Recalls of paper 2 – 11/9/2018

111/120 questions
By A. Elbeeli – Su

1- Patient 24 years old with Down syndrome, diagnosed with appendicitis, consent,
Patient consent.
2- Patient with RTA, hypotensive and tachycardia with evidence of internal bleeding
consent….Proceed without consent.

3- Patient fell down, wound at tibia, not opposed……… SSG

4- Pretibial wound, she takes steroids……Delayed skin graft
5- Colectomy done, developed heel wound…….Debridement
6- Scalp wound……. Debridement with closure

7- Depolarizing muscle relaxant……Suxamethonium

8- RTA Scenario, patient in shock, best anesthesia…….Ketamine
9- Bier’s block…. Prilocaine .5%
10- Some hard options about bandage pressure (I skipped the question immediately
without thinking)

11- Burn question, 70KG, BSA is 50%........14000

12- Female, with Scenario of heat water, developed blisters, how to treat……Leave
the wound open or occlusive dressing?

13- Scenario with thyroid swollen diagnosed as papillary carcinoma… Total

Thyroidectomy
14- Scenario with thyroid swollen diagnosed as medullary carcinoma… Total
Thyroidectomy
15- Scenario with thyroid swollen with pulsatile swollen in forehead….. Follicular
carcinoma

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16- Scenario with thyroid swollen, palpitation, headache,
HTN…………Phenochromocytoma
17- Table Scenario, thyroidectomy was done and on T3 replacement now new swollen
I think…?

18- A child with diffuse abdominal pain of 24 hours, he vomits twice, on abdominal
examination no guarding or rigidity, diagnosis…….Non-specific abdominal pain (
was the only logical option, others-appendicular abscess, intussusception,)
19- A child with abdominal pain, vomiting, rectal blood in PR…..Intussusception
20- A child with villous vomiting with scaphoid abdomen….Duodenal atresia.
21- A child with non-bilious vomiting….Pyloric stenosis.
22- Male with failure to survive and recurrent chest infection..Tracheo-esophageal
fistula.

23- 11 years old male, obese, limping with pain in groin………Slipped upper femoral
epiphysis.
24- 3 years old male, with fragmentation of femoral head and increase joint
space……perthes disease.
25- 5 years old female, limping with abnormal gluteal crease…….Developmental
dysplasia of hip “DDH”
26- Female with breast carcinoma, with back pain, investigation of choice….. I did
Isotope scan
27- Atypical epithelium…..DCIS OR Invasive ductal carcinoma?
28- Female had mammogram 2 years ago which was normal, mow mamo showed
mircocalcification, normal clinical examination and normal U/S, how to proceed?
......??
29- Breast, cyst aspirated, no collection, no blood……No further follow up

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30- Patient underwent esophagectomy for esophagus carcinoma, type of
feeding…..Intraoperative feeding jejenstomy
31- Patient with loss of sensation in 1st web space…..Anterior compartment syndrome
32- Patient underwent hernia repair, after operation he cannot flex his
knee…..Injury to femoral nerve.
33- Scenario with marked claw hand….. Ulnar nerve injury at wrist
34- Scenario, pain 60-120 degree….Supraspinatus tendinitis
35- Scenario, No abduction at all with sign i cannot remember….. Rotator cuff tear
36- Patient with crush injury, on examination nerve and artery transected
completely… Amputation
37- Scenario posterior hip dislocation, postoperative loss of hip extension… Sciatic
nerve injury
38- Fracture at distal femur, nerve may injured……Tibial nerve
39- Scenario, tibia fractured, operation done, placed in cast, patient developed foot
drop and parethesia at dorsum of foot ……CPN injury
40- Female with sup-capital fracture…… Internal fixation
41- Tibial fracture, dirty wound………. external fixator
42- A man, weight lifter, unexplained loss of weight, pain in both LL, unable to
urinate…..mets-stress vertebral body fracture, axial subluxation??
43- Ankle pain, normal x-ray before 2 month, comes back again…..X-ray-MRI-CT?
44- Scenario of twisting flexed leg with tenderness above medial joint line……Medial
collateral ligament rupture
45- Scenario of delayed joint swollen… torn meniscus
46- Patient with pain in the back of his leg, the doctors when squeeze on the muscle
no planter flexion occur……..Achilles tendon rupture

47- Patient with pain in 4 metatarsal cleft, reproduced by pressure……Morton’s

neuroma
48- Female with fracture, she developed respiratory distress, investigation….CT
pulmonary angiography
49- GCS Scenario….5+2+2=9
50- Scenario of patient with RTA admitted then discharge, then he came with
dysphagia and distress when he eat…….Diaphragmatic rupture

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51- Patient with RTA, has ribs fracture, admitted, intubated, after a while developed
sudden onset of respiratory distress…….Tension Pneumothorax
52- Patient with RTA, head injury, intubated, during rolling him for back
examination developed distress and oxygen saturation become 80% ……
Dislodged endotracheal tube
53- Scenario with tension pneumothorax, immediate action…..Needle thoracostomy
54- Scenario of widening of mediastinum…..Ascending or Descending Aorta?
55- Scenario of RTA, BP is 80/60, Pulse 120, action………..iv cannula and make
blood ready

56- Scenario of RTA, action…Activation of hemorrhage protocol

57- Scenario of RTA, action…IV Line

58- Patient go to bath to urinate and empty his bladder and after that his bladder is
still full and go to urinate again…..Bladder Diverticulum
59- RTA, suprapubic pain, unable to urinate…….Bladder rupture
60- Mother notice there was a testicular swollen in her child notice in bath,
disappear in early morning… Patent process vaginalis.
61- Patient with history of vasectomy has a swollen in above testis and pain …. I
answered sperm granuloma (other said hydatid of morgangi)

62- During herniorraphy, anterior structure, External oblique

63- Recurrent peptic ulcer not responds to PPI… Zollinger Ellison syndrome
64- Female with gallbladder stone, jaundice, splenomegaly………Hereditary
spherocytosis.
65- Patient with polyuria, blood glucose and Glucose tolerance test is high…..
Diabetic mellitus
66- Patient with Diabetic mellitus, preoperative management, how to monitor
him……Measurement of blood glucose regularly
67- Alcoholic p.t with symptoms of Thiamine deficiency B1
68- Patient with dermatitis and cloudy eye…… Vitamin C or A deficiency?
69- Patient with known case of Aortic aneurysm has gangrenous toe…. Arterial
Embolus
70- Ulcer above the medial malleolus…cause….venous insufficiency

By A. Elbeeli – Su Page 4
71- Scenario of RTA with lucid interval….Extradural hematoma
72- African guy with cough and lesion in lung apex… Tuberculosis
73- Lesion in lateral border of tongue can bleed…. Squamous cell carcinoma
74- Red macular lesion in floor of mouth…….Erythroplakia
75- Old male with unexplained loss of weight and persistent cough, with cavitation
lesion in the lung, cause? …. I did renal carcinoma Mets ((Because of I thought it
looks like cannon ball!!))other options were adenocarcinoma-SCC- Small cell
carcinoma
76- Rapidly growing swollen in mandibular gland area…. Lymphoma
77- Melanoma, prognosis, Breslow thickness
78- Scenario with headache, high ESR, Diagnosis……. Giant cell arteritis
79- Male with history of Bone Marrow Transplant, present with pneumonia… CMV
80- Scrotum ulcer, what’s LN will drainage to……….Medial group of superficial LN
81- A patient is admitted for elective surgery. He has been found to have nasal MRSA
positive, what to do……Nasal mupirocin ointment
82- Patient with iron deficiency anemia…has to go for elective surgery after 1 month
I guess.. How to prepare him regarding? I did oral iron “I think it is wrong
answer”
83- Patient underwent endarterectomy, injured something, after that he developed
dysarthria and tongue deviation…. Neuropraxia of hypoglossal nerve
84- Scenario with facial bone fracture with sings of infra-orbital nerve injury,
diplopia, what bone fractured……….I marked Maxillary bone
85- Scenario with cutting the facial nerve at the level of parotid gland……Paralysis of
facial muscles.
86- Nerve supply the area of tempro-mandibular joint…….Auriculotemporal nerve
87- Male came from Zimbabwe, developed jaundice…. Hepatitis A
88- Enhanced Recovery protocol! …………
89- Patient with some factor deficiency…. Warfarin for life
90- Patient with recurrent PE due to DVT……. Vena cava filter
91- Patient Known case of DM, presents with symptoms and signs of DKA, table
options with numbers….Metabolic acidosis.
92- Patient with vomiting for several days….Hypokalemic alkalosis
93- A female with postphlebitic syndrome, how to manage….compression stock or
warfarin for month?

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94- Table Scenario with coagulation numbers………….???
95- Male with left iliac fossa pain and unhealed anal fistula….. Chron’s Disease
96- Male with a long time ulcerative colitis, developed abdominal pain and yellowish
sclera….. Primary sclerosing cholangitis
97- Ulcerative colitis with hyper chromatin nuclei, failure of maturation and
something…….dysplasia??
98- Laparoscopic cholecystectomy with Charcot triat… cholangitis
99- Post open cholecystectomy, in ICU, developed pain, how to manage…. I marked
epidural analgesia
100- Patient with pancreatitis, developed respiratory distress……..ARDS
101- Female underwent laparoscopic cholecystectomy, present with right upper
abdominal pain….. U/S
102- Patient of cancer, there is mets to brain, what to give, I did steroid
103- Patient with pancreatitis, electrolyte abnormality….. Hypocalcaemia
104- Patient underwent thyroidectomy, developed carpopidal spasm, electrolyte
abnormality… Hypocalcaemia.
105- Patient had long duration of TURP, after operation developed confusion,
electrolyte abnormality…….. hyponatremia
106- Case with table and electrolyte abnormality, K was too high, asking what to
give… Calcium gluconate
107- Prostatic cancer with bony bane…..Radiotherapy
108- Pancreatic cancer, with back bane….Radio-morphine-nerve block
109- Pancreatic cancer with his Mets….. ERCP with stent
110- Esophageal cancer with mediastinum extent….stent insertion
111- Old man with loss of weight, microcytic hypochromic anemia and
supraclavicular LN Enlargement…… gastric carcinoma

Special thanks to Dr. Salah Elsaid and his useful materials

By A. Elbeeli – Su

By A. Elbeeli – Su Page 6