Surgery

Question 1

Causes of anorectal abscess or fistulas

Answer 1

1. Trauma
   
   2. Hard stools
   3. Excessive Diarrhea
   4. Anal intercourse
   5. Radiation
   6. Crohns Disease

Question 2

Give six differential diagnosis of nipple discharges

Answer 2

1. Pregnancy
   
   2. Infection and Mastitis
   3. Galactorrhea
   4. Fibrocystic changes
   5. Intraductal papilloma
   6. Carcinoma

Question 3

Give eight sources of infection in surgical patients

Answer 3

1. Indwelling intravenous line or catheter related sepsis
   
   2. Surgical Site Infection
   3. Clostridium Difficile Enteritis
   4. Urinary Tract Infection
   5. Sinusitis
   6. Acalculous Cholecystitis
   7. Perforated PUD
   8. Diverticulitis

Question 4

Give six causes of instability after blunt trauma

Answer 4

1. Tension Pneumothorax
   
   2. Hemothorax
   3. Cardiac Tamponade
   4. Cardiac Contusion
   5. Air emboli
   6. Injury to great vessels

Question 5

Give the type of cancer associated with the following tumor markers

1. CEA	
2. AFP	
3. CA19-9	
4. PSA
5. CA 15-3

Answer 5

1. CEA colon cancer
   
   2. AFP hepatocellular CA
   3. CA19-9 pancreatic CA
   4. PSA prostate
   5. CA 15-3 breast CA

Question 6

Give six indications for mandatory intra-operative exploration of the common bile duct

Answer 6

1. Jaundice
   
   2. CBD dilation more than 12 mm
   3. Filling defect in CBD noted on cholangiogram
   4. No stones in gallbladder
   5. Acute Pancreatitis
   6. Palpable stones in CBD

Question 7

Give eight conditions or disease entities for which splenectomy may be curative

Answer 7

1. Hereditary Spherocytosis
   
   2. Idiopathic thrombocytopenia purpura
   3. Sickle cell disease
   4. Idiopathic autoimmune hemolytic anemia
   5. Thalassemia
   6. Hereditary Elliptocytosis
   7. Secondary hypersplenism
   8. Splenic truma

Question 8

Give eight signs and symptoms of small bowel obstruction

Answer 8

1. Colicky abdominal pain
   
   2. Vomiting
   3. Constipation
   4. Obstipation or absence of flatus
   5. High-pitched tingling sounds
   6. Abdominal distention
   7. No rebound tenderness
   8. No peritonitis

Question 9

Give FIVE signs of limb ischemia

Answer 9

1. Pallor
   
   2. Paresthesia
   3. Pulselessness
   4. Poikilothermia
   5. Pain

Question 10

Give at least seven specific disease entities which causes GIT obstruction in the newborn

Answer 10

1. duodenal atresia
   
   2. malrotation or midgut volvulus
   3. jejunal atresia
   4. meconium ileus
   5. NEC
   6. Hirschprung’s diseases
   7. Congenital hypertrophic pyloric

Question 11

What are the ABCDE of trauma management?

Answer 11

A – Airway and cervical spine control
	B – Breathing
	C – Circulation
	D – Deficit / disability
	E – Exposure

Question 12

Give six signs and symptoms of spontaneous pneumothorax

Answer 12

1. sudden onset of severe pleuritic chest pain
   
   2. dyspnea
   3. hyperresonance to percussion
   4. absent tactile fremitus
   5. ipsilateral tracheal deviation
   6. elevation of ipsilateral hemidiaphragm

Question 13

Give six indications for exploratory laparotomy after penetrating abdominal trauma

Answer 13

1. signs of peritonitis
2. bowel/omental evisceration
3. hemodynamic instability despite adequate resuscitation
4. evidence of penetration of fascia during local wound exploration
5. pneumoperitoneum ( seen in abdominal x-rays)
6. blood in stomach (NGT) or rectum (rectal exams)

Question 14

Give Five signs and symptoms of gastric cancer

Answer 14

1. weight loss
   
   2. epigastric pain
   3. early satiety
   4. vomiting
   5. epigastric mass

Question 15

Give at least seven differential diagnosis of scrotal swelling

Answer 15

1. indirect inguinal hernia
   
   2. hydrocoele
   3. varicocoele
   4. seminoma
   5. epididymal cyst
   6. testicular torsion
   7. orchitis

Question 16

Give eight risk factors for breast cancer

Answer 16

1. age (average age is 64 y/o)
   
   2. family history
   3. excessive estrogen exposure (early menarche/late menopause)
   4. biopsy showing atypical ductal/lobular hyperplasia
   5. history of endometrial cancer
   6. history of previous breast cancer
   7. radiation
   8. increase fats

Question 17

Give 14 causes of poor wound repair

Answer 17

1. infection 
	2 .Foreign body
	3. malnutrition
   4. sepsis
	5. anemia
	6. zinc deficiency
	7. corticosteroids
	8. chemotherapy
	9. diabetes mellitus
	10. aids
	11. edema
	12. obesity
	13. radiation
	14. scurvy

Question 18

Give FIVE indications for surgery in peptic ulcer disease

Answer 18

1. persistent bleeding
   
   2. perforation
   3. obstruction
   4. intractable pain
   5. suspicious of malignancy

Question 19

Give six causes of explosive onset of abdominal pain

Answer 19

1. perforated peptic ulcer
   
   2. biliary colic
   3. ureteral colic
   4. ruptured aortic aneurysm
   5. dissecting aortic aneurysm
   6. bowel strangulation

Question 20

Give six clinical conditions predisposing to acquired hernias

Answer 20

1. obesity
   
   2. old age
   3. malnourished
   4. COPD
   5. BPH
   6. colonic obstruction

Question 21

Give seven signs and symptoms of peritonsillar abscess

Answer 21

1. medial displacement of tonsils
   
   2. buldging abscess thru anterior tonsillar pillars
   3. fever and chills
   4. pain with talking
   5. dysphonia/hot potato voice
   6. inflamed or deviated uvula
   7. foul smelling breath