MRCS A General Surgery Exam Questions
With Correct Answers
Presentation: small volume of fresh hematemesis often streaked in vomit. Often
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ceases spontaneously. Usually history of GORD - CORRECT ANSWER✔✔-
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Oesophagitis
Presentation: small volume of fresh hematemesis (except if preterminal event)
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Associated with dysphagia and constitutional symptoms like weight loss -
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CORRECT ANSWER✔✔-Oesophageal cancer
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Presentation: small to moderate brisk hematemesis following vomiting - CORRECT
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ANSWER✔✔-Mallory weiss tear
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Presentation: large volume of fresh hematemesis, may have melena, associate
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with haemodynamic compromise - CORRECT ANSWER✔✔-Varices
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Presentation: fresh hematemesis or mixed with vomit. Prodromal dyspepsia and
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constitutional symptoms - CORRECT ANSWER✔✔-Gastric cancer
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Presentation: fresh hematemesis and melena, considerable volume but difficult
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to find endoscopically - CORRECT ANSWER✔✔-Dieulafoy lesion
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, What is Dieulafoy's lesion? - CORRECT ANSWER✔✔-rare cause of acute upper GI
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bleed. Vascular malformation in which a large tortuous artery in the submucosa is
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eroded by gastric acid
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Presentation: fresh hematemesis and epigastric discomfort. recent NSAID usage -
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CORRECT ANSWER✔✔-Erosive gastritis | |
Presentation: small volume of fresh hematemesis, may not be noticed and has
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IDA - CORRECT ANSWER✔✔-Gastric ulcer
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Where is the most common site for a duodenal ulcer that would cause major
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haemorrhage? - CORRECT ANSWER✔✔-Posterior- invading gastroduodenal artery
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Cause of major upper GI haemorrhage in previous AAA repair? - CORRECT
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ANSWER✔✔-antero-enteric fistulation |
What is the management options for varices? - CORRECT ANSWER✔✔-Give
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telipressin prior to endoscopy | | | |
At endoscopy- banded or sclerotherapy
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If active bleeding- Sengstaken Blakemore or Minnesota tube- balloons can only be
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|inflated for 12 hours due to risk of necrosis
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Portal pressure decreased with medical therapy +/- TIPSS
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What is combination therapy for bleeds identified on endoscopy (non-varcies)? -
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CORRECT ANSWER✔✔-Injection of adrenaline and either thermal or mechanical
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treatment- banding or diathermy | | |
With Correct Answers
Presentation: small volume of fresh hematemesis often streaked in vomit. Often
| | | | | | | | | | |
ceases spontaneously. Usually history of GORD - CORRECT ANSWER✔✔-
| | | | | | | |
Oesophagitis
Presentation: small volume of fresh hematemesis (except if preterminal event)
| | | | | | | | | |
Associated with dysphagia and constitutional symptoms like weight loss -
| | | | | | | | | |
CORRECT ANSWER✔✔-Oesophageal cancer
| |
Presentation: small to moderate brisk hematemesis following vomiting - CORRECT
| | | | | | | | |
ANSWER✔✔-Mallory weiss tear
| | |
Presentation: large volume of fresh hematemesis, may have melena, associate
| | | | | | | | | |
with haemodynamic compromise - CORRECT ANSWER✔✔-Varices
| | | | |
Presentation: fresh hematemesis or mixed with vomit. Prodromal dyspepsia and
| | | | | | | | | |
constitutional symptoms - CORRECT ANSWER✔✔-Gastric cancer
| | | | |
Presentation: fresh hematemesis and melena, considerable volume but difficult
| | | | | | | | |
to find endoscopically - CORRECT ANSWER✔✔-Dieulafoy lesion
| | | | | |
, What is Dieulafoy's lesion? - CORRECT ANSWER✔✔-rare cause of acute upper GI
| | | | | | | | | | | |
bleed. Vascular malformation in which a large tortuous artery in the submucosa is
| | | | | | | | | | | |
eroded by gastric acid
| | | |
Presentation: fresh hematemesis and epigastric discomfort. recent NSAID usage -
| | | | | | | | | |
CORRECT ANSWER✔✔-Erosive gastritis | |
Presentation: small volume of fresh hematemesis, may not be noticed and has
| | | | | | | | | | | |
IDA - CORRECT ANSWER✔✔-Gastric ulcer
| | | |
Where is the most common site for a duodenal ulcer that would cause major
| | | | | | | | | | | | | |
haemorrhage? - CORRECT ANSWER✔✔-Posterior- invading gastroduodenal artery
| | | | | |
Cause of major upper GI haemorrhage in previous AAA repair? - CORRECT
| | | | | | | | | | | |
ANSWER✔✔-antero-enteric fistulation |
What is the management options for varices? - CORRECT ANSWER✔✔-Give
| | | | | | | | | |
telipressin prior to endoscopy | | | |
At endoscopy- banded or sclerotherapy
| | | | |
If active bleeding- Sengstaken Blakemore or Minnesota tube- balloons can only be
| | | | | | | | | | |
|inflated for 12 hours due to risk of necrosis
| | | | | | | | |
Portal pressure decreased with medical therapy +/- TIPSS
| | | | | | |
What is combination therapy for bleeds identified on endoscopy (non-varcies)? -
| | | | | | | | | | |
CORRECT ANSWER✔✔-Injection of adrenaline and either thermal or mechanical
| | | | | | | | |
treatment- banding or diathermy | | |
