The four Surgical Royal Colleges have recently received approval from the GMC to make
changes to the MRCS Part A Examination. The second edition of this popular book,SBAs and EMQs for the MRCS Part A is an invaluable guide to sitting and passing the new MRCS examination.There is an increased emp...
1. Concerning statistical analysis, B A 73-year-old plumber
which statement below is true? presents with a painful groin.
A A Type I error accepts the false He has had the pain for years
null hypothesis (e.g., false and it is associated with a
negative). A benefit is missed swelling. He is able to reduce
when it was there to be found. the lump with ease. Diagnosis:
B A Type II error is the incorrect Lumbar hernia.
rejection of a true null hypoth- C A 40-year-old woman presents
esis (e.g., false positive). A with a painful groin. There is a
benefit is perceived when really small palpable mass, which is
there is none. located in her right upper thigh.
C A Null hypothesis is a statement Diagnosis: Spigelean hernia.
of no significant difference or D A 53-year-old man presents
effect. with pain in the right iliac fossa
D Specificity (true negative rate) with a palpable mass. His past
measures the proportion of surgical history includes an
positives that are correctly appendicectomy. Diagnosis:
identified as such (e.g., the per- Umbilical hernia.
centage of people with a disease E A 6-year-old boy had a reduc-
who are correctly identified as ible swelling around his umbi-
having the disease). licus. Diagnosis: Paraumbilical
E Sensitivity (true positive rate) hernia.
measures the proportion of
3. Which nerve is damaged in the
negatives that are correctly
scenario below? A 65-year-old
identified as such (e.g., the per-
woman is referred with a loss of
centage of healthy individuals
sensation over her thumb index
who are correctly identified as
and middle finger. Her radio-
not having the disease).
graph confirms a distal radius
2. With regard to hernias, which of fracture.
the following is correct? A Axillary nerve
A A 28-year-old man presents B Lateral pectoral nerve
with abdominal and groin C Median nerve
pain following a rugby match. D Musculocutaneous nerve
Diagnosis: Paraumbilical hernia. E Radial nerve
, 2 Section 1: Single Best Answer Questions
4. Which nerve is damaged in the 8. Select the single best anatomical
scenario below? A 57-year-old level in which the superior mesen-
man has follow off his ladder and teric artery comes off the aorta?
presents with a wrist drop. His A T12
radiograph demonstrates a mid- B L1
shaft fracture. C L2
A Axillary nerve D L3
B Lateral pectoral nerve E L4
C Musculocutaneous nerve
9. For the equation
D Radial nerve
described below, select
E Suprascapular nerve
the single best answer.
[(2 × diastolic) + systolic]/3
5. Which nerve is damaged in the
A Cardiac index
scenario below? A 43-year-old
B Cerebral blood flow
man has a deep laceration to his
C Cerebral perfusion pressure
right wrist following a fight.
D Mean arterial pressure
On examination, he has a loss
E Pulmonary vascular resistance
of thumb adduction and loss of
sensation over his little and ring 10. For the equations described
fingers. below, select the single best
A Median nerve answer. Cardiac output/heart
B Musculocutaneous nerve rate (HR)
C Radial nerve A Cerebral blood flow
D Suprascapular nerve B Cerebral perfusion pressure
E Ulnar nerve C Mean arterial pressure
D Pulmonary vascular resistance
6. For each of the reflex described E Stroke volume
below, select the single best root
values from the options listed. 11. For the equation described below,
Biceps reflex. select the single best answer.
A C3/C4 (Mean pulmonary artery pres-
B C4/C5 sure – mean pulmonary capil-
C C5/C6 lary wedge pressure) × 80/cardiac
D C6/C7 output
E C7/C8 A Cardiac index
B Cerebral blood flow
C Cerebral perfusion pressure
7. Select the single best anatomical
D Mean arterial pressure
level in which the IVC is formed
E Pulmonary vascular resistance
from the common iliac veins?
A L1 12. For the equation described below,
B L2 select the single best answer.
C L3 CPP/CVR
D L4 A Cardiac index
E L5 B Cerebral blood flow
, Section 1: Single Best Answer Questions 3
C Cerebral perfusion pressure C Chromium
D Mean arterial pressure D Benzene
E Pulmonary vascular resistance E Nickel
13. For the equation described 18. What carcinogen is associated
below, select the single best with transitional cell carcinoma of
answer. Cardiac output/body the urinary tract?
surface area A Aniline dyes
A Cardiac index B Polyvinyl chloride
B Cerebral blood flow C Asbestos
C Cerebral perfusion pressure D Ultraviolet radiation
D Mean arterial pressure E Ionizing radiation
E Pulmonary vascular resistance
19. What carcinogen is associated
14. For the equation described below, with hepatocellular carcinoma?
select the single best answer. A Aniline dyes
MAP-ICP B Polyvinyl chloride
A Cardiac index C Asbestos
B Cerebral blood flow D Ultraviolet radiation
C Cerebral perfusion pressure E Ionizing radiation
D Mean arterial pressure
E Pulmonary vascular resistance 20. A 63-year-old male patient
presents with diarrhoea and
15. For the equation described below,
fresh rectal bleeding for
select the single best answer.
1 month. He experiences occa-
(Mean arterial pressure – mean
sional abdominal pain and loss
right atrial pressure) × 80/cardiac
of appetite. Select the single best
output
diagnosis?
A Cardiac index
A Diverticulitis
B Cerebral blood flow
B Rectal carcinoma
C Mean arterial pressure
C Colonic adenomata/polyps
D Pulmonary vascular resistance
D Crohn’s disease
E Systemic vascular resistance
E Ulcerative colitis
16. What carcinogen is associated
with thyroid cancer? 21. A 28-year-old woman presents
A Aniline dyes with central abdominal pains,
B Polyvinyl chloride bloodstained diarrhoea, and
C Asbestos anaemia. She has no relevant past
D Ultraviolet radiation medical history. Select the single
E Ionizing radiation best diagnosis?
A Diverticulitis
17. What carcinogen is associated B Rectal carcinoma
with cancer of the nasal cavity? C Colonic adenomata/polyps
A Ultraviolet radiation D Crohn’s disease
B Ionizing radiation E Ulcerative colitis
, 4 Section 1: Single Best Answer Questions
22. A 69-year-old woman is C Respiratory acidosis
awaiting surgery for a total D Respiratory alkalosis
hip replacement. She reports E None of the above
severe abdominal pain and
26. At what single level does the
nausea. She is currently
thoracic duct pass through the
taking nonsteroidal anti-
diaphragm?
inflammatory medication for
A T8 Level
pain relief. Select the single
B T9 Level
best diagnosis?
C T10 Level
A Diverticulitis
D T11 Level
B Rectal carcinoma
E T12 Level
C Colonic adenomata/polyps
D Crohn’s disease 27. At what single level does the
E Ulcerative colitis oesophagus pass through the
diaphragm?
23. For each of the conditions
A T8 Level
described below, select the single
B T9 Level
best arterial blood gas result from
C T10 Level
the options listed below. Thiazide
D T11 Level
diuretics
E T12 Level
A Metabolic acidosis
B Metabolic alkalosis 28. At what single level does the aorta
C Respiratory acidosis pass through the diaphragm?
D Respiratory alkalosis A T8 Level
E None of the above B T9 Level
C T10 Level
24. For each of the conditions
D T11 Level
described below, select the single
E T12 Level
best arterial blood gas result from
the options listed below. Chronic 29. The eustachian tube arises from
renal failure what pharyngeal pouch?
A Metabolic acidosis A First pharyngeal pouch
B Metabolic alkalosis B Second pharyngeal pouch
C Respiratory acidosis C Third pharyngeal pouch
D Respiratory alkalosis D Fourth pharyngeal pouch
E None of the above E Sixth pharyngeal pouch
25. For each of the conditions 30. The second pharyngeal pouch is
described below, select the single innervated by which nerve?
best arterial blood gas result from A Trigeminal nerve (V)
the options listed below. Guillain– B Abducent nerve (VI)
Barré syndrome C Facial nerve (VII)
A Metabolic acidosis D Glossopharyngeal nerve (IX)
B Metabolic alkalosis E Vagus nerve (X)
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