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MRCS High Yield Questions And Answers
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MRCS High Yield Questions And Answers MRCS High Yield Questions And Answers MRCS High Yield Questions And Answers
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MRCS High YieldWhat is the treatment of palliative colon cancer? - ANS Stents
Bypass surgery
Diversion stomas
What is the treatment of right colon cancer? - ANS Right hemicolectomy with ileo-colic anastomosis
<5% leak rate
What is the treatment transverse colon cancer? - ANS Extended right hemicolectomy with ileo-colic
anastomosis
<5% leak rate
What is the treatment of splenic flexure colon cancer? - ANS Extended right hemicolectomy with ileo-
colic anastomosis
<5% leak rate (better than left hemicolectomy w/ colo-colic: 2-5%)
What is the treatment of left colon cancer? - ANS Left hemicolectomy with colo-colon anastomosis
2-5% leak rate
What is the treatment of sigmoid colon cancer? - ANS High anterior resection with colo-rectal
anastomosis
,5% leak rate
What is the treatment of upper rectal cancer? - ANS Anterior resection with total mesorectal excision
and Colo-rectal anastomosis
Likely radiotherapy
5% leak rate
What is the treatment of low rectal cancer? - ANS Anterior resection with TME and colo-rectal
anastomsis (+/- defunctioning stoma)
Likely radiotherapy
10% leak rate
What is the treatment of anal verge rectal cancer? - ANS Abdomino-perineal excision of colon and
rectum
Likely radiotherapy
What is Hartmans procedure? - ANS Resection of sigmoid colon with end colostomy
How do you manage patients with large bowel obstruction resulting from carcinoma above the
peritoneal reflection? - ANS Resection
Stenting
,Defunctioning
How do you manage patients with large bowel obstruction from rectal cancer? - ANS *Defunctioning
loop colostomy*
Then staging
What is the level of the inferior phrenic branches? - ANS T12 (paired, parietal)
What is the level of the coeliac trunk? - ANS T12 (unpaired, visceral)
What is the level of the SMA? - ANS L1 (unpaired visceral)
What is the level of the middle suprarenal arteries? - ANS L1 (paired visceral)
What is the level of the renal arteries? - ANS L1/L2 (paired visceral)
What is the level of the gonadal arteries? - ANS L2 (paired visceral)
What is the level of the lumbar arteries? - ANS L1-L4 (paired parietal)
What is the level of the IMA? - ANS L3 (unpaired visceral)
What is the level of the median sacral artery? - ANS L4 (unpaired parietal)
, What is the level of the common iliac artery? - ANS L4 (paired terminal)
What vessel may be divided to improve access to aneurysm neck in juxtarenal AAA?
What branch of aorta overlies this? - ANS Left renal vein (anterior relation of AA)
SMA overlies left renal vein
When do you offer surgery for AAA? - ANS Aneurysm 5.5-6cm (asymptomatic)
Symptomatic aneurysms
Rupture
How many layers of abdominal wall are found in AAAs? - ANS All 3 layers
What are the risks of AAA rupture depending on size? - ANS 5-5.9cm = 25% 5yr
6-6.9cm = 35%
7cm+ = 75%
What is the most appropriate fluid regime in rAAA? - ANS 1 litre Hartmanns over 4hours
(avoid high volume infusion)
Mnemonic for decending abdominal aorta branches? - ANS Prostitutes cause sagging swollen red
testicles (in men) living in sin
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