Past papers

Question 1

What is the most sensitive indicator for intravascular volume depletion following surgery?

Answer 1

Resting tachycardia

Question 2

Pattern of dysphagia

• oropharyngeal
• esophageal: motor & mechanical (progressive & intermittent each)

Answer 2

1. Oropharyngeal: difficulty initiating a swallow. a/w cough, choking, nasal regurgitation
2. Esophageal: food getting stuck in esophagus
   A. Motor disorder (solids +/- liquids)
   - Intermittent: diffuse esophageal spasm, NEMD (nonspecific esophageal motility disorder)
   - Progressive: scleroderma (chronic heart burn), achalasia (regurgitation +/- resp symptoms +/- weight loss)

B. Mechanical obstruction

• Intermittent: esophageal ring
• Progressive: peptic stricture (chronic heart burn), esophageal/cardia cancer (elderly, weight loss, anaemia)

Question 3

Discuss the types of haemorrhages involved in haemorrhoids depending on time

• Primary Haemorrhage
• Reactionary Haemorrhage
• Secondary Haemorrhage

Answer 3

• Primary Haemorrhage: Haemorrhage occurring at the time of Injury/Trauma/Surgery
• Reactionary Haemorrhage: Haemorrhage occurring within first 24 hrs following Trauma/Surgery
• Secondary Haemorrhage: Haemorrhage occurring after 7 -14 days after Trauma/Surgery.
  The attributed cause is infection and sloughing away of the blood vessels

Question 4

All of the following occur commonly in delirium tremens except:

a. visual hallucinations
b. drowsiness
c. tremor
d. tachycardia
e. sweating

Answer 4

b. drowsiness