MRCS High Yield Exam Questions &
Answers 2024/2025
What is the treatment of palliative colon cancer? - ANSWERSStents
Bypass surgery
Diversion stomas
What is the treatment of right colon cancer? - ANSWERSRight hemicolectomy with ileo-colic anastomosis
<5% leak rate
What is the treatment transverse colon cancer? - ANSWERSExtended right hemicolectomy with ileo-colic
anastomosis
<5% leak rate
What is the treatment of splenic flexure colon cancer? - ANSWERSExtended right hemicolectomy with
ileo-colic anastomosis
<5% leak rate (better than left hemicolectomy w/ colo-colic: 2-5%)
What is the treatment of left colon cancer? - ANSWERSLeft hemicolectomy with colo-colon anastomosis
2-5% leak rate
What is the treatment of sigmoid colon cancer? - ANSWERSHigh anterior resection with colo-rectal
anastomosis
,5% leak rate
What is the treatment of upper rectal cancer? - ANSWERSAnterior resection with total mesorectal
excision and Colo-rectal anastomosis
Likely radiotherapy
5% leak rate
What is the treatment of low rectal cancer? - ANSWERSAnterior resection with TME and colo-rectal
anastomsis (+/- defunctioning stoma)
Likely radiotherapy
10% leak rate
What is the treatment of anal verge rectal cancer? - ANSWERSAbdomino-perineal excision of colon and
rectum
Likely radiotherapy
What is Hartmans procedure? - ANSWERSResection of sigmoid colon with end colostomy
How do you manage patients with large bowel obstruction resulting from carcinoma above the
peritoneal reflection? - ANSWERSResection
Stenting
Defunctioning
,How do you manage patients with large bowel obstruction from rectal cancer? -
ANSWERS*Defunctioning loop colostomy*
Then staging
What is the level of the inferior phrenic branches? - ANSWERST12 (paired, parietal)
What is the level of the coeliac trunk? - ANSWERST12 (unpaired, visceral)
What is the level of the SMA? - ANSWERSL1 (unpaired visceral)
What is the level of the middle suprarenal arteries? - ANSWERSL1 (paired visceral)
What is the level of the renal arteries? - ANSWERSL1/L2 (paired visceral)
What is the level of the gonadal arteries? - ANSWERSL2 (paired visceral)
What is the level of the lumbar arteries? - ANSWERSL1-L4 (paired parietal)
What is the level of the IMA? - ANSWERSL3 (unpaired visceral)
What is the level of the median sacral artery? - ANSWERSL4 (unpaired parietal)
What is the level of the common iliac artery? - ANSWERSL4 (paired terminal)
What vessel may be divided to improve access to aneurysm neck in juxtarenal AAA?
What branch of aorta overlies this? - ANSWERSLeft renal vein (anterior relation of AA)
, SMA overlies left renal vein
When do you offer surgery for AAA? - ANSWERSAneurysm 5.5-6cm (asymptomatic)
Symptomatic aneurysms
Rupture
How many layers of abdominal wall are found in AAAs? - ANSWERSAll 3 layers
What are the risks of AAA rupture depending on size? - ANSWERS5-5.9cm = 25% 5yr
6-6.9cm = 35%
7cm+ = 75%
What is the most appropriate fluid regime in rAAA? - ANSWERS1 litre Hartmanns over 4hours
(avoid high volume infusion)
Mnemonic for decending abdominal aorta branches? - ANSWERSProstitutes cause sagging swollen red
testicles (in men) living in sin
What vessels are the commonest cause of back bleeding during aortic surgery? - ANSWERSLumbar
arteries L1-4 are not cross clamped
Definition of abdominal compartment syndrome?
Risk factors? - ANSWERSSustained intraabdominal pressure >20mmHh with new organ dysfunction
Obese patients, prosthetic meshes
Answers 2024/2025
What is the treatment of palliative colon cancer? - ANSWERSStents
Bypass surgery
Diversion stomas
What is the treatment of right colon cancer? - ANSWERSRight hemicolectomy with ileo-colic anastomosis
<5% leak rate
What is the treatment transverse colon cancer? - ANSWERSExtended right hemicolectomy with ileo-colic
anastomosis
<5% leak rate
What is the treatment of splenic flexure colon cancer? - ANSWERSExtended right hemicolectomy with
ileo-colic anastomosis
<5% leak rate (better than left hemicolectomy w/ colo-colic: 2-5%)
What is the treatment of left colon cancer? - ANSWERSLeft hemicolectomy with colo-colon anastomosis
2-5% leak rate
What is the treatment of sigmoid colon cancer? - ANSWERSHigh anterior resection with colo-rectal
anastomosis
,5% leak rate
What is the treatment of upper rectal cancer? - ANSWERSAnterior resection with total mesorectal
excision and Colo-rectal anastomosis
Likely radiotherapy
5% leak rate
What is the treatment of low rectal cancer? - ANSWERSAnterior resection with TME and colo-rectal
anastomsis (+/- defunctioning stoma)
Likely radiotherapy
10% leak rate
What is the treatment of anal verge rectal cancer? - ANSWERSAbdomino-perineal excision of colon and
rectum
Likely radiotherapy
What is Hartmans procedure? - ANSWERSResection of sigmoid colon with end colostomy
How do you manage patients with large bowel obstruction resulting from carcinoma above the
peritoneal reflection? - ANSWERSResection
Stenting
Defunctioning
,How do you manage patients with large bowel obstruction from rectal cancer? -
ANSWERS*Defunctioning loop colostomy*
Then staging
What is the level of the inferior phrenic branches? - ANSWERST12 (paired, parietal)
What is the level of the coeliac trunk? - ANSWERST12 (unpaired, visceral)
What is the level of the SMA? - ANSWERSL1 (unpaired visceral)
What is the level of the middle suprarenal arteries? - ANSWERSL1 (paired visceral)
What is the level of the renal arteries? - ANSWERSL1/L2 (paired visceral)
What is the level of the gonadal arteries? - ANSWERSL2 (paired visceral)
What is the level of the lumbar arteries? - ANSWERSL1-L4 (paired parietal)
What is the level of the IMA? - ANSWERSL3 (unpaired visceral)
What is the level of the median sacral artery? - ANSWERSL4 (unpaired parietal)
What is the level of the common iliac artery? - ANSWERSL4 (paired terminal)
What vessel may be divided to improve access to aneurysm neck in juxtarenal AAA?
What branch of aorta overlies this? - ANSWERSLeft renal vein (anterior relation of AA)
, SMA overlies left renal vein
When do you offer surgery for AAA? - ANSWERSAneurysm 5.5-6cm (asymptomatic)
Symptomatic aneurysms
Rupture
How many layers of abdominal wall are found in AAAs? - ANSWERSAll 3 layers
What are the risks of AAA rupture depending on size? - ANSWERS5-5.9cm = 25% 5yr
6-6.9cm = 35%
7cm+ = 75%
What is the most appropriate fluid regime in rAAA? - ANSWERS1 litre Hartmanns over 4hours
(avoid high volume infusion)
Mnemonic for decending abdominal aorta branches? - ANSWERSProstitutes cause sagging swollen red
testicles (in men) living in sin
What vessels are the commonest cause of back bleeding during aortic surgery? - ANSWERSLumbar
arteries L1-4 are not cross clamped
Definition of abdominal compartment syndrome?
Risk factors? - ANSWERSSustained intraabdominal pressure >20mmHh with new organ dysfunction
Obese patients, prosthetic meshes
