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Question 1
Correct
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A 39 year old woman is knocked off her bike on the way home and she is taken to the hospital. Her ankle is observed to be grossly deformed with bilateral malleolar tenderness, severe ankle swelling and tenting of the medial soft tissues. Which of the following would be the best option in initial management?
Your Answer: Immediate reduction and application of backslab
Explanation:Ankle fractures most often occur by rotational mechanisms with the external forces transmitted through the foot via the talus to the malleoli. The specific pattern of fracture and ligamentous injury depends on the position of the foot and the direction of the force at the time of injury.
Reduce the ankle fracture as soon as possible once informed consent provided to the patient. Assess the neurovascular status of the limb before and after manipulation. Have splinting materials ready and measured out (use the uninjured, contralateral leg for measuring). Either a short leg splint or cast is applied based on fracture type, patient, surgical urgency, and surgeon preference.
Ensure adequate analgesia for the patient including NSAIDs, IV medications, hematoma block, or procedural sedation. Once reduced and splinted in place, recheck neurovascular status, elevate the leg and obtain a post-reduction X-ray.
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This question is part of the following fields:
- Generic Surgical Topics
- Orthopaedics
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Question 2
Correct
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A 42 year old lawyer is rushed to the emergency room after she was found lying unconscious on her left arm with an empty bottle of Diazepam beside her. Her left arm has red and purple marks and is swollen. Her hand is stiff and insensate. Which of the following substances would be expected to be present in her urine in increased quantities?
Your Answer: Myoglobin
Explanation:Answer: Myoglobin
When muscle is damaged, a protein called myoglobin is released into the bloodstream. It is then filtered out of the body by the kidneys. Myoglobin breaks down into substances that can damage kidney cells.
Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.Compartment syndrome can be either acute or chronic.
Acute compartment syndrome is a medical emergency. It is usually caused by a severe injury. Without treatment, it can lead to permanent muscle damage.
Chronic compartment syndrome, also known as exertional compartment syndrome, is usually not a medical emergency. It is most often caused by athletic exertion. Compartments are groupings of muscles, nerves, and blood vessels in your arms and legs. Covering these tissues is a tough membrane called a fascia. The role of the fascia is to keep the tissues in place, and, therefore, the fascia does not stretch or expand easily.
Compartment syndrome develops when swelling or bleeding occurs within a compartment. Because the fascia does not stretch, this can cause increased pressure on the capillaries, nerves, and muscles in the compartment. Blood flow to muscle and nerve cells is disrupted. Without a steady supply of oxygen and nutrients, nerve and muscle cells can be damaged.In acute compartment syndrome, unless the pressure is relieved quickly, permanent disability and tissue death may result. This does not usually happen in chronic (exertional) compartment syndrome.
Compartment syndrome most often occurs in the anterior (front) compartment of the lower leg (calf). It can also occur in other compartments in the leg, as well as in the arms, hands, feet, and buttocks.
Acute compartment syndrome usually develops after a severe injury, such as a car accident or a broken bone. Rarely, it develops after a relatively minor injury.
Conditions that may bring on acute compartment syndrome include:
A fracture.
A badly bruised muscle. This type of injury can occur when a motorcycle falls on the leg of the rider, or a football player is hit in the leg with another player’s helmet.
Re-established blood flow after blocked circulation. This may occur after a surgeon repairs a damaged blood vessel that has been blocked for several hours. A blood vessel can also be blocked during sleep. Lying for too long in a position that blocks a blood vessel, then moving or waking up can cause this condition. Most healthy people will naturally move when blood flow to a limb is blocked during sleep. The development of compartment syndrome in this manner usually occurs in people who are neurologically compromised. This can happen after severe intoxication with alcohol or other drugs.
Crush injuries.
Anabolic steroid use. Taking steroids is a possible factor in compartment syndrome.
Constricting bandages. Casts and tight bandages may lead to compartment syndrome. If symptoms of compartment syndrome develop, remove or loosen any constricting bandages. -
This question is part of the following fields:
- Emergency Medicine And Management Of Trauma
- Principles Of Surgery-in-General
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Question 3
Incorrect
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During a laparoscopic inguinal hernia repair, the surgeon finds an artery in the extraperitoneal connective tissue (preperitoneal fat) that courses vertically and just medial to the bowel as the bowel passes through the abdominal wall. Which artery is this?
Your Answer: Superficial epigastric
Correct Answer: Inferior epigastric
Explanation:The inferior epigastric artery comes from the external iliac artery just above the inguinal ligament to curve forward in the subperitoneal tissue and then ascend obliquely along the medial margin of the deep inguinal ring. It continues to ascend between the rectus abdominis and the posterior lamella of its sheath after piercing the fascia transversalis and passing anterior to the linea semicircularis. Finally it gives off numerous branches that anastomose above the umbilicus with the superior epigastric branch of the internal mammary artery and with the lower intercostal arteries. As this artery ascends obliquely upwards from its origin it lies along the lower medial margins of the deep inguinal ring and posterior to the start of the spermatic cord. It is found in the preperitoneal fat of the abdomen lying just superficial to the peritoneum and forms the lateral umbilical fold. Hernias that pass lateral to this are indirect and medial to this, direct hernias.
The deep circumflex artery travels along the iliac crest on the inner surface of the abdominal wall. It is very lateral to the abdominal wall and hernias would pass medial to it.
The superficial circumflex iliac, superficial epigastric, superficial external pudendal arteries are all superficial arteries found in the superficial fascia. -
This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 4
Correct
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Action potentials are used extensively by the nervous system to communicate between neurones and muscles or glands. What happens during the activation of a nerve cell membrane?
Your Answer: Sodium ions flow inward
Explanation:During the generation of an action potential, the membrane gets depolarized which cause the voltage gated sodium channels to open and sodium diffuses inside the neuron, resulting in the membrane potential moving towards a positive value. This positive potential will then open the voltage gated potassium channels and cause more K+ to move out decreasing the membrane potential and restoring the membrane potential to its resting value.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 5
Incorrect
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A man came to the hospital complaining of a sensation of pins and needles in the dorsum of the thumb and digits 1 and 2. On further examination they found that he had weakness in wrist dorsiflexion and finger extension. Which nerve do you think is injured in this case?
Your Answer: Ulnar
Correct Answer: Radial
Explanation:The radial nerve can be injured in multiple sites along its course in the upper limb, and each site has its own presentation. The major complaint is wrist drop which if high above the elbow, can cause numbness of the forearm and hand. It can last for several days or weeks. The most common site of compression for the radial nerve is at the proximal forearm in the area of the supinator muscles.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 6
Incorrect
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Question 7
Incorrect
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A woman that presented with dyspnoea, chest pain and cough was found to have a serous pleural effusion. This finding is most likely to be associated with which of the following conditions?
Your Answer: Metastatic carcinoma
Correct Answer: Congestive heart failure
Explanation:A pleural effusion is defined as an abnormal collection of fluid in the pleural space. Pleural effusion can result from excess fluid production or decreased absorption or both. Thoracentesis and laboratory testing help determine the origin of the accumulated fluid. Serous fluid accumulation in the pleural space indicates the presence of a hydrothorax and is most likely to develop secondary to congestive heart failure.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 8
Incorrect
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A cell is classified on the basis of its regenerative ability. Which of the following cells represent a permanent cell?
Your Answer: Acinar cell of the pancreas
Correct Answer: Erythrocyte
Explanation:An erythrocyte is the last cell in the progeny of RBC cell division and is not capable of further division and regeneration. Hepatocytes, osteocytes and epithelium of kidney tubules are all stable cells. Colonic mucosa and pluripotent hematopoietic stem cells are all labile cells.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 9
Incorrect
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A 39 year old male is identified as having gallstones after presenting with colicky right upper quadrant pain. An abdominal ultrasound scan was done. Which of the following is the best course of action?
Your Answer: ERCP
Correct Answer: Liver function tests
Explanation:In patients with suspected gallstone complications, blood tests should include a complete blood cell (CBC) count with differential, liver function panel, and amylase and lipase. Up to 24% of women and 12% of men may have gallstones. Of these up to 30% may develop local infection and cholecystitis.
Acute cholecystitis is associated with polymorphonuclear leucocytosis. However, up to one third of the patients with cholecystitis may not manifest leucocytosis. In severe cases, mild elevations of liver enzymes may be caused by inflammatory injury of the adjacent liver.
Patients with cholangitis and pancreatitis have abnormal laboratory test values. Importantly, a single abnormal laboratory value does not confirm the diagnosis of choledocholithiasis, cholangitis, or pancreatitis; rather, a coherent set of laboratory studies leads to the correct diagnosis.
Choledocholithiasis with acute common bile duct (CBD) obstruction initially produces an acute increase in the level of liver transaminases (alanine and aspartate aminotransferases), followed within hours by a rising serum bilirubin level. The higher the bilirubin level, the greater the predictive value for CBD obstruction. CBD stones are present in approximately 60% of patients with serum bilirubin levels greater than 3 mg/dL.
If obstruction persists, a progressive decline in the level of transaminases with rising alkaline phosphatase and bilirubin levels may be noted over several days. Prothrombin time may be elevated in patients with prolonged CBD obstruction, secondary to depletion of vitamin K (the absorption of which is bile-dependent). Concurrent obstruction of the pancreatic duct by a stone in the ampulla of Vater may be accompanied by increases in serum lipase and amylase levels.
Repeated testing over hours to days may be useful in evaluating patients with gallstone complications. Improvement of the levels of bilirubin and liver enzymes may indicate spontaneous passage of an obstructing stone. Conversely, rising levels of bilirubin and transaminases with progression of leucocytosis in the face of antibiotic therapy may indicate ascending cholangitis with the need for urgent intervention. Blood culture results are positive in 30%-60% of patients with cholangitis.
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This question is part of the following fields:
- Generic Surgical Topics
- Hepatobiliary And Pancreatic Surgery
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Question 10
Correct
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What percentage of the cardiac output is delivered to the brain?
Your Answer: 15%
Explanation:Among all body organs, the brain is most susceptible to ischaemia. Comprising of only 2.5% of total body weight, the brain receives 15% of the cardiac output. Oxygen extraction is also higher with venous oxygen levels approximating 13 vol%, and arteriovenous oxygen difference of 7 vol%.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 11
Incorrect
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The thyroid gland is a large ductless gland located in which part of the neck?
Your Answer: Submandibular triangle
Correct Answer: Visceral space
Explanation:The thyroid gland is an endocrine gland in the neck, consisting of two lobes connected by an isthmus. It is situated at the front and sides of the neck in the visceral space.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 12
Incorrect
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What is the name of the cutaneous branch of the posterior primary ramus of C2?
Your Answer: Great auricular nerve
Correct Answer: Greater occipital nerve
Explanation:The dorsal primary ramus of the spinal nerve C2 is the greater occipital nerve which provides cutaneous innervation to the skin of the back of the head. The ventral primary ramus gives off the great auricular nerve, the lesser occipital nerve and the ansa cervicalis.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 13
Correct
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A 63-year old lady presents with pain in multiple bones and renal failure. On enquiry, there is history of recurrent pneumonia in the past. What will be the likely finding on her bone marrow biopsy?
Your Answer: Plasma cells
Explanation:Multiple myeloma is a plasma cell malignancy that produce excessive monoclonal immunoglobulins. The disease presents with bone pains, renal dysfunction, increased calcium, anaemia and recurrent infections. Diagnosis is by demonstrating the presence of M-protein in urine or serum, lytic bone lesions, light chain proteinuria or excessive plasma cells on marrow biopsy.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 14
Incorrect
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Regarding the long head of the biceps femoris, which of the following is correct?
Your Answer: It will extend the leg at the knee
Correct Answer: It crosses two joints
Explanation:The long head of the biceps femoris arises from the lower and inner impression on the back of the tuberosity of the ischium. It inserts with the short head in an aponeurosis which becomes a tendon and this tendon is inserted into the lateral side of the head of the fibula and the lateral condyle of the tibia, thus crossing two joints.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 15
Correct
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A 47-year-old male is recovering in hospital following a total hip replacement. He develops profuse and watery diarrhoea. Several other patients have been suffering from similar symptoms. Infection with which of the following is the most likely underlying cause?
Your Answer: Clostridium difficile
Explanation:Clostridioides difficile (formerly Clostridium difficile) colitis results from a disturbance of the normal bacterial flora of the colon, colonization by C difficile, and the release of toxins that cause mucosal inflammation and damage. Antibiotic therapy is the key factor that alters the colonic flora. C difficile infection (CDI) occurs primarily in hospitalized patients.
The diagnosis of C difficile colitis should be suspected in any patient with diarrhoea who has received antibiotics within the previous 3 months, has been recently hospitalized, and/or has an occurrence of diarrhoea within 48 hours or more after hospitalization. In addition, C difficile can be a cause of diarrhoea in community dwellers without previous hospitalization or antibiotic exposureThe following recommendations on Clostridium difficile infection (CDI) were released on February 2018 by the Infectious Diseases Society of America (ISDA) and Society for Healthcare Epidemiology of America (SHEA).
Diagnosis (adults)
Patients with unexplained and new-onset ≥3 unformed stools in 24 hours are the preferred target population for testing for CDI.
Use a stool toxin test as part of a multistep algorithm (i.e., glutamate dehydrogenase [GDH] plus toxin; GDH plus toxin, arbitrated by nucleic acid amplification test [NAAT]; or NAAT plus toxin) rather than NAAT alone for all specimens when there are no pre-agreed institutional criteria for patient stool submission.
Use NAAT alone or a multistep algorithm for testing (i.e., GDH plus toxin; GDH plus toxin, arbitrated by NAAT; or NAAT plus toxin) rather than a toxin test alone when there are pre-agreed institutional criteria for patient stool submission.
Do not perform repeat testing (within 7 days) during the same episode of diarrhoea and do not test stool from asymptomatic patients, except for epidemiologic studies -
This question is part of the following fields:
- Clinical Microbiology
- Principles Of Surgery-in-General
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Question 16
Incorrect
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Which of the following enzymes is secreted by the small intestinal mucosa?
Your Answer: Gastrin
Correct Answer: Lactase
Explanation:Lactase, an enzyme belonging to β-galactosidase family of enzymes, brings about the hydrolysis of the disaccharide lactose into galactose and glucose. In humans, it is present along the brush border membrane of the cells lining the small intestinal villi. Deficiency of lactase causes lactose intolerance.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 17
Correct
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A space defined by the teres major muscle, the teres minor muscle, long head of the triceps brachii muscle and surgical neck of the humerus contains the axillary nerve and the?
Your Answer: Posterior circumflex humeral artery
Explanation:This quadrangular space transmits the posterior circumflex humeral vessels and the axillary nerve.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 18
Correct
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A 38-year-old woman with end-stage renal disease, is undergoing haemodialysis. She has normocytic normochromic anaemia. What is the best treatment for her?
Your Answer: Erythropoietin
Explanation:E erythropoietin (EPO) is a hormone that is released by the kidney. It is responsible for the regulation of red blood cell production in the body. It can be made using recombinant technology and is used in the treatment of anaemia of chronic renal failure and in patients under going chemotherapy
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 19
Incorrect
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The specimen sent to the pathologist for examination was found to be benign. Which one of the following is most likely a benign tumour?
Your Answer: Haematoma
Correct Answer: Warthin’s tumour
Explanation:Warthin’s tumour is also known as papillary cystadenoma lymphomatosum. It is a benign cystic tumour of the salivary glands containing abundant lymphocytes and germinal centres. It has a slightly higher incidence in males and most likely occur in older adults aged between 60 to 70 years. This tumour is also associated with smoking. Smokers have an eight-fold greater risk in developing the tumour compared to non-smokers.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 20
Incorrect
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A 32 year old woman presents to the ER with recurrent episodes of non specific abdominal pain. The labs including blood tests appear to be normal. Ct scan is done for further evaluation. The CT reveals a 1.5 cm nodule in the right adrenal gland that is associated with a lipid rich core. Urinary VMA is found to be within the normal range. Which of the following is the most likely diagnosis?
Your Answer: Benign functional adenoma
Correct Answer: Benign non functional adenoma
Explanation:Adrenal adenomas are benign tumours of the adrenal glands, which can be either functioning or non-functioning. Though the majority are clinically silent, functional adenomas from the cortex of medulla can lead to overproduction of any of their associated hormones. Benign adenomas often have a lipid rich core that is readily identifiable on CT scanning. In addition the nodules are often well circumscribed.
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This question is part of the following fields:
- Breast And Endocrine Surgery
- Generic Surgical Topics
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Question 21
Correct
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Whilst snorkelling, a 30-year old gentleman has the respiratory rate of 10/min, tidal volume of 550 ml and an effective anatomical dead space of 250 ml. Which of the following will bring about a maximum increase in his alveolar ventilation?
Your Answer: A 2x increase in tidal volume and a shorter snorkel
Explanation:Alveolar ventilation = respiratory rate × (tidal volume − anatomical dead space volume). Increase in respiratory rate simply causes movement of air in the anatomical dead space, with no contribution to the alveolar ventilation. By use of a shorter snorkel, the effective anatomical dead space will decrease and will cause a maximum rise in alveolar ventilation along with doubling of tidal volume.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 22
Incorrect
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The bronchial circulation is a part of the circulatory system that supplies nutrients and oxygen to the pulmonary parenchyma. What percentage of cardiac output is received by bronchial circulation?
Your Answer: 30%
Correct Answer: 2%
Explanation:The bronchial circulation is part of the systemic circulation and receives about 2% of the cardiac output from the left heart. Bronchial arteries arise from branches of the aorta, intercostal, subclavian or internal mammary arteries. The bronchial arteries supply the tracheobronchial tree with both nutrients and O2. It is complementary to the pulmonary circulation that brings deoxygenated blood to the lungs and carries oxygenated blood away from them in order to oxygenate the rest of the body.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 23
Correct
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In a young, sexually active male, what is the most common cause of non-gonococcal urethritis?
Your Answer: Chlamydia
Explanation:Non-gonococcal urethritis is most commonly caused by Chlamydia trachomatis (50% cases). Less common organisms include Mycoplasma genitalium, Urea urealyticum and Trichomonas vaginalis. Chlamydia is also the commonest cause of non-gonococcal cervicitis in women and proctitis in both sexes.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 24
Incorrect
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During an OSCE exam a medical student is asked to locate the sternal angle. The sternal angle is a land mark for locating the level of the:
Your Answer: Sternoclavicular joint
Correct Answer: Second costal cartilage
Explanation:The sternal angle, a key landmark used in the clinic for auscultating for heart sounds, is the point of attachment of the costal cartilage of rib 2 to the sternum. It thus corresponds to the location of the second rib. A horizontal plane through the sternal angle traverses the T4/T5 intervertebral disc and marks the inferior boundary of the superior mediastinum.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 25
Correct
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Which of the following foramina will the ophthalmic artery pass through in order to reach the eye?
Your Answer: Optic canal
Explanation:The optic foramen is the opening to the optic canal. The canal is located in the sphenoid bone; it is bounded medially by the body of the sphenoid and laterally by the lesser wing of the sphenoid. The superior surface of the sphenoid bone is bounded behind by a ridge, which forms the anterior border of a narrow, transverse groove, the chiasmatic groove (optic groove). The groove ends on either side in the optic foramen, which transmits the optic nerve and ophthalmic artery into the orbital cavity. Compared to the optic nerve, the ophthalmic artery is located inferolaterally within the canal.
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This question is part of the following fields:
- Anatomy
- Basic Sciences
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Question 26
Correct
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A 45 year old man presents to the hospital with a gastric carcinoma of the greater curvature of the stomach. His staging investigations are negative for metastatic disease. What is the best treatment option for him?
Your Answer: Sub total gastrectomy, D2 lymphadenectomy and Roux en Y reconstruction
Explanation:Surgical resection is the principal therapy for gastric cancer, as it offers the only potential for cure. A subtotal gastrectomy is usually performed for tumours of the distal stomach. Subtotal gastrectomy is the treatment of choice for middle and distal-third gastric cancer as it provides similar survival rates and better functional outcome compared to total gastrectomy, especially in early-stage disease with favourable prognosis. D2 dissections are recommended by the National Comprehensive Cancer Network over D1 dissections. A pancreas-and spleen-preserving D2 lymphadenectomy is suggested, as it provides greater staging information, and may provide a survival benefit while avoiding its excess morbidity when possible. Patients that undergo D2 lymphadenectomy as a standard part of surgical resection of gastric adenocarcinoma generally have better stage-for-stage overall survival figures compared to patients undergoing less extensive lymphadenectomies.
After partial gastrectomy, some patients report disorders such as reflux esophagitis and alkaline gastritis, as well as dumping syndrome, delayed gastric emptying and malabsorption, which are defined as functional dyspepsia. Duodenogastric reflux is recognized to be a major cause of clinical symptoms after resection.
Roux-Y reconstruction seems to be effective in reducing bile reflux into the stomach, compared to Billroth I and II procedure, and conversion to this procedure has been reported in patients with symptomatic uncontrolled reflux disease. -
This question is part of the following fields:
- Generic Surgical Topics
- Upper Gastrointestinal Surgery
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Question 27
Incorrect
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A new-born was found to have an undeveloped spiral septum in the heart. This is characteristic of which of the following?
Your Answer: Atrioventricular septal defect
Correct Answer: Persistent truncus arteriosus
Explanation:Persistent truncus arteriosus is a congenital heart disease that occurs when the primitive truncus does not divide into the pulmonary artery and aorta, resulting in a single arterial trunk. The spiral septum is created by fusion of a truncal septum and the aorticopulmonary spiral septum. Incomplete development of these septa results in incomplete separation of the common tube of the truncus arteriosus and the aorticopulmonary trunk.
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This question is part of the following fields:
- Basic Sciences
- Pathology
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Question 28
Incorrect
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What is the normal glomerular filtration rate?
Your Answer: 75 mL/min
Correct Answer: 125 mL/min
Explanation:The normal glomerular filtration rate (GFR) in humans is 125 mL/min. After the age of 40, GFR decreases progressively by about 0.4–1.2 mL/min per year.
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This question is part of the following fields:
- Basic Sciences
- Physiology
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Question 29
Incorrect
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A 31 year old woman arrives at the clinic due to a tender breast lump. On examination, there is a fluctuant and tender mass. She has a 2 month old child. Which of the following most likely caused her breast lump?
Your Answer: Fibroadenoma
Correct Answer: Breast abscess
Explanation:A breast abscess is a localised collection of pus in the breast tissue. It is usually caused by a bacterial infection. Breast infections, including mastitis and breast abscesses, are most often seen in women aged 15 to 45 years. Mastitis can occur as a result of breastfeeding and if left untreated it can progress to an abscess. The bacteria most commonly associated with this is staphylococcus aureus.
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This question is part of the following fields:
- Breast And Endocrine Surgery
- Generic Surgical Topics
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Question 30
Incorrect
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A 54 year old man with end stage renal failure is undergoing a live donor renal transplant. The surgeon decides to implant the kidney in the left iliac fossa via a Rutherford Morrison incision. To which vessels should the transplanted kidney be anastomosed?
Your Answer: Internal iliac artery and vein
Correct Answer: External iliac artery and vein
Explanation:For this procedure:
Following the preparation of the patient, a Rutherford-Morison incision was made at the right or left iliac fossa to access to the iliac vessels. Heparin (2500-4000 IU bolus) was given intravenously prior to the clamping of the iliac vessels. The renal artery was first anastomosed in an end-to-side fashion to the external iliac artery. The corner sutures (6/0 Prolene) were placed while the kidney allograft was first placed at the medial side of the incision. The lateral side of the renal artery was anastomosed by continuous suture using the 6/0 Prolene suture. The kidney allograft was then flipped to the lateral side and the medial side of the renal artery was anastomosed to the external iliac artery. The anastomosis was checked by placing a small vascular bulldog to the renal artery and the vascular clamp was released over the external iliac artery.Following the renal artery anastomosis, the renal vein was anastomosed in an end-to-side fashion to the external iliac vein. Two corner sutures (5/0 Prolene) were placed first, then the lateral side of renal vein anastomosis was performed with continuous sutures from inside the lumen, and then a medial side anastomosis was performed by continuous sutures from the outside of the lumen (Figure (Figure2).2). Similarly, the anastomosis was checked by placing a vascular clamp over the renal vein and then releasing the vascular clamp on the external iliac vein.
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This question is part of the following fields:
- Generic Surgical Topics
- Organ Transplantation
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SESSION STATS - PERFORMANCE PER SPECIALTY
