Principles of surgery

Question 1

What is an elective operation?

Answer 1

It has been planned- may or may not be medically required (wisdom teeth removal)

Question 2

What is an emergency operation?

Answer 2

Surgery is required and it was not previously planned or when an elective procedure has to be expedited

Question 3

What are the 4 NCEPOD interventions?

Answer 3

Immediate- Life saving/organ saving/resucitation. Minutes to decide to operate
Urgent- Acute onset/clinical deterioration/potentially life threatening. Hours decision to operate
Expedited- Pt requires early treatment where the condition is not immediately life threatening. Days decision to operate
Elective- Booked in advance- timing suits everyone

Question 4

A Patient with a news score of 6 or above when should they be seen by a doctor?

Answer 4

Within 15 mins

Question 5

What should be in a referral letter?

Answer 5

Medical history
Clinical history
Complaints
GDP details
Referral catagory
Referrers name
Contact for pt and referrer

Question 6

What is the patients surgical pathway?

Answer 6

Pt attends GDP
Pt referred to speciality
Attend special investigation
Elective surgery date proposed
Attend surgery and consent
Undergo surgery
Discharge
Follow up with GDP

Question 7

What info for an emergency referral?

Answer 7

Fasting history- ideally 6 hours solid and 2hrs for liquids
Vital signs
NCEPOD grade

Question 8

What should you ask in pre op ?

Answer 8

Family of malignant hyperthermia?
Sickle cell disease
Anticoagulants?

Question 9

What test will you do for someone with pancreatitis?

Answer 9

Amylase count

Question 10

If a patient can’t drink what should they receive for rehyration?

Answer 10

0.8%Saline
4%Dextrose
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