General Surgery

Question 1

Post operative patient - what would you look at in the notes?

Answer 1

Question 2

Investigations you would consider for a post operative patient with suspected abdominal sepsis

Answer 2

Question 3

Definition of sepsis

Answer 3

Life threatening organ dysfunction caused by a dysregulated host immune response

Question 4

Surviving Sepsis Guidelines 2021

Answer 4

Question 5

McBurney’s Point

Answer 5

1/3 the distance from ASIS to the umbilicus

Question 6

Eponymous signs of appendicitis

Answer 6

Obturator Sign: defined as discomfort felt by the subject/patient on the slow internal movement of the hip joint, while the right knee is flexed. It indicates an inflamed pelvic appendix that is in contact with the obturator internus muscle

Rosving’s Sign

Psoas Sign

Question 7

Scoring system for Appendicitis

Answer 7

Question 8

Risk factors for anastomotic leak

Answer 8

Question 9

Factors that affect wound healing

Answer 9

Pre op: anaemia, jaundice, malignancy, vitamin C deficiency, diabetes or protein deficiency + smoking

Operative: poor surgical technique/ error, Increased bowel handling (leads to oedema)

Post operative: chronic cough, intra-abdominal pressure, high body mass index

Question 10

NELA

Answer 10

National Emergency Laparotomy Audit
Provides an estimate of the risk of death within 30 days of emergency abdominal surgery