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Core 2 'mini' examination

Attempt all questions.  Check the box next to the answers that you believe to be true.  Leave unchecked all answers that you believe to be false.  Once you have completed each question it can be marked.  One point is scored for a correct answer.  Incorrect answers score zero.  There is no negative marking.  The answers to each question can then be explained.  You can not change the answers after they have been marked!

1. Ultrasound is the preferred method of investigation of
(a) A breast lump in a women less than 35 years old
(b) Right upper quadrant abdominal pain in a women aged 45 years
(c) Possible bone metastases in man age 70 years old
(d) A possible subphrenic abscess in a postoperative patient
(e) The detection of a deep venous thrombosis in any patient with a painful swollen leg


2. The following may be seen in iron deficiency anaemia
(a) A reduced mean cell volume
(b) An increased mean cell haemoglobin concentration
(c) A reduced serum ferritin concentration
(d) A reduced serum iron concentration
(e) A reduced total iron-binding capacity


3. Methods used in the sterilisation of surgical equipment include
(a) Ethylene oxide
(b) Gamma irradiation
(c) Autoclave
(d) 2% Gluteraldehyde
(e) Chlorhexidine


4. Spinal anaesthesia
(a) Has a more rapid onset than epidural anaesthesia
(b) Hypotension is a significant risk
(c) Is safe in anticoagulant patients
(d) Does not produce a block of the lower limb motor supply
(e) Has a higher risk of postoperative headache than epidural anaesthesia


5. A postoperative pulmonary embolus
(a) Is invariably associated with chest pain
(b) A chest x-ray may be normal
(c) Diagnosis can be confirmed by a radioisotope ventilation / perfusion scan
(d) ECG may show an S wave in Lead I, A Q wave in Lead III and a T wave in Lead III
(e) If most commonly seen between 7 and 10 days after operation


6. Regarding postoperative nutritional support
(a) Early enteral feeding is able to maintain the gut mucosal barrier
(b) Enteral feeding should never be considered in the early postoperative period following trauma or gastrointestinal surgery
(c) Parenteral nutrition should always be given through a central line
(d) An enterocutaneous fistula may be an indication for parenteral nutrition
(e) Jaundice is a recognised complication of parenteral nutrition


7. The following metabolic responses occur in response to trauma
(a) Increased growth hormone
(b) Increased anti-diuretic hormone
(c) Increased ACTH
(d) Increased urine osmolality
(e) Increased glucagon


8. In the management of major trauma
(a) The peripheral circulation should be evaluated before the airway is assessed
(b) The airway should always be assessed with the cervical spine
(c) CT scanning is a useful investigation for the assessment of unexplained shock
(d) A jaw thrust to maintain the airway is contraindicated in the presence of a suspected cervical spine injury
(e) Venous access should usually be by two large cannulas in the antecubital fossae


9. Regarding compartment syndromes
(a) They can occur only in the lower limb
(b) Are usually characterised by pain that is worse on passive movement
(c) Can be diagnosed by the loss of distal peripheral pulses
(d) Compartment pressure monitoring may be a useful diagnostic aid
(e) Require fasciotomies to be performed on the next available elective operating list


10. Regarding malignant melanoma
(a) Lentigo maligna melanoma is a superficial lesion with a good prognosis
(b) Acral lentiginous melanomas most commonly occur on the dorsum of then hand
(c) The Breslow thickness is a good prognostic factor
(d) Sentinel lymph node biopsy is a useful means of assessing lymph node status
(e) Isolated limb perfusion with cytotoxic agents palliates recurrent limb disease


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Authored in CALnet


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