JANUARY 2024 RECALLS ( COMPILED BY DR WAQAS)

Thanks to everyone who helped to make this recalls.

(There maybe some incorrect answers, errors or mistakes in this)

1. 45 years old woman developed a thyroid swelling. Her blood investigations

showed normal thyroid profile with CD20 cells atypical lymphocytic cells.
What is the cause?
a. Papillarythyroidcarcinoma b. Hashimoto thyroiditis
b. Hodgkin Lymphoma
c. Follicular thyroid carcinoma e. None of the above

2. Pt self-injected Diazepam slept over his arm, which substance in urine

→ myoglobin

3. Meckel's → CT with contrat

4. first to activate in RAAS → Renin

5. Which is the cause of vasoconstriction on efferent arterioles?

A. AngiotensinI
B. AngiotensinII correct
C. Angiotensinogen

6. Angina with stent, Poorly controlled Diabetic, EF 40% -> ASA 3,4,5

7. Epinephrine is given to → Septic shock

8. brown sequeard ipsilateral weakness, contralat pain and temp

9. Patient inhaled smoke after burn indication of intubation Carpoxy hg 20

%

10. Amyloid type in Multiple-myeloma AL

11. Asbestos methoselioma

12. QSofa score includes? a. Resp rate < 20 b. Sbp<90 c. Altered mental status

13. Patient with hypothermia 35C, going to elective hernia repair, how will you
deal with?

a. critical incident report

b. IV warm saline
 c. Make Ambient temperature 19
d. Warm by bur huger and do the operation under general Anesthesia
e. Do the operation under local anesthesia

14. stress post-op Hyperglycemia d.t A) increased GH ,B) dec insulin

15. Htn not controled on thiazid with hypokalmia, what is the cause of
hypertension increased Renin angiotensin ratio

16. Incase of Hypovolaemia -> Renin increases, Aldosterone increases, ADH

increases.

17. Graves disease give carbimazole

18. Patient has tibial and fibula fracture. Pt operated, shifted to ward . Has
severe pain. Next management?
a. Release 4 compartment
b. Measureicp
c. Puloximeter on great toe

19. Alcoholic Patient with head trauma can't remember of he lost consciousness
or not gcs 15, he thinks he made a full recovery
Admit for observation/ discharge with someone to accompany

20. 50-60 lady 6 week Hx of unilateral breast pain, 8/10 severity, not related to
menstrual cycle, management?
A. Reassure and discharge
B. USS
C. Mammogram

21. Patient with breast cancer presents with pain in the sternum. What will be
appropriate management a. Nsaids b. Nerve block c. Opiods d. Remove
sternum

22. 43 years old patient with 10 days breat pain, examination revealed diffuse
breast tenderness what is next step
MRI
US
Mammo
FNAS
core biopsy
23. piercing of tip of tongue lymph drainage submental

24. Enhanced recovery protocol aim at? A. Decrease hospital stay 30 days

25. Patients fell onto chin, reduced mouth opening, Jaws are not aligned like
they used to, Pre auricular tenderness. Which part of mandible fracture
..unable to bite
A. Mandibular condylar

B. Ramus
C. Body
D. Coronoid process
E. Angle Of the mandible

26. GCS ( 5 + 2 + 2 ) 9

27. late dump hypoglycemia

28. Patient with head trauma gcs 14, 1 vomit indication for urgent ct
retroauricular bruising

29. Hemoptysis cerv LN med LN night sweats TB

30. C5, spinal shock Delayed planter reflex

31. 120. Pediatric Supracond fx absent radial pulse Urgent Vascular

Consultation , internal fixation and recheck pulse

32. A65 year old man with long standing atrial fibrillation develops an embolus
to the lower leg. The decision is made to perform an embolectomy, utilising
a trans popliteal approach. After incising the deep
fascia, which of the following structures will the surgeons encounter firston
exploring the central region of the popliteal fossa?
a. Popliteal vein
b. Common peroneal nerve
c. Popliteal artery
d. Tibial nerve
e. None of the above

33. In Cubital fossa brachial artery relation

34. Content in deep post compartment - post tibal vessels and tibial nerve?
35. Axilla lateral boundery- axilary vein brachial plexus axilary artey?

36. During embryonic stages, red blood cells are produced in the liver and
spleen. Yolk sac?

37. Extrinsic factor -> 7

38. Celiac axis tortuous artery supply to?

39. Urinary incontinence root value s234?

40. Post renal transplant. Double DR matched. Become anuric in ward, bladder
irrigation done free flow of urine drainage noted. Likely cause?
a. Renal artery thrombosis
b. Uretheral blockage
.c Bladder outlet obstruction
d. Renal vein thrombosis
High pressure
Low pressure
Bilateral stones

41. Which structure donot get supply from internal iliac….?

42. Chorda tympani-> petrotympanic fissure ? stylomastoid foramen?

43. A patient hit on face leading to periorbital swelling proptosis and

subconjutuval hemorrhage. What is the immediate step
Ct scan
Pain control
Iv dexamteaisne Canthactomy
Burr hole aspiration

44. What should be given to avoid refeeding syndrom

Zinc. Selenium..folic acid.. Phosphate.. Thiamin?

45. Atrial fibrilation with ischemic leg.. Doppler will show

Acute cut off,,,
multiple filling defects ..etc

46. 2 cases of young females with RIF pain: one was a ruptured ectopic and the
other one mid cycle pain

47. Otitis externa not proper treatment -> oral amoxicillin

48. Statement about Thrombin – activated by viiia,? polymerization of fibrin?
Need ca for activation

49. Nerve responsible for downward movement of eye --- trochlear nerve?

50. Central line landmarking--- from sternoclavicular join to ear lobe or angle
of jaw?

51. Hit by elbow on face nasal bleed eye hematoma bone fracture--- frontal?
Nasal? Ethimoiid? Zygomatic?

52. Biconvex hematoma on ct artery involved--- middle meningeal artery?

53. Presented with nystagmus, ataxia, where is the cause of bleeding?

A. PICA correct

54. Parotid gland duct open into--- upper or lower 2nd molar?

55. Teeth extracted, pt develops numbness of gum, chin and lower lip. Which
nerve traversing through the body of mandible is responsible
A. Inferior alveolar nerve
B. Lingual
C. Facial
D. Mental correct

56. Injury at angle of mandible nerve damage What is the sensory nerve supply
to the angle of the jaw?

Maxillary branch of the trigeminal nerve

Mandibular branch of the trigeminal nerve
C3-C4
Greater auricular nerve (C2-C3)
Buccal branch of the facial nerve

57. Keratin plug, which CA-→ scc?

58. Squamous CA histology show →keratin?

59. Well circumscribed heterogeneous CA inc AFP → teratoma, seminoma, yolk

sac,

60. Worm bag varicocele, left testicular vein drain → left renal vein
61. A23 year old man undergoes an orchidectomy. The right testicular vein is
ligated; into which structure does it drain?
a. Right renal vein
b. Inferior vena cava
c. Common iliac vein
d. Internal iliac vein
e. External iliac vein

62. Stab injury to chest ,mediastinum pushed to opposite site, no breath

sound→ needle decompression in 2nd intercostal space

63. Unilateral tender lump in male

64. In Modified radical mastectomy structure to sacrifice

65. Dissection near staple muscle nerve type-→ mixed,? sensory,? Motor?

66. What did two Lateral ligaments passing from umbilicus carry during fetal
period
a. Deoxygenated blood from placenta to fetus
b. b. Deoxygenated blood from fetus to placenta
.c oxygenated blood from fetus to placenta
d. oxygenated blood from placenta to fetus

67. Erbs palsy. Which one not affected

A) musculocutanous
B) axillary
C) radial
D) suprascapular
E) nerve to subclavius

68. Brainstem death reflex to confirm ?

69. Lump in Anterior triangle scenerio

70. damage to nerve in Posterior triangle

A) can’t be able to move over head shoulder?

71. Patient Can’t move shoulder above 90 degrees which muscle involved?

72. Rotator cuff muscles→ supraspinatus , infraspinatus, subscapularis, teres

minor

73. Muscle attached to lateral border of scapula inferiorly→ teres major

74. Apical lung CA, horner what is effected… sympathetic chain?

75. Site of tracheostomy:

a. 1cm above sternal notch
b. Midway between sternal notch and cricoid

76. Male patient with longstanding asthma. Takes 15mg prednisone daily and
needs to undergo an operation. Most appropriate changes to be made to his
steroid dosage?

a.Increase steroid on day of op and continue for three days post op

b.Increase steroid on day of op and continue for one month post op
.c Decrease dose on day of op
d. Stop steroid preop
e. Continue normal dose of steroid peri-operatively

77. month old child, feeds on milk and vomits after sometime. Gains weight. pH,
electrolytes table was provided, all under normal range. Whats the
diagnosis?
a. GERD
b. Hypertrophic pyloric stenosis
c. Pyloric atresia
d. Duodenalwebs e. Intussusception

78. How to check ant compartment syndrome-→ halux extension, dosriflexion,

plantar flexion

79. Medial to phrenic nerve when entering from neck to thorax?

Trachea
SVC
BCV correct

80. Venous sinus at level of falx cerebri -> inferior sagital? Sigmoid?

81. Transverse sinus location

82. Damage to Brachial plexus which nerve will be spared (can’t exactly
remember the question)

83. Carlot triangle content →cystic artery

84. Inguinal ligament make superior border of? →Feromal triangle

85. Ant to inguinal canal? →External oblique aponeurosis

86. Direct hernia scenario → medial to inferior epigastric artery?

87. In PE → increase (Ventilation perfusion ratio) in options

88. during lithotmy position lost sensation on dorsum and lateral side of leg,
nerve involved→ superficial or deep peroneal nerve?

89. Can’t evert foot, lost sensation over some area of dorsum? root value was
asked L4-5?

90. Knee amputation, cyanosis,sob Death after amputation cause? Pulmonary

Embolism ?

91. Apatient with Malignant melanoma. what is the best prognostic factor?
a. Breslow thickness <1mm

92. Post cholecystectomy, patient comes with pain in right hypochondric

region. 5×5 cm collection seen. What will be the management?
a. Percutaneous drain b. Ercp+stent

93. Post cholecystectomy, pain after few hours didn’t relieved with morphine—
missed stone in duct?

94. Ct shows bilateral EDH. On OT table anaesthetist notes that one pupil is
dilated. Where should be the site for first burr hole? a. Ipsilateral side
b. Contralateralside c. Vertex

95. Aortic dissection = cystic medial necrosis?

96. Diabetic no pulse in leg , cold legs=> artherosclerosis , emobli,

97. AAA risk factor smoking?

98. Pundendal nerve block site →ischial spine

99. Bladder develop from →urogenital sinus

100. Primigravida 24 years, third trimester, chest tightness, cyanosis,

congested neck veins, her father died at 60 with MI A. Aortic dissection
B: Acute massive PE correct
C. MI
D. Pulmonary infarction
101. AV septal defect in down syndrome
Defect in which? a. Endocardialcushion
b. Sinus venosus
c. Bulbus cordis
d. Truncus Arteriosus

102. Non healing Ulcer On Medial malleolus, pigmentation ->

compression stocking? Debridment?

103. There was a Ulcer on lateral malleolus scenario, with good pulse

104. Not associated with chron disseas→ bronchiactasis

105. A case of endometrial, ovarian, colorectal carcinoma were mentioned

in different family members dx? → lynch syndrome

106. A 34 years old patient was in operation with tourniquet. After release
of tourniquet, what is the substance released causing VD?

a. Noradrenaline
b. Vasopressin
c. Histamine
d. Serotonin

107. Epidural catheta in site, itching on body → anaphylaxis?

108. First structure pierced by needle during CSF collection in vertebral

canal
a. Ligamentumflavum
b. Epiduralfat
c. Dura
d. Posterior ligament
e. Arachnoid

109. Massive blood transfusion after AAA dissection repair? Labs show
Hypocalcemia?

110. Low platelet, inc fibrinogen degradation product →Dic

111. Cpp formula → map-icp

112. Which blood test should you do for a 14 year old undergoing elective
tonsillectomy?
a. FBC,
b. Clotting,
 c. U&E
d. Al of the above,
e. None of the above

113. Flame Burn crusty — split thickness graft

114. Pining , Bleeding from back of head- occipital artery

115. Pt not responding to med of HTN-Conn disease scenario→ options??

116. Allergy to antibiotics which antibodies show response → igG igE igA

117. 3week of fx bone which stage of healing → callus formation?

118. which structure develops from an embryonic notochord → spinal

cord? Nucleus pulposus?

119. Embryology of cleft lip

A. Medial nasal process with maxillary process Correct

120. Absent limb - amelia

121. Patient with history of gastric bypass 2 years ago, si admitted for an
elective inguinal hernia repair in 6 weeks. Hb is 9. How would you correct
his anaemia?
a. Blood transfusion
b. plasma transfusion
.c VI IRON
d. oral iron
e. folic acid

122. Polyuria — ADH deficiency

123. Furosemide effect on → ascending loop

124. ADH act on →Collecting duct

125. LN drainage of glans penis?

a. Deep inguinal LN b. Sup inguinal LN
b. Paraaortic
c. External iliac
d. Internal iliac

126. ptwith diabetes presenting with oliguria, hematuria. There is slough

in urine. Diagnosis?
Acute tubular necrosis

127. Chronic pancreatits with stearohrrea . Cause of steatohrrea

Cck
Trypsin
Gastrin
GIP

128. What cause contraction of pyloric spinctrr → vasoactive peptide ,

vagal, secretin, cck , gastrin

129. Parathyroid hormone action → a)absorb calcium directly from

intestine? B) Inhibit 1-25dihydroxycholecalceferol

130. In hypotension, first baroreceptor response would be at?

a. Carotidsinus
b. Aortic arch
c. Superior vena cava
d. External carotid artery
e. Carotid body

131. Chemoreceptor question

132. Patient with seizures- hypomangasemia or hypocalcemia?

133. Patient with recently diagnosed pancreatitis.Muscle

weakness,hyperreflexia. ECG shows prolonged QT?? and T-wave inversion,
which electrolyte?
a. Hypocalcaemia?
b. Hypercalcaemia .
c Hypernatraemia
d. Hypokalaemia

134. Tricuspid stenosis - a wave

135. Taking warfarin inr 6/8 , → prothrombin complex concentrate with

or without vit k?

136. Woman with COPD ask to choose how the abg looks like abg =
Respiratory acidosis and Metabolic alkalosis

137. Lactulose absorbed in → ileum, duodenum, jejunum

138. Ureteric stone investigation for pregnant lady → usg

139. Chron disease, granuloma → gaint cell?

140. Blood reaction → Abo incompatibility

141. Hyperacusis - nerve involved → Facial

142. Patient passing ova and cysts, bloody diarrhoea treatment?

A. Mebendazole
B. Metronidazole correct

143. Why to remove thyroglossal cyst?

a. Recurrent inflammation
b. Malignancy
c. Aberrant tissues

144. Red nodules on skin, diarhea - infective organism → options?

145. 11 day old premature born baby with bile stained vomiting,
abdominal distention, blood with stoolA. Duodenal atresia B. Necrotising
enterocolitis correct

146. Osteoporotic bone scenerio →dec bone volume

147. pleuroperitoneal membrane defect

148. there was a question ck>1000. How would u manage, heamodialysis?

149. Spinal cord hemisection at c6 hyperreflexia

Which reflex normalise first
Biceps
Triceps
Knee
Ankle

150. Horseshoe kidney level → inferior mesenteric artery l3 to l5?,

superior mesenteric artery?

151. Priapism injection of → phenylnephrine

152. Priapism more than 6 hours managembt initial → ... aspiration of

blood
153. Distal tibia fx inc tibiofibular space… →syndemosis?

154. Amyloid histology

A. Negative birefringence
B. Congo red polarised +blue under polarised
C. Congo red polarised +green under polarised correct
D. Congo red positive+white under polarised

155. After aortic aneurysm repair, pt developed high k, low urine output,
high creatinine
A :measure intraccompartment pressure
B. Give1literofhartmann

156. Pyloric stenosis symptoms given , asked initial management -

a. Pyloromyotomy
b. Iv fluid rehydration
c. Fluoroscopic reduction

157. Something similar Knee injured during football match, can’t continue
playing. Immobilised 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?
A. Medial collateral ligament correct
B. . ACL
C. PCL
D. Meniscal

158. Mutliple patella fx → tension binding wiring?

159. man, has referred back pain to legs, improves on pushing trolley n
climbing uphill. While increases with going down hill.. cause?
A. Lumbar canal stenosis. Correct
B. Lumbar disc problem

160. wants to find out how long it takes for the letter from hospital to get
to the referring doctor.
A. Audit of standard
B. Audit of process correct

161. Morphine K &U receptor

162. Another morphine receptor question

163. A45-year-old woman feels a sudden pain in her left leg and feels as if
she has been hit in the back of the ankle as was playing tennis. Which of the
following is the most appropriate test?
a. An impingement sign
b. Apley's grinding test
c. Phalen's manoeuvre
d. Simmonds' squeeze test
e. e. Thomas test

164. Vessel close to third part of duodenum --. Portal vein, SMA, SMV,

165. Carotid bifurcation level → C4

166. Left Internal vein or maybe artery relation like question

167. Holosystolic murmur radiating all the way to the axilla, when doing a
TOE. What would you like to see? Options: left atrium, left ventricle , right
ventricle , right atrium, ventricle apex

168. Can’t lift his thumb - extensir pollisis longus

169. After cast removal 4 weeks of undisplaced fracture, pt Unable to lift

thumb off the table and patient cant extend IPJ even after stabilising thumb
CM joint.
A.radial nerve
B. PIN palsy
C.Median nerve and recurrent branch

170. Nerve damage passing Psoas major muscle lateral border, lateral half
of thigh numbness -?
lateral cutaneous nerve of thigh

171. Median nerve injury— atrophy of thenar eminence?

172. 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 and foot?
A. Posterior hip dislocation correct
B. Femoral shaft haft fracture
C. Supra condylar femoral fracture D. Anterior Hip dislocated

173. Deep laceration on ant lower leg - structure affected → anterior

compartment muscles was in options
174. Patient developed fever chest pain sob after endoscopy Compication
of upper gi endoscopy
Madiastintis
Aspiration pneumonia
Lung abscess

175. Tall guy with multiple pneumothorax in past. →Air emboli?

176. IPPV Ventilator pt ?.. → dec venous returN

177. smoker, unilateral laryngeal swelling, nodule on vocal cord, no LN

involvement?
Adenocarcinoma
Adenoid cystic carcinoma
lymphoma
squamous cell ca ,,Correct

178. Mean is a 100 SD20

Whats the range. 80-120 , 40-160

179. Gastrinoma work up...marker of →gastrin?

180. Flagelated bacteria ?? options?

181. Boy working in peg form..lesion on lower limb and bloody

stools...bacteria..
Yesenia enterocoletica..
Campylobacter

182. Proxmal esophagus mass → scc

183. From ejaculatory duct sperm transmit to which part? Prostatic

urethra correct
Seminal vesicle
Epididymis
External urethral meatus

184. Hydrocele scenerio, fluid is surrounded by-> tunica vaginalis Tunica

albuginea C. Cremasteric fascia

185. Dry eye - Orbital fracture, loss of lacrimation? Greater petrosal nerve
186. Bullets enter from anterolateral thigh and out from medial side near
groin. Nerve damage— femoral

187. IVDU what is found on histology ?

a. Mast cells
b. Sequestrum
c. Eosinophils
d. Fibrous wall
e. None of the above

188. Muscle of mastication nerve supply except- which one is Not a

mastication muscle → Buccinator

189. Fully developed abcess → macrophage?

190. Old age going downstairs knee give way..cant straight raise leg,
swelling above patela....patelar Fx,, quadriceps...patelar ligament tear, Acl
tear

191. Another with stab at right 9th intercostal space →

Right lobe liver
Gall bladder

192. Stab at Right side where rectus sheeth meet costs margin →
Gall bladder

193. 3cm stone wd 8 cm mass( granulomatous pyelonephritis on

histopathology) low functioning kidney... →PCNL... Nephrectomy..c/s
antibiotics

194. Which are the major cells in a granuloma?

a. Macrophage
b. Neutrophil
c. Eosinophil
d. gaint cell

195. After cholecystectomy, minor blood loss, no biliary slippage, no

leakage howt o describe the wound?
a. Clean
b. Clean contaminated
c. Contaminated

196. Addison disease scenerio -> acth level , Adh

197. A29 year old woman presents to the emergency department with
thirst and polyuria. She does not smoke and has rash that resolved three
months prior to her presentation. Her history is otherwise unremarkable.
her lung Xray shows hilar shadowing Serum biochemistry is performed and
this reveals: She was treated with normal saline and started on a course of
hydrocortisone. Aweek later, her corrected calcium is within normal range,
but her para thyroid hormone is 0.4 pmolL/L (normal 1.0- 6.5) which of the
following is most likely cause?
a. Carcinoma of the lung
b. Hypercalcemic hypocalciuric
c. Primaryhyperparathyroidism
d. Sarcoidosis
e. Secondaryhyperparathyroidism

198. 56 year old male presents to the acute surgical take with severe
abdominal pain. He is normally fit and well. He has no malignancy. The
biochemistry laboratory contacts the ward urgently, his corrected calcium
result is 3.6 mmol/I. What is the initial management?
a. VI Pamidronate
b. OralAlendronate .c Dexamethasone
c. Calcitonin
d. Fluid restriction, ecg and iv bisphosphonate

199. History of thornprick. Looking like this . Organism causing this? a.

Staph aureus
b. Strep pyogenes

200. Patient admitted with a penicillin sensitive bacterial infection

scenario of endocarditis). Has a history of rash when previously took
penicillin. What would be the appropriate medication?
a. Amoxycillin
b. Linezolid
c. Cefiroxime
d. Gentamicin
e. Metronidazole

201. Polytrauma patient, Saturation decreasing,

Hr elevated BP elevated
Cardiogenix shock, hypo, Neuro

202. Human bite bacteria?

203. Acute appendicitis causative organism →
Bacteroids?

204. Acute cholecystitis with gas in GB →

Clostridium perfringrs

205. Postoperative patient shift to ward when body temperature is 36

206. Night swets wt loss unilatelar cervical lymphadenopathy,

mediastinal lyphnodes.....lymphoma ..TB

207. Platelets life 10 days

208. Yeah old man with one kidney has low grade ureteric mass .
Treatment option?nephroureterectomty
Radiotherapy
Chemo

209. 4 year child with tender painful swelling below angle of

mandible, fever
a.Mumps
b.Suppurutuve lymphaadenitis

210. Old age u.retwntion BL Hydronephrosis... catheterized...HIGH

PRESSURE CHRONIC RETENTION?

211. Trauma face le forte type 3 oropharyngeal hemorrhage. Saturation

dropping. What to do
Oropharngeal intubation
Progastric tube
Tracheostomy
Cricothyroidectomy

212. Infliximab ..mec of action → tnf?

213. Oesophagus 25 cm from incisors lymph drain to? Cervical , bronchial?

214. fundus of uterus lymph drain to → iliac?

215. Old age..Hx of midline laprotomy..on examination: severe tenderness
in epigastric region, disteded, nausea,no vomiting....on mildly tender
distended abd.. options: ischaemic bowel, pancreatitis

216. Young athlete patient with single rib fracture. He has pain but vitals
are stable. Management:
 A. Analgesia and discharge
B. Admission and observation
C. Bupivacaine5%
D chest drain correct ( rib fracture risk of penetration & pulmonary contusion
,as per new guidelines chest drain is mandatory)

217. Low saturation rib fracture chest indrawing → chest tube?

Bupivacaine?

218. Flail chest →chest tube

219. Hx of chron ...ileocecal resection ..anemia...has 4weeks to

hemorrhoidectomy....how to give iron...oral injectable...transfuse before
surgery

220. Old age..Hx of midline laprotomy..now distention and tenderness

nausea,bowel protrudes from midline , no vomiting....on mildly tender
distended abd...DX restitch?

221. Tympanic cavity →1st pharyngeal pouch?

222. Pt having dyspnea symptoms, mass, sestamibi scan →Inferior

thyroid artery

223. Afferent of gag reflex nerve orign which pharyngeal arch → 3rd

224. 70 kg patient old patient after surgery. Post op day 3. Nurses are
saying low urine output. Below which point do you get worried about urine
output?
a. 10 mL/hr b. 15mL/hr c. 25mL/hr d. 35mL/hr
Note: 70 x 0.5 =35

225. SUPE xray views a) AP and frog lateral view pelvis b) AP and lateral
view pelvis

226. History of fall and there is loss of sensation of first 3 fingers ,,,which
view of x-ray will be done
A. true lateral view Correct
B.PA view of with ulnar deviation

227. Blood in pulmonary vaculature at rest..10-15.....20_ 30 % 60%

228. 18kg child maintenance fluid- 35ml/h ,Fluids 56 ml / hr

229. Ludwig angina submandibular space

230. Retroperitoneal nodes clearance patient cant ejaculate..pelvic

spalcnic nerve .lumber spalcnic nerve...Pudendal nerve

231. Renal ca ..ivc thrombus ... investigation for thrombus →..MRI...

venogram

232. Patient woth abdominal pain which relieved after maybe 2-3 hours,
hx of intususception during childhood which investigation to do
→colonoscopy?

233. Post renal transplant inc PTH , inc Ca normal phosphate normal... →
tertiary hyperparathyroidism

234. Horseshoe kidney associated congenital anomly →PUJ obstruction,

duodenal atresia

235. Post TURP confusion →HYPONATREMIA

236. Breast lump with fracture upper humerus---- treatment →internal

fixation, hemiarthroplasty, chemo, radio

237. Bone mets after breast cancer ,,management of pain?

A. NSAIDs. Correct ( directly from eMRCS ) B. Radiotherapy
B. Morphine
D.Sternal excision
E. Nerve block

238. 27 y Patient with breast lump 2 x 2.5cm . Family history positive

BRCA1 --- investigation → USG

239. Child with hypocholeremic mtblic alkalosis treatment →fluid,

pyloromoyotmy

240. Children with pr bleeding and mother told about cherry red PR lump-
→ juvenile polyp

241. Anal fissure common site with reference to Dentate line, ,

a) anterior proximal
b) b anterior distal
c) posterior proximal
d) posterior distal
 242. ICU PATIENT WITH NG TUB HYPOCHLOREMIC METABOLIC
ALKALOSIS— → nasogastric aspiration

243. Antibiotics that should not be given in pt with lung fibrosis

→nitrofurantine

244. One question about palsy asking the more proximal the lession the
more worse the prognosis
Options was
Supraspinatus
Musculoskeletal
Radial

245. Complement is from which cells? A. Endothelial cells

B. Hepatocytes Correct
C. Tcells
D. Bcells

246. Pain from pleura refered to abdomen nerve involved?

247. Anaphylaxis which immunoglobulin associated A. IgE Correct

B. IgA
C. IgD

248. In cushing reflex why HR dec → inc firing of aortic arch

249. Burn patient bilateral edema → hypoalbuminimia
250. Pt with angina →aortic stenosis?
251. Baby with abd distension and vomiting, pain in inguinal region-
→incarcerated hernia?
252. Opsonisation → inc macrophages engulfing
253. Copd pt → inc residual volume?
254. Pulmonary embolism → inc Co2 in blood
255. B12 deficiency ( vege pt) → macrocytic
256. Lactate is formed by → a) cori cycle b) pyruvate something
257. Baby with Gastroschiasis → options???
258. Esophageal hiatus → left vagus pass with it
259. Edh → middle meningeal artery
260. Crohn disease terminal ileum resected, → tpn, enteral diet
261. Inc infection rate in surgical patients → improper application of skin
antiseptic
262. How transplanted heart increase cardiac rate → inc atrial filling?
263. Most common breast malignancy→ invasion duct ca
264. Bowl disection 250 cm bowel remaining → enteral , tpn, nasogastric
265. BP,HR,resp, all decreased →neurogenic shock
266. Urachus remnant associated CA → adenocarcinoma
267. Hypotensive shock → renin inc, aldosterone inc, angiotensin inc
268. Zollinger ellison syndrome → inc. gastrin level
269. Multiple transfusion( calcium was low) → citrate toxicity?
270. Mystania gravis , antibodies against → acetylcholine
271. Resting membrene potential → K+
272. Urology scenario , what not to do → Option: self catherization, Long
term catherization
273. Sarcoidosis → non caseating granuloma
274. Numbness over check and upperteeth →nerve?
275. Patient with isolated lower lomb weakness → ACA
276. Patient with perforated viscus → metabolic acidosis with high anion
gap
277. Drug with half life 7 hours considered eliminate in ? 7 hour , 14
hours?
278. Structure outside of spermatic cord → ilioinguinal nerve
279. Stab at subxiphoid level → right ventricle
280. Renal cell carcinoma staging → ct scan
281. Renal artey → posterior to IVC
282. Direct swelling plus pain → Acl tear
283. Sub trochanter fx → internal fixation
284. Hemartoma
285. Omphalocele → 4/5cm defect?, surgery, isolation
286. Decrease hb in renal problem → erthropoetin
287. Child 5th centile short →Celiac scenario??
288. Heart block, pulse 40 scenerio
289. Which part of temporal bone form pterion → squamous, petrous
290. Pork meat and egg→ Camphylobactor . jejuni
291. Stab wound in right 2nd intercostal space, structure damaged →
thoracic duct?
292. Hypotension scenario → dec sv?
293. Inferolateral M.I , patient has reduced exercise tolerance → mitral
regurgitation?
294. Familial hypercholesterolima ask for gene defect → apolipoprotein E,
VLDL, LDL, HDL
295. Embolus in iliofemoral scan show compression of common iliac
from?? Can’t remember the exact question

296. Old man hit by car , did not loss consciousness but at er presented
with urinary incontinence , investigation of choice?
a) Ct
b) Mri
c) Pelvic xray