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  • Question 1 - A 50-year-old man is diagnosed with emphysema and cirrhosis of the liver. Which...

    Correct

    • A 50-year-old man is diagnosed with emphysema and cirrhosis of the liver. Which of the following condition may be the cause of both cirrhosis and emphysema in this patient?

      Your Answer: Alpha1-antitrypsin deficiency

      Explanation:

      Alpha-1 antitrypsin (A1AT) deficiency is a condition characterised by the lack of a protein that protects the lungs and liver from damage, called alpha1-antytripsin. The main complications of this condition are liver diseases such as cirrhosis and chronic hepatitis, due to accumulation of abnormal alpha 1-antytripsin and emphysema due to loss of the proteolytic protection of the lungs.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      1190.4
      Seconds

  • Question 2 - The muscle which has an antagonistic action to the serratus anterior muscle and...

    Correct

    • The muscle which has an antagonistic action to the serratus anterior muscle and is the primary protractor of the scapula is the?

      Your Answer: Rhomboid major

      Explanation:

      The rhomboid major arises from the second, third, fourth and fifth thoracic vertebrae. It is inserted into a narrow tendinous arch attached to the root of the spine of the scapula and the inferior angle. By its insertion in the inferior angle of the scapula, it acts on this angle and produces a slight rotation of the scapula on the side of the chest. It also retracts the scapula by working with the trapezius muscle.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      30.8
      Seconds

  • Question 3 - Calculate the cardiac output of a patient with the following measurements: oxygen uptake...

    Correct

    • Calculate the cardiac output of a patient with the following measurements: oxygen uptake 200 ml/min, oxygen concentration in the peripheral vein 7 vol%, oxygen concentration in the pulmonary artery 10 vol% and oxygen concentration in the aorta 15 vol%.

      Your Answer: 4000 ml/min

      Explanation:

      The Fick’s principle states that the uptake of a substance by an organ equals the arteriovenous difference of the substance multiplied by the blood flowing through the organ. We can thus calculate the pulmonary blood flow with pulmonary arterial (i.e., mixed venous) oxygen content, aortic oxygen content and oxygen uptake. The pulmonary blood flow, systemic blood flow and cardiac output can be considered the same assuming there are no intracardiac shunts. Thus, we can calculate the cardiac output. Cardiac output = oxygen uptake/(aortic − mixed venous oxygen content) = 200 ml/min/(15 ml O2/100 ml − 10 ml O2/100 ml) = 200 ml/min/(5 ml O2/100 ml) = 200 ml/min/0.05 = 4000 ml/min.
      It is crucial to remember to use pulmonary arterial oxygen content and not peripheral vein oxygen content, when calculating the cardiac output by Fick’s method.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      1284.6
      Seconds

  • Question 4 - The petrous part of the internal carotid artery is located inside of which...

    Correct

    • The petrous part of the internal carotid artery is located inside of which cranial bone?

      Your Answer: Temporal

      Explanation:

      The petrous segment, or C2, of the internal carotid is that which is inside the petrous part of the temporal bone. This segment extends until the foramen lacerum. The petrous portion classically has three sections: an ascending, or vertical portion; the genu, or bend; and the horizontal portion.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      6.5
      Seconds

  • Question 5 - Risk factors for hepatocellular carcinoma do NOT include: ...

    Incorrect

    • Risk factors for hepatocellular carcinoma do NOT include:

      Your Answer: Anabolic steroids

      Correct Answer: Heptitis E

      Explanation:

      Risk factors for hepatocellular carcinoma include hepatitis B and C, aflatoxin, anabolic steroids, alcohol cirrhosis and primary liver disease.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      11
      Seconds

  • Question 6 - A 5 year old boy is taken to the doctor with symptoms of...

    Correct

    • A 5 year old boy is taken to the doctor with symptoms of dysuria and frequency in urination. Blood and nitrites are shown positive on urine dipstick. A urinary tract infection is suspected. Which follow up strategy is the most appropriate?

      Your Answer: Watchful waiting

      Explanation:

      In a child 3 months to 12 years of age who is afebrile and well-appearing, it is reasonable to consider withholding empiric treatment if urine analysis (UA) is mildly positive or equivocal e.g.: leukocyte esterase (LE0 only, low WBC count) while awaiting culture results. Conversely, if the history is very consistent with UTI and positive UA, start treatment empirically.

      Positive leukocyte esterase: very sensitive, but less specific for true infection (false positives are common)
      Note: if no WBC on microscopy, more likely to be a false positive
      Positive nitrite: high specificity for UTI, but lower sensitivity i.e. positive nitrite means likely UTI, but negative nitrite does not rule out UTI

      Can also see positive nitrite in contaminated specimen if left at room temperature for too long
      • Positive blood and protein: not specific for UTI
      • Microscopy:>10 WBC/mm3 is suggestive of UTI

      Management
      – A single isolated UTI (in girls) may be managed expectantly.
      – > 2 UTI’s (or 1 in males) in a 6 month period should prompt further testing.
      – Voiding cystourethrograms show the greatest anatomical detail and is the ideal first line test in males; isotope cystography has a lower radiation dose and is the first line test in girls.
      – USS should also be performed.
      – Renal cortical scintigraphy should be performed when renal scarring is suspected.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Paediatric Surgery
      12.7
      Seconds

  • Question 7 - What is the action of the muscle of the orbit that originates on...

    Incorrect

    • What is the action of the muscle of the orbit that originates on the lesser wing of the sphenoid bone, just above the optic foramen?

      Your Answer: Adduction of the eyeball

      Correct Answer: Elevation of the upper eyelid

      Explanation:

      The levator palpebrae superioris is the muscle in the orbit that elevates the superior (upper) eyelid. The levator palpebrae superioris originates on the lesser wing of the sphenoid bone, just above the optic foramen and receives somatic motor input from the ipsilateral superior division of the oculomotor nerve.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      51.7
      Seconds

  • Question 8 - A 50 year old female patient with an history of chronic headache was...

    Correct

    • A 50 year old female patient with an history of chronic headache was scheduled for CT scan. If the CT scan revealed a tumour at the horn of the lateral ventricle, which of the following structures is most likely to be compressed by this tumour?

      Your Answer: Fibres of the corpus callosum

      Explanation:

      The ventricular system of the brain is made up of four ventricles namely; two lateral and a third and forth ventricle. The ventricles are the site of the development of the cerebrospinal fluid. The left and right lateral ventricles are located in each of the brain’s hemispheres. The roof of the lateral ventricles are made up of the fibres of the corpus callosum. This is the structure that would be compressed by the a tumour on the roof of the lateral ventricles.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      135.7
      Seconds

  • Question 9 - A 58-year-old woman has had a headache, fever, lethargy and nausea for the...

    Correct

    • A 58-year-old woman has had a headache, fever, lethargy and nausea for the last 10 days. He undergoes a CT scan which reveals a lesion in his frontal lobe, which, after a biopsy, is found to be formed by granulation tissue with collagenisation, gliosis and oedema. What's the most likely diagnosis?

      Your Answer: Chronic brain abscess

      Explanation:

      A cerebral abscess can result from direct extension of cranial infections, penetrating head trauma, haematogenous spread, or for unknown causes. An abscess forms when an area of cerebral inflammation becomes necrotic and encapsulated by glial cells and fibroblasts. Oedema around the abscess can increase the intracranial pressure. Symptoms result from increased intracranial pressure and mass effects. In a CT scan, an abscess appears as an oedematous mass with ring enhancement.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      15.7
      Seconds

  • Question 10 - A patient admitted for esophagectomy showed low levels of the lightest plasma protein...

    Correct

    • A patient admitted for esophagectomy showed low levels of the lightest plasma protein in terms of weight. Which of the following is the lightest plasma protein:

      Your Answer: Albumin

      Explanation:

      Albumin is the most abundant and the lightest of all the plasma proteins. It maintains osmotic pressure, transports unconjugated bilirubin, thyroid hormones, fatty acids, drugs and acts as a buffer for pH.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      24.9
      Seconds

  • Question 11 - A machine worker fractured the medial epicondyle of his right humerus resulting in...

    Incorrect

    • A machine worker fractured the medial epicondyle of his right humerus resulting in damage to an artery running with the ulnar nerve posterior to the medial epicondyle. The artery injured is the?

      Your Answer: Interosseous recurrent

      Correct Answer: Superior ulnar collateral

      Explanation:

      The superior ulnar collateral artery runs posterior to the medial epicondyle of the humerus, accompanied by the ulnar nerve. This artery arises from the brachial artery near the middle of the arm and ends under the flexor carpi ulnaris muscle by anastomosing with two arteries: the posterior ulnar recurrent and inferior ulnar collateral.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      48.8
      Seconds

  • Question 12 - A 50 year old lawyer is admitted to the medical ward for an...

    Correct

    • A 50 year old lawyer is admitted to the medical ward for an endarterectomy. His CT report confirms a left temporal lobe infarct. Which visual defect is most likely to be encountered?

      Your Answer: Right superior quadranopia

      Explanation:

      Quadrantanopia refers to an anopia affecting a quarter of the field of vision. While quadrantanopia can be caused by lesions in the temporal and parietal lobes, it is most commonly associated with lesions in the occipital lobe.
      A lesion affecting one side of the temporal lobe may cause damage to the inferior optic radiations (known as the temporal pathway or Meyer’s loop) which can lead to superior quadrantanopia on the contralateral side of both eyes (colloquially referred to as pie in the sky).

      Therefore, a left temporal lobe infarct will affect the right superior quadrantanopia.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Surgical Disorders Of The Brain
      11.2
      Seconds

  • Question 13 - Severe abdominal pain radiating to the back, along with increased serum amylase levels,...

    Correct

    • Severe abdominal pain radiating to the back, along with increased serum amylase levels, is seen in which of the following conditions?

      Your Answer: Pancreatitis

      Explanation:

      The primary test for diagnosis and monitoring of pancreatitis is amylase. Increased plasma levels of amylase can be found in: salivary trauma (including anaesthetic intubation), mumps, pancreatitis and renal failure. However, a rise in the total amylase levels over 10 times the upper limit of normal (ULN) is suggestive of pancreatitis; 5–10 times the ULN may indicate ileus or duodenal disease or renal failure. Lower levels are commonly found in salivary gland disease.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      6.1
      Seconds

  • Question 14 - Which organs amongst these are the derivatives of the endoderm? ...

    Correct

    • Which organs amongst these are the derivatives of the endoderm?

      Your Answer: Epithelial part of the tympanic cavity

      Explanation:

      Endoderm derivatives include the epithelium of the following: gastrointestinal tract and its glands, glandular cells of the liver and pancreases, urachus and urinary bladder, pharynx, trachea and alveoli, part of the tonsils, thyroid and parathyroid, tympanic cavity and thymus and part of the anterior pituitary gland.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      9.4
      Seconds

  • Question 15 - Bile salt reuptake principally occurs where? ...

    Correct

    • Bile salt reuptake principally occurs where?

      Your Answer: In the ileum

      Explanation:

      90 – 95% of the bile salts are absorbed from the small intestine (mostly terminal ileum and then excreted again from the liver. This is known as the enterohepatic circulation. The entire pool recycles twice per meal and approximately 6 to 8 times per day.

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      4.3
      Seconds

  • Question 16 - A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of...

    Correct

    • A surgical registrar performing an adrenalectomy procedure on the left suprarenal gland of a 25 - year old male patient, accidentally jabbed and injured a vital structure that lies anterior to the left suprarenal organ. Which of the following was the structure most likely injured?

      Your Answer: Pancreas

      Explanation:

      The adrenal (suprarenal) glands are organs of the endocrine system located on top of each of the kidneys. The left suprarenal gland, in question, is crescent in shape and slightly larger than the right suprarenal gland. It is posteriorly located to the lateral aspect of the head of the pancreas which is thus the most likely to be injured. The other organs like the duodenum, liver and the inferior vena cava are related to the right suprarenal gland. The spleen and the colon are not in close proximity with the left suprarenal gland and are not likely to be the organs injured.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      25.7
      Seconds

  • Question 17 - A 27-year-old woman has chronic low serum calcium levels. Which of the following...

    Correct

    • A 27-year-old woman has chronic low serum calcium levels. Which of the following conditions may be responsible for the hypocalcaemia in this patient?

      Your Answer: Hypoparathyroidism

      Explanation:

      Chronic hypocalcaemia is mostly seen in patients with hypoparathyroidism as a result of accidental removal or damage to parathyroid glands during thyroidectomy.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      10.6
      Seconds

  • Question 18 - A 21-year-old woman is admitted with loin pain and fever. She has given...

    Correct

    • A 21-year-old woman is admitted with loin pain and fever. She has given a history of haematuria for the past one week with associated dysuria, for which she was started on trimethoprim as an empirical outpatient treatment.What is the most likely diagnosis?

      Your Answer: Pyelonephritis

      Explanation:

      This is most likely a case of pyelonephritis.

      Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidneys most often seen in young adult women. History and physical examination are the most important tools for diagnosis. Most patients have fever, although it may be absent early in the illness. E. coli is the most common pathogen in acute pyelonephritis.

      For diagnosing the disease:
      1. A positive urinalysis confirms the diagnosis in patients with a compatible history and physical examination.
      2. Urine culture should be obtained in all patients to guide antibiotic therapy if the patient does not respond to initial empirical antibiotic regimens.
      3. Imaging, usually with contrast-enhanced CT scan, is not necessary unless there is no improvement in the patient’s symptoms or if there is recurrence of symptoms after initial improvement.

      Outpatient treatment is appropriate for most patients. Inpatient therapy is recommended for patients who have severe illness or in whom a complication is suspected. Oral beta-lactam antibiotics and trimethoprim/sulfamethoxazole are generally inappropriate for outpatient therapy because of high resistance rates. Several antibiotic regimens can be used for inpatient treatment, including fluoroquinolones, aminoglycosides, and cephalosporins.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Urology
      31.4
      Seconds

  • Question 19 - A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates...

    Correct

    • A elderly patient with bulbar palsy is bed ridden. While swallowing he aspirates one of his tablets into his lungs. In which bronchopulmonary segments is it most likely to end up?

      Your Answer: Superior segmental bronchus of the right inferior lobe

      Explanation:

      Inhaled objects are more likely to enter the right lung for several reasons. First the right bronchus is shorter, wider and more vertical than the left bronchus. Also, the carina (a ridge-like structure at the point of tracheal bifurcation) is set a little towards the left. The superior segmental bronchus branches posteriorly off the intermediate bronchus or the inferior lobe bronchus and is thus more likely to receive the foreign body that enters the right main bronchus. The lingula is only found on the left lung. The terminal bronchiole is a very small space almost impossible for the tablet to lodge here.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      18.7
      Seconds

  • Question 20 - An 18 -year-old female is diagnosed with folliculitis in the left axilla. What...

    Correct

    • An 18 -year-old female is diagnosed with folliculitis in the left axilla. What is the most likely organism that could cause this condition?

      Your Answer: Staphylococcus aureus

      Explanation:

      Folliculitis is the inflammation of the hair follicles. It is usually caused by Staphylococcus infection.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      6.7
      Seconds

  • Question 21 - A 59 year old man presents with septicaemia 48 hours after undergoing a...

    Correct

    • A 59 year old man presents with septicaemia 48 hours after undergoing a difficult colonoscopy to assess the extent of a caecal carcinoma. His abdomen is soft and non tender. Blood cultures grow gram positive cocci. Which of the following organisms is likely responsible for this condition?

      Your Answer: Streptococcus bovis

      Explanation:

      Streptococcus bovis (S. bovis) bacteria are associated with colorectal cancer and adenoma. S. bovis is currently named S. gallolyticus. 25-80% of patients with S. bovis/gallolyticus bacteraemia have concomitant colorectal tumours. Colonic neoplasia may arise years after the presentation of bacteraemia or infectious endocarditis of S. bovis/gallolyticus. The presence of S. bovis/gallolyticus bacteraemia and/or endocarditis is also related to the presence of villous or tubular-villous adenomas in the large intestine.

    • This question is part of the following fields:

      • Clinical Microbiology
      • Principles Of Surgery-in-General
      6.9
      Seconds

  • Question 22 - Gram positive bacteria differ from gram negative bacteria due to the presence of...

    Incorrect

    • Gram positive bacteria differ from gram negative bacteria due to the presence of which of the following structures?

      Your Answer: Capsule

      Correct Answer: Outer membrane

      Explanation:

      The reason bacteria are either Gram-positive or Gram-negative is due to the structure of their cell envelope (the cell envelope is defined as the cell membrane and cell wall plus an outer membrane, if one is present.) Gram-positive bacteria, for example, retain the crystal violet due to the amount of peptidoglycan in the cell wall. It can be said therefore that the Gram-stain procedure separates bacteria into two broad categories based on structural differences in the cell envelope.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      26.4
      Seconds

  • Question 23 - Which of the following conditions may cause hypovolaemic hyponatraemia? ...

    Incorrect

    • Which of the following conditions may cause hypovolaemic hyponatraemia?

      Your Answer: Protracted vomiting

      Correct Answer: Cirrhosis

      Explanation:

      The most common cause of hypovolaemic hyponatraemia include: liver cirrhosis, congestive heart failure and nephrotic syndrome. In hypovolaemic hyponatraemia, both sodium and water content increase: Increase in sodium content leads to hypervolemia and water content to hyponatraemia.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      6.4
      Seconds

  • Question 24 - Which of the following compensatory parameters is responsible for causing an increase in...

    Incorrect

    • Which of the following compensatory parameters is responsible for causing an increase in the blood pressure in a 30 year old patient with a BP of 40 mmHg?

      Your Answer: Ischaemic brain response

      Correct Answer: Baroreceptor reflex

      Explanation:

      The baroreflex or baroreceptor reflex is one of the body’s homeostatic mechanisms for regulating blood pressure. It provides a negative feedback response in which an elevated blood pressure will causes blood pressure to decrease; similarly, decreased blood pressure depresses the baroreflex, causing blood pressure to rise. The system relies on specialised neurones (baroreceptors) in the aortic arch, carotid sinuses and elsewhere to monitor changes in blood pressure and relay them to the brainstem. Subsequent changes in blood pressure are mediated by the autonomic nervous system. Baroreceptors include those in the auricles of the heart and vena cava, but the most sensitive baroreceptors are in the carotid sinuses and aortic arch. The carotid sinus baroreceptors are innervated by the glossopharyngeal nerve (CN IX); the aortic arch baroreceptors are innervated by the vagus nerve (CN X).

    • This question is part of the following fields:

      • Basic Sciences
      • Physiology
      60.8
      Seconds

  • Question 25 - Cyclophosphamide is used as a chemotherapy and immunosuppressant agent and is indicated in...

    Correct

    • Cyclophosphamide is used as a chemotherapy and immunosuppressant agent and is indicated in various diseases. One of the most severe complications of its use is cancer of the:

      Your Answer: Urinary bladder

      Explanation:

      Cyclophosphamide is used to treat various types of cancer and autoimmune disorders. The main use of cyclophosphamide is in combination with other chemotherapy agents in the treatment of lymphomas, some forms of leukaemia and some solid tumours. Side-effects include nausea and vomiting, bone marrow suppression, stomach ache, diarrhoea, darkening of the skin
      ails, alopecia, lethargy, and haemorrhagic cystitis. Cyclophosphamide is itself carcinogenic, potentially causing transitional cell carcinoma of the bladder as a long-term complication.

    • This question is part of the following fields:

      • Basic Sciences
      • Pathology
      9.9
      Seconds

  • Question 26 - During an operation to repair an indirect inguinal hernia, you are asked to...

    Correct

    • During an operation to repair an indirect inguinal hernia, you are asked to indicate the position of the deep inguinal ring. You indicate this as being:

      Your Answer: Above the midpoint of the inguinal ligament

      Explanation:

      The deep inguinal ring is near the midpoint of the inguinal ligament, below the anterior superior iliac spine. It is lateral to the inferior epigastric artery. The superficial ring, however, is found above the pubic tubercle. The supravesical fossa is the space between the median and medial umbilical folds.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      11.9
      Seconds

  • Question 27 - A textbook of cardiac surgery explains that while doing a left pneumonectomy, a...

    Correct

    • A textbook of cardiac surgery explains that while doing a left pneumonectomy, a surgeon must be careful to avoid injury to a vital structure that leaves an impression on the mediastinal surface of the left lung. Which structure is it referring to?

      Your Answer: Aortic arch

      Explanation:

      Structures that leave an impression on the mediastinal surface of the left lung include: the oesophagus, subclavian artery, brachiocephalic vein, first rib, thymus, the heart, the diaphragm, descending aorta and arch of the aorta. The other structures form an impression on the mediastinal aspect of the right lung.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      54.2
      Seconds

  • Question 28 - When conducting an exploratory laparotomy procedure of a patient diagnosed with a bleeding...

    Correct

    • When conducting an exploratory laparotomy procedure of a patient diagnosed with a bleeding ulcer of the lesser curvature of the stomach, which artery in this patient are you most likely to ligate to control the bleeding?

      Your Answer: Left gastric

      Explanation:

      The lesser curvature of the stomach is supplied by the left gastric artery along with the right gastric artery. These two arteries are the ones to most likely be ligated if bleeding was to be stopped at the lesser curvature of the stomach. The splenic artery branches from the celiac branch and supplies the spleen. The left gastro-omental, the right and left gastroepiploic arteries supply the greater curvature.

    • This question is part of the following fields:

      • Anatomy
      • Basic Sciences
      25.8
      Seconds

  • Question 29 - A 30-year-old man who is a known case of hepatitis C presents with...

    Incorrect

    • A 30-year-old man who is a known case of hepatitis C presents with pain and swelling in the right groin. On examination, a large, pulsatile swelling is noted in the right groin. There is no cough impulse. What is the most likely diagnosis?

      Your Answer: Reactive lymphadenopathy

      Correct Answer: False aneurysm of the femoral artery

      Explanation:

      Based on the history and examination findings, the correct diagnosis is false aneurysm of the femoral artery. It may occur following arterial trauma in intravenous drug users.

      A false aneurysm, or pseudoaneurysm of the vessels, occurs when a blood vessel wall is injured and the leaking blood collects in the surrounding tissue. It is not an enlargement of any of the layers of the vessel wall. Pseudoaneurysms usually present as a painful, tender, pulsatile mass. Diagnostic options include duplex scan, and CT angiogram or a conventional angiogram.

      In a true aneurysm, the artery or vessel weakens and bulges, usually forming a blood-filled sac.

    • This question is part of the following fields:

      • Generic Surgical Topics
      • Vascular
      86.7
      Seconds

  • Question 30 - A 29-year-old man who plays social rugby presents with recurrent anterior dislocation of...

    Correct

    • A 29-year-old man who plays social rugby presents with recurrent anterior dislocation of the right shoulder. Which of the following abnormalities is most likely to be present?

      Your Answer: Bankart lesion

      Explanation:

      This patient has a Bankart lesion which is the most common underlying abnormality in recurrent anterior dislocation of the shoulder.

      Bankart lesion is an injury of the anterior (inferior) glenoid labrum of the shoulder due to anterior shoulder dislocation. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. It is usually visualised by CT and MRI scanning and is often repaired arthroscopically.

      Shoulder fractures and dislocations usually result from low-energy falls in predominantly elderly females or from high-energy trauma in young males. They can be associated with nerve injury (commonly axillary), and fracture-dislocation of the humeral head. Anterior shoulder dislocation (glenohumeral dislocation) is the most common type of shoulder dislocation (>90%) and is usually traumatic in nature.

      Early assessment of shoulder dislocation:
      Careful history, examination, and documentation of neurovascular status of the upper limb, in particular the axillary nerve, is important. This should be re-assessed after manipulation. Early radiographs should also be done to confirm the direction of the dislocation.

      Initial management of anterior dislocation:
      It consists of emergent closed reduction (to prevent lasting chondral damage) under Entonox and analgesia, but often requires conscious sedation. The affected arm should then be immobilised in a polysling. Initial management requires emergent reduction to prevent lasting chondral damage.

    • This question is part of the following fields:

      • Emergency Medicine And Management Of Trauma
      • Principles Of Surgery-in-General
      15.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Basic Sciences (18/24) 75%
Pathology (5/8) 63%
Anatomy (9/11) 82%
Physiology (4/5) 80%
Generic Surgical Topics (3/4) 75%
Paediatric Surgery (1/1) 100%
Surgical Disorders Of The Brain (1/1) 100%
Urology (1/1) 100%
Clinical Microbiology (1/1) 100%
Principles Of Surgery-in-General (2/2) 100%
Vascular (0/1) 0%
Emergency Medicine And Management Of Trauma (1/1) 100%
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