Questions 41-50
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41. Regarding local anaesthesia a. Local anaesthetics act on large before small nerve fibres b. Their main toxic effects are seen on the central nervous and cardiovascular systems c. Adrenaline reduces absorption and prolongs the local effects d. Preparations containing adrenaline are safe to use on digits and appendages e. Lignocaine has a longer duration of action than bupivicaine
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42. With an iron deficiency anaemia a. Both serum iron and total iron binding capacity are reduced b. The blood film shows a hyperchromic microcytic picture c. The reticulocyte count is low in relation to the degree of anaemia d. Serum ferritin levels are increased e. The platelet count may be increased
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43. Regarding abdominal aortic aneurysms a. They commonly remain symptomless until they rupture b. The risk of rupture increases with aortic diameter c. Elective repair should have a 30-day mortality of less than 5% d. Emergency repair has a 30-day mortality of less than 10% e. The benefits of surgery for small (4.0-5.5 cm) is proven
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44. Regarding hepatitis B a. It is due to an RNA virus b. It has an incubation period of 2 to 6 days c. It can be transmitted via blood products d. About 1% of the UK population are Hepatitis B Surface Antigen positive e. About 10% of infected patients become chronic carriers
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45. Regarding vascular grafts a. PTFE grafts are less porous than Dacron b. Vein grafts have better long-term patency c. Graft failure less than a month after surgery is usually due to a surgical error d. Graft failure within the first year is often due to neo-intimal hyperplasia e. Graft failure beyond one year is due to progression of the underlying disease
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46. Regarding colorectal carcinomas a. About 40% present as surgical emergencies b. Right-sided tumours often present with a change in bowel habit c. 75% of tumours can be reached with a flexible sigmoidoscope d. Over 20% of patients present with more than one primary tumour e. A Duke's B tumour has nodal metastases
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47. Regarding colonic polyps a. Metaplastic polyps are pre-malignant b. Adenomatous polyps are pre-malignant c. Villous adenomas are more common than tubular adenomas d. Genetic mutations can result in epithelial metaplasia e. Most carcinomas arise in adenomatous polyps
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48. In patients with carotid artery disease a. A bruit is a reliable sign of the degree of stenosis b. Atheroma is most commonly seen in the external carotid artery c. An embolic event often results in an ipsilateral hemiplegia d. Prophylactic aspirin reduces the risk of a stroke e. Surgery is of proven benefit in those with asymptomatic stenoses
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49. Regarding acute limb ischaemia a. Arterial occlusion has less dramatic effects in those with underling occlusive disease b. Occurs more often in patients in sinus rhythm c. Objective sensory loss requires urgent treatment d. Fixed skin staining is an early sign e. Intra-arterial thrombolysis is invariably successful with no morbidity
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50. Regarding muscle relaxants a. Suxamethonium is a non-depolarising agent b. Vecuronium is a depolarising agent c. Suxamethonium induces histamine release and can produce a 'scoline rash' d. Suxamethonium has a duration of action of about 5 minutes in most people e. Scoline apnoea is due to pseudocholinesterase deficiency
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