DPD: General Surgery

Question 1

What is Rovsing’s sign? In what condition is it seen?

Answer 1

Deep palpation of LIF elicits pain in RIF

Appendicitis

Question 2

What is the illiopsoas and obturator tests? In which condition are they seen?

Answer 2

Pt lies on their left side
Hyperextend pts right thigh whilst applying counter resistance to right hip
Positive test= Abdominal Pain

Obturator test
Pain on passive internal rotation of the flexed thigh. Examiner moves lower leg laterally while applying resistance to the lateral side of the kneeresulting in internal rotation of the femur.
Appendicitis

Question 3

What is Murphy’s sign? In which condition is it seen?

Answer 3

Pressure on right costal margin causes pain on deep inspiration
Cholecystitis (inflamed gallbladder makes contact with hand)

Question 4

What is Courvoisiers law?

Answer 4

Painless jaundice with palpable gall bladder = malignancy

Question 5

In which condition is Grey-Turners and Cullens sign seen?

Answer 5

Pancreatitis

Question 6

What is involved in the 3 in and 3 out management of sepsis?

Answer 6

IN;
O2
IV fluids
IV Abx
OUT:
Urine output (catheter)
Blood cultures
Serum lactate

Question 7

List 5 signs that may be seen on AXR in pancreatitis

Answer 7

Calcified gallstones
Air in the biliary tree (post ERCP)
Sentinel loop (localized ileus)
Calcified pancreas (in chronic)
Chest signs e.g. pleural effusion/ ARDS

Question 8

List 7 C’s of post-op pyrexia

Answer 8

Chest
Catheter
CVP line
Cannula (can cause infection)
Cut
Collection
Calves (DVT)