Surgical Emergencies

Question 1

PS Biliary colic

Answer 1

RUQ pain

No fever + inflamm markers normal

Question 2

What is biliary colic

Answer 2

Gallstone lodged in bile duct

Question 3

What is acute cholecystitis

Answer 3

Inflammation of GD due to gall stones

Question 4

PS acute cholecystitis

Answer 4

RUQ pain
Murphys sign +ve
Fever + inflamm markers incr

Question 5

What is ascending cholangitis

Answer 5

Bacterial infection of biliary tree

+ Charcot’s triad

Question 6

What is Charcot’s triad

Answer 6

RUQ pain
Fever
Jaundice

Question 7

PS pancreatitis

Answer 7

Severe pain in epigasstrium which radiates to back

Question 8

PS appendicitis

Answer 8

pain - central –> RIF
Anorexia
Fever + bradyC
Rovsings sign

Question 9

What is Rovsing’s sign

Answer 9

Incr pain in RIF when pressing LIF

In appendicitis

Question 10

PS acute diverticulitis

Answer 10

Colicky pain LIF
Diarrhoea
Fever
Incr inflamm markers + WCC

Question 11

What is AAA due to?

Answer 11

Failure of elastic proteins within the ECM

Question 12

Norm diameter abdo aorta 50 y/o F

Answer 12

1.5cm

Question 13

Norm diametic abdominal aorta 50 y/o M

Answer 13

1.7cm

Question 14

What cm abdo aorta is considered aneurysmal

Answer 14

3cm

Question 15

RF AAA (5)

Answer 15

Smoking 
HTN
Syphillis 
Ehlers -Danlos 
Marfans

Question 16

Mx low risk AAA

Answer 16

USS surveillance

RF optimised

Question 17

def low risk AAA

Answer 17

Asymp

Diameter <5.5cm

Question 18

def high risk AAA

Answer 18

> 5.5cm

symp

Question 19

Mx high risk AAA

Answer 19

EVAR - elective endovascular repair

Question 20

DDx - ocular discomfort (4)

Answer 20

Conjunctivitis
Thyroid eye disease
Dry eye
Blephritis

Question 21

DDx - eye pain on movement

Answer 21

optic neuritis

Question 22

DDx - pain around eye (2)

Answer 22

Temporal arteritis

Orbital cellulitis

Question 23

Severe eye pain SSx (4)

Answer 23

Anterior uveitis
Bacterial keratitis
AACG
Scleritis

Question 24

Features of anterior uveitis

Answer 24

Photophobia
Blurred vision
Red eye
Synechiae

Question 25

Features of bacterial keraitis

Answer 25

Blurred vision

Hypopyon

Question 26

Features of AACG

Answer 26

Red eye 
Blurred vision 
Photophobia 
Headache 
Nausea

Question 27

Features of scleritis

Answer 27

Red eye
Intense pain
Blurred vision

Question 28

Mx ant uveitis

Answer 28

steroids
mydriatics
Abx

Question 29

Mx bacterial keratitis

Answer 29

Topical Abx

Question 30

Mx AACG

Answer 30

IV acetazolamide

TO pilocarpine ev 5mins

Question 31

Mx scleritis

Answer 31

Systemic steroids

Question 32

Sudden painful LOV DDx (4)

Answer 32

AACG
Uveitis
Optic neuritis
Giant cell/temporal arteritis

Question 33

Sudden painless LOV DDx (4)

Answer 33

Retinal aa/vv occlusion
Retinal detachment
Vitreous haemorrhage
ARMD

Question 34

Mx corneal foreign body

Answer 34

TO anaesthetic to eye
Fluorescein stain for abrasions
If embedded in cornea - seek help