Surgical

Question 1

Signs of peritonitis

Answer 1

Tenderness (And Tachyc)
Reflex guarding 
Absent bowel sounds
Pyrexial
Percussion pain
Extremely unwell
Distant-local sign (rovsing)

Question 2

Signs of shock

Answer 2

I ncreased resp rate
Sinus Tachy
Hypotension
Oligouria
Cold
Clammy
Slow CRT

Question 3

ASA grading

Answer 3

1 healthy
2 mild systemic disease
3 severe systemic d
4 severe systemic d that is constant threat to life
5 moribund person who is not expected to survive without operation
6 declared brain dead whose organs are being removed

Question 4

Groin mass differentials

Answer 4

Hernias
...femoral - below and lateral to pubis tubercle (high risk of strangulation -high wcc, temp, tenderness)
...inguinal - above and medial)
Lipoma
LN
Descended testis
Femoral aneurysm

Question 5

Most common salivary gland that tumours are found in and what are most of these

Answer 5

80%
And 80% of these are benign (pleomorphic adenoma)
80% are found in superficial lobe
Classic

Warthins tumours (a.k.a. adenolymphoma) are commoner in older men (especially smokers)

Question 6

Triple assessment for breast

Answer 6

Examination
Imaging (USS for under 35, USS and mammogram over)
Fine needle aspiration (cytology) and core biopsy (histology)

Question 7

What percentage of people presenting with one hernia have a second?

Answer 7

50%

Question 8

Pt has appendix removed yesterday. Since then she’s had pain managed with IM pethidine and prochlorperazine. She is behaving oddly and is hysterical. Fixed upward gaze. Dx and mx

Answer 8

Oculogyric crisis
It’s from misbalabce of low dopamine (she’s on a dop antag) and high cholinergic
So give antichol IV diazepam

Question 9

Vaccines and drugs if splenectomy

Answer 9

HiB and pneumococcal vaccines

Phenoxymethylpenicillin aka Pen V

Question 10

Causes of splenomegaly

Answer 10

Mild: polycythemia rubra Vera (pt may have red face)
Glandular fever
Moderate: lymphoma, haemolytic anaemia a
Massive: myelofibrosis, CML, malaria