Surgery

Question 1

What is normal ABPI?

Answer 1

0.8-1.3

Question 2

What is the first-line investigation in priapism and why?

Answer 2

Cavernosal blood gas analysis to determine if ischaemic vs non-ischaemic

Question 3

When should a fibroadenoma be referred for surgical excision?

Answer 3

Breast fibroadenoma: surgical excision is usual if >3cm

Question 4

How long does it take for finasteride to start becoming effective?

Answer 4

6 months

Question 5

What is UK screening programme for AAA? What size if aneurysmal?

Answer 5

In the UK, all men aged 65 years are offered aneurysm screening with a single abdominal ultrasound. Aortic diameters of 3cm and greater, are considered aneurysmal

Question 6

Surgery / diabetes: Once daily morning insulin should be reduced by how much on the day of surgery?

Answer 6

To 80%

Question 7

List potential side effects of tamoxifen

Answer 7

Amenorrhoea, endometrial cancer, vaginal bleeding and venous thromboembolism

Question 8

After SAH, what is the time interval for LP?

Answer 8

A LP is performed in patients with suspected SAH if a CT head scan performed more than 6 hours after symptom onset is inconclusive or negative. A LP must be performed at least 12 hours after symptom onset to allow time for xanthochromia to develop.

Question 9

Local anesthetic toxicity can be treated with what?

Answer 9

IV 20% lipid emulsion

Question 10

What is the age cut off for suspected breast cancer of routine referral vs urgent referral?

Answer 10

Urgent referral if >30

Question 11

What are the cutoffs for aortic aneurysm 3 months vs 12 month surveillance and referral to vascular surgery?

Answer 11

< 3cm; Normal; No further action
3 - 4.4 cm; Small aneurysm; Rescan every 12 months
4.5 - 5.4cm; Medium aneurysm; Rescan every 3 months
≥ 5.5cm; Large aneurysm; Refer within 2 weeks to vascular surgery for probable intervention

Question 12

Suspected epididymo-orchitis: If unknown organism what is the treatment?

Answer 12

Ceftriaxone 500mg intramuscularly single dose, plus oral doxycycline 100mg twice daily for 10-14 days

Question 13

How much should PSA be postponed after prostatitis or UTI?
What about ejaculation and vigorous exercise?

Answer 13

6 weeks
48 hours

Question 14

What would be the indications for URGENT surgical (including lithotripsy) intervention for renal stone?

Answer 14

Unwell, one kidney, severe pain, significantly reduced renal function, stone is too big to pass (>10).
Note stones that are less than 5mm usually pass spontaneously

Question 15

What anaesthetic agent can be used for those prone to post-op N&V?

Answer 15

Propofol as it is an anti-emetic

Question 16

What is the formula for calculating fluid replacement in 24hours for a large burn >10% total BSA.
How quickly is the fluid given as proportion of the 24 hours and total volume?

Answer 16

2mls/kg/% Burn
3mls children
4mls electrical burns

First 50% of fluid given in 8 hours, rest in other 16 hours

Question 17

What biochemical test can be used to test for exocrine function in chronic pancreatitis?

Answer 17

Faecal elastase

Question 18

What age and how frequently is breast cancer screening?

Answer 18

All women aged 50 up to their 71st birthday are invited for breast screening every 3 years