MRCS Made Easy January 2023 Past Paper PDF

## MRCS MADE EASY: JANUARY 2023 ### Q1. Half-life of platelets? - 12 hours - 2 days - 10 days - 120 days - 1 day ### Q2. A bullet is shot just at the right side of rectus muscle where it meets the tight costal margin and went out at the exact area through the back, organ most likely affected? -...

## MRCS MADE EASY: JANUARY 2023 ### Q1. Half-life of platelets? - 12 hours - 2 days - 10 days - 120 days - 1 day ### Q2. A bullet is shot just at the right side of rectus muscle where it meets the tight costal margin and went out at the exact area through the back, organ most likely affected? - Pylorus - Gallbladder - Right Liver Lobe - Right Kidney - Right Adrenal Gland ### Q3. Paneth cells present in- - Crypt of Lieberkühn - Intestinal villi - Gastric antrum - Lamina propria ### Q4. In COPD patient - PCO2 increased and HCO3- increased. - PCO2 increased and HCO3 Decrease - PCO2 decreased and HCO3 Increased - PCO2 decreased and HCO3 decreased ### Q5. COPD + given morphine, which ABG represents it ABG VALUES given. PH Low, PCO2 high, HCO3 high (Acute on top of chronic Respiratory Acidosis) ### Q6 Pt on warfarin and started to bleed. What is the cause of bleeding? - Deficiency of factor 2,7,9,10 - Prothrombin deficiency ### Q7. Female RA, on 10 mg bid steroid and salbutamol, Rt iliac fossa pain vomiting, fever, k high, WBCs 15, Na low, BP 80/50, pulse 80 what to do. - 250 ml colloid and reassess - 100 ml prednisolone - IV 100 mg Hydrocortisone - Ca resonium per rectal ### Q8. 70-year-old male, angina on going uphill. ECHO was done, showing mitral valve annular regurgitation and thickness with systolic murmur. What is the most likely finding? - Aortic stenosis - Aortic sclerosis - Mixed valvular disease - Aortic regurgitation ### Q9. 8-year-old child, harsh continuous murmur under the clavicle, Hypertension - Coarctation of aorta - PDA - VSD - ASD ### Q10. Primigravida with 36 week pregnancy, 24 years sudden massive chest tightness and pain, cyanosis, congested neck veins, her father died at 60 with MI - Aortic dissection - Acute massive pulmonary embolism - Pulmonary infarction ### Q11. After RTA, in helicopter EMS are going to, Intubate a hypotensive Pt which medication - Propofol - Ketamine - Etomidate - Sodiwa Thiopental ### Q12. Post op anterior resection, 10 days Pt developed shortness of breath most appropriate investigation. - CTPA - CXR - Ultrasound ### Q13. After aortic aneurysm repair, a 70-year-old male developed high k (5.7), low urine output, high creatinine. What is the first initial step in management? - Measure intercompartmental pressure - Give 1 liter of Hartmann - Insert Foley Catheter - CT KUB ### Q14. Child developed sudden scrotal pain 4 hrs. back, testis elevated, tender, mother gave chips to relieve and distract patient - Analgesic, block, and manipulation - Fast 3 hours first - Immediately exploration under GA - Scrotal Ultrasound - Give local anaesthesia ### Q15. After aortic aneurysm repair, pt increased ventilatory demand, pulmonary wedge pressure 20 (N - 8-12), dilated neck vein, low BP, Xray showed bilateral lung opacity - ARDS - Pulmonary edema due to heart failure ### Q16. Post splenectomy blood film at 1 week, what is not seen? - Howell Jolly bodies - Basophilia - Decreased WBC - Pitted RBC - Target cell **What are the hematological changes after splenectomy?** An increase in blood leukocytes can occur following a splenectomy. The post-splenectomy platelet count may rise to abnormally high levels (thrombocytosis), leading to an increased risk of potentially fatal clot formation. ### Q17. Management of lower leg compartment syndrome - 4 compartment release - Anterior Compartment Release - Analgesia ### Q18. GCS, spontaneous eye opening, obeys command, with confusion. - GCS 13 - GCS 14 - GCS 15 - GCS 11 - GCS 12 ### Q19. Pre-tibial flap laceration 6x8cm, intact periosteum, unable to be approximated. What is the best management? - Oppose wound edges without tension + remaining area cover with SSG - Oppose wound edges without tension + allow granulation - Excise Flap and repair STSG - Flap again - Rotational flap ### Q20. Amyloid histology - Negative birefringence - Congo red positive + blue under polarised light - Congo red positive + green under polarised light - Congo red positive + white under polarised light **Amyloidosis** Histologically, amyloid looks amorphous ("fluffy") on H&E staining, but displays apple-green birefringence when stained with Congo Red. ### Q21. Upper limb Biers block anesthetic, which choice of drug? - 0.5% prilocaine - 1% Lignocaine - 1% Lignocaine with Adrenaline - Bupivacaine ### Q22. A Mother of 3 children, came with pruritus ani, Tape showed eggs, causative organism - Enterobius vermicularis - Ascaris Lumbricoides - Entamoeba Histolytica - Giardia Lamblia - Echinococcus ### Q23. Patient passing ova and cysts, bloody diarrhoea treatment? - Mebendazole - Metronidazole - Doxycycline - Gentamicin - Sulfamethoxazole ### Q24. Knee injured during football match, can't continue playing. Immobilized for one week. After one-week, tender swelling 2.5cm above knee medial joint line and excessive lateral angulation of knee compared to the other one. Which ligament injured? - Medial collateral ligament - ACL - PCL - Meniscal ### Q25. After cast removal 4 weeks of undisplaced fracture, pt unable to lift thumb off the table and patient cant extend IPJ even after stabilizing thumb CM joint. - EPL tendon injury - PIN nerve palsy ### Q26. External spermatic fascia is a modification of - external oblique - internal oblique - transversalis fascia - rectus - transverse Abdo minis ### Q27. Ludwig's angina which space involved - Submandibular space - Parapharyngeal space - Retropharyngeal space - Buccal - Pretracheal Ludwig angina is a bilateral infection of the floor of the mouth that consists of three compartments: the submandibular, sublingual, and submental spaces. ### Q28. 10 years post midtarsal dislocation, that was surgically repaired. No issues until 2 days ago, patient experienced worsening pain at site of repair. cause - Malunion - Avascular necrosis - Primary osteoarthritis - Secondary osteoarthritis - Rheumatoid arthritis ### Q29. Patient involved in car crash, hits back of driver's seat, leg is shortened and internally rotated, all motor function of leg lost. Only preserved sensation in medial lower leg/foot? - Posterior hip dislocation - Femur shaft fracture - Anterior Hip dislocation ### Q30. Gastric dumping syndrome (gave symptoms of sweating, dizziness, nausea ect) after surgery for gastric outlet obstruction, what is the cause? - Hypoglycaemia - Hyperglycemia - Hypocalcemia - Hypercalcemia - Hyponatremia ### Q31. After gastric bariatric surgery, has been getting symptoms of sweating, palpitations, convulsions. What would you suggest the patient do? - Advice to Eat regular small meals - Supplement meals with glucose will solve the symotoms - Assure the pt it's normal post operative course - Vagotomy causing gastric relaxation ### Q32. Histological appearance of osteoporosis - Increased activity of osteoclasts - Decreased calcified bone compared to total bone volume - Decreased demineralization - Bone trabecular thickening Osteoporosis is a metabolic bone disease that, on a cellular level, results from osteoclastic bone resorption not compensated by osteoblastic bone formation. This causes bones to become weak and fragile, thus increasing the risk of fractures. ### Q33. Patient fell onto chin, reduced mouth opening, Jaws are not aligned like they used to, pre-auricular tenderness. Which part of mandible fracture - Mandibular condyle - Ramus - Body - Coronoid process - Angle of the mandible ### Q34. Patient 6 months post tooth extraction, pus, multiple sinuses and yellow granules - Actinomycosis - Staph Aureus - Strep pyogenes - Mycobacterium - Clostridium ### Q35. Teeth extracted, pt develops ipsilateral numbness of gum, chin and lower lip. Which nerve traversing through the body of mandible is responsible - Inferior alveolar nerve - Lingual - Mental Nerve - Marginal Mandibular Branch of Facial Nerve - Hypoglossal nerve ### Q36. Patient underwent Colonoscopy under conscious sedation. In the ward, the pt is unresponsive and the nurse informs you that the respiratory rate is slow. You examine the patient, and he is sleeping. Despite dark room, his pupils are constricted. Which drug used in the procedure is responsible - Fentanyl - Midazolam - Flumazenil - Naloxone ### Q37. Unilateral Buttock claudication, causative vessel - Common iliac artery - External iliac artery - Internal iliac - Posterior Circumflex Femoral Artery - Abdominal Aorta ### Q38. Gardener has thorn stuck in arm, photo given of red colour streaks surrounding cellulitis and lymphangitis 2 days later. causative organism - Strep pyogenes - Staph aureus ### Q39. Cause of discitis in a child - Staph aureus - Shigella - Streptococcus Pneumonia - E. Coli - Salmonella ### Q40. Young athlete patient with single rib fracture. He has pain but vitals are stable. Management: - Analgesia and discharge - Admission and observation - Bupivacaine 5% - CT Scan ### Q41. Old Patient attended A&E with history of falling in the pavement of a pub. He admits that he was drunk and but this never happened before. It's unclear and he is not sure if he lost consciousness or not. He lives alone. He has a small cut on his eye, otherwise normal on examination. Management: - Discharge with advices when to come back and be accompanied - Admit for observation. - CT head within 1 hr. (immediate) - CT head within 8 hrs (urgent) ### Q42. What would prompt you to do an urgent CT scanning under the NICE guidelines? - A single episode of vomiting - GCS 14 - Retroarticular hematoma/battle sign. ### Q43 Presented with nystagmus, ataxia, where is the cause of bleeding? - PICA - Posterior cerebral artery - Middle Cerebral Artery - Anterior Cerebral Artery - Basilar Artery ### Q44. Blockage in middle cerebral artery, what is the presenting symptom? - Upper abdominal muscles weakness - Contralateral lower facial numbness - Loss of hearing in the contralateral ear - Ipsilateral upper arm sensory loss A stroke of the MCA is denoted as middle artery syndrome. Middle artery syndrome presents with contralateral sensory loss of the legs, arms, and lower two-thirds of the face due to tissue necrosis of the primary somatosensory cortex. ### Q45. Which is the cause of vasoconstriction on efferent arterioles? - Angiotensin I - Angiotensin II - Angiotensinogen - Renin ### Q46. IVDU presents with groin swelling, what is found ?? - Mast cells - Sequestrum - Eosinophils - Fibrous wall (False aneurysm) - Fibroblast ### Q47. Senescence of cancer cells is due to (same as 2022 Sept) - Telomerase mutation - p53 mutation - Activation of tumor suppressor gen - Oncogenic enhancement - Antioxidant ### Q48. A 65-year-old man complains of being thirsty and getting up in the middle of the night to get to the toilet. Random fasting glucose 11.8 mg/dL, what is the diagnosis? - Diabetes Mellitus - Diabetes Insipidus - Impaired Glucose Tolerance - Normoglycemia - Impaired fasting glucose ### Q50. A patient presented with healed laceration at elbow with Loss of thenar muscle action, which nerve - Median nerve - Ulnar Nerve - Radial Nerve - Anterior interosseous nerve - musculocutaneous nerve ### Q51. Complement C3a is secreted from which cells? - Endothelial cells - Hepatocytes - T cells - B cells - macrophages While it is primarily synthesized by hepatocytes in the liver and distributed intravascularly, it is important to note that C3 is produced and secreted by various cells, thereby providing a source of tissue localized C3. ### Q52. LN drainage of glans penis - Para-aortic Lymph Nodes - Superficial Inguinal Lymph Nodes - Internal Iliac Lymph Nodes - Deep Inguinal Lymph Nodes - External Iliac Lymph Nodes ### Q53. LN drainage of body of uterus - Superficial Inguinal Lymph Nodes - External Iliac Lymph Nodes - Deep Inguinal Lymph Nodes - Para-aortic Lymph Nodes - Internal Iliac Lymph Nodes **Uterus Lymphatic drainage** The lymphatic vessels of the uterine fundus mainly drain, like the ovarian vessels, to the aortic or lumbar nodes. The external iliac lymph nodes drain the lymphatics of the uterine body and, occasionally, some lymphatics of the uterine fundus. ### Q54. A young lady Sudden pain in heel, unable to WB, Achilles rupture - Simmonds test - McMurray Test - Lachman Test - Adson Test - Hoffman Test ### Q55. Indications for renal replacement therapy in burns? - K+ 6.8 - Superficial Thickness Burns >50% - Full Thickness Burns > 30% - Urine output 10mls/ hour - Myoglobinuria ### Q56. Patient with diabetes presenting with oliguria, hematuria. There is slough in urine. Diagnosis? - Acute tubular necrosis / Renal papillary necrosis - Bilateral renal nephrosis - Nephrocalcinosis - Rapidly progressive glomerulonephritis (RPGN) - Amyloidosis ### Q57. Temporal bone fracture after high velocity accident, patient has otorrhea. Damage to which structure causes CSF to leak externally? - Internal auditory meatus - Tympanic membrane - Tegmen tympani - Secondary tympanic membrane - Eustachian tube CSF otorrhea usually occurs through a fracture in the petrous bone with perforation of the tympanic membrane, although it can occasionally take place through a laceration of the external canal via fractured mastoid air cells. ### Q58. Planned elective surgery in 8 weeks, has anaemia with Hb 9. What is the best form of iron replacement in pre op? - Oral iron - IV iron ### Q59. 3% burn in forearm with crusting, dry and loss of sensation, management post debridement? - Split thickness skin graft - Full thickness skin graft - Occlusive dressing ### Q60. A 26-year-old female has a 6-week History of unilateral breast pain, 8/10 severity, not related to menstrual cycle. What is the most appropriate initial step in her management? - Reassure and discharge - USS - Mammogram - Core Biopsy - CT scan ### Q61. Acutely swollen and painful knee. No hemarthrosis, Apyrexial and WCC normal. What investigation would give you a definitive diagnosis? - Aspiration and send for C&S and Cytology - X Ray - Arthroscopy - MRI - Ultrasound ### Q62. Which is responsible for autolysis of the pancreas in pancreatitis? - Lipases - Amylase - Trypsin - Protease - Elastase ### Q63. Pancreatitis, CT imaging shows diffuse fluid around the head. body/tail of pancreas are non-enhancing? cause - Pancreatic necrosis - Pseudocyst - Abscess - Fistulae The necrotic areas are seen as non-enhancing or low attenuating regions within the pancreas. ### Q64. Patient has chronic pancreatitis. On angiography, there is aneurysm of a Tortuous vessel which directly arise from coeliac trunk. Which structure does this vessel supply? - Head of pancreas - Fundus of stomach - 1st part of Duodenum - Liver - Tail of pancreas (not in options) ### Q65. Management of hypercalcaemia - Hartman Solution - Bisphosphonates - Normal Saline - Calcitonin ### Q66. Structure most as risk when preparing tibia with saw during knee replacement - Popliteal artery - Tibial nerve - Common Peroneal Nerve - Sural Nerve - Superficial Peroneal Nerve ### Q67. In ward a patient needs catheterization Where would you first notice resistance during male catheterization? - Bulbar Urethra - Prostatic Urethra - Spongy Urethra - Pre-prostatic Urethra - Membranous Urethra ### Q68. 11-day old baby with bile-stained vomiting, abdominal distention, blood with stool - Duodenal atresia - Necrotising enterocolitis - Intussusception - Pyloric Stenosis - Hirschprungs Disease ### Q69. Overweight 12-year-old, hip pain, antalgic gait - Perthes Disease - Slipped Upper Femoral Epiphysis - Avascular Necrosis - Osteomyelitis - Femoral Neck Stress Fracture ### Q70. 5-year-old, unilateral hip pain radiating to the knee. - Avascular Necrosis - Slipped Upper Femoral Epiphysis - Osteomyelitis - Perthes Disease - Transient Synovitis ### Q71. Young child, 24 hrs. history of abdomen distension, pyrexial, screaming, vomiting bile stained, small amount of blood and mucus on P/R/E - Intussusception - Meckel diverticulum ### Q72. 2-day old baby, vomiting and abdomen distention, passed mucus plug. Palpable bowel loops on right side - Hirschsprung disease - Meconium ileus - Duodenal Atresia - Intussusception - Midgut Volvulus ### Q73. Which nerve passing from the upper lateral side of Psoas Major if compressed by an abscess will cause pain on antero-lateral thigh. - Ilioinguinal Nerve - Femoral Branch of Genitofemoral Nerve - Lateral Cutaneous Nerve of Thigh - Obturator Nerve - Femoral Nerve ### Q74. Urethral injury in trauma, blood on meatus, high riding prostate - Membranous urethra rupture - Bladder rupture - Penile urethra ### Q75. Traumatic aorta injury, on X-ray widened mediastinum where is most likely - Ascending aorta - Descending aorta ### Q76. A patient presented with sweating diarrhoea, increased pulse rate, Thyroid storm management? - B-blocker + thionamides - B-blocker + iodides - B-blocker ### Q77. Supply of the labia majora? - Genital branch of Genitofemoral nerve - Ilioinguinal nerve - Pudendal Nerve - Obturator Nerve ### Q78. Best method of sterilization for modern arthroscopes - Glutaraldehyde - Autoclave - Ethylene Oxide - chlorohexidine ### Q79. Structure at greatest risk during splenectomy - Adrenal gland - Diaphragm - Transverse colon - Tail of pancreas - Left Kidney ### Q80. Lung function tests fev1 1.8litre FVC 2.1 (several questions) - Sept 22 showing restrictive pattern. - Pulmonary fibrosis - COPD - Bronchiectasis - Asthma - Chronic Bronchitis ### Q81. Non-differentiated thyroid cancer, RAPIDLY SPREADING WITH STRIDOR which results show recurrence of cancer? - ANAPLATIC CARCINOMA - MEDULLARY CA - FOLLICULAR CA ### Q82. What is true about the relation between brachial artery and the biceps tendon? - Biceps tendon is medial to brachial artery - Biceps tendon is lateral to the brachial artery - Brachial artery is superficial to biceps tendon - Brachial artery is lateral to biceps tendon - None of the above ### Q83. HEARNIAL DEFECT BECAUSE OF PLEUROPERITONEAL MEMBEFANE - BOCHDALEK - MORGAGNI HERNIA - ECTOPIA CARDIA - HIATUS HERNIA ### Q84. Elderly man, has referred back pain to legs, improves on pushing trolley uphill - Lumbar canal stenosis - Lumbar disc prolapse ### Q85. Carpometacarpal joint of thumb type - Ellipsoid - Hinge - Condyloid - Plane - Saddle ### Q86. A 50-year-old female was brought into the A+E department after a motor vehicular accident with a blood pressure of 80/60 mmHg. What hormone would be initially released? - Angiotensin II - Angiotensinogene - Angiotensin l - Renin - Aldosterone ### Q87. A 25 Year old man sustain a RTA and present to ED WITH GCS V3 he has dilated pupil and hypertensive and bradycardia his respiratory rate is slow and irregular and spo2 95 which of the following reason is bradycardia? - Decrease in activity of carotid sinus - Decrease in activity of aortic sinus - Increased activity of aortic arch (or carotid sinus) - Increased activity of carotid body - decrease in activity of cardiopulmonary receptors ### Q88. Histology of Medullary thyroid carcinoma with pink amorphous material - Amyloid stroma ### Q88. An elderly lady presents with sensorineural hearing loss. Imaging showed a tumor located at the cerebellopontine angle. What nerve would most likely be affected? - Abducens Nerve - Facial Nerve - Trigeminal Nerve - Vestibulocochlear Nerve - Glossopharyngeal Nerve ### Q89. Reciprocal of absolute risk reduction? - P value - Positive Predictive Value - Negative Predictive Value - Numbers needed to treat - Specificity ### Q90. The NHS would like to assess the length of time taken for a hospital to send discharge summary letters to the general practitioners. - Standard Based Audit - Systems Based Audit - Clinical Audit - Departmental Review - Operational Audit ### Q91. A newly enrolled colon cancer screening test has a positive predictive value of 7%. How should this information be interpreted? - 7% of the patients tested would yield a positive result. - 93% of the patients with positive tests will develop colon cancer. - 7% of the patients who tested positive will develop colon cancer - A patient with a positive test has a 7% chance of developing colon cancer **Formula** | Formula | Definition | Use | Prevalence | | -------- | ----------- | -------------------------- | ----------- | | PPV = TP / (TP + FP) | Percentage chance that a positive test result is a true positive | Determining how to proceed after a patient gets a positive result | ↑ Prev = ↑ PPV, ↓Prev = ↓PPV | | NPV = TN / (TN + FN) | Percentage chance that a patient with a positive result actually has the disease | Determining how to proceed after a patient gets a negative result | ↑ Prev = ↓NPV, ↓Prev = ↑NPV | | | Percentage chance that a negative test result is a true negative | | | | | Percentage chance that a negative test result is a true negative | | | ### Q92. What is the Embryology of cleft lip? - Medial nasal process and maxillary process - Lateral nasal process and maxillary process - Medial and Lateral nasal processes - Palatine process - frontonasal process ### Q93. 70 years old woman with extensive ovarian cancer, 5.5 cm aneurysm of external iliac artery. Management: - Best medical treatment - Endoscopic stent - Open repair - Ultrasound in 3 months - Ultrasound in 6 months ### Q94. Physiological release of aldosterone? - ADH - Angiotensinogen ### Q95. Patient with anemia and autoimmune thyroiditis with atrophic fundus, endoscopy normal. Morphology of RBC? - Normal - Small and Pale - Large and oval shaped - Sickle shaped - Spherical ### Q96. Positive anterior drawer test in knee injury, which ligament injured? - Patellar ligament - Posterior Cruciate Ligament - Medial Collateral Ligament - Lateral Collateral Ligament - Anterior Cruciate Ligament ### Q97. Transplanted kidney that turns dusky almost immediately. Cause? - Hyperacute Rejection - Type 1 hypersensitivity - Graft versus host disease - Acute Rejection - Chronic Rejection ### Q98. What may be the last clinical sign to present in compartment syndrome? - Excessive Pain despite adequate analgesia - Pain on passive stretch - Absent Dorsalis Pedis Pulse - Increase compartment pressures - Paraesthesia ### Q99. A 35-year-old female developed hypoxia, hypotension and urticaria after applying a new hair dye product. What is initial management? - IM adrenaline - IV Hydrocortisone - Oral Prednisolone - Oral Dexamethasone - IV Adrenaline ### Q100. A 40-year-old female had a Sudden onset of left forearm pain at home. His Echocardiogram showed superiorly displaced mitral valve leaflets during systole. What is the diagnosis? - Axillary artery thrombosis - Polyarteritis nodosa - Brachial Artery Embolism - Takayasu arteritis ### Q101. A 50-year-old man with a history of syncopal episodes was diagnosed with Subclavian steal syndrome. Retrograde blood flow in which vessel? - Vertebral artery - Subclavian artery - Common Carotid Artery - Internal Carotid Artery ### Q102. A 36-year-old butcher injures his left index finger with a knife, suffering a deep laceration on the palmar aspect of the middle phalanx. On examination he is unable to flex DIP, which tendon is likely to have been injured? - flexor carpi radialis - flexor carpi ulnaris - Flexor digitorum profundus - Flexor digitorum superficialis - Flexor indicis ### Q103. A 32 year old attends neurology clinic complaining of tingling in his hand. He has radial deviation of his wrist and there is mild clawing of his fingers, with the 4th and 5th digits being relatively spared. What is the most likely lesion? - Ulnar nerve damage at the wrist - Ulnar nerve damage at the elbow - Radial nerve damage at the elbow - Median nerve damage at the wrist - Median nerve damage at the elbow ### Q104. Left skewed gaussian distribution, how is the mean related to the median? - The same - Unrelated - Left of the median - Right to median ### Q105. History of fall, hyperacusis, which nerve injury? - Facial - Glossy pharyngeal - Vestibulocochlear - Hypoglossus ### Q106. Which of the following is not facial muscle? - frontalis - anterior belly of digastric - buccinator - orbicularis oculi - risorius ### Q107. Severe renal disease with foot ischemia, investigation? - CT angiography - MR angiography - Catheter angiography - B mode ultrasound - Duplex ### Q108. Nerve origin of acoustic neuroma/vestibular schwannoma - Vestibulocochlear nerve - Facial - Hypoglossal ### Q109. 45 female with discrete nodules showing dense fibrous tissue with no microcalcification, Diagnosis? - Fibrocystic - Malignancy - fibroadenoma ### Q111. SCC histology appearance - Keratin pearls - palisading - Flat cells Typical SCC has nests of squamous epithelial cells arising from the epidermis and extending into the dermis (figure 1). The malignant cells are often large with abundant eosinophilic cytoplasm and a large, often vesicular, nucleus. Variable keratinization (keratin pearls etc.) is present. ### Q112. Vitello intestinal duct connected to? - Forget - Midgut - Urachus - Hindgut - Urogenital sinus ### Q113. Teratoma has yolk sac inside core, What is raised in this testicular tumour? - B- HCG - AFR ### Q114. Smoker, peripheral lung mass with ground glass opacity, biopsy confirm malignancy. What variety? - SCC - Small - Adenocarcinoma - Carcinoid - Large cell tumor **The 4 Main Types of Lung Cancer** | Type | Smoking Link | Mets | Paraneoplastic syndrome | Tx | |---|---|---|---|---| | Squamous Cell | High | Late | PTHrp → High Ca++ | Possible surgery if stage is limited | | Adenocarcinoma | Low | Early | Hypertrophic pulmonary osteoarthopathy (but seen in the other three lung CAs)| Possible surgery if stage is limited | | Small Cell | High | Early | ADH, ACTH, Eaton-Lambert syndrome (weakness)| Chemo and radiation - no surgery! | | Large Cell | High | Early | Gynecomastia | Possible surgery if stage is limited | ### Q115. A teacher/singer has nodule on vocal cord malignant changes observed - Adenocarcinoma - SCC - leiomyoma - Leiomyosarcom ### Q116. Patient with heartburn and food sticking in throat, occasional difficulty drinking. No chest pain. - Achalasia - Stricture - Webs - Pharyngeal pouch - Spasm ### Q117. Dyspepsia. Investigated for doubtful angina - Diffuse esophageal spasm - Structure ### Q118. Diabetic patient previously treated for infection with pus at urethral meatus.2years back .....from last 2 months presents with later poor flow and increased frequency. - Urethral stricture - Ureter stone ### Q119. A man known to have raised PT and APTT is found unconscious in his living room with only carotid pulse. Carpet is wet with blood along with his cloth . The walls are smeared with fresh blood. What is most likely diagnosis? - Malory Weiss - Esophageal varices - Boerhaave syndromes - Bleeding ulcer - Peptic ulcer ### Q120. Thrombin core contains - Ca aids in thrombosis - Thrombin helps in fibrin polymerization - Platelet aggregate ### Q121. Patient complain left flank pain diagnosed with 8 mm ureteric stone, management - Ureteric lithotripsy - ESWL - Surgery + JJ Stent - Conservative management ### Q122. Which electrolyte imbalance, perioral tingling, and twitching - Calcium - Sodium - Potassium - Magnesium - Phosphorus ### Q123. Patient with recently diagnosed pancreatitis suffered from seizures. Muscle weakness, hyperreflexia. ECG shows prolonged QT interval and T-wave inversion, which electrolyte? - Calcium - Sodium - Potassium - Magnesium - Chloride ### Q124. Pt who just underwent TURP presents with confusion<drowsy and uncooperative. What is the cause of confusion? - Sodium - Calcium - Potassium - Glycine - Phosphate ### Q110. Breast carcinoma with headache and vomiting, treatment? - Dexamethasone - Normal saline - Ondansetron ### Q125. Metastatic breast carcinoma with chest pain, nausea, vomiting. Treatment? - Radiotherapy - NSAIDS - Paracetamol ### Q134. Sternum Mets from breast cancer - NSAIDS - Radiotherapy - Morphine - Sternal excision - Nerve block ### Q126. IgA secretion is from - macrophages - epithelial cell - neutrophil ### Q127. Tear drop sign in the maxillary sinus, what is the cause? - Nasal bone - Nasomaxillary buttress - Orbital floor - Cribriform plate - Frontal bone ### Q128. 23yrs old female with BRCA + breast lump what will be initial investigation? - US - MRI - mammography - CT - Reassure ### Q129. Road traffic accident present with + Relative afferent defect + proptosis, tense eyeball, ophthalmoplegia, what will be immediate. - CT Facial bone - Dexamethasone - Lat canthotomy - MRI - Analgesia ### Q130. DVT with femoral mobile extensive treatment? - LMWH - Streptokinase - Supportive ### Q131. Thyroglossal cyst investigation - Us + FNAC - Tc 99 scan - MRI - USS ### Q132. Total absent limb - Amelia - Oligodactyly - Phocomelia - Syndactyly - Ectrodyctly ### Q133. Emergency tracheostomy - One finger breadth above the sternal notch - Midway between sternal notch and cricoid - 1 cm below Thyroid cartilage - Thyroid isthmus ### Q135. Le fort III fracture, FACIAL haemorrhage, AND FACIAL TRAUMA, falling SATURATION, NEXT option for definitive airway? - Surgical cricothyroidotomy - Needle cricothyroidotomy - Tracheostomy - Orotracheal intubation - FACE MASK ### Q136. Homonymous hemianopia, MRI will show the lesion in? - Meyers loop of optic radiation - Optic nerve - Optic chiasm - Optic tract ### Q137. Penis fracture and spread to lower abdomen, which fascia rupture allowed the spread of the blood? - Dartos fascia - Scarpa's fascia - Camper's fascia - Bucks fascia - Sibson's fascia ### Q138. Development of hemivertebra - Mesoderm somites - Ectoderm - Endoderm - Cloaca - Notochord ### Q139. A picture given of a hand showing thorn prick injury on pulp and redness after 24 hours. Which organism responsible - Staph Aureus - Streptococcus - Sporothrix ### Q141. Histological feature of rheumatoid arthritis - Necrobiotic granuloma - Keratin pearl ### Q142. Myasthenia gravis Association with widened mediastinum - Thymom ### Q143. During lap hernioplasty cord like structure appeared coming along inguinal canal - Ilioinguinal nerve - Ureter - Round ligament - Iliohypogastric nerve - genitofemoral ### Q144. Anaphylaxis which immunoglobulin associated - IgE - IgA - IgD - IgM ### Q145. RAST test allergic reaction with sudden anaphylaxis after anaesthesia - IgE - Tryptase level - T cell mediated **RADIO-ALLERGOSORBENT TEST (RAST)** * It's a blood test used to determine to what substances a person is allergic. * This test is different from a skin allergy test, which determines allergy by the reaction of a person's skin to different substances. * Both of these tests have similar diagnostic values in terms of sensitivity and specificity. ### Q146. A preterm neonate with bilious vomiting and slight per rectal bleeding and distended abdomen - duodenal atresia - Necrotising enterocolitis - Meckel's ### Q147. Correct about IgA. - Pentameric - Produced in the mucosa of gut. ### Q148. Parathyroid nodule investigation -