Surgery

Question 1

What is an end colostomy?

Answer 1

Performed when a section of large bowel has been removed. Proximal end brought to the skin. Distal part sutured and left inside. Can be reversed later but can also be permanent.

Question 2

What is an end ileostomy?

Answer 2

Stoma from the end of the ileum when the whole large bowel has been removed. Permanent

Question 3

What is a loop colostomy?

Answer 3

Bowel is partially opened and a loop of bowel is taken outside the skin and opened - leaving 2 openings. Proximal end is turned into a spout. Temporary and will be reversed 6 - 8 weeks later

Question 4

ASA1

Answer 4

Normal healthy patient

Question 5

ASA2

Answer 5

Patient with mild systemic disease

Question 6

ASA 3

Answer 6

Substansive functional limitations/severe systemic disease eg renal disease on dialysis

Question 7

ASA4

Answer 7

Severe systemic disease that is a constant threat to life

Question 8

ASA5

Answer 8

Moribound patient who is not expected to survive without the operation eg ruptured AAA

Question 9

ASA6

Answer 9

Brain dead patient - organ harvesting

Question 10

What surgery is required for colorectal cancer on the anal verge?

Answer 10

Abdomino perineal excision of rectum

Question 11

What surgery is required for colorectal cancer in the low rectum?

Answer 11

Anterior resection

Question 12

What surgery is required for colorectal cancer in the upper rectum?

Answer 12

Anterior resection

Question 13

What surgery is required for colorectal cancer in the sigmoid colon?

Answer 13

High anterior resection

Question 14

What surgery is required for colorectal cancer in the distal transverse descending colon?

Answer 14

Left hemicolectomy

Question 15

What surgery is required for colorectal cancer in the caecal, ascending or proximal transverse colon

Answer 15

Right hemicolectomy

Question 16

How long should the COCP be stopped before surgery

Answer 16

4 weeks

Question 17

Hernia which is inferolateral to the pubic tubercle. Cough impulse is often absent . typically non reducible

Answer 17

Femoral

Question 18

Management of femoral hernia

Answer 18

Surgical repair - high risk of strangulation

Question 19

When does an AAA need to be referred to vascular surgery

Answer 19

Over 5.5cm

Question 20

AAA of 3 - 4.4cm

Answer 20

Rescan every 12 months

Question 21

AAA of 4.5 - 5.4cm

Answer 21

Rescan every 3 months

Question 22

soft, non-tender swelling of the hemi-scrotum. Usually anterior to and below the testicle
the swelling is confined to the scrotum, you can get ‘above’ the mass on examination
transilluminates with a pen torch

Answer 22

Hydrocele

Question 23

Testicular tumour. Elevated AFP and Beta HCG

Answer 23

Non seminoma

Question 24

Managment of anal fissure not improved by topical GTN

Answer 24

Sphincterotomy or botox

Question 25

First line investigation into priapism

Answer 25

Cavernosal blood gas to differentiate between ischaemic and non ischemia

Question 26

Management of priapism

Answer 26

If longer than 4 hours aspiration of blood from the cavernosa with an injection of saline flush.
If this fails intracavernosal injection of phenylephrine
If both fail then surgery

Question 27

Investigation for suspected renal stone

Answer 27

Non contrast CTKUB

Question 28

Ulcer that is relieved by eating

Answer 28

Duodenal ulcer

Question 29

Ulcer that is exacerbated by eating

Answer 29

Gastric ulcer