General

Question 1

Metabolic syndrome

Answer 1

A combination of at least three of the following:
abdominal obesity, hypertension, hypertriglyceridaemia, low levels of high-density lipoproteins, high fasting plasma glucose level

Clinical manifestations:
hypertension, hyperglycaemia, hypertriglyceridaemia, reduced high-density lipoprotein cholesterol (HDL-c), abdominal obesity, chest pains or SOB (suggesting rise of cardiovascular and other complications). Also, acanthosis nigricans, hirsutism, peripheral neuropathy, retinopathy w/ insulin resistance and hyperglycaemia or w/ DM.
Xanthomas or xanthelasmas w/ severe dyslipidaemia

Question 2

Parkland Formula

Answer 2

Fluid management for burns

Fluid requirement in first 24 hours: 4mls/kg/%BSA
(BSA - burn surface area - rule of 9s)
50% given in first 8 hours since the burn
Remaining 50% given over following 16 hours

Calculate from time of burn not from time of assessment

Question 3

Waterbrash

Answer 3

Sudden and unexpected secretion of a quantity of saliva into the mouth as a reflex response to symptoms of dyspepsia

Question 4

Pale stools

Answer 4

Indicate bile is not reaching the bowel

Question 5

Steatorrhoea

Answer 5

Poor digestion of fat usually due to pancreatic exocrine insufficiency or long standing biliary disease (implies chronic obstruction)

Question 6

Normal urinary output in adults

Answer 6

1ml/kg/hr

Question 7

Normal blood volume in adults

Answer 7

70mls/kg

Question 8

Signs of hypovolaemic shock

Answer 8

Pale Anxious Shocks
S - sinus tachycardia
H - hypotension
O - oliguria
C - cold
K - (k)clammy
S - slow capillary refill

Question 9

Signs of peritonitis

Answer 9

Trapped by Peritonitis
T - tenderness (and tachycardia)
R - reflex guarding that progresses to rigidity
A - absent bowel sounds (or reduced)
P - pyrexia
P - percussion pain (better than rebound)
E - extremely unwell
D - distant-local sign - Rovsing's sign

Question 10

Rovsing’s sign

Answer 10

Distant palpation, location tenderness
Palpation of the LLQ elicits pain in the RLQ
Seen in appendicitis

Question 11

SIRS

Answer 11

> /= 2 of the following
Temp: >38deg, 90 bpm
Resp rate: >20 bpm
PaCO2: 12x10^9/L or

Question 12

Sepsis

Answer 12

SIRS + known source or suspected source of infection

Question 13

Severe sepsis

Answer 13

Organ dysfunction, hypotension, hypoperfusion in association with lactic acidosis, systolic BP

Question 14

Septic shock

Answer 14

Severe sepsis with hypotension despite adequate fluid resuscitation

Question 15

General complications of surgery

Answer 15

A - anaesthetics
B - bed sores
C - chest infection
D - DVT/PE
E - electrolyte imbalance
F - fluid: overload/dehydration
G - gastritis (& stress ulcers)
H - haemorrhage
I - infection (urine, wound etc)
W - wound dehisence

H - haemorrhage
I - infection
D - DVT/PE

A - anesthetics

B - bed sores
A - acute retention
D - dehiscence

W - wound infection
I - ileus
F - fluid imbalance