Surgery

Question 1

What are the names of the bones in the wrist?

Answer 1

‘’Some Lovers Try Positions That They Can’t Handle’’

scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate and hamate

Question 2

What is the classic presentation of carpel tunnel?

Answer 2

Tingling in the thumb, index, and middle finger (affects median nerve)

Question 3

What is the most common type of femoral fracture?

Answer 3

Of the femoral neck

Question 4

What are the complications of fat embolisation?

Answer 4

Will cause blockages

Question 5

What are fat emboli caused by?

Answer 5

Trauma causing long bone and pelvic fractures

Question 6

What is a greenstick fracture?

Answer 6

When the bone bends and cracks on one side, not breaking completely into separate pieces

Question 7

What is the presentation of an Achilles tendon rupture?

Answer 7

A crack sound
Inability to plantar flex
Partially weight bearing
Normally men 30-50 years

Question 8

What is the Simmond’s/Thompson’s test for?

Answer 8

Test for rupture of the achilles tendon

• Patient lays on their front and you squeeze their calf to observe plantar flexion. If absent, it indicates rupture

Question 9

What is an equinus cast?

Answer 9

A non-surgical management of a ruptured achilles tendon

Foot is cast in plantar flexion to allow the ruptured ends to meet again

Question 10

What are the features of ulnar nerve damage?

Answer 10

Claw hand
Positive Froment’s test

Question 11

What is froment’s test?

Answer 11

While holding a piece of paper between thumb and index finger there is flexion of the terminal phalanx of the thumb on trying to pull paper away

(Instead of a relaxed grip on the paper, the fingers flex)

Question 12

What is the difference between oesophageal squamous cell and adenocarcinoma?

Answer 12

Adenocarcinoma: related to reflux

Squamous cell: related to smoking

Question 13

What are the complications of acute pancreatitis?

Answer 13

• Pseudocyst that can occlude vessels or burst leading to infection
• Chronic pancreatitis
• Necrosis

Question 14

What is Rigler’s sign?

Answer 14

Indicates free air enclosed in the peritoneal cavity (pneumoperitoneum)
- Both sides of the bowel wall are well-defined

Question 15

What is coffee bean sign?

Answer 15

Shows a grossly dilated loop of sigmoid secondary to volvulus

Appears as an upturned ‘U’

Question 16

How does toxic megacolon present?

Answer 16

Affects the transverse colon

Presents as severe distention, bloody diarrhoea, fever, tachycardia, dizziness, nausea and vomiting

Question 17

Which sections of the bowel are involved in UC compared to Crohn’s?

Answer 17

UC:
- Only affects colon, usually on left side only

Crohn’s:
- Skip lesions
- Affects small bowel usually on right side only
- Rectum is spared

Question 18

How is acute severe UC managed?

Answer 18

IV hydrocortisone and LMW heparin especially if there is haemorrhage

Question 19

What is the management of acute cholecystitis?

Answer 19

IV antibiotics then laparoscopic cholecystectomy 1 weeks later

If intreated, there is risk of chronic disease and recurrent infection that would impact QOL and morbidity

Question 20

What are the 6 P’s for acute limb ischaemia?

Answer 20

Pain
Pulseless
Paralysis
Paraesthesia
Pallor
Perishingly cold

Question 21

What is a ABPI?

Answer 21

Ankle–brachial pressure index

Calculates the ratio of systolic blood pressure at their ankle to the systolic pressure in the arm