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Oedoma in the legs can be caused by:

1. Hypothyroidism
2. Exposing the legs to subatmospheric pressure
3. High arterial blood pressure in the absence of heart failure
4. Varicose veins
5. destruction of pelvic lymphatics

Major elective surgery under general anaesthetic is absolutely contraindicated in patients:


6. Who have had an MI within the past 12 months
7. Upper respiratory tract infection
8. Pre-operative potassium of 2.5mmol/L
9. Incidental glycosuria during pre-operative assessment
10. Who have had a mitral valve replacement

Antibiotics can cause:


11. Pyrexia
12. Skin rash
13. Thrombocytopenia
14. Claudication
15. Angioneurotic oedoma

Daily electrolyte needs are:


16. 150-200 mmol of potassium
17. 50-60 mmol of sodium
18. 1000mg of calcium in a 50-year old woman
19. 1mg daily for a man
20. 0.5mg/kg/day of magnesium

The following are absorbale sutures:


21. Polypropylene (polypropene)
22. Vicryl (polyglactin)
23. Polydioxanone (PDS)
24. Monocryl (polyglecaprone)
25. silk

As part of the physiological response after surgery:


26. There is increased prolactin release
27. There is increased potassium reabsorption
28. There is ecreased release of growth hormone
29. There is a catabolic state
30. There is increased ADH release

Post-operative analgesia:
31. Epidural catheter analgesia will immobilise the patient
32. Local anaesthetic is limited by the size of the patient
33. Paracetamol can be given intravenously
34. NSAIDs are contraindicated in patients with renal impairment

The USA National Research Council classifies surgical wounds into:


35. Class I Clean, elective, non-emergency, with primary closure and no drains
36. Class 2 Contaminated, involving incision into pus
37. Class 2 Clean-contaminated, involving surgery in respiratory, genitourinary, and
alimentary tracts without significant spillage
38. Class 3 involving traumatic wounds
39. Class 4 involving operation on perforated gastrointestinal viscus

For elective bowel surgery:


40. Patients should ideally be on a low-residue enteral diet
41. Bowel lavage is performed on the table
42. Oral non-absorbable antibiotics are taken pre-operatively
43. A single dose of IV antibiotics at anaesthesia induction
44. General health should be optimised

A 35-year old dude crashes and flies out of his windscreen:


45. The neck should be immobilised
46. The primary concern is to establish an airway
47. A single narrow-bore peripheral cannula is sufficient
48. Brain injury can occur secondary to head injury
49. If hes complainign of abdominal pain, abdominal US may be a useful investigation

In an unconscious trauma patient:


50. The neck should always be immobilised
51. Lateralisation is a sign of intracranial injury
52. Endotracehal intubation and ventilation should be considered
53. Hypovolemia is most likely due to neurogenic shock
54. Opiate analgesia should be given if there is a fracture

A 65-year old man presents with confusion two days post-op


55. The man is probably demented and should be ignored
56. He could be hypoxic
57. He could be hypovolemic
58. He could be exhibiting withdrawal from alcohol
59. The nurses should take measures to keep him from harming himself

In trauma
60. CT scan is the best imaging for head injuries
61. lap belts should be applied above the anterior iliac spines
62. a chest X-ray is the only investigation available for a pneumothorax
63. a tension pneumothorax is caused by a bronchopleural fistula
64. Paralytic ileus can result from spinal damage

Pulmonary embolism
65. Is associated with DVT in approximately 50% of cases
66. Most cases have noticeable CXR signs
67. Insertion of a vena cava filter is one method of prevention
68. Can show ventialtion-perfusion mismatch on ventilation-perfusion scanning
69. There will be a high arterial PCO2

Heparin
70. Is a mix of polypeptides
71. Has a half life of 12 hours
72. Can be reversed using protamine sulfate
73. Potentiates the action of antithrombin III
74. Can result in idiosyncratic thrombocytopenia

Mammography screening
75. Has reduced breast cancer mortality by 30%
76. Fails to identify 20% of breast cancers
77. Is carried out yearly
78. Detects cancer in 4 out of every 1000 patients screened
79. Is cost-effective for women aged 30 years and over

The following are risk factors for malignancy:


80. Smoking
81. Ulcerative colitis
82. Obesity
83. Colonic adenoma

Previous partial gastrectomy can result in:


84. Cancer developing in the remainging gastric stump
85. Severe constipation due to desruction of the gastrocolic reflex
86. Anemia
87. Calcium malabsorption
88. Weight loss

In cirrhosis, the following can provide a good indication of the progress of disease:
89. Serum aminotransferase
90. Alkaline phosphatase
91. Serum bilirubin
92. Prothrombin time
93. Serum albumin

Dysphagia can be caused by:


94. Parkinsons disease
95. Cancer at the oseophagogastric junction
96. Achalasia
97. Pharyngeal pouch
98. Oesophageal reflux without stricture

Pharyngeal pouch:
99. Is commoner in young females
100. Invariably leads to carcinoma of the upper oesophagus
101. When visible, usually presents as a left-sided lump of the neck
102. Can present with vomiting of digested food
103. Even when small, will always present with difficulty vomiting

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