Acute abdomen

Question 1

Which antibiotics is it best to give in appendicitis?

Answer 1

Metronidazole

Cefuroxamine

Question 2

What are the 3 main complications of appendicitis that may occur?

Answer 2

Perforation
Appendix mass
Appendix abscess

Question 3

What is an appendix mass?

Answer 3

When appendix becomes covered in omentum and forms a mass

Question 4

What does a positive psoas sign indicate?

Answer 4

Retrocaecal positioning of appendix

Question 5

What is Hartmann’s procedure?

Answer 5

Removal of diseased bowel and stoma formation – followed by a primary anastomosis afterwards

Question 6

Differentiate the groups of patients most likely to get a femoral or inguinal hernia

Answer 6

Femoral: older females
Inguinal: younger males

Question 7

Which type of hernia is most likely to strangulate?

Answer 7

Femoral

Question 8

Which type of hernia could be treated without surgery?

Answer 8

Inguinal

Question 9

Differentiate the position of femoral and inguinal hernias with relation to the pubic tubercle

Answer 9

Inguinal: superior and medial
Femoral: lateral and inferior

Question 10

Where does the pain of pancreatitis radiate to?

Answer 10

The back

Question 11

What may relieve pancreatitis pain?

Answer 11

Sitting forwards

Question 12

Recall the expected faecal elastase level in pancreatitis?

Answer 12

Acute: normal
Chronic: high

Question 13

Recall the modified Glasgow Scoring system

Answer 13

PANCREAS
PaO2: <7.9kPa
Age: >55
Neutrophils (>15)
Calcium (<2)
Renal fx (urea >16) 
Enzymes (LDH >600) 
Albumin (<32) 
Sugar (>10)

Question 14

What modified Glasgow Score is indicative of severe pancreatitis?

Answer 14

> 3

Question 15

What is the main surgical management option for pancreatitis?

Answer 15

ERCP

Question 16

Describe the bowel sounds in intestinal obstruction

Answer 16

Either absent or high-pitched ‘tinkling’

Question 17

What is Rigler’s sign?

Answer 17

Air seen on both signs of the intestine wall