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SBAs for the MRCS Part A
SBAs for the MRCS Part A
A Bailey & Love Revision Guide
Second Edition

Vivian A. Elwell
BA (Hons), MA (Cantab), MBBS, MRCS, FRCS (Neuro. Surg.)
Consultant Neurosurgeon and Spinal Surgeon
Brighton and Sussex University Hospitals NHS Trust, Brighton

Jonathan M. Fishman
BA (Hons), MA (Cantab), BM BCh (Oxon), PhD, MRCS (Eng),
DOHNS (RCS Eng), FHEA, FRCS (ORL-HNS)
Consultant ENT Surgeon, University College London Hospitals NHS
Foundation Trust (UCLH) and Honorary Clinical Lecturer, University
College London, London

Rajat Chowdhury
BSc (Hons), MA (Oxon), BM BCh (Oxon), MRCS, FRCS, FBIR, PGCME
Consultant Musculoskeletal Radiologist, Oxford University Hospitals
NHS Foundation Trust, Oxford

All Managing Directors of Insider Medical Ltd.

CRC Press
Taylor & Francis Group
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© 2019 by Taylor & Francis Group, LLC

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No claim to original U.S. Government works

Printed on acid-free paper

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Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are
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Library of Congress Cataloging‑in‑Publication Data

Names: Elwell, Vivian A., author. | Fishman, Jonathan M., author. |

Chowdhury, Rajat, author.
Title: Single best answers (SBAs) for the MRCS Part A / Vivian A. Elwell,
Jonathan M. Fishman, Rajat Chowdhury.
Other titles: SBAs and EMQs for the MRCS Part A | SBAs for the MRCS part A
Description: Second edition. | Boca Raton : CRC Press, 2019. | Includes
index. | “A Bailey & Love revision guide.” | Preceded by SBAs and EMQs for
the MRCS Part A. 2011.
Identifiers: LCCN 2018013793| ISBN 9781138501997 (pbk. : alk. paper) | ISBN
9781315144672 (e-book)
Subjects: | MESH: General Surgery | Examination Questions
Classification: LCC RD37.2 | NLM WO 18.2 | DDC 617.0076--dc23
LC record available at https://lccn.loc.gov/2018013793

Visit the Taylor & Francis Web site at

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and the CRC Press Web site at

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 Also by Vivian A. Elwell, Jonathan M. Fishman, and Rajat Chowdhury

OSCEs for the MRCS Part B: A Bailey and Love Revision Guide (2nd Edition)

SBAs & EMQs for the MRCS Part A: A Bailey and

Love Revision Guide (1st Edition)

OSCEs for the MRCS Part B: A Bailey and Love Revision Guide (1st Edition)

The Insider’s Guide to the MRCS Clinical Examination

 By three methods we may learn wisdom:
first, by reflection, which is noblest;
second, by imitation, which is easiest;
and third by experience, which is the bitterest.

Confucius, 551 BC–479 BC

For all our past, present, and future patients
Contents
Preface to the Second Edition xi
Acknowledgements xiii
About the Authors xv
Introduction: The Insider’s Guide to the MRCS Part A Examination xix

SECTION 1: SINGLE BEST ANSWER QUESTIONS 1

SECTION 1: SBA ANSWERS AND EXPLANATIONS 29

SECTION 2: SINGLE BEST ANSWER QUESTIONS 99

SECTION 2: SBA ANSWERS AND EXPLANATIONS 129

SECTION 3: SINGLE BEST ANSWER QUESTIONS 209

SECTION 3: SBA ANSWERS AND EXPLANATIONS 237

Index 315
Preface to the Second Edition
This book has been written as an accompaniment to Bailey and Love’s Short
Practice of Surgery, 27th Edition and targeted for the MRCS Part A examination,
which is the first part of the Intercollegiate MRCS Examination. The examination
syllabus, format, and content are common to The Royal College of Surgeons of
Edinburgh, The Royal College of Surgeons of England, and The Royal College of
Physicians and Surgeons of Glasgow. This examination is designed and set by the
Royal Colleges of Surgeons to test the knowledge, skills, and attributes acquired
during core surgical training.
From September 2018, the Intercollegiate MRCS Part A examination will com-
prise two MCQ papers taken on the same day. The first paper (Applied Basic
Sciences) will be 3 hours and the second paper (Principles of Surgery-in-General)
will be 2 hours in duration. Both papers will be in a single best answer (SBA)
format. A minimum mark must be obtained in both papers, in addition to attain-
ing the total pass mark, to obtain an overall pass in the Intercollegiate Part A
Examination. Successful completion of the Intercollegiate Part A Examination
qualifies the trainee surgeon to enter the Intercollegiate Part B Objective
Structured Clinical Examination.
This book, now in its second edition, is based on our highly successful Insider
Medical MRCS Courses and the feedback obtained from countless candidates who
have sat for the examination. We have carefully selected those high-yield topics
that are likely to be faced in the examination and offer methods to tackle the
challenges that they may pose. We have drawn from our breadth of experience of
teaching at both the undergraduate and postgraduate levels and have identified
common pitfalls.
A thorough understanding of applied basic science and the ability to problem-
solve underpins surgical science and sets the foundation for future surgical prac-
tice. Whilst it is not feasible to cover the complete syllabus within the remit of
this book, we have selected the most important and high-yield topics to facilitate
examination study and revision. The style of questions is typical of those found
in the real examination and will therefore serve well as mock papers. We are
confident that this book will assist and help focus any trainee surgeon in their
revision for the MRCS Part A examination, and in doing so, refine their analyti-
cal approach to all areas of their surgical practice.

Vivian A. Elwell

Jonathan M. Fishman

Rajat Chowdhury
Acknowledgements
This book would not have been possible without the ongoing support of the
following individuals:
Mrs. Carole D. Elwell, Dr. Nigel Mendoza, Mr. and Mrs. John Cervieri Jr., Dr. and
Mrs. George Leib, Mr. and Mrs. Lawrence Flick, Dr. Sandra Ginsberg, Dr. David
Fishman, Mrs. Wendy Fishman, Dr. Galia Fishman, Master James Fishman,
Miss Emily Fishman, Mr. and Mrs. Ashit Chowdhury, and Dr. Madhuchanda
Bhattacharyya.
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