?​ - A.hypocalcemia - B.hyperkalemia-

111. Post throidectomy..Agitated and twitching of muscle..

Electrolyte?

112. Kaposi sarcoma in HIV patient caused by whhich virus?

113. the mx for hyperkalemia?

114. Na+ low in plasma ,Urine na is high normal , patient is

euvolemic what is the cause?​ SIADH

115. The cause of Aortic aneurysm extending from infrarenal to

the bifurcation, 5 cm ​:
A-atherosclerosis
B-systemic hypertension
C-marfan syndrome

116. Pt with fever and pain abdomen..Weeks ago had cholecystec

with cystic stump leak fb ERCP and stent..
a-Acute cholangitis.
b-Acute pancreatitis.
c-Bile duct injury
d-retained stones in cbd
e-pancreatic cancer
117. *​baby passing bloody stool but he is systematically well​?
Juvenile polyp

118. Baby crying and passing bloody stool ​: intussecption

119. Burn graft infected and there is seepage from the wound
which emperic antibiotics?
a​-penicillin+metronidazole
b-cephalosporine + metronidazole
-
-

120. Hormone acting locally after tourniquet release causing

vasodilatation?
A- histamine
B-thromboxane

121. Athlete Cardiac Output?

122. Level of conus medullaris in neonates?

123. Diabetic female with ketone +ve..ABG??

124. 3wk history of bloody diarrhoea ,mucus, and anemia..20 yr

male..with some granulomas on colonoscopsy
A-UC
b-CD
c-Non specific colitis
d-infectious colitis

125. ABG with decresed CO2, increased PH, decreased HCO3

decreased O2
 126. First response to hypothermia?
a​-peripheral vasoconstriction
b-hypothalamus regulating
c-shivering

127. *athlete runner after a race presented w generalised muscle

weakness and pain and abnormal urine color .Had low urine
volume
a-acute tubular necrosis
b- AKI Specufuc gravity < 1.005
c-increase sp. Gravity
d- Creatinine ki ase >300

128. THR with antibiotics then diarrhoea? ​Pseudomembranous

colitis

129. *type 2 diabetic how to control periop?

a- variable timings of insulin
b- fixed timings
c- blood sugar should be monitored regularly
d-should be Regularly monitored
e-Monitored by patient humself

130. Returned from EGYPT.with hematuria.ORGANISM?

A. Schistosoma haematobium
B. Schistosoma​ ​mansoni

131. Blood in coronary artery decreased in tachycardia due to:

a​-Decreased diastolic interval
b-Decreased systolic interval
c-decreased
 132. Kwshiorkor child deposit in liver??
a​-fat
b-lipofusion
c-protein
d-unmineralized acids

133. High T3, Low TSH, THYROID SWELLING, exopthalmus??

a-Graves
b-Hashi
c-Subacute
d-Reidles

134. Small discrete parotid swelling with facial nerve palsy? What
sign will be there?/ stab in the face
a​- ​Paralysis of facial muscles of expression
b-loss of ipsilateral cutaneous sensation,
c-Bilateral loss
D-loss of taste
135. *kidney increases renal perfusion in hypovolemia how?
- increase efferent diameter
a-decrease,,,,,,,,,,,
b-increase afferent ,,,
c-decrease afferent diameter
d-increase permeability

136. Most common cause of Mesenteric Ischemia..

a-SMA embolic..
b-SMA thrombotic
c-IMA embolic.

137. immediate Post THR..unable to pass urine..

a -Atonic bladder..
 b-Stricture.

138. T wave inversion in leadIII in unstable hypoxic Pt after 3days

of hip replacement:
a-​massive PE
b-Acute MI
c-Cardiogenic shock

139. Initial management of hypercalcemia?

a​ -Normal asaline
B-calcitonin
c-bisphosphonate

140. about tourniquet application:

a-above systolic pressure before exsanguination
b-below systolic after
c-below diastolic
d-above diastolic

141. *overweight person for LL surgery, which affect his enhanced

recovery after surgery:
a-weight reduction before surgery
b-oral carbohydrate 2hours preop
c. Antiemetic

d. Diazepam

e. Spinal Anesthesia

142. * Adversely effect on morbidity and mortality

a-fev ratio >90%

b-FEV1=3
c-increased RV
d-TLC 6
e-tidal volume 1500 m

143. Posterior triangle surgeryin the neck , nerve injury?

144. Ampulla location?

Anterior and medial - posterior anterior - lateral
145. Patient complains of claudication on walking they are less
when walking uphill?
a​- spinal stenosis
b- ischemia LL

146. Lacerated wound 5*7 traingular at pretibial region?

A- primary closure
B-delayed primary
C-full thickness
D-split thickness
E- free flap

147. Diabetic with post trauma non healing ulcer over med
malleolus..with eczema and induration normal pulses..?
a-Deep vein ineff..
b-Diabetic microangio
c-Diabetic neuro
d-Ischemic ulcer

148. Weakness of foot evertion and loss of sensation dorsum

foot?
a-​Common pero..
b-Tibial
c-Superficial pero
 d-Sural

149. THE CELL TYPE WITH ANTIBODY MATCHED

CORRECTLY​..IgG and plasma cell

150. Footballer had Swollen knee in 24 hours, repeated twisting

trauma of knee, ..loss of all movements of the knee :
a- meniscus tear
b-Acl
c-pcl
d-Chondritis dessicans

151. patient on long term of NSAID use post operative oliguria

tachcardia hypotension 90/60, cause of oliguria
a-(NSAID,
b-decreased renal perfusion )

152. PAH is used to measure

A. GFR
B. Renal plasma flow

153. 6 weeks pre op patient with hypochromic microcytic anemia

?management?
A-oral iron
B-iv iron
C-blood transfuson

154. Tape test positive for ova . treatment?​ Mebendazole

155. Pregnant Pt. With suspected perforated peptic ulcer. What the
INITIAL investigation.
A- CT
B- MRI
 C- lateral decubitusX_RAY
D- U/S

156. Female with benign cyst of the breast but has family history
of breast cancer. What do you advise her to decrease the risk?
A-abstain alcohol use
B-start bottle feeding her child
C- use oral contraceptives
D-delay first full term pregnancy
E-reduce caffeine intake

157. FAP gene responsible?

a-APC
B-P53
C-BRCA

158. Woman with keloid and scald management?

a- intralesional steroid injection
b-flap
c-graft

159. Winging scapula after axillary clearance?

A-serratus anterior
B- latissimus dorsi

160. Least reliable for tissue hypoxia.?​ Pulse oximetry

161. blue cystic soft lesion on the floor of the mouth of a young
girl?
A. Ranula
B. Cystic hygroma
C. Branchial cyst
D. Ankyloglossia
162. Female, tachycardic, hypotensive, abdominal pain, rt
shoulder pain?
A.liver abcess
B.empyema
C.pancreatitis
D.ectopic pregnancy

163. What is the bleeding disorder? Hb 10 , ptt normal, platelets

low?
A. DIC
B.hemophilia
C.
D.
e.

164. Young, anemia , gallbladder stones and jaundice?

A. SPHEROCYTOSIS
B.SICKLE CELL

165. Ectopic testis could not be found in which location?

A-root of penis
B-superficial inguinal neck
C-upper scrotum
D- inguinal canal

166. Origin of cremastric muscle in covering of testis?

167. LN with fever..LN biopsy showing granuloma..
a-​HL
b-NHL
c-TB
168. Structure incised to gain access to inguinal canal?

169. A patient complained of pain in RUQ which is referred to the

tip of Rt shoulder. What is the surface anatomy of the organ
(Obviously gall bladder)?
 A. Subcostal and linea semilunaris in the mid axillary line
B. Fourth intercostal space mid clavicular line

170. GCS..
Eye to pain
No verbal
Localize to pain

171. Tender nodule on the extensor aspect of the forearm?

A-erythema nodosum
B-pyoderma gangrenosum,
C-rheumatoid nodule
D-

172. Type of amyloid in renal failue?

A- AA
B- AL
C- B2 MICRGLOBULIN

173. A baby wd severe dysnea after birth intolerance to feeds CXR

showed bowel wd air in chest CDH reason:
Failure of left pleuroperitoneal canals

174. Ist response to blood loss?

a-baroreceptors venoconstriction
b-renin angiotensin system

175. 76 y/o male had a hemiarthroplasty , he receive enoxparin

and antibiotic , after 7 day he came hypotensive 90/68 and
tachycardia 120
A.With pleuritic pain with deep inhalation ?
 B.Thromboembolism
C.Fat Embolism
A. Lobar pnemonia
Tension pnemothorax

176. Fracture sternum what is most likely to be injured ?

A- rt atrium
B- rt ventricle
C -Left atrium
D- left ventricle

177. Level of left kidney hilum. What is the level of transpyloric

plane?

178. Structure ant to head of pancreas?

A.Pylorus of stomach
B. CBD
C.2nd part of duodenum
D.kidney
E.hepatic arteery

179. Post thyroidectomy...irritability and muscle twitch?

180. During surgery, a Bair hugger warmer was connected what

will decrease:
a-​GH,
b-TSH,
c- ACTH,
 d- Cortiso

181. Carotid endartrectomy dysarthria and tongue deviation:

hypoglossal
182. Patient feels tired Raised TSH, normal T4
A.1ry hypothyroidism
B.2ryryhyperthyroidism
C.sick euthyroid

183. A Pt with significant weight loss has undergone 3 stage

esophageal gastrectomy, what must be done prior to surgery?
1. Parentral nutrition
2. Specific enteral feed arginine etc
3 fine bore NG
4 intraoperative feeding Jejunostomy

184. Bp 110/80 intracranial pressure 18. Calculate cpp?​ 72

185. Vitals in increased intracranial pressure?

a​- tachycardia,hypertensive
b-brady, hyper
c-brdy hypo
d-tachy hypo

186. Child with scrotal swelling appearing during bath and

disappear in the morning..normal scrotal examination?
A-patent vaginalis
B-hydrocele
C-epidydimal cyst
D-
E-
187. Severe pain between 2nd and 3rd metatarsal with palpable
swelling?
A- morton neuroma
B-Hallux rigidus
C-plantar fasciitis
D-
E-

188. Cell that relies on cori cycle?

A.RBC
B. Hepatocyte

189. Clenching the calf produce no plantar response ?

A. rupture tendon achilis
B. Rupture of soleus and gastrocnemius

190. Tibia and fibula fracture 2cm above ankle , what is the
management-
a-Plate and screw
b-Intramedullary nail
c-POP cast
d-tension band wiring

191. Branchial arch of facial nerve?

192. Collection site after DU perf in supine pt?
a​-hepatorenal pouch
b-paracolic

193. Mass at the vas in the groin fluctuating and cough impulse
and below external ring and the testis is smaller than the other
(a-direct hernia
b- femoral-
C-varicocele
d- hydrocele)

194. Landmark for femoral artery?

195. Difference between male and female pelvis?

A-female heart shaped
B-female wider pubic arch
C-

196. Distal radial intra-articular #Inv.for planning sx?​/ct-mri-xray

197. MEN I include parathyroid, pancreas and what?

A.Thyroid
B. Pituitary
C. Adrenal
D.

198. Medial relation to direct hernia ?

199. Which is true about SA node:

A- present in left atrium
B-present in left ventricle
C-receives innervation from the vagus

200. Inf epigastric vein drain in?

 A. External iliac vein
B.Femoral Vein

201. Oesophageal varices which vessel responsible?

A. Left gastric vein
B. Right gastric vein

202. Vitamin needed for collagen cross linking? Vitamin C

203. Anterior duodenal / gastric ulcer bleeding vessel?

a.​Gastroepiploic a,
b. left gastric a

204. Posterior hip dislocation surgery post Op Pt was unable to

sense/move lower limbs below knee:
a.Sciatic injury,
B.femoral

205. Pain due to ureteric stone in the groin, which dermatomal

level?
A.T11-L2

206. pfannensteil incision after lateralizing rectus muscle what do

you see?
A- rectus sheath
B-peritoneum
C-transversalis fascia
207. Nerve found on the surface of the spermatic cord during
inguinal hernia repair?
a- ilioinguinal
b- iliohypogastric

208. Posterior relation of the kidney?

a- psoas
b-liver
c- peritoneum

209. Isolated one lower limb weakness after collapse..Which

arterial territory..
a.ACA
b.MCA
c.PICA
d.PCA
e.P cerebellar A

210. How dexamethasone works in case of cerebral mets?

a-decrease peri-tumor edema
b-decrease pain
c-decrease size of the tumour

211. Which one is a cause of metabolic alkalosis?

A-nasogastric aspiration

212. What Decreases gastric acid secretion..?

a-Increased Ca
b-Increased CAMP
c-Increase kinase.-
d-Prostaglandin E2

213. Most significant Contraindication to contrast media?

A- allergy to iodinated contrast
B-gfr <40
 C-

214. How to check ileocolic anastomosis?

A-water soluble gastrografin enema
B-barium
C-ct

215. After clamping umbilicus..what happens.. delivery of

oxygenated blood .will not occur..in :
-Ductus venosus..
-Umb art

216. RCC with bone metastases to the humerus what to give for
pain?
A- radiotherapy
B-nsaids
c-

217. Dermatome of umbilicus?

A. T10
B. T4
C. L1
D. L5

218. liver biopsy showed apple green birefrigent with Congo-red:

a.amyloid-
b.deposition of copper
C.haemochromatosis

219. Spine affection in a lesion in cervical vertebrae what is the

manifestation
(a- weakness of upper limbs with no affection of lower limbs
 b- weakness of lower limbs with no affection of upper limb
c- loss of reflexes of upper limb-reflexes lower limb)

220. A 65 yr old woman had a mammography done which showed

localized microcalcification. On examination she has a breast
lump. What is the likely diagnosis?
a-Fibroadenoma
b-carcinoma
c-Duct ectasia
-D. Fat necrosis

221. Bronchial cancer with headache and blurring of vision what

drug will help
a-dexamethasone
b-Morphine

222. Metastatic prostate in elderly, palliative of choice

(a-hormonal
B-radio
c-surgery)

223. Nerve leading to weakness of knee extension after hernia

repair?
224.

225. A pt was admitted in the icu for severe head injury. He is

comatose but slowly improving. He has been there for more than
2 weeks now.. what is the ideal way to provide nutrition to him?
A) NG tube
B) feeding jejunostomy
C) special preparation of gluten and other amino acids
 D) TPN.

226. Metabolic effects of adrenaline?

a.Glycolysis
b-vasoconstriction

227. some surgery or post op unable to feel below

knee/anteromedial leg:
a-​Saphenous n injury
b-, sural,
c- infra patellar

228. Negative intrathoracic pressure in all except?

-Valsalva

229. Which of these breast conditions has a risk of malignant

transformation?
A. Atypical hyperplasia
B. Intraductal papilloma
C. Fibroadenoma
D. Fibroadenosis
E. Breast cyst

230. Patient after Aortic and Tricuspid valve replacement , free

Hemoglobin in circulation, he noticed dark urine And 6 ml/hour
cause?

a-Hemolysis
b-Acute blood transfusion reaction
c-Myoglubinemi
 231. 56yrold, hit the occpit by a shelf when he was standing up.
His wife said he lost cons 15 seconds with normal recovery.
Gcs15. Options:
a- discharge with head injury instructions
b -admit and observe
c -ct 1hour
d -ct 8 hour
e -neuro consult

232. An African man with Huge Scrotal swelling and chyluria

a-​Brugia Malayi
b -wuchereria bancrofti-
c- Malaria

233. Patient with long history of reflux and on ppi develop

dysphagia to solids
a-barret ulcer
b-cancer lower third oes

234. venous supply of heart:

a-Great cardiac vein runs along posterior interventricular groove
b-Middle cardiac in anterior
c- Coronary sinus empties into rt atrium

236- Patient complaing of dysphagia and chest pain , gastroscopy ok,

manommetry is normal to high diagnosis?
a​-esophageal spasm
b-achalasia
c-benign stricture
d- cancer
e-​ Barrets
237.type 2 diabetic how to control periop?
a- variable timings of insulin
b- fixed timings blood sugar should be monitored regularly
C-place on insulin sliding scale

238. ​10 yr old boy with sudden onset scrotal pain, left scrotum tender
and higher than the right What's the diagnosis​?
A. Testicular torsionB
B. Hydrocele
C. Orchitis
239. ​Paralytic ileus​.​Gastric motility decreased by..(NB: No P
receptors)
A.ACh
B.Noradrenaline
C.doparminergic
D. GABA
E. Serotonin

239. Pregnant Pt. With suspected perforated peptic ulcer. What the
INITIAL investigation.
1. A- CT scan
2. B- MRI
3. C- CXR
4. D- U/S

240- Distal Radial Fracture pain in supination

A.Malunion
B.CRPS

241. A 26 yrs old woman collapsed and was brought to emergency

with tachycardia, hypotension and cold clammy skin. She was
surprised and complains about generalised abdominal pain and pain
at the tip of the shoulder. You find the abdomen is tense and muscle
guarding is present.
What is the most likely DX?
 A) mesenteric ischemia
B) ruptured ectopic pregnancy
C) perforated diverticular disease
D) acute gastroenteritis

242. ​Type of data:Hypertension

■ a. Continuous
■ b. Nominal
■ c. Numeric

243. ​Responsible for secretion of pancreatic ENZYMES

■ a. Cholecystokinin
■ b. Secretin

244. ​Renal mass inv​.

■ a. CT
■ b. MRI
■ c. Biopsy
■ D. PET CT

245. ​6 yrs after vasectomy s patient came h/o swelling testis 4 weeks
duration, after 5 year follow up in OPD with small nodule palpated in
region of vas

■ a. Sperm granuloma

246. ​Associated with staghorn calculus Proteus mirabilis

247. ​Scenario of trauma 19y male with low BP, inernal organ injury suspected.
Currently unconscious. How would you proceed:

■ a. Consent by proxy
 ■ b. Proceed without consent
■

249. Ventilator associated pneumonia

■ a. Pseudomonas
■ b. Aspergillus

250. Scenario (including table indicating ?decreased renal perfusion). Patient is

taking antihypertensive. Failure to respond by kidney is due to blockage of
which receptor​?

■ a. Angiotensinogen
■ b. Beta adnergic

251. ​Delayed hemolytic reaction:

a. jaundice,
b. pyrexia

252. ​Most common organism in osteomyelitis

■ a. S aureus

253. Spontaneous hemorthrosis

■ a. Factor VIII deficiency

■ b. Decreased platelet

254. Calcium related scenario (high PTH, high urinary calcium. Serum calcium in
upper normal range) ALP normal

■ a. Primary hyperparathyroidism
■ b. Hypocalcuri hypocalemia
■ c. Tertiary hyperparathyroidism

255. Site of biopsy in iron deficiency anemia​:

 ■ a. Duodenum,
■ b. Pyloric antrum
■ C. rectum
■ D. colon
■ E. esophagus

256. Milk alkali syndrome question

257. Pain in calf muscle in adult male

■ a. compression of SFA in adductor canal

■ b. femoral a. occlusion

258. Patient with Diabetic Autonomic neuropathy scheduled for day case
surgery, which of the following is risk​:

■ a. Orthostatic hypotension
■ b. Reduced HR variability

259. Movement of DIP joint

■ a. FDP
■ b. FDS

260. Antibody associated with APLA syndrome

■ a. Anticardiolipin antibodies
■ B. antiphospholipid antibodies

261. Child with intermittent painless rectal bleed, normal abdominal:

■ a. Meckels diverticulum

262. Man after RTA BP and Pulse deranged, what is the initial management

■ a. IV fluid for patient and cross match

■ b. CT abdomen
263. Young female, breast lesion, blood stained discharge and smooth lobule
behind nipple?

■ a. Papilloma

264. Mediastinal tumor with flat cells and keratin:​ SCC

268. Spironolactone site of action

■ a. Na/K in CT

269. you noticed A nurse was practicing a minor procedure in the

ward which lacks evidence or any reference what will you do?
1)risk assessment
2) medical audit
3) report to gmc
4) health & safety
5) Incident

270. ​Female pt fall when she was upstair presented with open
triangular flap on shin of tibia 7cm long & 5cm wide but couldnt
approximated
A- delayed primary
B- immediate graft
C- flap repair
D- immediate primary
E- delayed graft repair

271.​prick of needle of sewing machine. The next day she developed

red streaks on the skin extending forearm Causative organism?
A- staph aurues
B-strept agalactie
C-strept mimi
D. Strep pyogenes
272- ​open contaminated fracture tibia
a. ​external fixation
273. ​10 yr old boy who presented with 1 week history of painless
bleeding per rectum of frank blood. What's the likely diagnosis?
A. Arteriovenous malformation
B. Mesenteric ischaemia
C. Colonic ca
D. Fissure in ano