asm (ANA) port ed for di si a oe 1 Seg eh an el H9ption in mukiple morbidity Parcs HY morta om 90% arin ernie ll [| ero ee i J Can cause prolonged spice Seep atienss Isreversed with mi Dh. Isthe drug of hoc inpatient With appr sinvays obstruction 1s stein patients with malignant hyphen ( [ [ [ [ 1 Brachial plexus block isan example Sea eral ancesthetc is technieally more difficult than s spinal Regarding hypovoluemic shock: Cold clammy peripteres is one ofthe signs Urine ouput can be used to monilogmesusottion ‘The CVP tine Measures aftciloag 7harOhe ould be induce lao Blog wh ld ‘The terial blood gases typical MPa mtabole Osa Adtinister adrenaline fr he ABCS come ater defi lefibrillation ‘The is ater sition shout ye done With 200) tension pneumoy e mechanical dissoc Atropine hes po an aut cecum ssoe tO Regarding cardiopy it Assarding cardiopulmonary esuscitation:asm (ANA) port ed for di si a oe 1 Seg eh an el H9ption in mukiple morbidity Parcs HY morta om 90% arin ernie ll [| ero ee i J Can cause prolonged spice Seep atienss Isreversed with mi Dh. Isthe drug of hoc inpatient With appr sinvays obstruction 1s stein patients with malignant hyphen ( [ [ [ [ 1 Brachial plexus block isan example Sea eral ancesthetc is technieally more difficult than s spinal Regarding hypovoluemic shock: Cold clammy peripteres is one ofthe signs Urine ouput can be used to monilogmesusottion ‘The CVP tine Measures aftciloag 7harOhe ould be induce lao Blog wh ld ‘The terial blood gases typical MPa mtabole Osa Adtinister adrenaline fr he ABCS come ater defi lefibrillation ‘The is ater sition shout ye done With 200) tension pneumoy e mechanical dissoc Atropine hes po an aut cecum ssoe tO Regarding cardiopy it Assarding cardiopulmonary esuscitation:on wile’ °t nggg RS Tolowing are trees as 0 et ‘minal mass bythe care-giver isgnosis 8 espe vic seve ae eo acy Sess 1B aa inet ae tor HN Be aati cases contiraed BY reetgy ain biopsy. Which of the following Bact inte dee agement gfe went fy Barium real and follow tho Barium ener ve Uitrasound san Anorectal manometry END OF PAPERon wile’ °t nggg RS Tolowing are trees as 0 et ‘minal mass bythe care-giver isgnosis 8 espe vic seve ae eo acy Sess 1B aa inet ae tor HN Be aati cases contiraed BY reetgy ain biopsy. Which of the following Bact inte dee agement gfe went fy Barium real and follow tho Barium ener ve Uitrasound san Anorectal manometry END OF PAPERotic administration i sraction 1 Scaling of teeth ] Filling ofteeth Removal of impacted wisdom tooth Marsupialization of mandibular cyst a A: Min ean win nme a 2) Columntel tT) (F) warlinctiorn iE roe 4 lire results ftom early sequestrecton is usually brief (less than 2 weeks) _ -—&* The hip joint is at risk with proximal metaphyseal involvement of the femur ‘The knee joint will likely exhibit a marked sterile sympathetic effusion with distal metaphyseal involvement of the femur Periosteal reaction/bone mottling on X-ray is a relatively late sign6S. colic is characteristic” | * inary carcinogen T C Arise from transitional epithelium T Fd) [E] Best treated is partial or total nephrectomy only” F ©) —[F1 The cosinophil count is usually raised ~ 66. The following are agreed specific measures regarding calcium stones inthe &) [T] Restriction of dietary: may lower calcium absorption Limitation of ‘nd carbobyaratesTs #) P BE [6] tsdoneintheare only § ») F [45] Is contraindicated in trauma of kidney ©) = [$1 Canshow all stones QFE Is contraindicated in jaundice ©) ELF] Canbedone orally Match the following: Column Carcinoma of colon 4 Stricture of common bile duct Stones in gall bladder + Hypertension - Salivary fistulaThe following are inhalational induction agents: a) [FE] Etomidate 5) ‘Suxamethonium Enthirane Fentanyl Halothane Is a non-depolarizing muscle relaxant po cuntdingly'radionensitive and can be ig0 Of dosage and therefore require pri Te - 94. Match the: ete rc ato evi A * ‘) 1 )epistaxis onginates from Kiesselbach"s plexus ia ‘An antesior pack may be adequite t6 stop the bleeding in anterior epistaxis Posterior epistanis is a more seriousproblem | “T tial Successiu! treatment of posterior epistavis i¢ adequately managed with an anterior pack f yi used in diffeult eases of epistaxis, “Y i fsonia predisposes 10 it \ for siirgical treatment of BPH are: Do Usinary retention Bigprostate Azotemia Fi Bladder stones Severe LUTS ~] Colloids infusion Crystalloids: infusion Equal ee of colloids and cenystalloids infusion Urethra catheter drainage Prevention of burn yn SS etn pred FT mies ne may need changes at j evel 4 co 2 | I) byvmeet bers :are more often affected than males les are more often affected than females ‘| 1 Mumps is usually bilateral (4) } Bacterial infection is a disease of lactating women 2) Fl ‘Tuberculous infect ‘ion is always associated with active pulmonary tuberculosis 2 ln nead of mammary carcinoma: et a 3 Itereses ise ¢ly Shitting duliness absent ge , ‘Malignant tumours are never found ina perforated appendix at appendicectomy. sewing surgery for peptic ulosr: cin pasrojajunoatomy occuring on he stomach ade 7 ic and gastro colic fistula oF] Alkaline gastritis TUJKT roa deficiency anaemia ‘ollowing are recognized complications following splenectomy: IT] The younger the patient the greater the risk of d splenectomy sepsis fe pee most common pathogen i t Ce lyvalent pneumococcal vaccine | ‘should be re¢ metabolism, in the pri renal disease gh with hyperuricaemia normal patient who takes a course 9: cohol intake 7-trochanteric fractures despite irestment ater Avascular necrosis of the femora {F] Sciatic nerve palsy :re site 1: of bone from the fracturec oma directly becomes bone je joint. True or False: a Fngto the mechanism of injury + above the inferior tibio-fibular T cord An oblique! ture of the fibula jus joint isa trivial injury ANT LET this pemissbleto fx theme fracture dislocation 4) [£1 Aradiograph showing ao fracture exehides serious injury ©) [F] Compression fractures carry a good prognosis sia) malleolus with a screw in compound degree of low ae a sloceeite Novation es ‘ eae p> oie &Kor es ESL SPR aT% bed e 6 WHE uh a43. According to the Salter and et Harris elassification of physeal injuries, how is a Cae itoork the assis, physis and epiphysis classified? shock due to big size of its haematoma id forwards by quadriceps femoris muscle. pulled upwards and backwards by the adductors features of club f erosion of the os clacis adduction of the bones of the fore a small os calcis abnormal histology of the cal! Valgus of os calcis scanning Clinical details affect thet Solid organs in the abdo Assessment or comment Skull X ray should be d mild head injury or skul The request form should have or nol. ‘Ultrasound is used to A normal KUB plain CT KUB is done onlya) » 9 °) 18. a) » O} 9) °) a) *) ad ° a) b) 9) ) O) 21. 19, 20. fe Lear old male patient is involved i a Fond trafic accident and is brought to Srlete seht and Emergency Department and is short of breath. He complains Perinat Shest pain. His blood pressure is 100/60 and has a pulse of 110 bents oe Maule. His oxygen saturation improves to 96% an administration of oxygen correay Nast: Which of the foiowing statements regarding his management are UJ The patient is a candidate for hypotensive fluid resuscitation J The patient has splenic : 7 1) Ene beans acta ppt foie icmediate lpertomy [ CJ The patient has comper ( ] Amungent CT sean is The following statements relate to snake bites f ] A tourniquet should be applied to minimise absorption of venom l [ l ] The limb should te immobilised | Patients should be commenced on antibiotics | Neurotoxic snake bites cause descending flaccid spastic paralysis ] Most snake bites are poisonous With regards to diabetic foot ulcer [| Ischaemia accounts for the majority of ulcers [| Neuropathic ulcers ate painful [. ] A Seirimes- Weinstein 10 gram monofilament assess the presence of neuropathy by testing 10 spats on the foot [_ ] Infection of the ulcer is tnono microbial [ ] A positive bone probe a ‘underlying osteomyelitis fare true with regards to skin malignancies Which of the following statemer [ ] Melanoma is the commonest skin malignancy [J Squamous cell carcinoma accounts for mast of the mortality. [1 Excisional biopsy is ideal for melanomas less than 3 centimetres [_ ] Acral tentiginous has @ worse prognosis than lentigo maligna melanona i ] The excision margin for squamous cell carcinoma is 1 Omi The following thyroid malignaneies can be diagnosed accurately using fine needle aspiration biopsy [ 1] Hurthle’s [1 Papillary [1] Follicular [ ] Lymphoma [ ] Thyroglossal J plenectomy ] This is indicated for autoit } sated for capsular J Patients should be vacci i ine thrombocytopenitt that are 2em deep into the parenchyma Patients are at a higher 5 [ [ t [ { ] Postoperative penicillina) 5) °) a) ©) a) °) a) c) a) b) ) e) ‘The following statements relate to surgical wound closure (A delayed primary closure is when dirty wounds are cleaned and dressed and Tater on sutured when they are macroscopically and microscopically clean { J Split skin grafting is an example of a healing by primary intention t Whi { { C i. [ J Ancxample of a delayed secondary closure is when a surgeon only closes the fascia after a dirt operation and later usually within 10 to 15 days closes the skin when the wound is macroscopically and microscopically clean 1 Myocutancous flaps are iden! for infected wounds A fascio-cutaneous flapimiist be used! to cover bone ich of the following 14 are true with regards to esophagogastroduodenoseopy (upper GI endoscopy)? ] All patients with alarm symptoms must have an endoscopy ] Haematochezia is an indication for upper Gl endoscopy J Patients must have bowel preparation before upper GI endoscopy J Biopsies taken at the centre of the tumuor are recommended in gastric cancer J Upper GI endoscopy can be used for therapeutic purrposes Which of the following statements are true with regards to liver adenoma { ji [ [ [ It is common in patients on combined oral contraceptives adenoma can undergo malignant transformation Patients with liver cell adenomas need early surgery Alpha-fetoprotein is raised in patients with liver adenoma Watchful waiting is an acceptable approach A 70 year old female patient with portal hypertension secondary to schistosomiasis presents with haeihatemesis. He has a blood pressure of 105/77 and Whi pulse rate of 90 beats per . His Child-Turcotte - Purgh score is 8. ich of the following state ‘ure true with regards to his management? [ ] A Blakemore-Sungsteken tube must be inserted with inflation of the ce [ [ [ t With regard to modified radical { a ] 1 ARDS: J J J J Le J It is synonymous with ] J esophageal ballon prioritized ‘An infusion of Terlepressin heeds to be commenced His blood pressure is reassuring as it excludes shock: He is Child B His portal hypertension is pre hepatic in origin v ‘omplications of acute pancreatitis include Sudden blindness bic Gastrointestinal haemorrhage ‘Myocardial infarction tectomy ‘Axillary dissection is carried ott to stage the axilla and for loco regional control oe Axillary dissection is [out up to level II Lymph nodes ‘The axillary nerve i at Damage to the th ‘nerve will results in the winging of the scapulati |» vascular clinic with severe cramping pain out 900 yards before the pain starts, which arettes a day and suffers from angina. On pulse is weak but otherwise the rest of the Lis the most likely diagnosis? caustic injury to the ive tha injury = “gomach due to its normal acidic pH gs through the esophagus: and stomach into the smal Steroids are very useful in pre ye Children are less likely to for { f [ [ With regard to eardine- tam} [ ] There is accumulation [ ] There will bea fall [ ] Heart sounds are mt [ ] Patients will present ¥ [ ] Needle peri-cardiocent ‘A 69 year old gentleman presc his right calf, He can only walk by rest. He smokes 30 examination his right dorsalis examination is unremarkable. ¥ Femoral artery stenosis Blocked iliac artery Popliteal artery anew Blocked posterior ‘Abdominal aortic:ML. a) °) a) °) 12. b) 8) @) s) 13. a) ©) a ®) Investigations in patients with enterocutaneous fistula must includes [ ] Endoscopic retrograde cholangiopancreatography(ERCP) [1] Fistulogram [1] Blood gases { ] Transferrin [1 Urea and electrolytes In acute cholecystitis {| Couversier's sign is posit [1 The commonest cats is gallstone stuck inthe infundibulum [1] There is leukocytosis { t J On admission, patients must be prepared for laparoscopic cholecystectomy ] Intravenous Ampigilfin is an antibiotic of choice ‘The following statements relate to fluid management in burns patient Fluid resuscitation should commence from the time of admission Albumin can be given within the first 24 hours after the burn Colloids are more effective thin erystalloids ‘When fully resuscitated all patients have a urine output of Lmilkg/ir Half-strength Darrows dextrose solution is a fluid of choice in paediatric patients f | A severely dehydrated surgical patient passes through the following phases of fluid resuscitation [ J Rescue Optimisation Stabilisation i De-escalation Comatose 1 ] ] ) 1 [ [ t Complications of wound healing include [1 Perforation [ 1. Pyogenic granuloma [| Hypertrophic scar ; [ 1 Bleeding j [ ] Contractures ‘The following complications are associated with hernia repair Sliding hemi ‘Testicular atrophy Loss of libido Osteitis pubis Retrograde ejaculation39. Common complications of Toa! Parenteral Nutrition include fF Bypenily ») f } Hyperphosp [| Hyperatremia ) [ ] Hypermagnesiunin 9 LJ Hyperosinolardirest lst inclute 2 wen ») FJ Fibrondenosie “4 O° If Cane #) [J Pregnancy mastitis ®) {J A‘ibroadenoms agit 32. Osteogenic sarcoma a) [J Has two age peaks of incidence 4) [1 When affecting the timb, is weated by amputation im most easea 8) [| Has 2eray features including ‘Codman’s triangle* 4) [|] Most commonty affects the metuphysics of the femur ®) [| Develops ina third of patients with Paget's disease of the bone 33. Complications of tibial fructureeinelude a) [ ] Leg shortening 5) f ] Compartment syndrame ©) [ ] Delayed union ‘ [| Tibialnerve ©) [ ] Fatembolism { 34. The rotator cuff of the shouluk he {s formed by which of the following muscles? 4) [ ] Subscapularis ») EJ Teres major ©) [ ] Pectoralis major ad) [ J Dekoig [ ] Infraspinatus 35, Avaseular necrosis is particularly associated with fracture of the following bones a) [| Third metacarpal b) [J Scaphoid f [ J Talus @ [J Mandibular condyle ©) [ ] Neck of femur terior shoulder disiuc: 7 ] Is less common tiun pdsietior dislocation J Can be treated usine Kocher manoeuvre J Isarecognized cause Sf axillary nerve palsy J Isusually subcorscoid J Usually presents ith drm ip the adduction positionUW - ae ee Sb:8L '8LOz/zo/eL S asOWALL 7 (M%/8 OL OD L2:8L SO SNO«L3N Mz it EIpeaw |IV‘ct pa mily saath g est re Aucater & \usng, matleshasts skit Sodeitahdl atts ia bia Winaals je (G24 AG stabi Mrowa « > ino Mule tlointle = Miet epsaile) —3 tet Seal, aut peed alli aE ge oa Serta = efit fuer er Glen cond fs Len ou Fenn pal ofSUrgeOn's preference When the fracture is open from trauma \C In grossly unstable fractures When ¢losed reduction has { led displaced intra-articula (e) ' Disadvantages and Complications of internal fixation {a) there is damage to the soi (b) the rigidity of fixation favou () technically demanding (d) nfecti ® drills and screws car Features in an injured patient whi injury should al (a) Serie evidence of neurologic (b) mubtiple injury © head injury . @ facial injury © fall from a height 29° Major morbidity after day surgery include (a) myocardial infarction (b) pulmonary embolism (c) respiratory failure " @ . major postoperative haemorrhage c (©) Phas cerebrovascular accident — ° Pe$i. 82. @ Complications of acute pancreatitis (a) zy re carly suegentis indicated ) (b) cardiovascular (c) necrosis (d) oedema et (e) ascites Functions of the peritoneum \ : & 4. visceral peritoneum: pain perception (a) (b) visceral lubrication (c) fluid and particulate absorption @ fibrolytic activity (e) immune rsponse On treatment of postoperative peritonitis (a) general care of the patient (b) specific treatment of the cause (c) peritoneal lavage (d) colostomy (e) liver function tests, urgent Laparascopic surgery fs diagnostic: colorectal resection * (b) (c) (¢) (e)widen per face mask. Which oft gle iP egiel® correct Teng ee LF] The ps en tl {T) tt [F] A toumiquet should be tr] teineana {r] Paine Lr] Neurotoxic snake bites sa in 1] Now stebeewees irr ab ay Neuropathic uleen arepalaful 1 Somer Sear non neuropathy by testing 10 spats on the foot Infection of the ulcer is mano microbial poste ae pera seovei jlament assess the presence Of Which of the following statements are tree with regards to skin malignancies F] Melanoma is the commonest skin nalignancy TE] Squamous cel carinona acouns for mostof the mortality ['T] Exsisional biopsy is ideal for melanomas les tan 3 centimetres [1] _Acra lentignous has awone prognosis than lentigo maligna melanoma [-T] The excision margin fr squas cell arcinom is 1Oram ‘The following thyroid malignancies ca be diagnosed accurately using fine needle aspiration biopsy (F] Humhle Papillary Follicular Lymphoma, Thyrogiossal Splenectomy. PT] This is indicated for auolmmure thombocstopenia { []_ Wis indcated for apsuar rs tht are em deep into th fr] Patents sald wna in Meingosocas parenchyma Patients are at ai fection fram en 4 tt j Postoperative penicillin prophylaxis is, pel a oe organismswiden per face mask. Which oft gle iP egiel® correct Teng ee LF] The ps en tl {T) tt [F] A toumiquet should be tr] teineana {r] Paine Lr] Neurotoxic snake bites sa in 1] Now stebeewees irr ab ay Neuropathic uleen arepalaful 1 Somer Sear non neuropathy by testing 10 spats on the foot Infection of the ulcer is mano microbial poste ae pera seovei jlament assess the presence Of Which of the following statements are tree with regards to skin malignancies F] Melanoma is the commonest skin nalignancy TE] Squamous cel carinona acouns for mostof the mortality ['T] Exsisional biopsy is ideal for melanomas les tan 3 centimetres [1] _Acra lentignous has awone prognosis than lentigo maligna melanoma [-T] The excision margin fr squas cell arcinom is 1Oram ‘The following thyroid malignancies ca be diagnosed accurately using fine needle aspiration biopsy (F] Humhle Papillary Follicular Lymphoma, Thyrogiossal Splenectomy. PT] This is indicated for auolmmure thombocstopenia { []_ Wis indcated for apsuar rs tht are em deep into th fr] Patents sald wna in Meingosocas parenchyma Patients are at ai fection fram en 4 tt j Postoperative penicillin prophylaxis is, pel a oe organisms* ‘ wo “Ss * ° nor diagnosis x brain 7 abe = Concerning Ora, Zit . 73 ye in le a > LE Or pcain e on Peeters 3 fr) ameter ce ie gee “eody SY0TOMe sg. SPACE Occupying lesion a a The Foster ised by a petroclival meningo™ jymor CAN fgg ©) TE] A posicortosa eaNse staggering in walking ” |. Hydrocephalus sor FS fT is cused by «pe* SSSI the Amold-Chir ralformartion al codon Re tany T ) Ts treated by ventricilOPeONGH shunting [J Istreated by vertrculonl¢utal Sint. ©) [ie] treated by encoscopi Stemiogtaphy 75, ‘Trigeminal neuralgia 3 EEA Temore common in the elderly b) [7] Iscaused often by compresSingOfthe fifth cranial nerve by the anterior inferior cerebellar artery i ©) [7] Can be trepted by posterior miehodeeompression @) [7] Canbe treated by percutaneotisthizotomy. ©) [7] Can be treated by eryotherapy 76. — The following is true concerning tie presentation of brain tumors 8) [ ] The classic presentation of olfactory groove meningioma is with headaches ‘and bitemporal hemianopia +) [ ] Pituitary umors often present with the Foster-Kennedy syndrome { ] Glioblastoma multiforme i associated with confusion, memory loss and rapid progression of symptoms over a few Weeks 4 —[ ] Ackild who is clumsy and keepson falling to one side maybe harbouring & cerebellar astrocytoma © [1 Papillodema on fundoscopy suggests the presence of an intracranial space cecupying lesion 77. Which of the following regarding aoptie Transection are true: 4) [1] Mediastinal widening on a chest Xray is feature. By [E] Ithas a low mortality rate 1 [Ff] Thesite ofthe transaction hus apanatomical predeliction. ) CJ Requires immediate trearment with large volumes of TV fluids if the Patient is to survive, ©) IF 1 Cannot be managed through endovascular means,_ Urinary Tract i orev An uncom In males, cue UML s. i 1 [nate gu ir 3 609% a gertying elsrder 7] Pregnant wombat yee! grant unde rt, [1 Low dose long genttatigt enities NY nave a post eints with recurrent an 2% ge sc ve eg ina C1. Wide ree ani : infections am inet sement of urinary Tact The following are part of my pinaders 7} Internit cahggge amet [77] Chronic indwelling tea (1 ] Sphinterectomy =the [T] Bladder augemenati [1] Antichotinergic drugs The management of pati nts wit eee [11 Obscrvaticg Paes Wiha prosaic enlargement incl [TL] Anticholinense therayy LT) Alpha reductase inhititon Le] Radical prostatectomy: Te] Radiation therapy ‘The following drugs are associated asion of urinary tract caleulus: [1] Hydrochlrothieagges me orsnton ree? {1] Frusemide [1] Triamterene [1] Indinayior [F]Allupurinot ‘The following statemenis are TRUEOR FALSE about scrotal and testicular problems: LF] Torsion of the testis is seen most commonly between the ages of 20 and 30 years ee [F.] Hydrocele is diagnosed by tasillamination and, if any portion transilluminates, malignasey & excluded : : [eT] A right-sided vriocelee sil) les common than aeft-sided varisocele [7]. A painless tetcular matintmanaged 20 to 35 years, found incidentally, is the most common presentation of testicular tumour {1 Bpididmyaleystsaremae camer oscurin the wail of he epididymis ture ofthe snembrtus (prostatic) urethra: ‘Traumatic ru Drostate"™ inati ‘with ‘on tectal examination May be associated wethral ca rr } f iy immedi theterisation [FE] Rarely leads to long rethropram [E] Ts usualy dogo eS ry [Is most often due'®