General Surgery

Question 1

Most common type kidney stone

Answer 1

calcium oxalate
ass. w/ hypercalcaemia

Question 2

Kidney stones ass. w/ inherited metabolic condition

Answer 2

cystine

Question 3

uric acid stones

Answer 3

associated with chemo

Question 4

calcium phosphate stones

Answer 4

associated with renal tubular acidosis (type 1 and 3)

Question 5

which stones associated with infection & staghorn calculus

Answer 5

struvite

Question 6

which stones not radiopaque

Answer 6

uric acid

Question 7

kidney stone diagnostic investigation

Answer 7

non-contrast CT KUB

Question 8

prophylactic drug for calcium oxalate stones

Answer 8

thiazide diuretics

Question 9

prophylactic drugs for uric acid stones

Answer 9

Allopurinol
potassium citrate

Question 10

kidney stone management

Answer 10

watchful waiting, pain relief if <5mm
Percutaneous nephrolithotomy if >2cm
Shock wave lithotropsy
Ureteroscopy if pregnant/ureteric stones

Question 11

MOA lidocaine

Answer 11

blockage sodium channels

Question 12

inguinal hernia vs femoral hernia

Answer 12

inguinal: superior and medial to the pubic tubercle
femoral: inferior and lateral to pubic tubercle

Question 13

Inguinal hernia management

Answer 13

treat medically fit patients even if they are asymptomatic
mesh surgery

Question 14

Direct vs indirect inguinal hernia

Answer 14

direct - bulges through wall of inguinal canal
indirect - goes through inguinal canal
to differentiate: press on deep inguinal ring, patient coughs and indirect won’t come back through

Question 15

BPH treatment

Answer 15

1st line: alpha-1 antagonist = tamsulosin, alfuzosin
2nd line: 5 alpha-reductase i = finasteride (stops testosterone making)
3rd line: anticholinergics (oxybutnin, tolterodine)

Question 16

S/E alpha 1 antagonist

Answer 16

dizzy
postural hypotension
dry mouth
depression

Question 17

how long can it take for 5-alpha reductase inhibitors to work

Answer 17

6 months

Question 18

marjolin’s ulcer

Answer 18

Squamous cell carcinoma
Occurring at sites of chronic inflammation e.g; burns, osteomyelitis after 10-20 years

Question 19

marjolin’s ulcer

Answer 19

Squamous cell carcinoma
Occurring at sites of chronic inflammation e.g; burns, osteomyelitis after 10-20 years

Question 20

Pyoderma gangrenosum

Answer 20

Associated with inflammatory bowel disease/RA
Can occur at stoma sites
Erythematous nodules or pustules which ulcerate

Question 21

fibroadenoma surgical removal if?

Answer 21

> 3cm

Question 22

Longer history of dysphagia, often not progressive.
Usually symptoms of GORD.
Often lack systemic features seen with malignancy

Answer 22

Peptic stricture

Question 23

May have dysphagia that is episodic and non progressive.
Retrosternal pain may accompany the episodes.

Answer 23

Dysmotility disorder

Question 24

Superficial thrombophlebitis management

Answer 24

NSAIDS
compression stockings

Question 25

Most common breast cancer

Answer 25

Invasive ductal carcinoma

Question 26

Most common breast cancers

Answer 26

Invasive ductal carcinoma Invasive lobular carcinoma Ductal carcinoma-in-situ (DCIS) Lobular carcinoma-in-situ (LCIS)

Question 27

Boerhaave syndrome diagnosis

Answer 27

CT contrast swallow.

Question 28

Baby Billous vomiting Few hours after birth

Answer 28

Duodenal atresia

Question 29

Baby Billous vomiting Usually 3-7 days after birth, may have haemodynamic instability

Answer 29

malrotation with volvulus volvulus with compromised circulation may result in peritoneal signs and haemodynamic instability

Question 30

Baby Billous vomiting Usually within 24 hours of birth

Answer 30

Jejunal/ ileal atresia

Question 31

Baby Billous vomiting hasn't passed poop Typically in first 24-48 hours of life with abdominal distension and bilious vomiting

Answer 31

Meconium ileus

Question 32

Baby Billous vomiting Usually second week of life

Answer 32

NEC

Question 33

Duodenal atresia diagnosis

Answer 33

AXR shows double bubble sign, contrast study may confirm

Question 34

malrotation with volvulus diagnosis

Answer 34

USS - whirlpool sign Upper GI contrast study may show DJ flexure is more medially placed,

Question 35

jejunal/ileal atresia diagnosis

Answer 35

AXR will show air-fluid levels - triple bubble

Question 36

meconium ileus diagnosis

Answer 36

Air - fluid levels on AXR, sweat test to confirm cystic fibrosis

Question 37

NEC diagnosis

Answer 37

Dilated bowel loops on AXR, pneumatosis and portal venous air

Question 38

Pyloric stenosis diagnosis

Answer 38

test/feed USS

Question 39

Projectile non bile stained vomiting at 4-6 weeks of life

Answer 39

Pyloric stenosis

Question 40

Intussusception diagnosis

Answer 40

USS - target-like mass

Question 41

Brain death confirmation

Answer 41

pupillary reflex, corneal reflex, oculo-vestibular reflex, cough reflex, absent response to supraorbital pressure no spontaneous respiratory effort

Question 42

Prognostic criteria of pancreatitis

Answer 42

age > 55 years hypocalcaemia hyperglycaemia hypoxia neutrophilia elevated LDH and AST