Final MB Surgical Written + Medicine MCQ done....!!!

Wow..finally... all the written papers are done. The medicine MCQ is harder than expected. The Surgical Written is just simply stupid. I think the faculty is trying to ask us stupid questions so that the guys from the new curriculum can out perform us next year, justifying their change in the curriculum.

So..once again.. before I forget...

1) clinical scenario of a breast lump (5cm with ipsilateral mobile axillary lymph node)
ask about the TNM staging
ask about the doubling time of the cancer and the time before it was diagnosed
about the false positive rate of FNAC
The patient is sad and depressed, despite a supportive family and social worker, name 3 ways to approach this problem.
the 3 factors for prognosis
2 drugs for chemotherapy
What are the chacnce of a oestrogen receptor +ve cancer responding to hormonal therapy
develop PATHOLOGICAL fracture neck of femur, what is the principle of treatment
Mx of metastatic disease

2) Young man, dying, no hope, on ventilator, TPN, vasopressor, eventually will die,…very gray. SMO and Consultants want to step down the treatment (in other words, let him die.)
a. What source of info will you seek (other than the medical team) before you make any adjustment to the management plan. And how would you do it?
b. If source 1 is not available, what other sources are there?
c. If the relatives agree, is there any way to proof their opinion legally? (or something to that effect?)
d. What are the priorities in steping down the treatment?
e. What are the 3 moral principles in making these decisions?
f. How can you make use of the 3 pricinples in the making of these decisions?
g. What if the family does not agree with you? What investigation, and legal actions that you can take to manage this patient?

3) fill in the table comparing neurological and vascular claudication
given a table for peripheral pulses
what is the bedside Ix for PVD at OPD?
Name 2 Ix for PVD
Patient also has unhealed foot ulcer
Mx

4) Some one with jaundice.. I forget
5) I forget
6) 2 studies… both are crappy… one on chances of cancer after total hip replacement, another compares somnoplasty to oral devices on reducing snoring… both no good