Intro to Surgery

Question 1

What different types of surgery are there? (3)

Answer 1

Elective

Emergency (immediate, urgent)

Expedited

Question 2

What does a surgeon do? From diagnosis to post-op

Answer 2

• Diagnosis: evaluate patient problem, investigations
• Treatment options: surgical, non-surgical
• Operate
• Post-op care: immediate post-op care, rehabilitation, follow-up care

Question 3

What is the order in which you should take a history?

Answer 3

Presenting complaint

Medical history

Drug history

Family history

Social history

Question 4

After the history, what needs to be looked at in an examination?

Answer 4

• General
• Vital Signs: pulse rate and rhythm, BP, resp. rate, temperature
• System Specific Exam: abdo, orthopaedic, neuro, head and neck, vascular

Question 5

What pre-op care can ensure safe surgery and safe anaesthetic?

Answer 5

informed consent

anticipate complications (infection / blood loss??)

assess co-morbidities

specific heart/lung investigation

Question 6

What is the ASA physiological classification of patients requiring surgery?

What is the point of these classifications?

Answer 6

• ASA I Healthy patient
• ASA II Mild systemic disease with no functional limitation - controlled hypertension
• ASA III Severe systemic disease with definite functional limitation - COPD
• ASA IV Severe systemic disease that is a constant threat to life - unstable angina
• ASA V Moribund patient who is not expected to survive for 24 hours with or without surgery - ruptured aortic aneurysm
• Suffix E Emergency procedure

These can estimate the risk of complications and guide choice of treatment