MRCS-1507
A 47 year old accountant presents with symptoms of biliary colic and tests confirmed the diagnosis of gallstones. Which of the procedures listed below would most likely increase the risk of gallstone formation?
Category: Hepatobiliary and pancreatic surgery
MRCS-1508
A 41 year old paediatrician presents with right upper quadrant pain and a sensation of abdominal fullness. A 6.7 cm hyperechoic lesion in the right lobe of the liver is detected when an ultrasound scan is done. Tests show that the serum AFP is normal. What is the most likely underlying lesion?
MRCS-1501
A 41 year old lecturer is admitted with abdominal pain. He has suffered from repeated episodes of this colicky right upper quadrant pain. On examination, he has a fever with right upper quadrant peritonism. His blood tests show a white cell count of 22. An abdominal ultrasound scan shows multiple gallstones in a thick walled gallbladder, the bile duct measures 4mm. Tests show that his liver function is normal. What is the best course of action?
MRCS-1445
A 33 year old woman presents to the clinic with abdominal pain and a progressively worsening condition. She is admitted with cholangitis. Lab results reveal:Serum bilirubin: 180, Alkaline phosphatase: 348, Serum amylase: 1080. Standard treatment is carried out and her Glasgow score is 3. Which of the following is the most appropriate step in her management?
MRCS-1425
A 35 year old woman with cholecystitis is admitted for laparoscopic cholecystectomy. She has reported feeling unwell for the last 10 days. During the procedure, while attempting to dissect the distended gallbladder, only the fundus is visualized and dense adhesions make it difficult to access Calot’s triangle. Which of the following would be the next best course of action?
MRCS-1419
A 35 year old woman with jaundice is scheduled for ERCP. However, the procedure is complicated and she is returned to the ward, with signs of jaundice still present accompanied by severe abdominal pain that is generalized. What should be the next best step in management?
MRCS-1421
A 35 year old lady is admitted to the clinic after experiencing an attack of pancreatitis with moderate severity according to the Glasgow criteria. Imaging reveals no gallstones or fluid surrounding the pancreas. The aetiology is unclear. How would you manage the patient?
MRCS-1248
A 20-year-old woman is admitted with right upper quadrant pain. On examination, there is tenderness in the right upper quadrant region. Imaging shows signs of acute cholecystitis due to gallstones. The common bile duct appears normal and liver function tests are normal as well. What should be the most appropriate course of action?
MRCS-1240
A 34-year-old female teacher is admitted with severe epigastric pain. Her blood reports show normal levels of serum amylase. In order to exclude a perforated viscus and determine whether pancreatitis is present, what should be the best course of action?