FCS(SA) Final Practice Questions - Fellowship of the College of Surgeons of South Africa Final Examination FCS(SA) Final Exam - FCS(SA) Final Practice Questions - Fellowship of the College of Surgeons of South Africa Final Examination FCS(SA) Final Exam

Question 1

A 62-year-old male presents with dysphagia to solid foods and unintentional weight loss. Endoscopy reveals an adenocarcinoma extending from 1 cm above to 2 cm below the oesophagogastric junction (Siewert Type II). Staging CT and PET show T3N1M0 disease. What is the most appropriate definitive management strategy?

Primary endoscopic mucosal resection followed by oral proton pump inhibitor therapy Neoadjuvant chemoradiotherapy followed by transthoracic or transhiatal subtotal oesophagectomy with proximal gastrectomy Immediate total gastrectomy with Roux-en-Y reconstruction without neoadjuvant therapy Definitive chemoradiotherapy alone without surgical resection

Correct Answer:

Neoadjuvant chemoradiotherapy followed by transthoracic or transhiatal subtotal oesophagectomy with proximal gastrectomy

Question 2

A 54-year-old male presents with severe lower retrosternal pain, fever, and subcutaneous emphysema of the neck 4 hours after a bout of violent emesis following heavy alcohol ingestion. Chest X-ray demonstrates a left-sided pleural effusion and pneumomediastinum. What is the most definitive initial diagnostic investigation to confirm the clinical suspicion?

Flexible upper gastrointestinal endoscopy Water-soluble contrast swallow fluoroscopy (or contrast-enhanced CT with oral water-soluble contrast) High-resolution oesophageal manometry 24-hour ambulatory pH monitoring

Correct Answer:

Water-soluble contrast swallow fluoroscopy (or contrast-enhanced CT with oral water-soluble contrast)

Question 3

A 58-year-old woman is found to have a 4 cm submucosal lesion in the gastric body on upper endoscopy. Endoscopic ultrasound-guided fine-needle biopsy confirms a Gastrointestinal Stromal Tumour (GIST) positive for CD117 (c-KIT). Staging CT shows no metastatic disease. What is the standard surgical approach?

Total gastrectomy with formal D2 lymph node dissection Wedge resection of the stomach with macroscopic negative (R0) margins without routine lymphadenectomy Endoscopic mucosal capping without surgical excision En-bloc total gastrectomy, splenectomy, and distal pancreatectomy

Correct Answer:

Wedge resection of the stomach with macroscopic negative (R0) margins without routine lymphadenectomy

Question 4

A 72-year-old man presents with progressive cervical dysphagia, regurgitation of undigested food, halitosis, and recurrent aspiration pneumonia. Contrast swallow reveals a 4 cm posterior pharyngeal pouch above the cricopharyngeus muscle. What is the definitive treatment of choice?

Long-term oral proton pump inhibitor therapy Cricopharyngeal myotomy with endoscopic stapled diverticulotomy (or open diverticulectomy/diverticulopexy) Balloon dilatation of the lower oesophageal sphincter Subtotal oesophagectomy with gastric pull-up

Correct Answer:

Cricopharyngeal myotomy with endoscopic stapled diverticulotomy (or open diverticulectomy/diverticulopexy)

Question 5

A 40-year-old female presents with dysphagia to solids and liquids. High-Resolution Manometry (HRM) shows integrated relaxation pressure (IRP) >15 mmHg with failure of peristalsis and premature (spastic) contractions in >20% of swallows (Chicago Classification Type III Achalasia). Which therapeutic option offers superior clinical efficacy for Type III achalasia?

Laparoscopic Heller Myotomy with Dor fundoplication Peroral Endoscopic Myotomy (POEM) Pneumatic balloon dilatation Botulinum toxin injection into the lower oesophageal sphincter

Correct Answer:

Peroral Endoscopic Myotomy (POEM)

Question 1

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Prepare with the FCS(SA) Final Practice Questions - Fellowship of the College of Surgeons of South Africa Final Examination FCS(SA) Final Exam practice quiz. This question bank includes 100 questions covering year-old, presents, male, surgical, and female. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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FCS(SA) Final Practice Questions - Fellowship of the College of Surgeons of South Africa Final Examination FCS(SA) Final Exam

This practice set contains 100 questions from the matching question bank and focuses on year-old, presents, male, surgical, and female. Work through each question carefully, review the provided solutions, and revisit topics that need more study before your next attempt.

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FCS(SA) Final Practice Questions - Fellowship of the College of Surgeons of South Africa Final Examination FCS(SA) Final Exam

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