gen surg

Question 1

what is the threshold NICE recommends for carotid endartectomy?

Answer 1

if the carotid stenosis is severe like 70-99% and the symptoms are present on the contralateral weakness like tias

Question 2

if the cancer is 7 cm away from the anal canal what is the management

Answer 2

there has to be a margin of 8cm for anterior resection so will have to do APER with end colostomy

Question 3

trousseau syndrome is associated with

Answer 3

pancreatic carcinoma( migratory thrombhlebitis) that affects the extremities

Question 4

pain on swallowing food or liquid, retrosternal pain, what is the definitive investigation?

Answer 4

barrium swallow which show corkscrew esophagous

Question 5

during total hip replacement there is iv abx given to the patient what is the reasn for the it

Answer 5

to prevent penetrative wound infection

Question 6

A 60 year old female patient presents to the general practitioner with a dragging sensation associated with a lump in her right groin.

On physical examination there is a soft, compressible, non-tender lump in the right groin. The lump is more prominent on standing. The lump has a purple/blue discolouration.

Which of the following clinical signs is consistent with the most likely diagnosis?

Answer 6

saphena varix

Question 7

what is the best investigation for Zollinger ellison syndrome?

Answer 7

secreatin stimulation test

Question 8

what is the initial management for haemorrhoids?

Answer 8

promote high fibre diet and prescribe short course of corticosteroids …. for the anal fissure the management is topical GTN.

Question 9

what is the management of the guy who is found to have colon cancer with liver mets

Answer 9

surgical resection of both

Question 10

which tye of surgery are the patient referred to if their aaa is more than 5.6

Answer 10

open surgery, and if the patient is not suitable for open surgery then go for EVAR.
Rapid expansion is defined as increase in diameter >5mm over a 6 month period or >10mm over one year.

Question 11

if the hernia is irreducible after putting pressure on the superficial ring what kind of hernia is it andwhat will be the management

Answer 11

its the direct type of and its medial to the inferior epigastric vessel and the mnanagment is open mesh repair as the chace of getting incarcerated is high.The annual probability of strangulation is up to 3% and is more common in indirect hernias. DM

Question 12

On physical examination the patient is cachectic, with supernumerary teeth and multiple lipomas. she presents with pr bleeding what is the gene that is faulty

Answer 12

the APC gene , its the gardener variant of the apc

Question 13

grey turners sign is present in

Answer 13

haemorrhagic pancreatitis

Question 14

in a pregnant woamn with a stone of 13mm what is the management .?

Answer 14

uteroscopy because shock wave lithotripsy is contra

Question 15

which incission is horizontal in the right iliac fossa

Answer 15

lanz and rutherford morrison is an oblique incission

Question 16

You are asked to examine a 69 year old male patient on the wards. You find there is a stoma in the right iliac fossa, with liquid contents, and a spouted end. Two ends of bowel are visible. You also notice a number of laparoscopic port incisions which look relatively recent.

Which of the following surgical procedures is consistent with these examination findings?

Answer 16

anterior resection with loop iliostomy

Question 17

what is the most common site of anal fissure

Answer 17

midline posterior

Question 18

Malignanat hyperthermia is a reaction seen after administering anaethetic agent. what kind of defect is usually seen in the patient who suffer from this?

Answer 18

autosomal dominant disorder in RYR1 gene.

Question 19

in a patient with suspected pancreatic cancer what is the imaging that is most sensitive

Answer 19

endoscopic ultrasound

Question 20

if there is a breach or tear in the gut lumen surgery what is the classification of the wound here

Answer 20

contaminated

Question 21

what is the survival rate of duke c carcinoma

Answer 21

47.7%

Question 22

what is the 2nd largest cause of death in patient with familial adenomatosis polyposis

Answer 22

duodenal carcinoma

Question 23

which anti emetic should be used with caustion(risk of urinary retension) in elderly and IVDU

Answer 23

cyclizine(5HT1 receptor antagonist)

Question 24

what is the management of grade 2 haemorrhoids

Answer 24

which bulge out on straining but retract back on its own. the management include- rubber band ligation

Question 25

which liver pathology has raised AFP?

Answer 25

hepatocellular carcinoma

Question 26

von hipple liddau is associated with which type of cancer

Answer 26

renal cell carcinoma

Question 27

which thyrid cancer spreads fast to the adjacent nodes

Answer 27

papillary aso the most common cancer

Question 28

which ondition do you see embryo sign

Answer 28

in caecal vulvulous and its a large bowel obstruction.

Question 29

what is the most common site of oesophageal cancer and how much percentage of cancer are present there?

Answer 29

50% in the middle part of the oesophagous.especially adenocarcinoma.

Question 30

sudden onset severe backpain should be treated as

Answer 30

aaa rupture it radiates to the lif sometimes.

Question 31

which gene is faulty in lynch syndrome

Answer 31

MHS-1...cancers are colorectal cancer, or cancer of the endometrium, small intestine, ureter or renal pelvis.

Question 32

which oesophageal cancer has the potential to impinge on the recurrent laryngeal nerve

Answer 32

upper 1/3 rd of the osophagous cancer

Question 33

what is a complication of TPN which makes a patient prone to congestive heart failure, seizures, confusion, muscle pain and fluid shifts.

Answer 33

refeeding syndrome- hypophosphatemia

Question 34

what is the intervention for intussussception

Answer 34

contrast enema or air enema if the child is stable and if the child is unstable then laparotomy.

Question 35

what is the first line and second line management of angiodysplasia

Answer 35

first- interventional endoscopy and second isangiography with embolisation(especally in patient who are unstable)

Question 36

what is the management of acute appendicitis

Answer 36

immidiate laproscopy removala nd 1 dose of abx before and 2 doses of abx after the surgery

Question 37

which part of git does get ulcerated when the patient is on nsaids

Answer 37

duodenum

Question 38

in a duke c cancer of the descending colon what is the management

Answer 38

left hemicolectomy and adjuvent chemo

Question 39

what is the investigation for perforated diverticular disease?

Answer 39

ct abdo

Question 40

what happens when on ultrasound on screening the AAA is more than 3cm

Answer 40

referral to the vascular surgeons within 12 weeks.

Question 41

which drug is assciated with pancreatitis?

Answer 41

sulphonamides(co-trimoxazole) A good mnemonic for drug-induced pancreatitis is FATSHEEP: ``` Furosemide Azathioprine/Asparaginase Thiazides/Tetracycline Statins/Sulfonamides/Sodium Valproate Hydrochlorothiazide Estrogens Ethanol Protease inhibitors and NRTIs ```

Question 42

what are the 3 conditions that warant urrgent ogd for gastric adenocarcinoma

Answer 42

weight loss of more than 4 kgs in 1 month, upper abdo pain and age of more than 55

Question 43

risk factor for pancreatic cancer is

Answer 43

smoking

Question 44

which thyroid cancer can present with breathless due to invasion in the lungs

Answer 44

anaplastic is the rarest cancer but it invaded the local structure really fast

Question 45

what is the management of umblical hernia/

Answer 45

weight loss and later on cosmetic surgery coz its the fat that is protruding out

Question 46

what is the condition in which arterialduplex shows corkscrew shaped collateral supply

Answer 46

buergers...its called mortels sign.

Question 47

which type of colonic polyps are related to the finding of hypokalemia

Answer 47

villous polyps