1) Posteromedial approach Baker cyst, most superficial susceptible to damage

• Sciatic n.
• Tibial n.
• Sural n.
• CPN
• Saphenous n.
2) Neck stab, tongue deviation
• Hypoglossal n. injury
3) Chest XRAY - foreign body
• R lower lobe
• Middle lobe
4) Ileoanal pouch, put on metronidazole. Common side effect.
• Ileoanal fibrosis
• Peripheral neuropathy
• Coagulopathy
• Ileovesical fistula
• Pouchitis
5) Reciprocal of absolute risk reduction
• Number needed to treat
6) 17yo recurrent R upper quadrant pain, hereditary spherocytosis, jaundice, increased ALP, liver
enzymes. Diagnostic investigation
• ERCP
• MRCP
• U/S
7) 8yo enlarged tonsils midline, white covered, bleed when remove it. Pyrexial, otherwise well.
• Infectious mononucleosis
• Acute bacterial tonsillitis
• Quinsy
• Lymphoma
• Diphtheria
8) XRAY - patient with hysterectomy scar
• Small bowel obstruction
• Large bowel obstruction
• Meckels
• Pneumobilia
9) 50yo b/l cervical lymphadenopathy, hepatomegaly, fever, positive antibodies
• Infectious mononucleosis
• Cat-scratch
• Non-Hodgkin
• Hepatitis
• Epstein Barr virus
10) 34yo lady neck swelling, diarrhoea, hypertension, diagnosis of MEN2.
• Phaeochromocytoma
• Medullary thyroid ca
• HypoPTH
• Gastric ca
11) Female hematuria comes to clinic. Investigation not helpful for assessment.
• CT KUB
• CT Urogram
• U/S
 • Renogram
• Cystoscopy
12) Patient weak hallux extension, weak foot dorsiflexion, ankle reflex lost after RTA. Spinal cord.
• L5/S1
• L4/L5
• L3/L4
• S1/S2
13) Old patient severe penis pain after catheter. Prepuce retracted, penis swollen, engorged.
• Balanitis
• Balanoposthitis
• Paraphimosis
• Phimosis
14) Extradural heamatoma patient on CT. One pupil fixed, dilated, GCS declined. Next step.
• Admit ICU & ICP monitor
• Neuroprotective measures and refer to neuro
• Add mannitol
15) Chest XRAY - widened mediastinum
• Oesophageal perforation
• Obstructed paraoesophageal hernia
• Boerhave syndrome
16) XRAY - dark shadow R iliac fossa and faecal vomiting, distended abdomen.
• Caecal volvulus
• Small bowel obstruction
• Large bowel obstruction
17) Postop fluids given, high chloride on ABG and acidosis. Cause by which fluid
• N/S
• Dextrose
• Hartmann
18) Required resuscitation fluid for 11yo 34kg in 24hours with shock features.
• 680ml N/S stat
• 300ml
19) Xray barium swallow.
• Pharyngeal pouch
• Achalasia
• Oesophageal ca
• Postcricoid web
20) 53yo scrotal swelling, testis palpable separate for 2months. Can get above swelling.
• Hydrocele
• Seminoma
• Hernia
• Epididymal cyst
• Inguinoscrotal swelling
?21) Heart stab L 5th intercostal space near sternum. Injured structure
• R atrium
• R ventricle
22) Smoking & GORD, metaplasia columnar epithelium lower oesophagus
• Irreversible change cell type due to external factor
• Reversible change cell type due to internal factor
23) Head injury, brain heamorrhage, admitted ICU & hematemesis. Endoscopy multiple ulcers
stomach, duodenum. Cause.
 • Zollinger-Ellison syndrome
• Vagal discharge
• Hypotension
• Stress ulcer
• NSAIDs
24) Most reliable score for preoperative mortality
• NELA
• ASA
• Apache II
• P-POSSUM
25) Clinical drug trial. Drug tested on patients compared to previous management after preclinical
safety trials
• Phase I
• Phase II
• Phase III
• Phase IV
• Phase 0
26) Stroke, diabetes and punched out ulcer on hallux
• Neuropathic
• Arterial
• Critical limb ischaemia
27) Goal directed treatment
• Protect heart
• Glucose
• Diuretics
• Prophylactic antibiotics
• Restriction of iv fluids
28) Audit historical records (retrospective evaluation)
• Criterion audit
• Outcomes audit
• Standard audit
• Process audit
29) Cervical vertebra injury, upper limb weaker than lower limb
• Central cord injury
30) Midtarsal # treated surgically. After 10 years pain.
• Avascular necrosis
• Instability
• Primary osteoarthritis
• Secondary osteoarthritis
31) RTA patient, postop day 8 increased prothrombin time & aPTT, low platelets
• DIC
32) Relation of inferior posterior L adrenal gland
• Crus of diaphragm
• Quadratus
• Iliacus
• Body of pancreas
• L renal vein
33) Patient with Familial Adenomatous Polyposis (FAP). Polyp type
• Tubular adenoma
• Hyperplastic
 • Villous
• Peutz-Jeghers
34) Splenic artery ligation, damage after splenectomy. Area blood supply by it.
• Gastric fundus
35) Froment’s test
• Adductor pollicis
36) Primary action of cortisol postop period
• Glycolysis
• Gluconeogenesis
• Stimulate glycogen synthesis
37) Trauma during splenectomy (splenic vein/artery ligation)
• Tail of pancreas
• Lienorenal ligament
38) Bilateral ptosis, tired with activity, lesion in superior mediastinum
• Thymus mass (thymoma)
39) Pain when brushing lower teeth & jaw. Nerve exits from cranium
• V3 and foramen ovale
40) Brown Sequard syndrome
• R weakness & L pain sensation loss
41) Level of artery that provides superior rectum blood supply
• L3
42) Carpal tunnel syndrome surgery, palmar sensory loss & thenar wasting. Median nerve injury
• Proximal to flexor retinaculum
43) Osgood-Schlatter disease
• Problem in later life
• Rest
• Self-limiting
• Commoner in females than males
• Treated with cast
44) Areflexia
• LMN (lower motor neurone) injury
45) R testicular vein drains to
• IVC
46) ADH acts on
• Collecting duct
47) Child with upper interventricular defect. Originated from.
• Bulbis cordis
• Sinus venosus
• Septum primum
• Septum secondum
48) GCS calculation
• 7
49) 56yo alcoholic, head injury, minor cut on forehead, initial GCS 13, after 2h GCS 15.
• Discharge with someone to accompany him
• CT in 1h
• CT in 8h
• Admission
• Observation
50) Starling forces if 45 hydrostatic cappillaries, 10 hydrostatic bowman, 27 oncotic capillaries, 0
oncotic Bowman. Filtration pressure.
 • 8
• 18
51) Homonymous hemianopia
• Optic tract
52) 73yo angina on going uphill. Cause
• Aortic sclerosis
• Aortic stenosis
• Aortic regurgitation
• Mitral stenosis
53) What is more risky for surgical patients
• Aortic stenosis
• Mitral stenosis
54) Severe pain 100m subsides with rest & sitting, increased on walking & standing, multiple
diseases and diabetes. Cause
• Critical limb ischaemia
• Intermittent claudication
• Neuropathic
• Vascular
55) After L carotid endarterectomy, tongue deviation
• Hypoglossal n. injury
56) Head up and large midline swelling above umbilicus, increased in size
• Umbilical hernia
• Paraumbilical hernia
• Epigastric hernia
• Recti diastasis
57) Patient after abdominal surgery, hypotensive, HR increased, cold dry skin
• Adrenaline
• Bisoprolol
• Noradrenaline
• iv fluids
58) Line of Zahn on autopsy
• Thrombus
• Atheroma
59) Submandibular gland surgery. Artery damage
• Lingual
• Facial
60) Radial nerve moves from anterior to posterior compartment (10cm above proximal radial joint)
• Cuboidal fossa
• Spiral groove
61) 42yo bloody nipple discharge, skin tethering, retraction. U/S normal. Next step
• Core biopsy
• MRI
• U/S in 6 months
• Mammogram
62) 3month catheterization after pelvic trauma. Catheter removed, unable to pass urine. Injury
• Bladder neck
• External sphincter
• Internal sphincter
• Membranous urethra
63) Retractile (or undescended) testis. Pathognomonic origin structure.
 • Transversalis fascia
• Internal oblique
• External oblique
• Transversus abdominus
64) 4yo penis skin not retracted
• Circumcision
• Steroids
• Dorsal slit
65) Screening mammogram 13mm (pleomorphic) microcalcifications, previous normal mammo
• DCIS
• Fibroadenoma
• Invasive lobular ca
• Duct ectasia
66) Breast eczema. Paget association
• DCIS
• Invasive lobular ca
67) Thumb base laceration. Palm faces ceiling, unable to make 90O with thumb
• Abductor pollicis brevis
• Flexor pollicis brevis
68) Non-functioning pituitary macroadenoma with severe headache & vomiting
• Hydrocephalus
• Pituitary apoplexy
69) Anterior dural sac (fold) tumour with surrounding cyst capping
• Glioma
• Meningioma
• Glioblastoma multiforme
70) 75yo back pain after minor fall. Osteoporotic crush #
• Normocalceamia
• Hypercalceamia
• Hyperphosphateamia
• Hypocalcaemia
• Hyponatreamia
71) Old poor debilitating man, brain head injury, slow recovery. Prolonged nutrition option
• NG
• Gastrostomy (PEG)
• Jejunostomy
• TPN
72) 70% of small bowel gone. Long nutritional option
• TPN
• NG tube
• Nasoenteric tube feeding
• PEG
• Jejunostomy
73) 250cm residual bowel. Nutritional option
• Oral (enteral)
• TPN
74) Appendectomy patient, 5 cigs smoker, 25yo. ASA score
• 1
• 2
• 3
 • 4
• 5
75) Patient with unilateral gynaecomastia. Check for
• Testis
• Liver
76) Child testicular pain suddenly, ate chocolate chips
• Immediate testicular exploration
• U/S
• Wait 4h & reassess
77) Lever of research after finishing & compare with RCT
• 1E
• 2E
• 3E
• 4E
• 5E
78) Insulinoma patient tired with effort and low BP. Box with C peptide and insulin levels.
• Both increase
79) ABG - COPD
• Mixed metabolic alkalosis & respiratory acidosis (high CO2, high HCO3)
80) Femoral canal (or hernia) lateral border
• Femoral vein
81) Postop, hypertensive, SOB, tachy, ECG with T wave inversion in V3
• Pulmonary embolism
82) Hernia medial to inferior epigastric artery
• Direct inguinal
• Indirect inguinal
• Femoral
83) 56yo ICU after aortic aneurysm repair, pulmonary wedge pressure 20, diffuse opacities Xray.
• Pulmonary edema secondary to heart failure
• Pulmonary embolus
• Lobar pneumonia
• Aspiration pneumonia
• ARDS
84) Damage during tibial saw
• Popliteal artery
85) Cardiac patient, unfit, IHD, bilateral common iliac artery block
• Axillo-bifemoral bypass
86) What is seen in anterior surface of heart
• Pulmonary trunk & infundibulum
87) Supply to which vessel makes person left heart dominant
• PDA (posterior interventricular artery)
• Circumflex
• R coronary
• SA node
• AV node
88) Oesophageal ca compression anteriorly level T3. Structure
• Trachea
• L atrium
89) C6, C6 spine injury (neurogenic shock), now in ICU. Clinical parameters (Capillary pressure,
HR, BP, SVR)
 • Everything low
90) Chest stab, JVP increased, no trachea deviation, lungs clear
• Hemopericardium (cardiac tamponade)
91) Thoracic duct diaphragmatic opening
• T12
92) 11yo with pruritus ani & scotch tape shows eggs. Causative organism
• Enterobius vermicularis
93) Lumbar puncture surface mark
• Iliac crest
• Anterior inferior iliac spine
• Posterior inferior iliac spine
94) Foot drop, dorsiflexion & anterior tibial artery affected, muscle involved
• Tibialis anterior
95) Child burn anterior abdominal wall & thigh. First step on management to minimise burn
damage
• Rinse area
• iv fluids
• 100% O2
• non-adhesive dressing
96) Pterygopalatine ganglion pathway nucleus
• Inferior salivatory
• Superior salivatory
97) Spared from facial nerve injury after geniculate ganglion
• Lacrimation
98) Burn calculation 20%, 65kg.
• 1.3L in 8h
99) 75yo active patient. Subcapital #. Treatment
• Cemented hemiarthroplasty
• Cemented THR
100) 2yo vomits, abdominal distention, passed mucus plug, palpable R bowel loops
• Hirschsprung
• Meconium ileus
101) Patient loss sensation to lateral forearm & supination, weak grip, can’t hold suitcase
• Lateral cord injury
• Medial cord injury
• Posterior cord injury
102) Patient postop femoral bypass graft on Aspirin & Clopidogrel 75mg until one day before
surgery. 3 days after oozing from wound. Normal platelet count.
• DIC
• Heparin induced thrombocytopenia
• Platelet dysfunction
103) Child 12yo obese, hip pain extends to knee
• SCFE
104) 6yo child hip pain
• Perthes
105) Painful supination and pronation after 3 months, had casting distal radial # for 6 weeks
• Malunion
• Non-union
• Complex regional pain
106) Meckels contains heterotopic pancreatic mucosa. Histology
 • Basophil acini cells & duct
• Mucoid acini cell
• Mucoserous acini
• beta cells islets of Langerhans
• All islets of Langerhans
107) Meckel’s blood supply
• Ileocolic
• SMA
• Middle colic
108) Gallstones, hereditary spherocytosis, hepatomegaly, raised ALP
• Bile pigment
109) RTA, hypotensive, small intestine haematoma, free fluid
• Laparotomy
110) Girl supracondular humeral #, after 8h severe pain, compartment syndrome. Initial step
• Analgesia
• Fasciotomy
• Loosen slab
111) Stab posterior thigh, sciatic nerve injury. Movement affected
• Knee flexion
112) Lymph node drainage from cervix rather than internal iliac
• External iliac & presacral
113) Cleft palate embryology
• 1st arch
• 2st arch
114) Thyroglossal cyst origin
• Thyroglossal duct
115) Lady L anterior triangle neck mass moves with swallowing. Investigation
• FNAC & U/S
116) Thyroid swelling with FNAC showing nuclear inclusions and clearings
• Papillary thyroid ca
117) Thyroid swelling & biopsy with epithelial cells, immunoblasts and mature lymphocytes
• Hashimoto’s
• Grave’s
• Papillary thyroid ca
• Follicular thyroid ca
• Medullary thyroid ca
118) True about dural sac
• Dural sac ends on S2 in adult
119) Chronic pancreatitis with long term back pain
• NSAIDs
• Nerve block
120) Meralgia anesthetica. Root value of lateral cutaneous nerve of thigh
• Lateral L2/L3
• Lateral L2/L3/L4
121) Sterilising modern orthopedic arthroscope
• Gluteraldehyde
• Ethylene oxide
122) Pelvic trauma, sacroiliac dislocation. Most likely nerve injury that comes through great sciatic
foramen, below piriformis.
• Nerve to obturator internus
 • Sciatic n.
• Lateral cutaneous n. of thigh
123) Child at the distal thigh, bone forming tumour
• Ewing
• Osteosarcoma
124) Child penis urethra ventral opening. Management
• Hypospadias surgery
• Epispadias surgery
• Meatoplasty
• Circumcision
125) Tranexamic acid acts on
• Plasmin inhibition
• Prothrombin
126) Oral anticoagulant patient with needle phobia, 5 days postoperative. Anticoagulant choice
• Rivaroxaban
• Warfarin
• Clopidogrel
• Aspirin
127) Child bleeding issues, divorced parents, inherited from dad.
• Factor VIII deficiency
128) Rectus abdominus retracted during Pfannenstiel incision. Structure below
• Transversalis fascia
• External oblique
• Rectus abdominus
• Peritoneum
129) Ureter blood supply not from
• Iliolumbar
130) Middle finger dermotome
• C7
131) Disc prolapse, loss of ankle jerk. Initial step
• Lumbar corset
• NSAIDs
• Physiotherapy
• Steroid injection
• Spinal decompression
132) Urinary bladder embryology
• Urogenital sinus
133) 58yo fluctuant swelling recent bite, pyrexia, tachycardia, goiter. ECG fibrillation. Swelling
needs drainage. Preop action.
• b-blockers + thionamides
• b-agonists + thionamides
• a-blockers + thionamides
• a1-agonists + thionamides
• a2-agonists + thionamides
134) Colon cancer with metastasis to lung, only did U/S. Next action
• Further investigations
• Chemotherapy
135) ERAS protocol
• Reduced hospital stay
• Early mobilisation
136) Hernia case, what will help reduce mesh infection rate
• Antiseptic skin preparation
• Ultra filtration air system
• Shaving before surgery
137) ERAS protocol, what is not included
• Preop benzodiazepines
• Intraoperative antiemetics
138) Hyperacute rejection immediate after transplant
• ABO
139) Renal transplant, after 10 days swelling at graft site
• Acute rejection
• Renal vein thrombosis
140) Tumour senescence
• Telomerase mutation
• Oncogenic enhancement
141) Gleason score
• 4+5
142) Renin acts on
• Angiotensinogen
• Angiotensin I
143) Mass above hyoid moves on swallowing
• Thyroglossal cyst
144) Sensation loss on cheek & face flattening after trauma. Bone damaged
• Maxillary
• Lacrimal
• Zygoma
145) Vascular tone due to
• Angiotensin II
146) Cavernous sinus pathology. Not affected
• Sensation to lower lip
• Sensation to cheek
147) Muscle not involved in TMJ movement (muscles of mastication)
• Buccinator
• Medial pterygoid
• Lateral pterygoid
• Masseter
• Temporalis
148) Loss of extension, lost sensation to little finger
• C8
149) Post-colonoscopy patient had miosis. What drug caused it.
• Naloxone
• Fentanyl
150) B/l lymphadenopathy, back & body pain, histology with plasma cells
• Multiple myeloma
151) Hepatic flexure tumour. Surgery option
• Resection anastomosis only
• Resection & loop ileostomy
• Hartmann’s
• Loop colostomy
152) Jaundice 3 months after blood transfusion
 • Hepatitis C
• Hepatitis B
• Hepatitis A
• Haemolysis of transfused blood
• ABO incompatibility
153) Not a risk factor for aortic dissection
• DM (Diabetes Mellitus)
154) Furosemide action site
• Ascending limb of Henle
155) SGLT-2 present at
• PCT (proximal convoluted tubule)
156) Lymph node drainage anal canal below dentate line
• Superficial inguinal
157) Undifferentiated thyroid ca. Tumour recurrence suspected, takes T3 supplements. Investigation
• TSH
• T3
• T4
• Thyroglobulin
• Calcitonin
158) Osteosarcoma metastasizes to
• Lungs
159) Diabetes insipidus
• Collecting tubules
160) Patient with grease, pale stool. Diagnostic option
• Faecal elastase
• Faecal calprotectin
• Serum transglutaminase
161) Pancreatic autodigestion
• Trypsin
162) Lateral angulation
• Torn meniscus
• MCL (medial collateral ligament) injury
163) TURP operation, patient confused prolonged surgery
• Hyponatraemia
164) High output fistula, after ileostomy. Electrolyte imbalance.
• Hypokalaemia
165) Oesophagus mucosa lining
• Non-keratinising stratified squamous epithelium
• Columnar epithelium
166) Non-bleeding varices
• Terlipressin & octeotride
• Sengstaken-Blakemore tube
• Banding
• Botulinum
• Adrenaline
167) Excessive normal saline infusion
• Hyperchloraemic (metabolic) acidosis
• Hypochloraemic acidosis
• Hyperchloraemic alkalosis
168) Child with tension pneumothorax. Initial management
 • Needle decompression 2nd mid-clavicular line
• Chest tube 5th mid-axillary line
169) Nerve emerges from superior part of psoas major.
• Iliohypogastric
• Ilioinguinal
• Genitofemoral
• Femoral
• Obturator
170) Knee extension & quadriceps contraction carried out by
• Golgi tendon
• Muscle spindle
• Brain stem
171) Nerve pierces external oblique and infront of spermatic cord
• Ilioinguinal
172) Flesh mass bleeding with touch
• Pyogenic granuloma
• Angiofibroma
173) Woman after parotic surgery asymmetrical, dry face, absent forehead wrinkles. Nerve injured
• Temporal branch of facial nerve
• Zygomatic branch of facial nerve
• Ophthalmic
• Zygomaticotemporal
174) Man with increased creatinine and low calcium, what is reduced
• 1,25 Dihydroxycholecalciferol
175) Hypothermia ECG
• J wave
176) Bilateral inguinal (groin) swelling, cancer from
• Labia minora
• Vaginal vault
• Uterine fundus
• Anal cancer
• Vulvar cancer
177) Addisonian crisis
• Fluids
• 100mg Hydrocortisone
178) Patient had CT, develops perioral swelling and hypotension
• Anaphylactic reaction
• Hypovolaemic shock
• Septic shock
179) Relation to plasma of insulin & 5% dextrose, given to diabetic patient
• Isosmolar & isotonic
• Hyposmolar & isotonic
• Hyperosmolar & hypotonic
• Hyperosmolar & hypertonic
• Hyposmolar & hypotonic
180) Fluid rate for 24 kg child
• 24ml/h
• 34ml/h
• 44ml/h
• 54ml/h
 • 64ml/h
181) Paralytic ileus. Potassium requirements 70kg patient.
• 35
• 70
• 140
182) Loss of dorsiflexion, eversion & dorsum sensation
• CPN (common peroneal nerve)
183) Statistics
• Positive predictive value related to prevalence
184) 52yo aortic aneurysm repair, histology showed medial necrosis (cystic wall degeneration)
• Atheroma
• Connective tissue disorder
• Syphilis
185) Smoker & xray with peripheral shadows (ground glass appearance).
• Small cell carcinoma
• Adenocarcinoma
• SCC
186) Dumping syndrome, insulin increased
• Hypoglycaemia
187) Microscopy showed pink amorphous material
• Amyloidosis
188) Red green congo stain
• Amyloidosis
189) LMN injury
• Flaccid paralysis
190) Clostridium difficile intestine biopsy
• Deep ulceration reaching muscularis propria
• Ulcers covered by fibrin & deposits
• Granuloma
• Ulcers covered by amoeba
• By fungi
191) Bilateral lymph nodes
• Pancoast tumour
• Sarcoidosis
• Retrosternal goitre
192) Cushing triad, cause of bradycardia
• Baro receptor decrease, Vagal tone decrease
• Baro receptor increase, Vagal tone increase
• Baro receptor decrease, Vagal tone increase
193) Parotid gland surgery, nerve injury, can’t wear ear rings
• Auriculotemporal n.
• Greater auricular n.
• Marginal mandibular of facial n.
• Mandibular branch of trigeminal n.
194) Positive ventilation (IPPV)
• Decrease end diastolic volume
195) Friends had party, 2h after all have diarrhoea
• Staphylococcus aureus
196) Constipation, morphine
• Mu receptors
197) Patient travelling from subsaharian Africa in UK with heamaturia
• Bladder SCC
198) Fistula between sigmoid & ileum, 5 year history of diarrhoea, weight loss
• Crohn’s
• Sigmoid diverticulitis
199) Lung lesion, adipocytes (fat) and cartilage
• Chondroma
• Hamartoma
• Teratoma
200) Paraneoplastic syndrome of lung SCC
• Acromegaly & GH
• Bone & PTH
• Insulin & Hypoglycaemia
201) Haemolytic uraemic syndrome
• E. Coli
202) Recurrents UTIs, now renal stones. Microorganism
• Proteus
203) Smoker with dorsum ulceration
• Buerger’s
• Diabetic neuropathy
• Intermittent claudication
204) Hypovoleamia & after fluid challenge still oliguric
• Urine to plasma osmolarity ratio 1:1
• Urine specific gravity 1010
• Increased urine nitrate
• Urine osmolarity 250
• Urine sodium 10
205) Blood out of aorta after one cardiac cycle (cardiac output)
• 70ml
206) Clostridium perfringens
• Gram+ rod
207) 79yo back pain, suspicion of inflamed intervertebral disk, spondylodiscitis. Microorganism
• Staph aureus
• H. influenza
• Strep pneumoniae
• Kingella
• Streptococci
208) 70yo recovery room, 28% oxygen mask, ph decreased, pCO2 increased. Reduced sensitivity
• Adrenergic receptors
• Baroreceptors
• Central chemoreceptors
• J receptors
• Lung stretch receptors
209) Femoral artery location
• Mid-inguinal point
210) Na/K pump
• Primary active transport
211) Pancreatitis patient with carpopedal spasm
• Hypocalcaemia
212) Pringle’s maneuver. Where is the injured vessel located
 • Gastrohepatic ligament
• Falciform ligament
213) Indication for renal replacement
• K+ 6.8
214) Ligament support for uterus after delivery
• Transverse cervical ligament
• Round ligament
• Peritoneum
215) Embryologically not from foregut, that have blood supply from coeliac
• Spleen
216) 39yo after burns, vomit, abdominal distention and hiccup
• Acute gastric dilatation
• Acute intestinal obstruction
• C. difficile
• Faecal impaction
• Sepsis
217) Hodgkin’s lymphoma pathology
• Large cells with large (prominent) nuclei
218) Hamartoma
• Peutz-Jeghers syndrome
219) Unopposed parasympathetic activity
• Detrusor muscle contraction
220) Child with bleeding, abdominal distention, crying, pain in R iliac fossa
• Intussusception
221) 9 months child with undescended testis. Next step.
• Surgical exploration
• hCG
• Laparotomy with anesthesia in 3 months
222) Poor man with wound not healing, bruising and ecchymosis. Deficiency of what
• Vit C
• Vit K
223) Most appropriate regimen for daily sodium requirements
• 1L 0.9% NS + 1L 4% dextrose 0.18% NS
• 1L 0.9% NS + 1.5L dextrose 5%
• 1L Hartmann + 1L NS
• 1L Hartmann + 1L 5% dextrose
224) Patient with single rib fracture, in pain, all vitals normal
• Rib fixation
• Admission
• Observation
• Chest drain
• Analgesic and discharge
225) Prostate ca metastasis spread
• Vertebral arterial system
• Sclerotic leads to decreased trabeculae
• Long bones
226) Drug derived from isoprenaline that causes vasodilation, acts on b1
• Epinephrine
• Norepinephrine
• Dobutamine
227) Diplopia with adducted eye. Nerve injury
• Trochlear
• Abducens
• Oculomotor
228) Osteoid forming tumour
• Osteosarcoma
229) How to confirm 3rd degree burn
• Loss of pin prick sensation
• Black eschars in edges
230) Hypercalcaemia initial management
• iv fluids
231) Giant cell arteritis, temporal pain & headaches
• Chronic granuloma with macrophages
232) Found after trauma and fractured ribs after 24h. What will increase
• CRP
• Fibrinogen
• Albumin
233) Not true after splenectomy
• Low WBCs
• Basophilia
• Low platelets
234) 20yo, has 2 children, breast lesion 3cm mobile, FNAC benign
• Discharge & reassure
• Core biopsy
• U/S in 3 months
235) Preganglionic sympathetic neurotransmitter
• Acetylcholine
236) Patient crushed limb and dark red urine
• Myoglobin
237) Testicular cancer and metastasis. Elevated tumour marker
• AFP
238) Anal cancer
• HPV
239) Patient on amoxycillin, develops hypotension, wheezes, rash
• Type 1 hypersensitivity reaction
• Type 2 hypersensitivity reaction
• Type 3 hypersensitivity reaction
• Type 4 hypersensitivity reaction
• Drug autoimmunity
240) Anaphylactic reaction post hair dye. What to give
• im Adrenaline
241) Patient with IHD and now HR 40, anterior wall MI (NSTEMI)
• Bundle of His
• SA node
242) Ptosis, enopthalmos, miosis, dry face
• Sympathetic trunk injury
243) Pleomorphic cells not invading basal membrane
• Dysplasia
244) Ulcer pus discharging sinus from osteomyelitis. Initial change to carcinoma
• Metaplasia
 • Anaplasia
• Hyperplasia
245) Pulmonary embolism, patient stable
• LMWH
• UFH
246) Ureter not related to
• Round ligament
• Broad ligament
247) MS and dysphagia, what compress oesophagus
• L atrium
248) Tricuspid closure
• Isovolumetric contraction
• Isovolumetric relaxation
249) 45yo patient dense shadows, no microcalcifications
• Fibrocystic disease
250) Head injury, confussion, vomiting, Na 125. Management
• 50ml 3% hypertonic saline
• Mannitol
• Diuretics
• Vasopressor agonist
251) ABG - High output fistula
• Uncompensated metabolic acidosis
252) Leg trauma stab lower gluteal, knee bruising, no haemarthrosis, cold, pale, femoral pulse
present, popliteal artery and distal pulses absent
• Knee dislocation
• Supracondular #
• Tibial #
• Patellar #
• Compartment syndrome
253) Aortic bifurcation level
• L4
254) Dilated lateral ventricle. Obstructed foramen
• Interverticular foramen
• Cerebral aqueduct
255) Surgical site infection after emergency appendicectomy. Common microorganism
• Staphylococcus aureus
• Bacteroides
256) 27yo appendicectomy 3years ago, now elbow pigmentation, gluteal, buttock & severe
hypotension, rash & hyperkalaemia, hyponatraemia
• ACTH
• Adrenal insufficiency
257) Lower border of quandragular space
• Teres major
• Teres minor
• Pectoralis major
258) Locked knee
• Meniscus tear
259) After trauma has nasal fluid. Best diagnostic test for CSF
• b2 transferrin test
260) Bleeding during lumbar puncture
 • Vertebral venous plexus
• Vertebral artery
261) Patient rheumatoid disease, dysphagia, upper GI endoscopy normal
• L atrium hypertrophy
262) Wrist injury, severe claw hand, muscle responsible
• 3rd and 4th lumbrical
263) Patient atrophic gastric mucosa, autoimmune disease, thyroiditis. Peripheral smear
• Large & oval
• Small & pale
264) Boy RTA, pelvis #, resuscitated, passed 350ml urine, now decreased 10ml in Foley
• Hypovolaemic shock
265) Extends hip, origin from lumbar intervertebral disk
• Psoas major
266) H. Pylori emergency intubation. Best anesthetic agent
• Ketamine
267) Lateral forearm sensation lost, other affected function
• Supination
268) Appendicitis pain referral
• Thoracic splanchnic nerve
269) Unable to initiate abduction
• Suprascapular nerve
• Dorsal scapular nerve
270) Lady NOF# fixed with dynamic hip screw, after 8-10 days SOB, SpO2 93%, reduced BP
• Pulmonary embolism
• Fat embolism
271) Pupil dilated
• Unopposed sympathetic discharge
272) Upper calf claudication
• SFA (superficial femoral artery)
273) Stomach tumour biopsy inconclusive (well circumscribed lesion)
• GIST
274) Laparoscopic hernia repair. Mesh posterior relation
• Peritoneum
275) Pain relieved by hot compression
• A beta modulating C fibers
276) Upper limb motor weakness and speech problem
• Middle cerebral artery
277) Disturbed balance, uvula deviation. Location of injury
• Medulla
278) Posterior relation of lower pole of kidney
• Quadratus lumborum
• Erector spinae
279) Patient back pain during resting but improved during walking
• Spinal stenosis
280) Kidney mass, smoker, heamaturia
• Renal cell carcinoma (RCC)
• Adenocarcinoma
• Transitional cell carcinoma
281) COPD patient on 30% O2, high CO2, unresponsive
• Medullary receptors
282) XRAY - pneumothorax
• Chest drain at 5th intercostal space midaxillary
283) Acts on b2 to decrease blood pressure
• Dobutamine
284) Left side diaphragmatic hernia embryology
• Pleuroperitoneal membrane
285) Late sign of compartment syndrome
• Loss of pulse
286) Grave’s patient
• Carbimazole
287) Bleed on DRE on finger. Source
• Sigmoid artery
288) Local anesthetic blocks
• Na channels
289) For GFR calculation why substance (inulin) used
• Filtered, secreted, not reabsorbed
290) Breast mass, U/S & examination inconclusive. Next step
• Core biopsy
291) Least reliable in hypothermic patient
• Pulse oximeter
292) Malignant melanoma completely excised. Management
• Discharge & educate about self examination
293) Found in MALT in gut mucosa
• IgA
294) Multiple liver lesions, 3year after colon ca resection, T3N1. Appropriate management
• Further investigations
• Resection
• Chemotherapy
• Radiotherapy
295) Bronchodilation
• Sympathetic
296) Warfarin patient, emergency surgery
• PCC & iv Vitamin K
• Stop warfarin
• FFP