General Surgery CAT 2 (MBSG 4600): 4 October 2021

MKU General Surgery CAT 2, 4 October 2021 (MBSG 4600): splenic trauma, refeeding syndrome, GI bleeding, procedures, Hesselbach's triangle, tumour biology, appendicitis scores, fluids and breast disease, with answers.

Mount Kenya University · School of Medicine · Department of Surgery

Paper details

  • Unit: MBSG 4600, General Surgery, MBChB Level IV
  • Sitting: CAT 2, 2021/2022, Monday 4 October 2021, 14:00 to 16:00. Trimester 1 (September to December).
  • Marks: 100. Answer all questions. MCQs take the single best answer.
  • Questions: 25 (short answer, procedure and recall questions, including 3 MCQs).
  • Answers: written by OmpathStudy for revision. They are not the official MKU marking scheme.
  • Topics tested: splenic trauma and shock, refeeding syndrome, pneumoperitoneum, upper GI bleeding, Meckel's diverticulum, practical procedures, testicular venous drainage, Hesselbach's triangle, tumour biology, intestinal motility and obstruction, appendicitis, fluids and electrolytes, benign breast disease, cerebral perfusion pressure.

Question 1. A young man, drowsy, after blunt abdominal injury: pulse 100, BP 80/60, tenderness and guarding in the left hypochondrium

(a) Likely diagnosis (2 marks)

(b) Initial investigations, with reasons (10 marks)

(c) Initial management (6 marks)

Question 2. Three electrolyte abnormalities of refeeding syndrome (3 marks)

Question 3. The most common cause of free intraperitoneal air (2 marks)

Question 4. Percentage of upper GI bleeds that stop spontaneously (1 mark)

  • A. 80%
  • B. 25%
  • C. 45%
  • D. 10%
  • E. Never

Question 5. Percentage of the population with a Meckel's diverticulum (1 mark)

  • A. 2%
  • B. 20%
  • C. 22%
  • D. 12%
  • E. 32%

Question 6. Which is thicker, 1/0 or 3/0 suture? (1 mark)

Question 7. Five steps in inserting a peripheral IV catheter (5 marks)

Question 8. Placing a Foley catheter in a male patient (7 marks)

Question 9. Drainage of the left testicular vein (1 mark)

Question 10. Drainage of the right testicular vein (1 mark)

Question 11. Which artery bleeds in a bleeding duodenal ulcer? (1 mark)

Question 12. Borders of Hesselbach's triangle (3 marks)

Question 13. Prefix for cancers arising from the following (11 marks)

Question 14. The 4 grades of tumour differentiation (2 marks)

Question 15. Routes of tumour metastasis, with examples (4 marks)

Question 16. Types of intestinal motility (10 marks)

Question 17. The four cardinal symptoms of intestinal obstruction (2 marks)

Question 18. Five diagnostic scoring systems for acute appendicitis (5 marks)

Question 19. Six pre-operative care points for acute appendicitis (3 marks)

Question 20. Medical treatment of hypokalaemic hypochloraemic metabolic alkalosis, with an example (3 marks)

Question 21. What is normal saline? (2 marks)

Question 22. The source of cholecystokinin (1 mark)

Question 23. MM, 36, has haematemesis, orthostatic hypotension and clammy hands but no tachycardia. How much blood has he lost? (1 mark)

  • A. More than 40%
  • B. 20 to 40%
  • C. 10 to 20%
  • D. Under 10%
  • E. 15%

Question 24. Benign breast disease and breast cancer risk (11 marks)

Question 25. Formula for cerebral perfusion pressure, with reference ranges (1 mark)

Model answers are on the page for subscribers.

Compiled by Abongo Davis · Ompath Study · shared for MBChB students at Mount Kenya University and other universities.