Archives: MSRA

MSRA-0809

A 51-year-old woman presents with non-specific abdominal discomfort that has been bothering her for the past 2 months. She also reports experiencing loose stools up to three times a day for the past month, despite previously having solid stools once daily. She denies any weight loss or blood in her stool. Upon examination, her abdomen is soft and nontender, and she has normal urine dip results. Blood tests, including a CA-125 and coeliac screen, and a faecal calprotectin test all come back within the normal range. Although you suspect irritable bowel syndrome, the patient is worried about the possibility of colorectal cancer. What is the best course of action?

MSRA-0810

A 56-year-old woman presents to the emergency department complaining of right upper quadrant pain and rigors that have been ongoing for 2 days. She had previously seen her GP 6 months ago for biliary colic and was referred for an elective cholecystectomy. Upon examination, her blood work reveals elevated levels of WCC, CRP, and bilirubin. Based on these findings, what is the most probable diagnosis?

MSRA-0811

A 30-year-old female comes to the surgery complaining of painless rectal bleeding that has been going on for 2 weeks. Upon inspection of the perineum and rectal examination, there are no notable findings. However, proctoscopy reveals haemorrhoidal cushions located at the left lateral and right anterior position. What is the crucial aspect of management?

MSRA-0812

A 25-year-old woman presents with complaints of intermittent diarrhoea and constipation. She experiences bloating that is relieved by defecation and finds relief with hyoscine butylbromide (Buscopan). She denies any weight loss and has no relevant family history. Coeliac disease screening was negative and both full blood count and CRP were normal. Despite being diagnosed with irritable bowel syndrome and given dietary advice and antispasmodics, she disagrees with the diagnosis and requests further investigations. What is the most appropriate course of action?

MSRA-0813

A 26-year-old male patient complains of severe pain during defecation for the last two weeks. He has also noticed occasional blood on the toilet paper while wiping. During the examination, a tear is observed on the posterior midline of the anal verge. Which of the following treatment options should not be suggested?

MSRA-0814

A 68-year-old man presents with ‘burning’ chest pain, halitosis and frequent belching. An oesophagogastroduodenoscopy reveals a 3 cm sliding hiatus hernia. The patient has a BMI of 34 kg/m² and does not smoke or drink alcohol. What is the best course of action for managing this patient’s condition?

MSRA-0815

A 76-year-old man comes to the emergency department complaining of severe abdominal pain. He reports not having had a bowel movement or passed gas in the past 48 hours. Upon further questioning, he reveals that he has experienced constipation and weight loss in recent weeks. After a CT scan, a mass is discovered in the hepatic flexure, leading the medical team to suspect a large bowel obstruction caused by cancer. What is the most suitable surgical treatment plan for this patient?

MSRA-0816

An 80-year-old man visits his GP complaining of blood in his stools that has been ongoing for three weeks. The stools are hard and contain a lot of mucus. The patient has no significant medical history. During a digital rectal examination, a suspicious mass is detected on the anal sphincter. What is the most suitable management plan for this patient?

MSRA-0817

A 72-year-old woman comes to the emergency department with a blocked stoma bag. She had surgery for bowel cancer recently, which involved removing a section of her bowel. The stoma bag is situated in the upper left quadrant of her abdomen. The bag is entirely empty, and you can see that the proximal part of the resected bowel is flush with the skin. Her abdomen is swollen, and you can hear tinkling bowel sounds. What kind of stoma does this patient have?

MSRA-0801

An 80-year-old male has been diagnosed with upper rectal cancer. The cancer is confined to the area and the medical team has decided to perform an anterior resection to remove it. The surgeon believes that to achieve the best long-term outcome, it is necessary to temporarily divert the colon to safeguard the colorectal anastomosis. What type of stoma would be most suitable?