General surgery and Urology

Question 1

Alvardo score is for?

Answer 1

For appendicitis

Question 2

First line pain relief for renal colic

Answer 2

NSAID by ANY route

Question 3

Caecal vs sigmoid volvulus

Answer 3

Question 4

Management of systemically well diverticulitis

Answer 4

Just analgesia

Question 5

Blue dot sign

Answer 5

Torsion of the appendix testes

Question 6

Treatment for epidiymo-orchitis where a STI is not suspected

Answer 6

Ofloxacin

Question 7

Medical management for a renal stone

Answer 7

Tamsulosin

Question 8

Pain medication contraindicated in renal colic

Answer 8

Anti spasmodics

Question 9

Oakland risk score

Answer 9

The Oakland Score for safe discharge after lower GI bleed predicts readmission risk in patients with acute lower GI bleeding.

Question 10

Surface marking of McBurney’s point

Answer 10

One-third of the distance from the anterior superior iliac spine to the umbilicus

Question 11

Gallstone ileus cause

Presents like

Answer 11

is caused by the impaction of a gallstone within the lumen of the small intestine. The stone typically impacts at the caeco-ileal valve.

SBO

Question 12

Shock index is calculated by

Answer 12

the ratio between heart rate and systolic blood pressure (HR/SBP)

Question 13

Reynold’s pentad

Answer 13

Jaundice
Fever (usually with rigors)
Right upper quadrant pain
Shock
Altered mental status

Obstructive ascending cholangitis

Question 14

Chilaiditi sign cause on XR

Answer 14

Is caused by the interposition of a loop of the large intestine between the diaphragm and the liver.

the presence of visible gas below the right diaphragm. Rugal folds are often seen within the gas, showing that it lies within the bowel and is not free.

Question 15

Where is the commonest location for gallstones to become lodged and cause cholestasis?

Answer 15

Hartmann’s pouch

Question 16

90% of cases of diverticulitis involve the …

Answer 16

sigmoid colon

Question 17

Ranson criteria

Answer 17

A clinical prediction rule for predicting the severity of acute pancreatitis.

A score >3 is indicative of severe pancreatitis (>15% mortality).

The criteria at admission are:
Age >55 years
White cell count >16 x 109/L
Blood glucose >11 mmol/L
Serum AST >250 IU/L
Serum LDH >350 IU/L

Question 18

If NSAIDs contraindicated, what should be given 1st line in renal colic?

Answer 18

IV paracetamol

Question 19

Penile fracture is the traumatic rupture of …

Answer 19

corpus cavernosa and tunica albugineaz

Question 20

Classes of drugs used for medical expulsion of renal stones

Answer 20

Alpha and calcium channel blockers

Question 21

In penile #, if any clinical features are suggesting a co-existing urethral injury, such as voiding difficulties or blood at the meatus, what should be requested?

Answer 21

Retrograde urethrography should be performed

Question 22

Acute prostatitis, 1st line (2)

2nd line (2)

Answer 22

Ciprofloxacin 500 mg twice daily or ofloxacin 200 mg twice daily first line, or if they are unsuitable trimethoprim 200 mg twice daily.

Levofloxacin 500 mg once daily, or co-trimoxazole 960 mg twice daily (when there is bacteriological evidence of sensitivity and good reasons to prefer this combination to a single antibiotic) second-line.

Question 23

Most staghorn calculi are comprised of?

Answer 23

magnesium ammonium phosphate (struvite).

Question 24

How to calculate the shock index

Answer 24

HR / SBP

Question 25

Which investigation is recommended first-line for haemodynamically stable patients with lower gastrointestinal bleeds that require hospital admission?

Answer 25

Colonoscopy

Question 26

Angell’s sign

Answer 26

horizontal lie of the contralateral testis

Question 27

Cystinuria

Answer 27

a rare, inherited condition that causes the formation of kidney stones

Question 28

Citrate action in urine

Answer 28

Prevent kidney stone formation