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Systems 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. A varicocele
(a) Consists of aneurysmal dilatation of the testicular artery
(b) Is more common on the right
(c) May be associated with a left renal tumour
(d) May be associated with infertility
(e) Requires surgery in all cases

        

2. In patients with a subarachnoid haemorrhage
(a) 70% of bleeds are due to Berry aneurysms
(b) Sub-hyloid haemorrhages may be seen on fundoscopy
(c) CT scanning has a sensitivity of approximately 90% if performed within the first 24 hours
(d) Lumbar puncture may show xanthochromia of the CSF
(e) The risk of rebleed is less than 5% within the first two weeks

        

3. Regarding salivary gland stones
(a) 80% of stones occur within the parotid gland
(b) 80% of submandibular duct stones are radio-opaque
(c) Most parotid duct stones are radio-lucent
(d) The classic presentation is with pain and swelling occurring one hour after a meal
(e) If a stone is surgically removed the duct should be repaired

        

4. Sjogren's syndrome
(a) Is an autoimmune condition affecting the salivary and lacrimal glands
(b) Primary Sjogren's syndrome is associated with connective tissue disorders
(c) Over 30% of patients with Systemic Lupus Erythematosis develop the disorder
(d) The male to female ratio is over 10 : 1
(e) Sjogren' s syndrome is associated with an increased risk of a B-cell lymphoma

        

5. Regarding benign salivary gland adenomas
(a) Pleomorphic adenomas account for less than 10% of parotid gland tumours
(b) Pleomorphic adenomas can undergo malignant change
(c) Warthin's tumour is otherwise known as an adenolymphoma
(d) Adenolymphomas usually occur in elderly men
(e) Approximately 10% of adenolymphomas are bilateral

        

6. During surgical excision of the submandibular gland
(a) The skin incision should be placed 1 cm below the lower border of the mandible
(b) Both the facial artery and vein may need to be divided
(c) The lingual nerve should be identified and preserved
(d) The hypoglossal nerve should be divided
(e) The submandibular duct is ligated and divided as far forward as possible

        

7. Regarding ulcerative colitis
(a) It usually arises in the caecum and spreads distally
(b) Chronic inflammatory polyps (pseudo-polyps) develop in approximately 20% of patients
(c) Approximately 15% of patients develop total colitis
(d) Systemic manifestations include a large joint polyarthropathy
(e) Overall, about 50% of patients will develop colonic cancer

        

8. Carcinoma of the prostate
(a) Is the commonest malignancy in men over the age of 65 years
(b) Arises in the central zone of the prostate
(c) Bone is the commonest site of metastatic disease
(d) A serum prostate specific antigen concentration of more than 10 nmol/ml would support the diagnosis
(e) A serum prostate specific antigen concentration of more than 35 nmol/ml is highly suggestive of advanced disease

        

9. In patients with ascites the following conditions are due to an exudate
(a) Tuberculous peritonitis
(b) Nephrotic syndrome
(c) Congestive cardiac failure
(d) Peritoneal malignancy
(e) Constrictive pericarditis

        

10. A Meckel's diverticulum
(a) Occurs in 10% of the population
(b) Will be found on the mesenteric border of the small intestine
(c) Consists of mucosa without a muscle coat
(d) Heterotopic gastric mucosa can ulcerate and cause a brisk gastrointestinal bleed
(e) A fibrous band between the apex and umbilicus can cause intestinal obstruction

        

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