RECALL JANUARY 2021 – MRCS PART A

Thanks to my beloved members who appeared in this exam – for this collection:-

1. Infusion of 3L DW post elective splenectomy what is seen the initial observation? A. low B. PB OLIGURIA C. High urine osmolality D. low UO E. ?
2. Post splenectomy vaccination A. pneumo only B. pneumo and Hib AB C. pneumo and Hib AB and flucox D. pneumo and Hib AB and penV E. ?
3. 3L NS infusion in post appendectomy patient what will u seen A. Hyperchromic alkalosis B. Hypokalemia C. Hypernatremic alkalosis D. ?
4. Causes of Blood pressure reduction and bradycardia in Spinal anesthesia
5. Patient with Glioblastoma worsening condition and pre-terminal stage, Cushing Triad, Given RR, HR, BP
6. Case scenario =Bier block -0.5% prilocaine in Bier block
7. Last layer in Spinal anesthesia ?
8. Reduce BP and HR after spinal anesthesia due to?
9. Old man with osteoporosis biological change… dx?
10. Widened QRS, Flattens P wave, Heart Block = ECG – dx?
11. Hypocalcemia changes- A Hyporeflexia B Long QT interval C.?
12. 12yr old girl knee pain no local sign. External rotation of leg on flexion of hip – A. Paget B. DDH C.SUFE D. Ostoor sharot knee joint E. ?
13. Young boy loin pain 3mm stone at PUJ relieved by NSAID Mx?
14. Girl with SLE with Osteoporosis change cause – option Drugs?
15. Gun shot in the hip, bullet at ischial tuberosity, which nerve would be damaged.
16. Treatment of clostridium diff
17. Microbiologist telling surg of cross infections of urinary catheter…which org.
18. Initial Investigation for perforation in preg woman
19. Fluid calculation in 90 kg man with circumferential burns
20. Lots of brachial plexus injury questions
21. Nerves piercing through psoas major muscle.
22. Patient with prv history of MI and PVD due for mid thigh amputation, what is the best prophylaxis for prevention of DVT.
23. 70 years old man with multiple bony lesions, in skull vertebrae, tinia with multiple cement lines.
24. Biochemical changes following diarrhea
25. Lots of questions related to knee joint ligaments
26. Supraspinatus tendon injury.
27. Indications for ventilation in a patient.
28. Young individual treated for perianal fistula, develops diarrhea and left iliac fossa pain raised inflammatory markers….diagnosis.
29. Someone with 30cm small bowel, no large bowel…mode of nutrition.
30. Post oesophagectomy…
31. Nerve supply of parietal pleura at the level of safety triangle
32. Nerve supply around umbilicus during appendicitis
33. Lymph node drainage of ovary, prostate
34. Morton’s neuroma cause
35. Myalgia paraesthesia
36. Sciatic nerve injury scenario foot
37. Foot drop scenario
38. Discitis cause
39. Lymphadenopathy cause
40. SUFE
41. Blood picture osteoporosis
42. Fat embolism scenario
43. Pulmonary embolism scenario
44. They gave an ecg to interpretdon’t know what it is.i chose pulmonary embolism
45. Biers block which drug
46. Ring block which drug
47. Mechanism of spinal anaesthesia to cause vasodilatation
48. Complication of local anaesthesia
49. Carcinoma breast humerus fracture type
50. Carcinoma prostate bone pain choice of treatment
51. Regional pain syndrome scenario
52. Angle of rib fracture injury to which structure
53. Biopsy from middle lobe of lung from which area
54. Midline incision which structure cut
55. Inguinal hernia surgery which structure cut
56. Formation of inferior vena cava which level
57. Injury to which structure at left 5th intercostal space
58. GCS scenario
59. Cerebral perfusion pressure calculation scenario
60. Burn fluid calculation scenario
61. Carpal tunnel syndrome scenario.asking treatment
62. Dupuytren contracture scenario.asking treatment
63. Scenario about L3, T1, C8, musculocutaneous, L5, S1 nerve lesion
64. Structure not related to 3rd part of duodenum
65. Site of ureter opening at bladder
66. Ureter crossing pelvic brim at which level
67. Ductus arteriosus which pharyngeal arch
68. Scenario about intussusception, necrotizing enterocolitis, pyloric stenosis
69. Numerous recall from fawzia sheet
70. Patient with hyperacusis. Diagnosis?
71. Patient with pupillary reflex problem. Lesion where?
72. A scenario about frey syndrome.
73. Scenario of osteoarthritis, ankylosing spondylitis, spondylolisthesis
74. Rheumatic joint operation.what will be found in histopathology?
75. Varicella zoster infection T8-T10 level which area?
76. Feeding jejunostomy, TPN scenario
77. Enhanced recovery programme.
78. Which drug to give in cardiac transplant patient for bradycardia?
79. Horner syndrome scenario
80. Posteroinferior cerebellar artery scenario
81. Schwannoma scenario
82. Scenario about supraspinatus injury, meniscus injury, acl injury, pcl injury
83. Anal incontinence diagnosis
84. Breast carcinoma her2 positive which therapy?
85. 40 year old man minimally displaced capitular fracture of femur.mx
86. Blood supply of scaphoid
87. Compartment syndrome scenario
88. Talofibular ligament injury scenario
89. Foreign body at T10 level.distance from incisor teeth?
90. Left colic artery embolization scenario
91. Indication of intubation of patient recovered from burnt house
92. Numerous scenario about abg
93. Scenario about hypothyroidism, hyperparathyroidism, men syndrome
94. ECG finding of hyperkalemia, hypocalcemia
95. A patient with pigmented spots on the lip & palm, undergo colonoscopy. There were polyps in the Left colon. Which type of polyps? A. Hyåerplastic B. Dysplastic C. Adenomatous D. ?
96. A 70 years old patient with lower GI bleed. Angiography shows lesion in sigmoid colon. Which vessel to embolize? A. Anterior branch of Aorta at L3 B. Lateral branch of Aorta at L3 C. ?
97. An 80 years old patient with massive lower GI bleed. Angiography reveals a lesion in Left colon. Which vessel to embolize? A. Left Colic Artery B. Middle Colic Artery C. Right Colic Artery D. ?
98. Patient undergone 3rd stage of esophagectomy. Management of nutrition? A. Intraoperative feeding jejunostomy B. TPN C. ?
99. A patient with high output fistula due to massive gut resection due to infarction. 30 cm remaining jejunum. What should have for nutrition? A. TPN through peripheral line B. NG feed C. Regular home TPN D. ?
100. Patient with macrocytic anemia & gastric mucosal atrophy. Should have? A. Antibodies to Parietal Cells B. Antibodies to chief cells C. ?
101. A patient with Crohn’s disease with multiple resections and high output fistula. To support his nutrition? A. Elemental diet B. TPN C. ?
102. A question from clotting factors of Extrinsic pathway
103. A question from clotting factors of Intrinsic pathway
104. A scenario of midgut rotation in embryo around SMA
105. A 25 years old female with cough, weakness. CXR shows bilateral hilar shadowing. S. Ca. 2.89 – diagnosis?
106. A scrubbed nurse have allergy to latex gloves. A. Type I hypersensitivity reaction B. Type IV hypersensitivity reaction C. ?
107. A patient diagnosed with TB. Which type of hypersensitivity reaction? A. Type IV cell mediated B. Type III C. ?
108. A patient ingested coin. On x-ray coin appears to be at T8 level. At which distance from incisor teeths it is? A. 40cm B. 25cm C. 15cm D. ?
109. Treatment of gas gangrene? A. Cephalosporin B. Metronidazol+Penicillin C. ?
110. A patient with chronic non-healing ulcer on the ankle. On culture found to be MRSA+ve. Treatment? A. Oral Vancomycin B. Flucloxacillin C. Rifampicin D. ?
111. A patient on i/v antibiotics developed C. Difficile infection. Treatment? A. i/v metronidazole B. Oral metronidazole C. i/v Vancomycin D. Flucloxacillin E. ?
112. Prognosis of BCC depends upon? A. Depth of the lesion B. Proper margins of excision C. ?
113. A pregnant female develops DVT. Her mother & aunt suffered the same problem. Diagnosis is by? A. Anticardiolipin antibodies B. ANA C. ?
114. A newborn with pulmonary hypoplasia and scaphoid abdomen. On x-ray abd. visceras in chest. The underlying defect? A. Failure of fusion of pleuroperitoneal membrane on Left B. Failure of fusion of pleuroperitoneal membrane on Right C. ?
115. Origin of right coronary artery
116. A patient presented with paresthesia & numbness on the palm of Right hand. The symptoms are more at night. What is the definitive management? A. Release of flexor retinaculum B. Splints C. ?
117. A patient with calf intermittent claudication. The lesion lies in the? A. SFA B. CFA C. Iliacs D. ?
118. The most medial structure in the cubital fossa?
119. A patient of RTA presented in emergency with #femur. Despite resuscitations he died. On autopsy there are petechial haemorrhages on brain surface. Diagnosis?
120. A scenario related to porto-systemic anastomosis
121. A patient came to UK after spending holidays in Zimbabwe. Now presented with jaundice, diarrhea, fever & splenomegaly. Liver biopsy has no cirrhosis. Diagnosis?
122. After cholecystectomy what changes occur? A. Decreased enterohepatic circulation of bile salts B. Decrease bile reflux
123. A 16 years old patient presented with h/o intermittent RHC pain & nausea. He is a known case of hereditary spherocytosis. O/E adb soft & non-tender. Diagnosis? A. Biliary Colic B. Colangitis C. ?
124. A patient is having unconjugated hyperbilirubinemia. The type of gallstones?
125. Multiple MCQ related to renal stones
126. Multiple MCQ related to ECG changes in electrolyte abnormalities
127. One MCQ related to Mann-Whitney test
128. A patient in intensive care unit have cardiac index decreased, PAWP increased >19, CO decreased. The ICU doctor came to evaluate. What next treatment he will order? A. Give Infusion Griseofulvin 250 ml B. Start Adrenaline C. Start Noradrenaline D. ?
129. A type 2 DM patient is undergoing surgery. What Mx to do? A. Monitor blood glucose level regularly B. Patient on glucose infusion C. ?
130. A known case of ca prostate presented with bony mets in spine – treatment? A. Radio-therapy B. NSAIDS C. Radical Prostatectomy D. ?
131. Biochemical changes in osteoporosis? A. Normocalcemia B. Hypercalcemia C. Hypocalcemia D. ?
132. A patient of renal failure with serum calcium 2.89 & increased PTH – diagnosis? A. Primary Hyperparathyroidism B. Secondary Hyperparathyroidism C. Tertiary Hyperparathyroidism D. ?
133. A patient of known ca breast with mets presented with confusion & drowsiness. What is the likely abnormality will be found?
134. A patient with loin pain. X-ray shows radiopaque ureteric stones. Diagnosis? A. Calcium phosphate stones B. Uric acid C. Cystin D. Struvate E. ?
135. A patient with calcium oxalate renal stones. The cause?
136. A malnourished patient presented with dry skin & corneal changes. The deficiency of vit.? A. Vit. A B. Vit. K C. Vit. B D. ?
137. A patient of esophagectomy suddenly develops Right sided heart strains on 12th POD & collapsed. Diagnosis?
138. A patient unable to lift off his thumb from table with palm facing downwards. Diagnosis?
139. A patient presented with stab on the Right side of chest. On CXR there is RIGHT pneumothorax with air fluid levels. Treatment? A. Intercostal chest drain insertion B. Intercostal chest drain insertion with -ve suction C. Thoracotomy D. ?
140. Medial boundary of Calot’s triangle? A. Common Hepatic artery B. Cystic duct C. Inf. edge of liver D. ?
141. A patient presented after cholecystectomy with pain abdomen in emergency. How will you investigate? A. USG B. CT C. ERCP D. ?
142. A patient presented with wound on dorsum of foot with surrounding redness & discolored skin. Treatment? A. Excision of wound & secondary closure B. Primary Closure C. ?
143. A patient with EEV/FVC = 65% – Diagnosis? A. COPD B. Restrictive lung disease C. ?
144. A patient with rectal adenoma & secretary diarrhea rich in bicarbonate secretions. What you expect on ABG’s?
145. A smoker patient with with SCC of lung. Which investigation for local staging of disease? A. Mediastinoscopy B. CT C. Bronchoscopy D. ?
146. Regarding SA node – receives innervation from which nerve?
147. A patient with diarrhea, pain abdominal & recurrent gastric ulceration – will have increased levels of what?
148. Right ventricle forms? A. Right border of heart B. Left border of heart C. Apex D. Base E. ?
149. Which ABG’s matches with a patient who has COPD?
150. Maintenance fluid requirements of a young patient who is NPO for 24 hours? A. 2L 5% DW, 1L 0.9% NS B. 3L 5%DW C. 1L 5% DW, 1L 0.9% NS D. ?
151. Left renal vein is compressed by aneurysm of a vessel, anterior to abdominal aorta. Which vessel is that? A. SMA B. IMA C. ?
152. A patient is undergoing Aortic valve replacement surgery for calcified stenosed aortic valve. Suddenly heart rate decreases to 40, SV 40 ml and decreased Right atrial filling pressure. Diagnosis? A. Heart block B. LVF C. ?
153. A patient on anticoagulation develops recurrent DVT. Mx?
154. A patient of PVD undergoes fempop.bypass. He is on clopidogrel before surgery. Post-op have diffuse oozing from wound. It is due to? A. Platelet dysfunction B. Heparin therapy C. ?
155. A patient on warfarin has to undergo emergency surgery. What to give? A. Vit. K B. Prothrombin concentrate C. Cryoprecipitate D. ?
156. What is true regarding FFP’s?
157. A patient of SLE presented with #femur. Which drug makes her prone to osteoporosis# ? A. Methotrexate B. Prednisolone C. ?
158. Post-splenectomy prophylaxis? A. HIB B. Pneumococcal C. Meningococcal & Penicillin D. ?
159. During LP – what is the last structure the needle touches before reaching subarachnoid space? A. Arachnoid B. Pia mater C. Dura D. Lig. flavoum E. ?
160. A patient presented with hydrocele. The fluid accumulate between layers of? A. Tunica Vaginalis B. Tunica Albuginea C. ?
161. Post prostatectomy patient develops confusion. Diagnosis?
162. A post-op patient with monitoring chart = 2pm/80ml, 3pm/80ml, 4pm/nill, 5pm/nill, 6pm/nill. The cause is? A. Blocked catheter B. ATN C. ?
163. A patient presented in OPD after anterior resection of rectal ca with erectile dysfunction. It is due to damage to which nerves?
164. A patient has undergone anterior resection & on 7th POD he develops fever & severe lower abdominal. Diagnosis?
165. Relation of ulnar N to Brachial artery in the upper arm?
166. A neonate with abdominal distention. He passed meconium plug 2nd day after birth. His cousin also had the similar problem. What will you find on investigation?
167. A patient can have spontaneous breathing if the injury is below the level of? A. Cricoid B. Mandible C. Hyoid bone D. Thyroid cartilage E. ?
168. A patient treated for perianal fistula but 3 months later he presented with bloody diarrhea and weight loss. Diagnosis? A. UC B. Crohn’s
169. A patient with anemia and weight loss – most likely diagnosis?
170. Spinal anaesthesia – hypotension & bradycardia – cause is?
171. ABG’s table of a patient with mesenteric ischemia
172. A patient with multiple co-morbidities & rheumatoid arthritis and on prednisolone – undergoes emergency surgery. Post.op develops BP 80/50, Na+ 124. K+ 6. Mx ? A. Hydrocortisone B. i/v fluids C. ?
173. After taking meal entry of glucose in to the cell is dependent on insulin in? A. Adipose tissue B. Liver C. Brain D. ?
174. Post-op a patient develops concentrated urine output. The most likely cause is?
175. Serosanguinous nipple discharge from a single duct in a young patient. Diagnosis? A. Duct ectasia B. Periductal mastitis C. Carcinoma D. Duct papilloma E. ?
176. A young patient with brownish discharge from the nipple. Diagnosis? A. Periductal mastitis B. Duct papilloma C. Carcinoma D. ?
177. Treatment of hyperthyroidism in pregnancy? A. Propylthiouracil B. Carbimazole C. Propranolol D. ?
178. A patient caught in burning house. What is the indication of ventilation? A. RR > 35 B. pH >7.25 C. ?
179. Following a pin insertion for a skull frame – the surgeon encounter the bleeding. Which artery likely to be injured? A. Occipital artery B. Posterior cerebral artery C. Posterior communicating artery D. ?