MRCS PART A September 2023

S.NO CORRECT QUESTIONS CONFUSED QUESTIONS

1. Cervical injury – central cord Phimosis and tx was circumcission
2. Lower motor neuron lesion features Permanent inconGnent – Ext or int
sphincter
3. Pulmunary edema due to cardiac Tumor senscence – Telomerase
failure mutaGon
4. Cant pick suitcase – posterior cord of Cecal volvolus cray
brachial plexus
5. Pharyngeal pouch xray Oesophageal perforaGon cray
6. Foreign body xray- Rt main bronchus Small bowel obstrucGon cray
7. Pneumotjorax xray- chest tube Rectus diastasis or epigastric hernia
8. Tension pneumothorax scenario – Flat face – maxilla or zygoma
needle 2nd ICS
9. Inf pole of lt adrenal – body of Paraphimosis scenario
pancreas
10. Splenic occlusion – fundus stomach VSD defect due to
11. Spleen surgery – pancreaGc tail Metrandazole side effect – peripheral
damage neuropathy or fibrosis
12. Post and inf to rt kidney- quadratus Hyponatremia scenario – what to give
lumburum – 3% NaCl
13. Dural sac end at S2 level Best periop mortality – charlson , ASA ,
posum or Neela
14. Small intesGne hematoma and Chronic pancreaGGs- nerve block or
hypotensive – laparotomy nsaids
15. GCS calculaGon was – 7 Stemi with bradycardia what is
affected – SA node or bundle of his
16. EDH scenario and xray – neuro Baker cyst nerve injury – Tibial
protecGve and reffer to neuro
17. Hernia – pleuroperitoneal Arthroscope – ethylene oxide
membrane
18. 6kg child fluid – 600ml Stable PE – LMW heparin or
unfracGoned
19. Fluid scenario – 1.3 L over 8 hr DVT , afraid of needle what to give
20. N/S excess – hypercholoremic Deranged RFT and low calcium – vit d
acidosis
21. High chloride due excess N/S 3 month old child undescend tesGs –
clinical and Us
22. Lateral femoral hernia structure – Old age tesGcular mass – epidydima
femoral vien cyst or seminoma
23. Hernia medial to IEV – direct GynaecomasGa – liver or tesGs
24. Rt renal drain into IVC Fever and lymphodenopathy – IM or
cat scratch
25. Measure to prevent hernia infecGon Jaundice afer 3 months – hemolysis
– skin preparaGon or anG rh factor
26. Hypercalcemia iniGal treatment - IV Bilateral enlarged ingunial nodes -
N/S distal rectum or labia minora
27. Low Na and High Potasium due to Hodgkin lymphoma histology
aldosterone deficiency
28. Head injury scenario with DI feature Osgood schlater scenario
due to ADH deficiency

PREPARED BY: DR IRFANULLAH MAJEEDZADA

 MRCS PART A September 2023
29. One was addisonian crisis scenario – Ant surface of heart what is right -
IV hydrocorGsone
30. Pigementaion and hypotension due Girl with burn 30 mint ago what is
to adrenal insufficiency iniGal – iv line or wash under tap
water
31. PigmentaGon and hypotension what Audit related scenario – criteria or
test ACTH sGmulaGon outcome
32. Child with compartment syndrome- Pre renal Aki urinary findings
shif to OT for faciotomy
33. Post op 10 day , hypotension and Smoker renal stone and hematuria
hypoxia with T inversion in lead 3 – ehich is not invesGgaGon – ct uro or
PE renogram
34. Trauma with finger red swelling and RetracGle tesGs , structure responsible
bleeding – pyogenic granuloma
35. Late sign of compartment syndrome Non funcGoning pituitary
– dorsalis paedis disappearance macroadenoma with headcahe and
nause
36. Meconium ileus Dural fold tumor with cyst capping
37. Thoracic duct passes at T12 Where radial pass from post to ant
38. Swelling move with tongue What is inculded in goal directed
protrucGon derive from thyroglossal surgery
duct
39. Dorsal halux ulcer mulGple Smoker with perioheral lung Ca
comorbids – criGcal limb ischemia
40. Most common in MEN 2 – medullary Alcohlic head injury discharge or Ct
thyroid CA
41. Head injury with mulGple ulcers due Upper psoas margin nerve
to increase vagal
42. Thyroid swelling and family history Knee reflex golgi or muscle spindle
with amyloid stroma – Medullary
thyroid CA
43. Merlagia parastheGca – lateral Disc prolapse and radicuopathy what
border of psoas L2,L3 is iniGal
44. Hypospdia repair Pain on walking and relive on siing –
spinal stenosis ?
45. SUFE scenario Thoracic splanchnic nerve
46. Perthes scenario Clef palat – 1st arch I wrote 4th arch
47. SpondylodisciGs – Staph aureus Disc prolapse was L4-5 I marked L3-4
48. Perinal itching and sillotape test +ve K for adult I marked 35
– Entrobius
49. C. Difficile – gram positve rod Insulin and dextrose – I marked
isotonic isoosmolar
50. Renal transplant- Acute rejecGon
51. Markers for thyroid CA – decrease
TSH and T4 and normal T3 and high
throglobin
52. Zahn lines – thrombus
53. Thyroid Ca with pappilary thyroid ca
feature’s
54. Pappilry ca spread to lymph node

PREPARED BY: DR IRFANULLAH MAJEEDZADA

 MRCS PART A September 2023
55. Sarcoma spread to Lung
56. Hypospaida – urethral folds failure
57. Bladder – urogenital sinus
58. Brown sequard scenario
59. Drug for graves – carbamizole
60. Thyrotoxicosis plus aial fibrillaGon -
b blocker and thionamide
61. Trauma 24 hr what will increase -
CRP
62. ASA score of amokers ASA 2
63. Clinical trial phase 3
64. IntussusepGon scenario
65. Crhons disease scenario
66. Meckels blood supply – SMA
67. Meckels with pancreaGc Gssue –
basophils with duct cells
68. Medial Meniscus torn
69. Medial collateral ligament injury
70. Lef ureter not related to round
ligament uterus
71. Abductor policis brevis
72. Adductor policis
73. 3rd and 4th lumbricals
74. Facial injury distal to geniculate what
is preserved - lacrimaGin
75. 10 and 12 CN injury features –
medulla
76. V3 trigiminal features – foramen
ovale
77. Cavernous sinus thrombosis feature
not include parasthesia over lower
lip
78. Cervix lymph nodes – external iliac
plus sacral
79. Horners features damage to
sympatheGc trunk
80. Upper rectum supply – IMA
81. Fresh per rectal bleed , embolize –
sigmoidal arteris
82. PancreaGGs and carpopedal spasm -
hypocalcemia
83. Turp with headache and confusion –
hyponatremia
84. High jejunistomy – Hypokalemia
85. Ureter blood supply not include –
iliolumbar
86. 73 old with angina uphill – aorGc
sclerosis
87. Dangerous periop – AS

PREPARED BY: DR IRFANULLAH MAJEEDZADA

 MRCS PART A September 2023
88. Psoas – origin from intervertebral
disc
89. One was anaphylacGc shock
90. One was intra muscular adrenaline
91. One was HS type 1 reacGon
92. Oesophageal CA at T3 will invade
anteriorly – Trachea
93. MS and dysphagia what compress
oesophagus – Lt Atrium
94. Tricuspid closure - isovolumetric
contracGon
95. OsteolyGc lesions with plasmacytoid
histolgy – MM
96. Renal pink fleshy lesions –
Amyloidosis
97. Amyloid stain – congo red under
green polarized
98. EDH , dilated pupil – unopposed
sympatheGc
99. Unopposed parasympatheGc
increase – detrusal acGvity
100. VenGlaGon what will decrease – rt
ventricle EDV
101. Drug to intubate hypotensive paGent
in Helicopter – ketamine
102. Local anesthesia – Na channels
103. Reciprocal of risk reducGon - NNT
104. Mature lymphocytes with thyroid -
Hashimoto
105. Head injury long term feeding – PEG
tube
106. Preganglionic neurotransminer - Ach
107. Subcapital fracture fit man –
cemented THR
108. Tibia cuing with saw injury –
popliteal artery
109. Unable to dorsiflex and evert –
Common peroneal neuropraxia
110. Foot drop – Tibialis anterior
111. SympatheGc- bronchodilaGon
112. Eb phase of injury – gluconeogenesis
113. Lower femur tumor with osteoid –
osteosarcoma
114. I On warfarin inr 4.5 – vit k and PCC
115. Hemophila scenarion- factor VIII
116. Echymosis and poor healing – Vit C
117. Tranxemic acid – plasmin inhibiGon
118. Inulin – filtered not absorbed
119. Morphine – MU receptor

PREPARED BY: DR IRFANULLAH MAJEEDZADA

 MRCS PART A September 2023
120. Dark room , constricted pupil ,
colonoscopy – fentanyl
121. Hypothermia – J wave
122. 70 % small bowel resecGon –
parenteral
123. TesGcular torsion – immediate
explore
124. Group of people eat , diarhea 2
hours – aureus
125. Greasy pale stool – dec fecal elastase
126. PancreaGc autolysis – trypsin
127. Appnedix abcess – bacteroid
128. Vit A – gut mucosal surface
129. HUS – E coli
130. TonsiliGs and bleed – acute
streptococcus tonsilliGs
131. Subsahran afriqa and hematuria –
Squamous CA
132. Smoker, hematuria and renal mass –
renal cell CA
133. Anal cancer – HPV
134. Spherocytois – pigment stone
135. SensaGon and weakness – median
proximal to flexor reGnaculum
136. Lateral forearm sensaGon lost which
will be lost – supinaGon
137. SciaGc injury will leg weakness what
else lost – knee flexion
138. CBD stone – ErcP
139. Not reliable in low perfusion – pulse
oximetry
140. Copd both co2 and hco3 inc
141. Insulinoma scenario both insulin and
c pepGde increase
142. Neurogenic shock scenario
everything decrease
143. Head injury how bradycardia – inc
parasympatheGc inc vagal
144. Pseudomembrane coliGs histology
145. Temporal arthriGs histology
146. Metaplasia – reversible injury
147. One was about dysplasia
148. Warm relieve pain – a beta modulate
c fibres
149. One was about DIC
150. Neck mass move with swallowing –
US and fnac
151. Furosemide- ascending LOH
152. SGLT present at – PCT
153. ADH act on collecGng duct

PREPARED BY: DR IRFANULLAH MAJEEDZADA

 MRCS PART A September 2023
154. Inf border of quadrangular space –
terese major
155. Na/k pump – primary acGve
transport
156. Cant iniGtae abducGon –
suprascapular
157. Below piriformis – nerve to internus
158. Drug induced platelt dysfuncGon
159. Renal replacement therapy – k > 6.9
160. Atrphic gastriGs dizzines and anemia-
oval and large
161. Esophageal bleed – terlipressin plus
octreoGde
162. Liver mets – chemo
163. HepaGc flexure tumor – primary
resecGon and anastomosis
164. Young paGnt one rib fracture –
analgesia and discharge
165. Anurysm and cysGc medial necrosis
– connecGve Gssue
166. Not risk for aorGc dissceGon - DM
167. Hiccups afer burn – acute gastric
dilaGon
168. Stroke – 70ml
169. FAP history – tubular adenoma
170. Hamartoma- peutz jigger
171. Submandibular gland surgery and
bleeding – facial artery
172. CaroGd end arterectomy and tongue
deviaGon CN XII
173. Cant wrinkle and preauricular
surgery – temporal of facial N
174. ParoGd surgery difficulty ear pirecing
– great auricular
175. Isopranline derrivaGve – dobutamine
176. Dobutamine dec BP – B2
177. 1 mm melanoma in situ excised with
clear margins- educate and reassure
178. MicrocalcificaGon – DCIS
179. LacrimaGin – pterygopalarine
180. Nucleus for lacrimal – superior
salivatory
181. Middle finger dermatome – C7
182. AcGvated in hypovolumia - renin
183. Renin act on angiotensinogen
184. Hypovolumia what act on vessel –
Ang 2
185. Hypovoumia acGvated 1st – caroGd
baroreceptor

PREPARED BY: DR IRFANULLAH MAJEEDZADA

 MRCS PART A September 2023
186. Pt on opiates how it cause
respiratory acidosis – medullary
chemo receptors
187. Gleason – 4+5
188. Net filtarGon pressure – 8
189. Kidney stone and recurrent UTI –
proteus mirabilis
190. Fracture paiful pronaGon and
supinaGon – malunion
191. Midtrasal fracture pain afer 10 years
– sec osteoarthriGs
192. Rhabdomyolysis and hematuria what
is urine – myoglobin
193. Calf claudicaGon SFA
194. IHD and bilateral common femoral
occlusion- axillobifemoral
195. ERAs – early mobilizaGon
196. Not ERAs – preop bezodiazipine
197. Neck stab tongue deviaGon –
hypoglassal
198. Structure not foregut – spleen
199. Prostate CA – scelroGc and dec
trabeculae
200. One was cardiac tamponade
201. Lap hernia repair posterior to mesh
– peritoneum
202. Pfanestl incision , rectus displaced
laneraly to expose – transversalis
facia
203. OsteoporoGc fracture –
Normocalcemia
204. Uterus support – Transverse perineal
ligament
205. 1 lit N/s + 2 lit 5% dextrose
206. 1 lit N/s + 1.5 lit 5% dextrose
207. Femoral artery – midinguinal point
208. LP level – iliac creat
209. Aorta bifucaGon – L4
210. Pringle maneur – hepatogastric
ligament
211. Oesophagus – NK squamous
epithelium
212. Homonymous hemianopia – opGc
tract
213. All are muscle of masGcaGon except
– buccinator
214. Csf – beta 2 transferrin
215. Head injury diplopoa and adducted
eye – abducent
216. Heart stab injury – Rt ventricle

PREPARED BY: DR IRFANULLAH MAJEEDZADA

 MRCS PART A September 2023
217. Hyper acute rejecGon – ABO
incompaGbility
218. Hypotension pt – iv fluid
219. Upper limb weakness – MCA
220. Myasthenia symptoms with
mediasGnal mass – thymoma
221. Linle finger – C8
222. One was intraductal Ca
223. Nerve while exposing spermaGc cord
– ilioinguinal
224. Stomach tumor biopsy inconclusive
– GIST
225. 3rd degree burn – insensate to pin
prick
226. Afer spleenectomy what is not true
– dec WBC
227. TesGcular tumor marker – AFP
228. Ulcer afer sinus, iniGal change –
metaplasia
229. PosiGve predicGve value increase
prevalence
230. Artery supplying upper part of
rectum is at level of – L3
231. Lef lateral ventricle dilaGon –
interventricular foramen
232. Lung lesion, fat plus carGlage –
Hamartoma
233. 4-5 ABGs will be correct
234. Dumping syndrome and inc insulin-
hypoglycaemia
235.

PREPARED BY: DR IRFANULLAH MAJEEDZADA