SBA MCQs for the MRCS Part A by Thrumurthy, Sri G. et al.

By Thrumurthy, Sri G. et al.

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G. steroids, azathioprine, and thiazide diuretics), mumps, autoimmune pancreatitis, scorpion venom (rare), hyperlipidaemia, hypercalcaemia, and endoscopic retrograde cholangiopancreatography (ERCP). Pancreatitis results from the early activation of pancreatic enzymes, producing autodigestion of the pancreas and surrounding tissues. Exposure of trypsinogen to lysosomal enzymes such as cathepsin B has been elucidated as a mechanism for early trypsin activation. Digestive enzyme release is amplified as acinar cells lyse, leading to a vicious cycle of inflammation and necrosis.

The motor branch to the iliopsoas originates in the pelvis proximal to the inguinal ligament and injury at or above this level leads to loss of hip flexion. The sensory branch of the femoral nerve, the saphenous nerve, innervates the skin over the medial aspect of the thigh and the anteromedial aspect of the calf. Hence, femoral nerve injury results in numbness over the medial aspect of the thigh and the anteromedial aspect of the leg. Motor loss includes weakness of the quadriceps and decreased patellar reflex (knee jerk) (the ankle jerk is preserved since it is innervated by the tibial nerve (S1–S2)).

3% cholesterol, fatty acids, and lecithin. The gallbladder concentrates this 5 L into 500 mL per day by gradually extracting the water into its mucosal lining. In the absence of a gallbladder to concentrate bile, large volumes of it will flow into the duodenum and may cause biliary reflux. Similarly, a bile leak as previously described may result in litres of bile being leaked daily. Production of bile salts is stimulated by secretin, cholecystokinin, and vagal innervation. It is suppressed by fasting and sympathetic alpha agonists.

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