MRCS VIVA TOPICS

Updated May 2004

Complied by Mr EA Griffiths MRCS

MRCS VIVA QUESTIONS

ANATOMY

Head and Neck

Thorax

Abdomen

Muscles of masticationTriangles of the neckMandible – parts and foramenSkull – paranasal sinuses, surgical anatomy of middle menigeal arterySkull base and foramina Trachea – surface anatomyThyroid (anatomy and development)Cranial nerves Facial N (Funct, tests, lesions) Visual pathway anatomy Branches of facial nerve Anatomy of Horner’s Syndrome Oculomotor N, other cranial nerves Movements of the eye Glossopharygeal nerveAtanto-axial anatomyCervical rib1st Rib Pituitary glandCavernous sinusOesophagus blood supplyCervial fasciaCircle of WillisBuccinatorSubmanidubular glandFloor of the mouthLingual NParotid GlandTongue (muscles, nerves, attachments, blood supp)

Heart anatomy (coronary arteries, borders, conduction system)Heart – ext surface and int structureVagus nervePleural and lung anatomy (surface markings)OesophagusLymphactic drainage of the breastSympathetic chainPosterior mediastinumDiaphragm anatomy

Femoral trianglePortal venous systemHepatocyte relationship (Portal triad)Liver – porta hepatisBoundaries of the axilla (axillary dissection)Pro-section – small and large bowelBlood supply of the stomachKidney – surface anatomyInguinal and femoral canalGonadal vesselsPancreasColonic blood supply

Orthopaedic

Misc

Reproductive anatomyDuodenum blood supplyBlood supply to the rectumMale urethraAnal canal + embryologyTesticular anatomy and descentBiliary tract Abdominal aortic branchesBrachial plexusCoeliac axisVas defernsRecurrent laryngeal NAdrenal – blood supplySpleen blood supplyIschiorectal fossaCourse of IMASaphenofemoral, saphenpopliteal junctions, LSV and SSVNerve injuries around the humerousCarpal bones (median N cross section with carpal bone)Spina bifidaObturator NFemur – bone, muscle att, blood supply, approachesPelvic autonomic nervesClavicleScapluaHand anatomy and anatomical snuff boxHand tendonsStructures around the wristBony pelvisPopliteal fossaCauda equinaSciatic nerveFoot Nerve supplyFascial compartments of limbs, esp in relation to compartment sydromeShoulder joint anatomyUlna, Radial nerveCarpal bones and attachmentsCarpal tunnelKnee anatomyBone anatomy, i.e. tibia etcNerves and vessels around the humerusLymph drainage of lower limbBone growth plates

Reflexes and reflex mechanismLevels and structures of abdominal CTSites of referred pain

PHYSIOLOGY ‘Secondary messengers’Light reflexGastrointestinal hormonesCervical sympathectomyOsmotic and oncotic pressureSmall bowel fistulaeRods and conesBuffers definitionTransaminasesFaecal and urinary incontinenceLung function testsLiver physiologyBreast physiologyGastro-oeopageal junctionGastric response to a large mealPituitary and hypothalamusOsmolalityCoagulation factors and clottingADH and aldosteroneRenal angiotensin systemStarlings Law of the heartAdrenal physiologyPortal hypertensionDraw a cardiac action potentialPancreatic secretionsHyperparathyroidismHypo/hyperthyroidismMetabolic response to trauma/sepsis/shockMolecular structure of haemoglobinCalcium heomostasisNeuro-muscular junctionCatecholaminesCoronary blood flowCauses of hyperglycaemiaIodine to thyroxine sequenceCough reflexBladder physiology and controlO2 dissociation curve, CO2 transportLactateHenderson-Hasselbach equation and Acid BaseRenal physiology and Loop of Henle (absorption and excretion in renal tubule)Nephrotoxic drugsIntra-cranial pressureHypercalcaemia and Ca++ metabolismGastric acid production and physiologyCSF and cranial pressureThermoregulationCreatinine clearanceSmall bowel physiologyBile salt (enterohepatic circulation)Adrenal physiologyCompartment syndromeHow a ventilator worksHypovolaemia – physiological responseActive transport mechanisms

Nerve membrane potentials

PATHOLOGY Definitions (dysplasia, metaplasia, etc etc)Define aneurysm (types, classification, causes)SteptococciThrombus/EmbolusTypes of necrosisAvascular necrosisDisinfection vs sterilizationBerry AneurysmPathology of OAClostridial infectionsSpore forming organismsOsteomyelitisFNACB-cells, Plasma Cells, Macrophages, Golgi apperatusOsteoporosisMetastasesCell membrane structureFistulaeDVT and Virchow’s triadAscitesDefinitions i.e. dysplasia, metaplasia, hyperplasiaAtherosclerosisTumour markersCauses of dysphagiaNeoplasiaTNM scoring (breast, bronchus, colon)TBWhat is cellulitis?Blood groups and blood transfusionDiabetesH pylori and ulcer diseaseProstate cancerTesticular cancerColorectal polyps and adenoma-carcinoma sequence (types, histology, and malignant potential)Malignant melanoma/SCC/BCCDiverticular diseaseGranulomasImmunoglobins/Immunology and antibodiesEndo/exotoxinsGrading and staging of colorectal cancerWound healing, Keloids etcCell CycleP53, tumour suppressor promotersOncogenesisViruses in Ca (Hep B,C, HPV, EBV)Parotid tumoursFistulaePathological fracturesInflammatory bowel diseaseMendelian geneticsAmyloidosisFat embolismPSATeratomasMRSA

IschaemiaFracture healingSkin tumoursMalignant melanoma (Clark’s, Breslow thickness)UV damage LymphomaUses of the frozen sectionHaemopoesis (pleuripotent stem cells lines)

CRITICAL CARE Indications for ITUComplications of sepsis in ITU patientsPanceatitis (ITU management and complications)Tension pneumothoraxMODS/SIRSARDSIntubation and airway problemsEbb/flow of metabolic responseRenal supportHigh output fistulaeHeparinisation and warfarinisationHyperkalaemia and ECGStarlings law of heart and capillary flowBurns and fluid replacementRenal autoregulationPain pathways in acute appendicitsCardiovascular monitoringShockCardiac arrest, CPR, internal cardiac massageCardiac tamponadeElectrolyte distrubancesFluid management (crystalloid/colloid/blood)Fluid compartmentsAcid Base balanceTracheostomyPhysiological scoring systems i.e. APACHE IIMuscle relaxantsArterial line insertion (indications, risks, how to)Central lines (indications, risk, how to)InotropesTPNCVP lines and Swan GanzPulmonary artery wedge pressuresAcute assessment of critical ill patientSurgical nutritionTypical TPN regeme (constituents)Physiological consequences of IPPVSepsis vs hypovolaemiaPericarditis, causes, drainage of pericardial fluidHypoxia (causes)SteroidsPain pathwaysAction of morphineLocal anaesthetics

OPERATIVE SURG ERCPTME rectal caMastectomy anatomyReduction of the dislocation shoulderTRAM flap reconstruction breastHernia repair (MESH)TracheostomyHaemorrhiodectomySkin flaps and grafts and closureOperations for hydrocoele

Ingrown toenail opsNephrectomyBier’s blockAKA/BKAApproaches to the pancreasPreparation for surgery THRAppendiectomyLaparoscopy cholecystectomyReduction of Colles’ fractureRight hemicolectomyCrohn’s disease surgeryChest drainsOGDGanglion excisionFasciotomy (compartment syn)LaparoscopyVaricose vein surgeryCircumcisionHernia operations (umbilical, epigastric, inguinal, femoral)Burr HolesApproachs to AAABowel anastomosisArthroscopy of the kneeMethods of fixationAxillary dissectionInsertion of chest drain

GEN PRINCIPALS Skin flapsPain managementCompartment sydromePyloric stenosis (ABGS, etc)Upper GI bleedingAsepsis/sterilizationGoitresColles #Management of cancerIndications for splenectomySmall and large bowel obstructionManagement of high risk surgical patientNipple dischargeVaricose VeinsTesticular painDifferential of stiff shoulderPulmonary EmbolismSpinal shock at various levelsGynaecological causes of abdominal painDifferential of a groin lumpDay-case surgeryPost op complicationsCoroner – what deaths to reportManagement of bilary sepsis/obstructionVenous ulcersAbdominal X-rayPancreatitisComplications of hernia repairHead injury managementManagement of diabetic floot ulcerIntermittent claudicationManagement of DVTGunshot injuresDiathermyOesophageal cancer symptoms and stagingFracture managementGlasgow Coma ScaleIssues about consentAnalgesia in childrenStomasAbdominal aortic aneurysmsSplenic injuryAcute AbdomenCauses of post-op pyrexiaScaphoid fracturesFactors determining level of amputationComplications of laproscopic surgeryAnticoalgulationDifferentiation of types of jaundiceThyroid surgeryBlood transfusionsDICScreening for diseases Esp breast cancer screening, colorectal screening and prostatic ca Investigation of haematuria

Trauma management and ATLSManagement of jaundiceBrain stem deathFracture NOFIncisional herniasTrigemminal neuralgiaHIV in surgical patientEpistaxisImmunosuppressionIDDM peri-operative managementMajor haemorrhage (variceal, upper GI, lower GI etc)Suture materialManagement of ureteric stonesAntibiotic prophyaxisClassification of open fracturesNecrotising fascitis (causes and management)Investigation of thyroid diseaseTreatment of anaphylaxisBlast injuriesSterilsation (male and female)Carotid artery diseaseEndoscopy

MORE VIVA TOPICS

All these further pages have been emailed to me by various helpful people who responded to my posting on www.surgical-tutor.org.uk

Applied surgical AnatomyAnd operative surgery

Clinical Pathology And Principles of surgery

Applied Physiological And Critical Care

Bones and Joints in foot, inversion, eversion injury, stomach blood supply, lesser sac, foramen of winslow,, femoral hernias, nerve injuries, principles of Anatomises, dural venous sinuses, femoral triangle, appendicectomy,thyroidectomy, and thyroid tumors,local anaesthetics,Axillary artery and and its relation to pectoralis minor, cavernous sinus, carotid endarterectomy- structures damaged in surgery, hip and blood supply,, skull foramina, celiac axis, vascular anastmosis, tendon repair, structures and functions of the brainstem, branches of subclavian artery, large and small bowel anatomy, transpyloric plane, formen of winslow, epiploic foramen, lesser sac, nerve supply of leg, brainstem functions, layers of spermatic cord, structure around wrist joint, chest drain, colon blood supply, surface markings of pleura, posterior triangle boundaries and contents, approach to AAA, bladder control, submandibular gland anatomy, course of inferior mesenteric vein, posterior medistinum, atlanto-axial joint, shoulder joint anatomy, surface anatomy of sciatic nerve, typical rib, rectal blood supply, branches of facial nerve, abdominal aortic branches, management of diabetic ulcer foot, brachial plexus, diaphragm anatomy, cervical facia, popliteal fossa,

Wounds, Incisions, Jenkins rule, principle and complications of fractures, fat embolism, post splenectomy complications, death reported to coroners, disinfections and sterilisation, embolism surgery, causes of free peritoneal air, complications of laproscopic surgery, gall bladder emphyma physiology, necrosis and comparison with apoptosis, staging of a cancer, dukes staging, abscess formation, organisms involved on fistula-in. ano and treatment, goodsalls treatment, starlings curve, ARDS, thyroid nodule, melanoma, salivary gland, wound dehiscence, grafts, flaps, laminar flow theatres, GI hormones, treatment of fracture neck of femur, colles, post op pyrexia, skin cancers, clearance margins, staging, burns, diverticulum’s, meckels ,peptic ulceration, gastrinoma, barrets,gall stones, cholesterol metabolism,MEN syndromes, CVP insertion, gout, how does subcut heparin works, portal hypertension

LCIS, buffers, GFR, pressures across bowman’s capsule, auto regulation, Clearance and measurement inulin, CVS effects of PE, Hypoxia, reasons for tracheotomy, starvation, micturition, crush injury, liver functions and failure, treatment of raised ICP, neuromuscular junction, spinal anaesthesia, calcium functions, gastric acid secretions, oxygen dissociation curve, normal ECG, renal stones, intussusceptions, shock, how diuretics work, role of aldosterone, ADH, adrenal physiology, multi organ failure, intestinal obstruction, intraabdominal compartment syndrome, compartment syndrome, DPL, patterns of breathing, bowel infarction, blood groups, macrophages, treatment of anaphylactic shock, inotropes, co2 carriage, Handersen-hasslebachs equation, fluid management, pheochrmocytoma, osmalality, SIRS, endo-exotoxin, adrenal cortex anatomy and physiology, oedema, glascow coma scale, management of head injury, blood groups, parental nutrition, hyperkalemaia, translocation of bacteria,

carcinoma of oesophagus, cheloscystitis, cytology versus histology, DVT, jaundice, post po pyrexia, anueryms, bowel preparation, MRSA, jaundice, anaemia, fracture healing, metabolic response to trauma, malignant melanoma, dysphagia, tumour markers,

Phsiology &Crtical Care:-1.Management of multiple long bone fractures.2.Compartment Syndrome.3.Compartments of the leg.4.Management of the unconscious patient.5.Preop management of patients on anticoagulants.6.ALS7.Pulmonary Odema.8.ABG’sanatomy

1. Course of 3,4,6 cranial nerves.2. mechanism of Extradural hematomas3. Sign’s of Horner’s Sundome.4. Effects of Pancoast Tumor (anatomical Basis)5. Brachial Plexus.6. First Rib,7. Mehanism of Erb’s Injury

1. Causes of lump in the neck.2. Management of lymph node in the neck.3. Mangement of dog bites.4. Mangement of druken youg patient.

Operative Surgery & Pathology:-1. Causes of dysphagia2. Oesophagitis 3. Sequalae of persistent inflammation.4. Hydrocepahalus.5. Def. Of Fustula6. Types.7. Tracheoesopahgeal fistula in the newborn.8. Diverticular disease.9. Colovesical fistula10. mangemnt of thyroid nodule11. Causes of gynaecomastia

.

Questions asked in Viva :

APPLIED PHYSIOLOGY & CRITICAL CARE

Evaluation of a patient with regards to kidneys:

How would you evaluate the renal function in a preoperative patient?What is creatinine clearance? How is it assessed & what is normal creatinine clearance?Draw a nephron, label parts & give their function?How does the kidney conserve water? What is the maximum concentration capacity of kidney?What is normal plasma osmolality & urinary osmolality?

Evaluation of respiratory system:

Give a simple test that can be used by the bedside to evaluate respiratory function.How would you assess a patients' respiratory function?What are the terms you would use to describe a patient in respiratory failure?( He was looking for the word CONFUSION ..... it didn't strike me until he uttered it.....)

Scoring systems in surgery:

What are the scoring systems you know of that are routinely used in surgical practice?( I listed AVPU, GCS, Ransons & APACHE 2......he asked me list the full GCS, Ransons & Acute Physical Assessment criteria of the APACHE 2)

Acute pancreatitis:

Causes of pancreatitis?Where would you manage a patient with pancreatitis? What are the complications of acute pancreatitis?

APPLIED ANATOMY & PRINCIPLES OF SURGERY

Mandible

Draw on the mandible the nerves related to it.Which nerve are these branches?What is the function of inferior alveolar nerve?When is the lingual nerve at risk of damage & how frequent is it?What would a patient with lingual nerve injury complain of? ( He was looking for RECURRENT BLEEDS DUE TO TONGUE BITES due to anesthesia .... I just kept repeating anesthesia, loss of taste....)

Vertebra

was given a vertebra with a broken R transverse process & a large articular surface on the left. It was large to be a thoracic vertebra. I had no clue as to what it was but in view of the extra articular surface on the transverse process I answered it as a thoracic vertebra. I was obviously wrong! It turned out that it was a sacralised L5 & the transverse process was broken when trying to separate it from the sacrum!! IT WAS MEANT TO BE THE CLUE FOR IDENTIFYING THE BONE!!! Which I didn't catch!!!! Well, these questions followed:

What passes in the spinal canal at this (L5) level?Where are the spinal arteries situated & what is their Surgical importance?

Where do the spinal nerve roots lie emerge at various levels?In spinal decompression show on the bone what is removed.

Hernia:

How do you define hernia?( I said..... protrusion of whole or part of a viscus through natural or acquired defects in the walls of the cavity containing it.....She asked me WHAT ABOUT FAT? I replied fat is a viscus by its own right.....)What are the types of abdominal hernia you know?With respect to incisional hernias describe principles of wound closure & healing that could lead to hernia formation.What are the principles of incisional hernia repair? When would you not use a mesh in the repair of an incisional hernia?

Tourniquet use in surgery:

What are the indications for use of a tourniquet?(I mentioned blood less field, emergency control of haemorrhage & regional anaesthesia)What principles govern the use of tourniquets in surgery?How would you administer regional anaesthesia using a tourniquet?What is the technique called? What agent is used?

SURGIGAL PATHOLOGY & CLINICAL SURGERY:

Raised Intra Cranial Pressure:

What is normal ICP? List causes of raised ICP?Draw where an EDH is situated.What is its classical presentation?How can you explain this presentation?How would you manage a patient with EDH? Give me 2 words.What are the neoplastic lesions affecting the brain?

Obstructing lesions of sigmoid colon:

How would you manage a person with the above?

Preoperative preparation:

How would you prepare a patient with prosthetic heart valve for laparoscopic cholecystectomy?

CLINICAL CASES:

'MAIN CASE': Carotid artery stenosis. Had to take history & examine relevant systems in this case. This 78 year young gentleman presented with one episode of sudden transient loss of sensation of his right lower limb.

Other cases:

Consent for laparoscopic cholecystectomy.Examination of ulnar nerve.Examination of peripheral pulses.Examination of abdomen – paraumbilical hernia.Examination of incisional hernia.Examination of varicose veins.Examination of hip.

Dear Ewen, Success! :) London Dec 2003ANATOMY: MRI of brain, Cranial venous sinuses, Posterior Triangle of Neck, Stabilising structures of SIJOPERATIVE Sx: Wound dehiscence, Abdominal Incisions Pros & Cons, AAA, femoral herniaPATHOLOGY: Lymphadenopathy & Causes, Viral Oncogenesis, Frozen SectionPRINCIPLES OF Sx: Fracture management/complications, ERCP, JaundiceAPPLIED PHYSIOLOGY: LFTs, Ca metabolism, Blood constituents, JaundiceCRITICAL CARE: Blunt chest trauma, Acute pancreatitis, Postoperative analgesia EDINBURGH Feb 2004PHYSIOLOGY: Liver, Head Injury, PneumothoraxANATOMY: Liver (plastinated), Stomach/Pancreas/Spleen (plastinated), Splenectomy (how to do), lesser sacPATHOLOGY: Carpal Tunnel Syndrome, Parotid Gland, Bloody diarrhoea Hope this helps! Regards

Dear Ewen,

I'd like to have a copy of your list as you posted insurgical tutor forum, for my preparation of exam incoming March.

I've attempted once. Here are the questions I wasasked:1. LA, how it works2. Blood group systems3. discuss about ischemic bowel disease4. R hemicolectomy5. discuss about 'LN and malignancy'6. BPH and CA Prostate, presentations, pathology7. Ectopic pregnancy, how it presented, dx.

Dear Ewen, Had an unsucceful attmpt at MRCS viva ED. Sending you list of questions which I hope will be useful. Anatomy: 

Patella, lower end of femur,dislocation of patella,menisciiknee joint - screw home mechanism Operative surgery: Hypotension with an acute abdomenInformed consent and anatomy of ParotidInguinoscrotal swelling in 8 yr bou - management Pathology: thyroid swellingDD of swelling in anterior triangle of neck with anatomyPara neoplastic syndromes Surgery: Difference beteween UC and CrohnsLymphomasPeritonitis Critical care: CCFARDSHead injury and managementPancreatitis lung physiology in fluidoverloaded patient Do you have an updated list? Some other questionsa sked to my colleagues are as follows: Craniectomymeningitis and lumbar puncture and difference between spinal fluids  If I can get any more questions I wil let you know. Bye, PareshHello, do you still remember me? I had requested the list of viva questions from you last month, for the preparation of my Viva AFRCSI (held on 4th Sept 2003). Here, let me return you the favour. Following is the list of questions I got for my Viva: 1) Anatomy

Blood supply to the stomach and the gut Hepatobiliary system

 2) Operative surgery

Principles of vascular surgery o How to anastomose blood vessels, what suture, method o Complications of AAA surgery

Hartman’s procedure Orchidopexy

 3) Pathology

Skin cancers: types, classifications of malig. Melanoma 4) Principles of surgery

Wound healing Portal hypertension # neck of femur # mid-shaft of humerus Fat embolism

 5) Physiology

Regulations of cardiac output Regulations of blood pressure

 6) Critical care

Management of crush injury of the pelvis Well, those were the questions I got. Unfortunately, I didn’t manage to get through the exam. So, that means I will need to re-sit for it again L I hope you can email the up-dated list again, say after about 3 months. Thanks and looking forward to receive your mail again!

Hi there,             I'd be grateful if you wouldn't mind sending me your copy of viva questions that you have it'd be a life saver.             I've sat London once before and the questions I got asked were:

Anatomy: Vertebrae and spinal nerves               Facial nerve course etc               Snuff Box

Op Anat: Parotid              Short saphenous              Bowel anastamosis

Physiology              Bone/Ca              CSF              Starlings law

Critical care:              Pulse Ox              Steroids              Pneumothorax

Pathology              Blood transfusion              Methods of fixation              Microbiology

Principles              Nutrition

              Wound comtamination              Jaundice

Thanks Syed

MRCS Viva Glasgow Oct 2003

Applied Anatomy

Colles fracture, treatment and complications (EPL rupture - Listers tubercle),

Angiogram - point out vessels, PVD medical management and surgical principals

Staghorn calculus

Principals Surgery

Prophylactic antibiotics,

Surgical Audit principals History taking in jaundice

Crit Care

Ca metabolism, hormones controlling, why you get reduced ionized Ca in hyperventilation,

CVP insertion - how to do and what to warn the patient of.

GFR - normal value,

Pressures across bowmans capsule.

Pathology

Diverticular disease picture - discuss aetiology, complications and management.

Kidney specimen with Amyoloid!,

Picture of 1st MTP showing gout - what crystalls find on microscopy, causes of gout.

Picture of avuscular necrosis of head of femur - patient groups at risk of this, why alcoholics more at risk? (apparently due to increased fat in marrow causing femoral head ischaemia).

Lung specimen (man died 6 post op) - large PE in pulmonary circulation - discuss prophylaxis. How does subcut heparin work?

Edinburgh is more clinically orientated in my experience. Topics I was asked include

Anatomy:groin anatomy and causes of lumpsblood supply stomachanatomy/embryology rectum and anal canalskull foramina plus the venous dural sinuses esp the cavernous sinusblood supply neck of femurblood supply colon

pathology:fracture healingWhat info is given on a path report pertaining to a large bowel resection...then moved onto dukes classificationpre-op assesment for theatremelanoma (breslow and clarkes levels)thromboembolism diagnosis and treatmentviruses that cause neoplasia

Physiology:Pt in itu just stopped pu'ing..why? (remeber to flush catheter first and look in any drains)ATLS stuff inc blast injuryBurns and resuscitationWhat is absorbed/excreted where in renal tubule.Calcium metabolism

As for clinical in Edinburgh it was just a whizz round the wards on whatever they had in....no special cases just fairly routine stuff.

london was trickier in that the things asked seemed to be less clinically orientated. Anatomy was ok, as was pathology. Physiology was awful......got a physiologst not a clinician whom asked me about protein metabolism and then went onto ask me to draw the urea cycle......I can't bring myself to remember any more of that experience.

at the end of the day there is a certain amount of luck involved. try to be confident, DONT bullshit, and smile!

best of luck

steve

did my edinburgh exam in january, this is what I remember

anatomy,

testis and descent of testis, given a bony pelvis to play withsites of referred pain

physiology,

nutritioncompartment syndromemanagement of acute abdomen/pancreatitisATLS stuffpopliteal fossa injuries and anatomy

pathology

lymphomathyroid canceruses of frozen sectionatheroma and aneurysmsprostate ca

the clinical was very much what i expected, hernias, veins, abdo masses, dupytrens, # ankle, odd skin lesions...

there's a book called Short cases for the MRCS by Catherine Parchmont-Smith, it's great for the clinical.

john

Dear Ewen,As promised here are the viva question .I sat the Glasgow exam which has 2 tables. One : Critical care, physiology (15 minutes)and bacteriology (15 minutes) and the second one : Pathology (15 minutes) and principles and practice of surgery (15minutes)..Table 1 questions:Poisseuilles equation.Starling equation.Exudate/transudate - examples and patophysiological changes for those examples.Adrenal gland: structure, hormones, actions, regulation.Burns: Which is the major problem? Monitoring and managementPrevention of infection in the surgical patient: preoperative measures, in-hospital measures. Prophylactic antibioterapy: which patients, how, for how long?Barrett's oesophagus: What is it? monitoring? What is metaplasia/dysplasia. Malignant tumours in gallbladder, bile ducts, liver and pancreas. What types do you know? Table 2 questions: Starting with a clinical scenario: HDu, 48 h post elective AAA repair, lob BP, Minial urinary output, tachycardia.What do you do?What are the potential reasons for this picture? How do you investigate? How do you treat?What are the most common cardiac complications following this operation? Cardiac optimisation - how do you do it?Acute renal failure - define, management? What is acute tubular necrosis?The remaning 15 minutes - cases with Xrays, anatomical dissection specimens, USS, etc.1. Intussusception : clinical picture, describe plain AXR and gastrografin enema, how do you treat?2. AAA - Xray, USS - describe findings. Abdominal specimen - demonstrate vessels, ureter, other important structures. Branches of the aorta.3. Carpal tunnel sdr. - demonstrate structures around the carpus (specimen). Identify branches of the nerves, arteries, etc. C-spineX-ray - describe, diagnosis. Long and intense but it's done and dusted!Hope it helps.All the best,Anca As promised I have just sat Glasgow and passed and below are the questions that came up

Viva Questions:

1. sterilisation2. antibiotic prophylaxis3. bone tumours4. skin function5. physiology of burns6. physiology of pyloric stenosis7. the cycle of a red blood cell8. intraabdominal compartment syndrome9. Ix of dysphagia10.neck of femur fractures

11. staghorn calculus12. PVD13 intussusception

Clinical:

patient with an enterocutaneous fistula with a vac pump placed over a wound dehiscence

2. palliative pt with a frozen abdomen

3. haematuria - ask this pt some questions etc...

4. RCC

5. preop for TKR

Hope this is of help

Best wishes,

Tjun Tang

hi ewen

had a shocker... awaiting results but fairly sure have failed.  ourquestions that I can remember, as promised:

PathWhat staging systems do you know?  Why do we stage?  Why bother havingdifferent staging systems for the same cancerWhat is a granuloma/ granulomatous diseases.  What does TB look like uderthe microscope?  What does a turberculum look like...?Tell me about lympahdenopathy.

Principles.Tell me about rib fractures (7 minutes later...)Acute pancreatitis and Imrie criteriaIntestinal fistulaeWound closureObstructive jaundice

PhysiologyTell me about gut hormonesNMJWhat is a buffer? leads to acid base - they only care about metabolicacidosisWhat types of muscle do you know?

Critical careCBD obstructionSplenectomy - the immune function of the spleen - encapulated organismsInhalation injuryRaised ICPMediastinitisHypothermiaWhat does insulin do?

AnatomyMRI sagittal through pelvis - 8 minutes on the bladder...MRI sagittal just proximal to pelvis... - tell me about the nucleus pulposusStructures that cross the sacrum, medial to later, in orderAnatomy of the medulla and CN roots, in order and level

Operative surgeryIschaemic limb - history, clinincal findings, leading to femoral embolectomyin detailApproaches to the distal radiusIncarcerated inguinal hernia - in a babyFemoral hernias - approachesApproach the axillary artey/ external iliac artery

Am sure it's all fairly standard stuff.  Examiners were quite arsey withsome people, and their favourite technique was to challenge you oneverything you said, particularly if you were right...

thanks for your questions.  hope some of the above is useful.

alia x

EwenThe questions were helpfuli got asked in MRCS Enganatomy of footMRI of bladder and peritoneal reflectionsbladder anatomy ,epithelium etc

pathologymechasism of flow phase of injury and mediators!cororner inquest frozen\sectiotumor staging

physioand critical careBP methods of assessment,graphsischaemic limbICP

operativeprinciples of bowel anastamosisprinciples of vascular anastamosisembolectomy

got asked different versions of ischaemic limp on 3 tables!

thanks 4 ur helpbye nowsaroj

Thank you for the lists!!!!Read what you listed and passed Ed on Tuesday....Topics: Path: metaplasia, dysplasia, Barret's oesophagus, Bladder, Thrombosis, Virchow's triad, propagation of a clot, Congenital Aneuryms, Clinical Audit, Diverticula, fracture healing and complications Anatomy/Operat:(Bones on desk: femur, humerus, scapula, skull base)Structures around neck of humerus, Axillary nerve, axillary artery 3 rd branches, snuff box,  antiseptic agents, Diathermy, Hemiarthroplasty, fracture complications (esp non union), apendicectomy, Rif pain d/d, Varicose veins- diagnosis, management, femoral vein , saphenous vein, crohns operation options Physio,CC:How would you manage a patient on the ward in a coma? what are his needs medical & nursing? physiological changes you would expect.. 5 minute questionMuscle ischaemia what happens with a tourniquet, treatment of Lactic acidodsis, hyperkalemia, examiner drew a box on paper called it a hormone then asked describe how this hormone works, or could work , negative feedback, second messangers. Well, that's it....If you have a list of Clinical cases can you please send them you mE?tHANKS AGAIN FOR YOU HELP!tony