Emergency Surgery*

Question 1

In which quadrant is the the cecum located?

Answer 1

Right lower quadrant

Question 2

In which quadrant is the the sigmoid colon located?

Answer 2

Left lower quadrant

Question 3

In which quadrant is the the pancreas body located?

Answer 3

Left upper quad

Question 4

In which quadrant is the head of pancreas located?

Answer 4

Right upper quad

Question 5

……. Sign is ecchymosis (discoloration of skin due to bruises) of flank from retroperitoneal injury

Answer 5

Gray Turner

Question 6

What are the causes of small bowel obstruction (SBO)?

Answer 6

FAST GRIVB;
Foreign body
Adhesion
Strangulated hernia
Tumors

Gallstones
Radiation
Intussusception(inversion of one portion of the intestine into another)
Volvulus(obstruction caused by twisting)
Bezoar(mass in the gastrointestinal system caused by the accumulation of indigestible ingested materials)

Question 7

What are the causes of large bowel obstruction (LBO)?

Answer 7

CHEVA FD

Colon cancer
Hernia
Extrinsic cancer
Volvulus
Adhesion

Fecal impaction
Diverticulitis

Question 8

Within how long can you operate on ischemia and perforation+bleeding+obstruction[B.I.O.P]?

Answer 8

[hours in BIO P]
Hours

Question 9

Within how long can you operate on obstruction and infeection?

Answer 9

Days

Question 10

Within how long can you operate on bleeding?

Answer 10

Minutes

Question 11

What is a sign of retroperitoneal injury?

Answer 11

Gray tuner(echymosis)

Question 12

When do you seen “Currant jelly stool” or stool with mucus?

Answer 12

In intussusception

Question 13

What are the complications of intussusception?

Answer 13

[BPSP]
Bowel obstruction

Perforation

Sepsis

Peritonitis

Question 14

**What is the dx of intussusception ?

Answer 14

Hx and physical exam

X-ray

Ultrasound

Contrast enema

Ct scan

Question 15

*What are the clinical features of pyloric stenosis?

Answer 15

-Non-bilious vomiting

-Normal appetite

-dehydration

-Hypochloremia, hypokalemia,metabolic alkalosis*

Question 16

**What are the complications of appendicitis?

Answer 16

Peritonitis

Perforation

Abscess

Generalized abdominal rigidity

Fever

Increased pain with cough

Question 17

**What is the history of of a person with pancreatitis?

Answer 17

Qualities of current pain(epigastric pain)

Hx of alcohol abuse

Hx of past pancreatitis

Hx of gallstones

inc lipase and amylase

Question 18

**What are the elevated lab values in pancreatitis?

Answer 18

Elevated lipase and amylase

Question 19

**What are the symptoms of ascending choliangitis?

Answer 19

CHARCOT’s Triad Combination of : Jaundice, Fever, and RUQ pain

Question 20

What are the complications of gallstones?

Answer 20

Necrosis/perforation

Gallstone illeus

Ascending choliangitis(charcot’s triad)

Question 21

Which disease of the intestine is described as small mucosal pockets or pouches?

Answer 21

Diverticulitis

Question 22

Where can you see **urinary frequency+ Left lower quadrant pain+ Dysuria+ change in bowel habits?

Answer 22

Diverticulitis

Question 23

During assessment of diverticulitis what is the prominent signs?

Answer 23

**Change in bowel habits

LLQ tenderness*

Occult blood

Question 24

**Q, upper GIS bleeding causes?

Answer 24

[VARICES]
Varices &vascular malformation(osler weber)

Alcohol and drugs

Ruptures(mallory-weiss tear)

I-peptic ulcers

Carcinoma

Esophagitis

Stomach ulcer

Question 25

**Q, lower GIS bleeding causes?

Answer 25

[DRAIN-M]
Diverticulosis

Radiation

Angiodysplasia/ AV malformation (AVM)

Ischemia/inflammatory bowel dis

Neoplasm

Meckel’s diverticulum
Enteritis

Question 26

In which disease are Veins distended and can be fragile and at risk for **tearing and
bleeding*?

Answer 26

Esophageal varices

Question 27

In which disease do you see clinical features including :• Hematemesis
– “coffee-ground emesis”
• **Hematochezia
• **Melena
• Fatigue
• Hypovolemia
• Tachycardia

Answer 27

upper GIS bleeding such as esophageal varices

Question 28

In a person with a history of alcohol use, Hematochezia, Melena, Hematemesis

Answer 28

Esophageal varices

Question 29

When do you see Kehr’s sign and LUQ pain?

Answer 29

Splenic injury/rupture

Question 30

When do you use Nasogastric tube stomach injury

Question 31

When are amylase and lipase elevated and epigastric pain?

Answer 31

Pancreatitis