MRCS VIVA TOPICS

Updated May 2004

Complied by Mr EA Griffiths MRCS

MRCS VIVA QUESTIONS

ANATOMY
Head and Neck

Muscles of mastication
Triangles of the neck
Mandible parts and foramen
Skull paranasal sinuses, surgical anatomy of middle menigeal
artery
Skull base and foramina
Trachea surface anatomy
Thyroid (anatomy and development)
Cranial nerves
Facial N (Funct, tests, lesions)
Visual pathway anatomy
Branches of facial nerve
Anatomy of Horners Syndrome
Oculomotor N, other cranial nerves
Movements of the eye
Glossopharygeal nerve
Atanto-axial anatomy
Cervical rib
1st Rib
Pituitary gland
Cavernous sinus
Oesophagus blood supply
Cervial fascia
Circle of Willis
Buccinator
Submanidubular gland
Floor of the mouth
Lingual N
Parotid Gland
Tongue (muscles, nerves, attachments, blood supp)

Thorax

Heart anatomy (coronary arteries, borders, conduction system)

Heart ext surface and int structure
Vagus nerve
Pleural and lung anatomy (surface markings)
Oesophagus
Lymphactic drainage of the breast
Sympathetic chain
Posterior mediastinum
Diaphragm anatomy

Abdomen

Femoral triangle
Portal venous system
Hepatocyte relationship (Portal triad)
Liver porta hepatis
Boundaries of the axilla (axillary dissection)
Pro-section small and large bowel
Blood supply of the stomach
Kidney surface anatomy
Inguinal and femoral canal
Gonadal vessels
Pancreas
Colonic blood supply

Orthopaedic

Reproductive anatomy
Duodenum blood supply
Blood supply to the rectum
Male urethra
Anal canal + embryology
Testicular anatomy and descent
Biliary tract
Abdominal aortic branches
Brachial plexus
Coeliac axis
Vas deferns
Recurrent laryngeal N
Adrenal blood supply
Spleen blood supply
Ischiorectal fossa
Course of IMA
Saphenofemoral, saphenpopliteal junctions, LSV and SSV
Nerve injuries around the humerous
Carpal bones (median N cross section with carpal bone)
Spina bifida
Obturator N
Femur bone, muscle att, blood supply, approaches
Pelvic autonomic nerves
Clavicle
Scaplua
Hand anatomy and anatomical snuff box
Hand tendons
Structures around the wrist
Bony pelvis
Popliteal fossa
Cauda equina
Sciatic nerve
Foot Nerve supply
Fascial compartments of limbs, esp in relation to compartment
sydrome
Shoulder joint anatomy
Ulna, Radial nerve
Carpal bones and attachments
Carpal tunnel
Knee anatomy
Bone anatomy, i.e. tibia etc
Nerves and vessels around the humerus
Lymph drainage of lower limb
Bone growth plates
Reflexes and reflex mechanism
Levels and structures of abdominal CT
Sites of referred pain

Misc

PHYSIOLOGY

Secondary messengers
Light reflex
Gastrointestinal hormones
Cervical sympathectomy
Osmotic and oncotic pressure
Small bowel fistulae
Rods and cones
Buffers definition
Transaminases
Faecal and urinary incontinence
Lung function tests
Liver physiology
Breast physiology
Gastro-oeopageal junction
Gastric response to a large meal
Pituitary and hypothalamus
Osmolality
Coagulation factors and clotting
ADH and aldosterone
Renal angiotensin system
Starlings Law of the heart
Adrenal physiology
Portal hypertension
Draw a cardiac action potential
Pancreatic secretions
Hyperparathyroidism
Hypo/hyperthyroidism
Metabolic response to trauma/sepsis/shock
Molecular structure of haemoglobin
Calcium heomostasis
Neuro-muscular junction
Catecholamines
Coronary blood flow
Causes of hyperglycaemia
Iodine to thyroxine sequence
Cough reflex
Bladder physiology and control
O2 dissociation curve, CO2 transport
Lactate
Henderson-Hasselbach equation and Acid Base
Renal physiology and Loop of Henle (absorption and excretion
in renal tubule)
Nephrotoxic drugs
Intra-cranial pressure
Hypercalcaemia and Ca++ metabolism
Gastric acid production and physiology
CSF and cranial pressure
Thermoregulation
Creatinine clearance
Small bowel physiology
Bile salt (enterohepatic circulation)
Adrenal physiology
Compartment syndrome
How a ventilator works
Hypovolaemia physiological response
Active transport mechanisms

Nerve membrane potentials

PATHOLOGY

Definitions (dysplasia, metaplasia, etc etc)

Define aneurysm (types, classification, causes)
Steptococci
Thrombus/Embolus
Types of necrosis
Avascular necrosis
Disinfection vs sterilization
Berry Aneurysm
Pathology of OA
Clostridial infections
Spore forming organisms
Osteomyelitis
FNAC
B-cells, Plasma Cells, Macrophages, Golgi apperatus
Osteoporosis
Metastases
Cell membrane structure
Fistulae
DVT and Virchows triad
Ascites
Definitions i.e. dysplasia, metaplasia, hyperplasia
Atherosclerosis
Tumour markers
Causes of dysphagia
Neoplasia
TNM scoring (breast, bronchus, colon)
TB
What is cellulitis?
Blood groups and blood transfusion
Diabetes
H pylori and ulcer disease
Prostate cancer
Testicular cancer
Colorectal polyps and adenoma-carcinoma sequence
(types, histology, and malignant potential)
Malignant melanoma/SCC/BCC
Diverticular disease
Granulomas
Immunoglobins/Immunology and antibodies
Endo/exotoxins
Grading and staging of colorectal cancer
Wound healing, Keloids etc
Cell Cycle
P53, tumour suppressor promoters
Oncogenesis
Viruses in Ca (Hep B,C, HPV, EBV)
Parotid tumours
Fistulae
Pathological fractures
Inflammatory bowel disease
Mendelian genetics
Amyloidosis
Fat embolism
PSA
Teratomas
MRSA

Ischaemia
Fracture healing
Skin tumours
Malignant melanoma (Clarks, Breslow thickness)
UV damage
Lymphoma
Uses of the frozen section
Haemopoesis (pleuripotent stem cells lines)

CRITICAL CARE

Indications for ITU

Complications of sepsis in ITU patients
Panceatitis (ITU management and complications)
Tension pneumothorax
MODS/SIRS
ARDS
Intubation and airway problems
Ebb/flow of metabolic response
Renal support
High output fistulae
Heparinisation and warfarinisation
Hyperkalaemia and ECG
Starlings law of heart and capillary flow
Burns and fluid replacement
Renal autoregulation
Pain pathways in acute appendicits
Cardiovascular monitoring
Shock
Cardiac arrest, CPR, internal cardiac massage
Cardiac tamponade
Electrolyte distrubances
Fluid management (crystalloid/colloid/blood)
Fluid compartments
Acid Base balance
Tracheostomy
Physiological scoring systems i.e. APACHE II
Muscle relaxants
Arterial line insertion (indications, risks, how to)
Central lines (indications, risk, how to)
Inotropes
TPN
CVP lines and Swan Ganz
Pulmonary artery wedge pressures
Acute assessment of critical ill patient
Surgical nutrition
Typical TPN regeme (constituents)
Physiological consequences of IPPV
Sepsis vs hypovolaemia
Pericarditis, causes, drainage of pericardial fluid
Hypoxia (causes)
Steroids
Pain pathways
Action of morphine
Local anaesthetics

OPERATIVE SURG

ERCP
TME rectal ca
Mastectomy anatomy
Reduction of the dislocation shoulder
TRAM flap reconstruction breast
Hernia repair (MESH)
Tracheostomy
Haemorrhiodectomy
Skin flaps and grafts and closure
Operations for hydrocoele

Ingrown toenail ops

Nephrectomy
Biers block
AKA/BKA
Approaches to the pancreas
Preparation for surgery THR
Appendiectomy
Laparoscopy cholecystectomy
Reduction of Colles fracture
Right hemicolectomy
Crohns disease surgery
Chest drains
OGD
Ganglion excision
Fasciotomy (compartment syn)
Laparoscopy
Varicose vein surgery
Circumcision
Hernia operations (umbilical, epigastric, inguinal, femoral)
Burr Holes
Approachs to AAA
Bowel anastomosis
Arthroscopy of the knee
Methods of fixation
Axillary dissection
Insertion of chest drain

GEN PRINCIPALS

Skin flaps
Pain management
Compartment sydrome
Pyloric stenosis (ABGS, etc)
Upper GI bleeding
Asepsis/sterilization
Goitres
Colles #
Management of cancer
Indications for splenectomy
Small and large bowel obstruction
Management of high risk surgical patient
Nipple discharge
Varicose Veins
Testicular pain
Differential of stiff shoulder
Pulmonary Embolism
Spinal shock at various levels
Gynaecological causes of abdominal pain
Differential of a groin lump
Day-case surgery
Post op complications
Coroner what deaths to report
Management of bilary sepsis/obstruction
Venous ulcers
Abdominal X-ray
Pancreatitis
Complications of hernia repair
Head injury management
Management of diabetic floot ulcer
Intermittent claudication
Management of DVT
Gunshot injures
Diathermy
Oesophageal cancer symptoms and staging
Fracture management
Glasgow Coma Scale
Issues about consent
Analgesia in children
Stomas
Abdominal aortic aneurysms
Splenic injury
Acute Abdomen
Causes of post-op pyrexia
Scaphoid fractures
Factors determining level of amputation
Complications of laproscopic surgery
Anticoalgulation
Differentiation of types of jaundice
Thyroid surgery
Blood transfusions
DIC
Screening for diseases
Esp breast cancer screening, colorectal screening
and prostatic ca
Investigation of haematuria

Trauma management and ATLS

Management of jaundice
Brain stem death
Fracture NOF
Incisional hernias
Trigemminal neuralgia
HIV in surgical patient
Epistaxis
Immunosuppression
IDDM peri-operative management
Major haemorrhage (variceal, upper GI, lower GI etc)
Suture material
Management of ureteric stones
Antibiotic prophyaxis
Classification of open fractures
Necrotising fascitis (causes and management)
Investigation of thyroid disease
Treatment of anaphylaxis
Blast injuries
Sterilsation (male and female)
Carotid artery disease
Endoscopy

MORE VIVA TOPICS

All these further pages have been emailed to me by various helpful people
who responded to my posting on www.surgical-tutor.org.uk

Applied surgical Anatomy

And operative surgery
Bones and Joints in foot, inversion,
eversion injury, stomach blood supply,
lesser sac, foramen of winslow,,
femoral hernias, nerve injuries,
principles of Anatomises, dural venous
sinuses, femoral triangle,
appendicectomy,thyroidectomy, and
thyroid tumors,local anaesthetics,
Axillary artery and and its relation
to pectoralis minor, cavernous sinus,
carotid endarterectomy- structures
damaged in surgery, hip and blood
supply,, skull foramina, celiac axis,
vascular anastmosis, tendon repair,
structures and functions of the
brainstem, branches of subclavian
artery, large and small bowel
anatomy, transpyloric plane, formen
of winslow, epiploic foramen, lesser
sac, nerve supply of leg, brainstem
functions, layers of spermatic cord,
structure around wrist joint, chest
drain, colon blood supply, surface
markings of pleura, posterior triangle
boundaries and contents, approach to
AAA, bladder control, submandibular
gland anatomy, course of inferior
mesenteric vein, posterior medistinum,
atlanto-axial joint, shoulder joint
anatomy, surface anatomy of sciatic
nerve, typical rib, rectal blood supply,
branches of facial nerve, abdominal
aortic branches, management of
diabetic ulcer foot, brachial plexus,
diaphragm anatomy, cervical facia,
popliteal fossa,

Clinical Pathology
And Principles of
surgery
Wounds, Incisions,
Jenkins rule, principle and
complications of fractures,
fat embolism, post
splenectomy
complications, death
reported to coroners,
disinfections and
sterilisation, embolism
surgery, causes of free
peritoneal air,
complications of
laproscopic surgery, gall
bladder emphyma
physiology, necrosis and
comparison with
apoptosis, staging of a
cancer, dukes staging,
abscess formation,
organisms involved on
fistula-in. ano and
treatment, goodsalls
treatment, starlings curve,
ARDS, thyroid nodule,
melanoma, salivary gland,
wound dehiscence, grafts,
flaps, laminar flow
theatres, GI hormones,
treatment of fracture neck
of femur, colles, post op
pyrexia, skin cancers,
clearance margins,
staging, burns,
diverticulums, meckels
,peptic ulceration,
gastrinoma, barrets,gall
stones, cholesterol
metabolism,MEN
syndromes, CVP
insertion, gout, how does
subcut heparin works,
portal hypertension
carcinoma of

Applied Physiological
And Critical Care
LCIS, buffers, GFR,
pressures across
bowmans capsule, auto
regulation, Clearance and
measurement inulin, CVS
effects of PE, Hypoxia,
reasons for tracheotomy,
starvation, micturition,
crush injury, liver functions
and failure, treatment of
raised ICP, neuromuscular
junction, spinal
anaesthesia, calcium
functions, gastric acid
secretions, oxygen
dissociation curve, normal
ECG, renal stones,
intussusceptions, shock,
how diuretics work, role of
aldosterone, ADH, adrenal
physiology, multi organ
failure, intestinal
obstruction, intraabdominal
compartment syndrome,
compartment syndrome,
DPL, patterns of breathing,
bowel infarction, blood
groups, macrophages,
treatment of anaphylactic
shock, inotropes, co2
carriage, Handersenhasslebachs equation, fluid
management,
pheochrmocytoma,
osmalality, SIRS, endoexotoxin, adrenal cortex
anatomy and physiology,
oedema, glascow coma
scale, management of
head injury, blood groups,
parental nutrition,
hyperkalemaia,
translocation of bacteria,

oesophagus,
cheloscystitis, cytology
versus histology, DVT,
jaundice, post po pyrexia,
anueryms, bowel
preparation, MRSA,
jaundice, anaemia,
fracture healing,
metabolic response to
trauma, malignant
melanoma, dysphagia,
tumour markers,

Phsiology &Crtical Care:1.Management of multiple long bone fractures.

2.Compartment Syndrome.
3.Compartments of the leg.
4.Management of the unconscious patient.
5.Preop management of patients on anticoagulants.
6.ALS
7.Pulmonary Odema.
8.ABGs
anatomy
1. Course of 3,4,6 cranial nerves.
2. mechanism of Extradural hematomas
3. Signs of Horners Sundome.
4. Effects of Pancoast Tumor (anatomical Basis)
5. Brachial Plexus.
6. First Rib,
7. Mehanism of Erbs Injury
1. Causes of lump in the neck.
2. Management of lymph node in the neck.
3. Mangement of dog bites.
4. Mangement of druken youg patient.
Operative Surgery & Pathology:1. Causes of dysphagia
2. Oesophagitis
3. Sequalae of persistent inflammation.
4. Hydrocepahalus.
5. Def. Of Fustula
6. Types.
7. Tracheoesopahgeal fistula in the newborn.
8. Diverticular disease.
9. Colovesical fistula
10. mangemnt of thyroid nodule
11. Causes of gynaecomastia
.

Questions asked in Viva :

APPLIED PHYSIOLOGY & CRITICAL CARE
Evaluation of a patient with regards to kidneys:
How would you evaluate the renal function in a preoperative patient?
What is creatinine clearance? How is it assessed & what is normal creatinine clearance?
Draw a nephron, label parts & give their function?
How does the kidney conserve water? What is the maximum concentration capacity of kidney?
What is normal plasma osmolality & urinary osmolality?
Evaluation of respiratory system:
Give a simple test that can be used by the bedside to evaluate respiratory function.
How would you assess a patients' respiratory function?
What are the terms you would use to describe a patient in respiratory failure?( He was looking for the word
CONFUSION ..... it didn't strike me until he uttered it.....)
Scoring systems in surgery:
What are the scoring systems you know of that are routinely used in surgical practice?
( I listed AVPU, GCS, Ransons & APACHE 2......he asked me list the full GCS, Ransons & Acute Physical
Assessment criteria of the APACHE 2)
Acute pancreatitis:
Causes of pancreatitis?
Where would you manage a patient with pancreatitis? What are the complications of acute pancreatitis?
APPLIED ANATOMY & PRINCIPLES OF SURGERY
Mandible
Draw on the mandible the nerves related to it.
Which nerve are these branches?
What is the function of inferior alveolar nerve?
When is the lingual nerve at risk of damage & how frequent is it?
What would a patient with lingual nerve injury complain of? ( He was looking for RECURRENT
BLEEDS DUE TO TONGUE BITES due to anesthesia .... I just kept repeating anesthesia, loss of taste....)
Vertebra
was given a vertebra with a broken R transverse process & a large articular surface on the left. It was large
to be a thoracic vertebra. I had no clue as to what it was but in view of the extra articular surface on the
transverse process I answered it as a thoracic vertebra. I was obviously wrong! It turned out that it was a
sacralised L5 & the transverse process was broken when trying to separate it from the sacrum!! IT WAS
MEANT TO BE THE CLUE FOR IDENTIFYING THE BONE!!! Which I didn't catch!!!! Well, these
questions followed:
What passes in the spinal canal at this (L5) level?
Where are the spinal arteries situated & what is their Surgical importance?
Where do the spinal nerve roots lie emerge at various levels?

In spinal decompression show on the bone what is removed.

Hernia:
How do you define hernia?( I said..... protrusion of whole or part of a viscus through natural or acquired
defects in the walls of the cavity containing it.....She asked me WHAT ABOUT FAT? I replied fat is a
viscus by its own right.....)
What are the types of abdominal hernia you know?
With respect to incisional hernias describe principles of wound closure & healing that could lead to hernia
formation.
What are the principles of incisional hernia repair? When would you not use a mesh in the repair of an
incisional hernia?
Tourniquet use in surgery:
What are the indications for use of a tourniquet?(I mentioned blood less field, emergency control of
haemorrhage & regional anaesthesia)
What principles govern the use of tourniquets in surgery?
How would you administer regional anaesthesia using a tourniquet?What is the technique called? What
agent is used?
SURGIGAL PATHOLOGY & CLINICAL SURGERY:
Raised Intra Cranial Pressure:
What is normal ICP? List causes of raised ICP?
Draw where an EDH is situated.
What is its classical presentation?How can you explain this presentation?
How would you manage a patient with EDH? Give me 2 words.
What are the neoplastic lesions affecting the brain?
Obstructing lesions of sigmoid colon:
How would you manage a person with the above?
Preoperative preparation:
How would you prepare a patient with prosthetic heart valve for laparoscopic cholecystectomy?

CLINICAL CASES:
'MAIN CASE': Carotid artery stenosis. Had to take history & examine relevant systems in this case. This
78 year young gentleman presented with one episode of sudden transient loss of sensation of his right lower
limb.
Other cases:

Consent for laparoscopic cholecystectomy.

Examination of ulnar nerve.
Examination of peripheral pulses.
Examination of abdomen paraumbilical hernia.
Examination of incisional hernia.
Examination of varicose veins.
Examination of hip.
Dear Ewen,
Success! :)
London Dec 2003
ANATOMY: MRI of brain, Cranial venous sinuses, Posterior Triangle of Neck, Stabilising
structures of SIJ
OPERATIVE Sx: Wound dehiscence, Abdominal Incisions Pros & Cons, AAA, femoral hernia
PATHOLOGY: Lymphadenopathy & Causes, Viral Oncogenesis, Frozen Section
PRINCIPLES OF Sx: Fracture management/complications, ERCP, Jaundice
APPLIED PHYSIOLOGY: LFTs, Ca metabolism, Blood constituents, Jaundice
CRITICAL CARE: Blunt chest trauma, Acute pancreatitis, Postoperative analgesia
EDINBURGH Feb 2004
PHYSIOLOGY: Liver, Head Injury, Pneumothorax
ANATOMY: Liver (plastinated), Stomach/Pancreas/Spleen (plastinated), Splenectomy (how to
do), lesser sac
PATHOLOGY: Carpal Tunnel Syndrome, Parotid Gland, Bloody diarrhoea
Hope this helps!
Regards
Dear Ewen,
I'd like to have a copy of your list as you posted in
surgical tutor forum, for my preparation of exam in
coming March.
I've attempted once. Here are the questions I was
asked:
1. LA, how it works
2. Blood group systems
3. discuss about ischemic bowel disease
4. R hemicolectomy
5. discuss about 'LN and malignancy'
6. BPH and CA Prostate, presentations, pathology
7. Ectopic pregnancy, how it presented, dx.
Dear Ewen,
Had an unsucceful attmpt at MRCS viva ED. Sending you list of questions which I hope will be useful.
Anatomy:
Patella, lower end of femur,

dislocation of patella,
meniscii
knee joint - screw home mechanism
Operative surgery:
Hypotension with an acute abdomen
Informed consent and anatomy of Parotid
Inguinoscrotal swelling in 8 yr bou - management
Pathology:
thyroid swelling
DD of swelling in anterior triangle of neck with anatomy
Para neoplastic syndromes
Surgery:
Difference beteween UC and Crohns
Lymphomas
Peritonitis
Critical care:
CCF
ARDS
Head injury and management
Pancreatitis
lung physiology in fluidoverloaded patient
Do you have an updated list? Some other questionsa sked to my colleagues are as follows:
Craniectomy
meningitis and lumbar puncture and difference between spinal fluids
If I can get any more questions I wil let you know.
Bye,
Paresh
Hello, do you still remember me? I had requested the list of viva questions from you last month, for the
preparation of my Viva AFRCSI (held on 4th Sept 2003). Here, let me return you the favour. Following is
the list of questions I got for my Viva:
1) Anatomy
Blood supply to the stomach and the gut
Hepatobiliary system
2) Operative surgery
Principles of vascular surgery
o How to anastomose blood vessels, what suture, method
o Complications of AAA surgery
Hartmans procedure
Orchidopexy

3) Pathology
Skin cancers: types, classifications of malig. Melanoma
4) Principles of surgery
Wound healing
Portal hypertension
# neck of femur
# mid-shaft of humerus
Fat embolism
5) Physiology
Regulations of cardiac output
Regulations of blood pressure
6) Critical care
Management of crush injury of the pelvis
Well, those were the questions I got. Unfortunately, I didnt manage to get through the exam. So, that
means I will need to re-sit for it again L
I hope you can email the up-dated list again, say after about 3 months.
Thanks and looking forward to receive your mail again!
Hi there,
I'd be grateful if you wouldn't mind sending me your copy of viva questions that you have
it'd be a life saver.
I've sat London once before and the questions I got asked were:
Anatomy: Vertebrae and spinal nerves
Facial nerve course etc
Snuff Box
Op Anat: Parotid
Short saphenous
Bowel anastamosis
Physiology
Bone/Ca
CSF
Starlings law
Critical care:
Pulse Ox
Steroids
Pneumothorax
Pathology
Blood transfusion
Methods of fixation
Microbiology
Principles
Nutrition

Wound comtamination
Jaundice
Thanks
Syed
MRCS Viva Glasgow

Oct 2003

Applied Anatomy
Colles fracture, treatment and complications (EPL rupture - Listers tubercle),
Angiogram - point out vessels, PVD medical management and surgical principals
Staghorn calculus
Principals Surgery
Prophylactic antibiotics,
Surgical Audit principals History taking in jaundice
Crit Care
Ca metabolism, hormones controlling, why you get reduced ionized Ca in hyperventilation,
CVP insertion - how to do and what to warn the patient of.
GFR - normal value,
Pressures across bowmans capsule.
Pathology
Diverticular disease picture - discuss aetiology, complications and management.
Kidney specimen with Amyoloid!,
Picture of 1st MTP showing gout - what crystalls find on microscopy, causes of gout.
Picture of avuscular necrosis of head of femur - patient groups at risk of this, why alcoholics
more at risk? (apparently due to increased fat in marrow causing femoral head ischaemia).
Lung specimen (man died 6 post op) - large PE in pulmonary circulation - discuss prophylaxis.
How does subcut heparin work?

Edinburgh is more clinically orientated in my experience. Topics I was asked include

Anatomy:
groin anatomy and causes of lumps
blood supply stomach
anatomy/embryology rectum and anal canal
skull foramina plus the venous dural sinuses esp the cavernous sinus
blood supply neck of femur
blood supply colon

pathology:
fracture healing
What info is given on a path report pertaining to a large bowel resection...then moved onto dukes
classification
pre-op assesment for theatre
melanoma (breslow and clarkes levels)
thromboembolism diagnosis and treatment
viruses that cause neoplasia
Physiology:
Pt in itu just stopped pu'ing..why? (remeber to flush catheter first and look in any drains)
ATLS stuff inc blast injury
Burns and resuscitation
What is absorbed/excreted where in renal tubule.
Calcium metabolism
As for clinical in Edinburgh it was just a whizz round the wards on whatever they had in....no special cases
just fairly routine stuff.
london was trickier in that the things asked seemed to be less clinically orientated. Anatomy was ok, as was
pathology. Physiology was awful......got a physiologst not a clinician whom asked me about protein
metabolism and then went onto ask me to draw the urea cycle......I can't bring myself to remember any
more of that experience.
at the end of the day there is a certain amount of luck involved. try to be confident, DONT bullshit, and
smile!
best of luck
steve
did my edinburgh exam in january, this is what I remember
anatomy,
testis and descent of testis,
given a bony pelvis to play with
sites of referred pain
physiology,
nutrition
compartment syndrome
management of acute abdomen/pancreatitis
ATLS stuff
popliteal fossa injuries and anatomy
pathology
lymphoma
thyroid cancer
uses of frozen section
atheroma and aneurysms
prostate ca

the clinical was very much what i expected, hernias, veins, abdo masses, dupytrens, # ankle, odd skin
lesions...
there's a book called Short cases for the MRCS by Catherine Parchmont-Smith, it's great for the clinical.
john
Dear Ewen,
As promised here are the viva question .
I sat the Glasgow exam which has 2 tables. One : Critical care, physiology (15 minutes)and bacteriology
(15 minutes) and the second one : Pathology (15 minutes) and principles and practice of surgery
(15minutes)..
Table 1 questions:
Poisseuilles equation.
Starling equation.
Exudate/transudate - examples and patophysiological changes for those examples.
Adrenal gland: structure, hormones, actions, regulation.
Burns: Which is the major problem? Monitoring and management
Prevention of infection in the surgical patient: preoperative measures, in-hospital measures. Prophylactic
antibioterapy: which patients, how, for how long?
Barrett's oesophagus: What is it? monitoring? What is metaplasia/dysplasia.
Malignant tumours in gallbladder, bile ducts, liver and pancreas. What types do you know?
Table 2 questions: Starting with a clinical scenario: HDu, 48 h post elective AAA repair, lob BP, Minial
urinary output, tachycardia.What do you do?
What are the potential reasons for this picture? How do you investigate? How do you treat?
What are the most common cardiac complications following this operation? Cardiac optimisation - how do
you do it?
Acute renal failure - define, management? What is acute tubular necrosis?
The remaning 15 minutes - cases with Xrays, anatomical dissection specimens, USS, etc.
1. Intussusception : clinical picture, describe plain AXR and gastrografin enema, how do you treat?
2. AAA - Xray, USS - describe findings. Abdominal specimen - demonstrate vessels, ureter, other important
structures. Branches of the aorta.
3. Carpal tunnel sdr. - demonstrate structures around the carpus (specimen). Identify branches of the nerves,
arteries, etc. C-spineX-ray - describe, diagnosis.
Long and intense but it's done and dusted!
Hope it helps.
All the best,
Anca
As promised I have just sat Glasgow and passed and below are the questions that came up
Viva Questions:
1. sterilisation
2. antibiotic prophylaxis
3. bone tumours
4. skin function
5. physiology of burns
6. physiology of pyloric stenosis
7. the cycle of a red blood cell
8. intraabdominal compartment syndrome
9. Ix of dysphagia
10.neck of femur fractures

11. staghorn calculus

12. PVD
13 intussusception
Clinical:
patient with an enterocutaneous fistula with a vac pump placed over a wound dehiscence
2. palliative pt with a frozen abdomen
3. haematuria - ask this pt some questions etc...
4. RCC
5. preop for TKR
Hope this is of help
Best wishes,
Tjun Tang

hi ewen
had a shocker... awaiting results but fairly sure have failed. our
questions that I can remember, as promised:
Path
What staging systems do you know? Why do we stage? Why bother having
different staging systems for the same cancer
What is a granuloma/ granulomatous diseases. What does TB look like uder
the microscope? What does a turberculum look like...?
Tell me about lympahdenopathy.
Principles.
Tell me about rib fractures (7 minutes later...)
Acute pancreatitis and Imrie criteria
Intestinal fistulae
Wound closure
Obstructive jaundice
Physiology
Tell me about gut hormones
NMJ
What is a buffer? leads to acid base - they only care about metabolic
acidosis
What types of muscle do you know?

Critical care
CBD obstruction
Splenectomy - the immune function of the spleen - encapulated organisms
Inhalation injury
Raised ICP
Mediastinitis
Hypothermia
What does insulin do?
Anatomy
MRI sagittal through pelvis - 8 minutes on the bladder...
MRI sagittal just proximal to pelvis... - tell me about the nucleus pulposus
Structures that cross the sacrum, medial to later, in order
Anatomy of the medulla and CN roots, in order and level
Operative surgery
Ischaemic limb - history, clinincal findings, leading to femoral embolectomy
in detail
Approaches to the distal radius
Incarcerated inguinal hernia - in a baby
Femoral hernias - approaches
Approach the axillary artey/ external iliac artery
Am sure it's all fairly standard stuff. Examiners were quite arsey with
some people, and their favourite technique was to challenge you on
everything you said, particularly if you were right...
thanks for your questions. hope some of the above is useful.
alia x
Ewen
The questions were helpful
i got asked in MRCS Eng
anatomy of foot
MRI of bladder and peritoneal reflections
bladder anatomy ,epithelium etc
pathology
mechasism of flow phase of injury and mediators!
cororner inquest
frozen\sectio
tumor staging
physioand critical care
BP methods of assessment,graphs
ischaemic limb
ICP
operative
principles of bowel anastamosis
principles of vascular anastamosis
embolectomy
got asked different versions of ischaemic limp on 3 tables!

thanks 4 ur help
bye now
saroj
Thank you for the lists!!!!
Read what you listed and passed Ed on Tuesday....
Topics:
Path: metaplasia, dysplasia, Barret's oesophagus, Bladder, Thrombosis, Virchow's triad,
propagation of a clot, Congenital Aneuryms, Clinical Audit, Diverticula, fracture healing
and complications
Anatomy/Operat:
(Bones on desk: femur, humerus, scapula, skull base)
Structures around neck of humerus, Axillary nerve, axillary artery 3 rd branches, snuff box,
antiseptic agents, Diathermy, Hemiarthroplasty, fracture complications (esp non union),
apendicectomy, Rif pain d/d, Varicose veins- diagnosis, management, femoral vein , saphenous
vein, crohns operation options
Physio,CC:
How would you manage a patient on the ward in a coma? what are his needs medical & nursing?
physiological changes you would expect.. 5 minute question
Muscle ischaemia what happens with a tourniquet, treatment of Lactic acidodsis, hyperkalemia,
examiner drew a box on paper called it a hormone then asked describe how this hormone works,
or could work , negative feedback, second messangers.
Well, that's it....
If you have a list of Clinical cases can you please send them you mE?
tHANKS AGAIN FOR YOU HELP!
tony