Archives: FRCA Part 1

FCA1-0176

A 65-year-old man, presents to the emergency department. He explains that an hour ago, he experienced central chest pain, which moved down his left arm. On ECG, elevation in the ST-segment was noted in the anterior leads. He undergoes emergency percutaneous coronary intervention (PCI) which requires the cardiologist to access the heart via the femoral artery. Where is the surface marking for identifying the femoral artery?

FCA1-0169

A 35-year-old female, presents to the emergency department via ambulance. The paramedics have noted the patient’s symptoms as unilateral left-sided weakness of the upper and lower limbs, homonymous hemianopia and dysphasia. She has previous personal and family history of deep vein thromboses. The report of her CT scan suggests a stroke involving the middle cerebral artery. Post recovery, she undergoes further diagnostic investigations to determine the cause of a stroke at her young age. She is eventually diagnosed with a hypercoagulable state disease called Factor V Leiden thrombophilia. An emboli in the middle cerebral artery results in dysfunction of which areas of the brain?

FCA1-0170

A 41-year-old man, with symptomatic tracheal compression is scheduled for a thyroidectomy. He has previous personal history of hyperthyroidism, controlled by a carbimazole prescription. He has previously presented to the emergency department with dyspnoea and stridor, for which the surgery is indicated. Prior to his thyroidectomy, excessive bleeding is controlled for by ligation of the superior thyroid artery. The superior thyroid artery branches into the superior laryngeal artery which is closely related to a structure which upon injury will cause loss of sensation in the laryngeal mucosa. What is the name of this structure?

FCA1-0171

A 50-year-old man, presents to the hospital with bilateral inguinal hernias. After examination and investigation, the surgical team decides to perform a laparoscopic hernia repair using the extraperitoneal approach. After making an infraumbilical incision, the surgeons perform the repair by placing a prosthetic mesh over the affected area, after shifting the inferior aspect of the rectus abdominis muscle anteriorly. Name the structure that would like posterior to the mesh?

FCA1-0172

A 20-year-old woman, presented to her GP after swallowing a tiny, sharp bone and is referred to an ENT. She explains that the bone feels stuck in her throat. A laryngoscopy is performed and it shows the bone is lodged in the piriform recess. Name the nerve at highest risk of damage by the bone?

FCA1-0165

A 72-year-old man complains of severe, central abdominal pain that radiates to the back. He has a past medical history of an abdominal aortic aneurysm. A focused abdominal ultrasonography test (FAST) is performed, revealing diffuse dilatation of the abdominal aorta. The most prominent dilatation is at the bifurcation site of abdominal aorta into the iliac arteries. What vertebra level corresponds to the site of the most prominent dilatation as evident on the FAST scan?

FCA1-0166

A 58-year-old man is being operated on for a radical gastrectomy for carcinoma of the stomach. Which structure needs to be divided to gain access to the coeliac axis?

FCA1-0167

A radical neck dissection is being performed. The ENT surgeon wishes to expose the external carotid artery fully. He inserts a self-retaining retractor close to the origin of the external carotid artery. What structure lies posterolaterally to the external carotid at this point?

FCA1-0168

Where should you insert a needle to obtain a femoral artery sample to be used for an arterial blood gas?