Cases for Surgical Finals

SAQs, EMQs and MCQs

Philip Stather, Helen Cheshire, Philip Stather, Helen Cheshire

• Publisher: CRC Press
• Year: 2022
• Print ISBN: 9781846195587
• eBook ISBN: 9780429533358
• Edition: 1
• Topic: Medicine
• Subtopic: Surgery & Surgical Medicine

A complete guide to passing your surgical finals! This comprehensive new guide tests your knowledge of general surgery, upper GI, lower GI, vascular, urology, trauma and orthopaedics, breast surgery, paediatric surgery, otolaryngology, plastic surgery, maxillofacial surgery, cardiothoracic surgery, and neurosurgery using a variety of question types

Chapter 1

General surgery

Scott Castell

SAQs

1. the midline of her neck.
2. 1 A 22-year-old girl comes to see you in the GP surgery. She complains of a month-long history of worsening tremor, palpitations and swelling in the midline of her neck.

1. a Give three possible causes of a lump in the midline of the neck.

(3 marks)

1. b Through history and examination, how would you determine the cause of the lump? Give four factors in the history and four in the examination.

(4 marks)

1. c You ascertain the lump is most likely thyroid in origin. Name two different types of thyroid lump.

(2 marks)

1. d Give three ways you would further investigate the thyroid lump.

(3 marks)

1. e Not all thyroid lumps require surgery. Give two indications for surgical removal of the thyroid.

(2 marks)

1. f Why is hoarseness of the voice a complication of thyroid surgery? (1 mark)

1. 2 A 57-year-old lady presents to her GP with a 2-week history of vague abdominal discomfort and back pain. Her past medical history includes a fractured wrist 2 weeks previously. She comes in with her husband who comments that she has been ‘acting strange’ lately.

1. a Routine blood tests show that her serum calcium level is 3.0mmol/L. Give three other symptoms you should ask about.

(2 marks)

1. b You admit her to hospital, what four other investigations would you request?

(4 marks)

1. c Results show that she has primary hyperparathyroidism. What three blood results could you expect?

(3 marks)

1. d What is the commonest cause of primary hyperparathyroidism? (1 mark)
2. e It is decided that surgical management of this lady is appropriate. What three complications may arise from surgery?

(3 marks)

1. 3 A 46-year-old man presents to A&E after recently being discharged following an explorative laparoscopy. He complains his scar is not healing. Examination reveals a swollen, erythematous area around one of his laparoscopy wounds.

1. a Name four signs associated with any inflammatory response.

(4 marks)

1. b You diagnose the lump as a post-surgical cutaneous abscess. Give three ways in which you would further investigate this.

(3 marks)

1. c What is the definitive curative treatment for cutaneous abscesses? (1 mark)
2. d Name three risk factors for forming an abscess.

(3 marks)

1. e Name three complications of abscess formation.

(3 marks)

1. 4 A 30-year-old gentleman presents to A&E after injuring his finger. He works on a construction site and says that he caught his finger in a drill. Examination reveals an open wound at the tip of his left middle finger that will require cleaning and suturing.

1. a Give three methods you may use to control the pain for the patient to facilitate cleaning and suturing.

(3 marks)

1. b Explain the mechanism of action for local anaesthetic (LA) agents.

(3 marks)

1. c What other agent would you normally administer along with LA, but is contraindicated in this case, and why is it contraindicated?

(2 marks)

1. d Name three types of LA agent.

(3 marks)

1. e When the LA agent is administered, the skin of the finger becomes warm and dry – what is the explanation for this?

(2 marks)

1. f What are the benefits of administering local anaesthesia over general anaesthesia?

(4 marks)

1. 5 Frank is a 65-year-old man who has severe osteoarthritis. He requires a hip replacement under general anaesthetic (GA).

1. a Explain the triad of general anaesthesia.

(3 marks)

1. b What are the three phases of general anaesthesia?

(3 marks)

1. c Induction of anaesthesia can be either IV or inhalation. Which is most common, and what induction agents are widely used?

(4 marks)

1. d What physiological markers are used for monitoring during a GA?

(4 marks)

1. e As the muscle relaxant is administered in to Frank, he appears to shake and his muscles contract. He then relaxes. This is common during induction. What is happening?

(3 ma...

Table of contents

• Cover
• Title Page
• Copyright Page
• Table of Contents
• Acknowledgement
• Preface
• About the editors
• Contributors
• Abbreviations
• 1 General surgery
• 2 Lower GI surgery Pandora
• 3 Upper GI surgery
• 4 Vascular surgery
• 5 Urology
• 6 Trauma and orthopaedic surgery
• 7 Breast surgery
• 8 Paediatric surgery
• 9 Otolaryngology
• 10 Plastic surgery
• 11 Cardiothoracic surgery
• 12 Maxillofacial surgery
• 13 Neurosurgery