Sample 1

A 27 year old woman presents with diarrhoea and weight loss. This is associated with
abdominal distension after meals. What would be the best investigation?

A Barium enema
B Barium enema and follow through
C CT scan
D Gastroscopy and biopsy of small bowel
E Gastroscopy and biopsy of stomach for helicobacter


Sample 2

Laparoscopic donor nephrectomy is generally considered to be superior to open nephrectomy
for which one of the following reasons?

A Reduced incidence of complications in the recipient operation
B Reduced intra-operative blood loss
C Reduced postoperative analgesic requirements
D Reduced warm ischaemia time
E Shorter operating time


Sample 3

A 70 year old man develops hypotension and sweating with associated abdominal pain seven
days post sigmoid colectomy. His temperature is 39C and WCC 18x10
9
/L. What is the
most likely diagnosis?

A Acute pyelonephritis
B Anastomotic leak
C Leaking aortic aneurysm
D Myocardial infarction
E Pulmonary embolus


Sample 4

A 42 year old woman presents with a two day history of colicky upper abdominal pain
radiating to the back. She has previously been well. On examination she is clinically
jaundiced. There is no abdominal mass or tenderness. Ultrasound examination of her
abdomen shows multiple stones in the gallbladder. Her bile duct is measured at 10 mm and
her intra-hepatic ducts were dilated. What is the most likely diagnosis?

A Bile duct stones
B Biliary dyskinesia
C Carcinoma of the pancreas
D Chronic pancreatitis
E Primary sclerosing cholangitis
Sample 5

A 62 year old man presents with several weeks history of altered bowel habit and small traces
of blood per rectum. A barium enema has shown severe diverticular disease affecting
predominantly the sigmoid colon. Which of the following is the most important?

A He should be given advice about a high roughage diet
B He should be reassured that there is no serious underlying pathology
C He should have a CEA level checked
D He should have an abdominal CT scan
E Visualisation of the mucosa in the sigmoid colon may not have been optimal