New MCQs of MRCS (A&E) 2003.

Only the new questions are shown here. The wordings may not be the same as the original questions.

1. Acute pancreatitis associated with

Hypothermia T

Hypocalcaemia T

Fat necrosis T (Robbins pathologic basis of disease)

Islet cell tumor F

Hyperparathyroidism T

2. Wound healing

In old people is as rapid as in young F

Ant-inflammatory drugs delay healing T

Presence of collegenase strengthen the edge of the wound ?T (Robbins)

Calf wound heal better than pretibial wound T

3. Healing of open wound

Granulation T

Inflammation T

Gaint cell formation F

Wound contraction T

Migration of epithelial cell ?T

4. Gun shot injury

Hand gun shot is the most common cause

high velocity missles injury in UK civilian F

Shot gun bullet cause temportory cavitation F

Presence of yaw increase energy

dissipation in biological target T

High velocity missles follow tissue plane F

Gun shot injury treat by primary closure F

5. Mallory Wesis sydrome

Need OGD for definite diagnosis T

Cause massive GIB F

Full thickness tear in lower esophagus F

Rarely require surgical intervention T

Caused by repeated violent vomiting T

6. Dysphagia

Causes in upper esophagus is obstructive

in majority of case F

Ca esophagus is the commonest

cause in lower esophagus T

Achalasia affect swallowing of

both solid and fluid T

Affect swallowing of fluid first

then progress to affect solid food F

Patient always can accuately

locate the site of obstruction F

7. Diamorphine

Inhibit respiratory centre T

Directly stimulate vomiting centre T (Rang and Dale)

Naloxone reverse the respiratory depression

but not the analgesia F

Spasm of sphinter of Oddi T

Decrease both the preload and afterload T

8. Unconscious man on 100% O2

[H+] 5, pCO2 5.2, HCO3 10, Na 132, K 4.1, Cl 98, Ur 7, Cr 100

Normal anion gap F

Metabloic acidosis with respiratory compensation T

Compatible with methanol intoxication T

Compatible with renal tubular acidosis F

Compatible with lactic acidosis T

9. Cyanosis

Polycythemia T

Reduced Hb greater than 50g/dL T

?More prominent in elevated PaCO2

?Occlusion of circulation of upper limbs for 30mins

10. Differentiation between esophageal spasm against ischaemic chest pain

Typically precipitated by cold water ingestion

in esophageal spasm T

Often happen at rest in esophageal spasm T

Relieved by nitrate can differentiate F

Reflux esophageal esophagitis associated

with salivation T

11. Crush syndrome

Hyperuracaemia T

Hypokalaemia F

Elevated ALP F

Elevated CK T

Myoglobinaemia T

12. Proven benefit in RCT in management of acute myocardial infarction

Aspirin 300mg daily for 28 days F

Atenolol iv & oral 50-100mg for 7 days F

Prophylactic lignocacine F

Streptokinase 1,500,000 units for 1 hour T

Magnesium sulphate F

13. Fracture base of skull

CSF leakage will self terminated T (Emergency medicine, Tintinalli)

Antibiotics with proven benefit T (Tintinalli)

Bruises in mastoid process

appear within 4 hours F

Can cause retrobulbar haematoma ?T

Fluid in the sphenoid sinus T

14. Retinal detachment

Early loss of vision

Often present with “flash and floater” T

15. Drowning, poor prognostic factor

Children older than 3 years and adult

Hypothermia F

Fully alert on arrival to AED F