Australian Medical Council (AMC) Surgery Questions 1-5

Questions from previous years in AMC in surgery

Q1) Which of the following is a feature of complicated  hemorrhoids

a) Bright red bleeding

b) Prolapse

c) Pain

d) Pruritis

Q2) All the following would be seen after splenectomy for hereditary spherocytosis except?

a) Persistence of spherocytosis

b) Anemia

c) Same osmotic fragility

d) Normal life span of erythrocytes

Q3) Causes of acute pancreatitis are all except

a) Pancreatic islet cell tumor

b) Mumps virus

c) Hyperlipidemia

d) Autoimmune

Q4) A middle aged woman compains of morning diarroea and cramps. Examination is grossly normal. What is the possible etiology

a) Irritable bowel disease

b) Inflamatory bowel disease

c) Carcinoma colon

d) Carcinoma rectum

 

Q5) 9th day after appendicectomy, a 49 year old man presents to you with diarrhea, fever  and retention of urine. Most probable diagnosis is 

a) Pelvic abscess

b) UTI

c) Diverticulitis

d) Nephritis

Answers in AMC Questions

Hemorrhoids are cushions of submucosa in the anal canal. Their typical postions are left lateral, right anterior and right posterior.

Normally they are painless but when thrombosis of piles occurs they become very painful. All other are normal symptoms.

2) d

Normal physiological  changes are expected in the blood cells after splenectomy. Normally spleen stores 1/3rd of the body platelets and these platelets are released to the circulation after splenectomy leading to thrombocytosis.

Other changes after splenectomy are

  1. Howell - Jolly bodies
  2. Siderocytes
  3. Heinz cells
  4. Poikilocytosis
  5. Increase in WBCs and lymphocytes

After splenectomy for hereditary spherocytosis the life span of RBC is decreased and is not normal

Spherocytes, Anemia and osmotic fragility remains the same.

Ref; http://emedicine.medscape.com/article/206107-treatment

3) a

Islet cell tumors do not cause acute pancreatitis. CA head of pancreas can sometimes cause acute pancreatitis due to pancreatic duct obstruction.

Other causes are 

1. gall stones
2) Diabetes Mellitus
3.trauma
4.steroids

5.mumps
7.autoimmune

8.scorpion venom
9.hyperlipidaemia

10.ERCP

11.DM/drugs: azathioprine,pentamdine

4) a

Irritable bowel disease is seen in middle aged women and presents with crampy abdominal pain and diarrhoea. It is often a diagnosis of exclusion and require a normal colonoscopy and CT Scan abdomen

5) a

Pelvic abscess can occur after surgery for appendicitis and progresses over a period of few days. Common symptoms are diarrhea, fever and urinary retention along with chills.

Diverticulitis and nephritis are unlikely after surgery for appendix. 

What our members think