EMQ's and Data Interpretation Questions in Surgery

312 Pages·2010·1.94 MB·English

EMQs and Data
Interpretation
Questions in
SURGERY
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EMQs and Data
Interpretation
Questions in
SURGERY
Irfan Syed BSc(Hons) MBBS MRCS
Senior House Officer in Neurosurgery, Royal Free Hospital,
London, UK
Mohammed Keshtgar BSc MBBS FRCSI FRCS(Gen) PhD
Senior Lecturer in Surgery and Consultant Surgical Oncologist,
University College London, UK
Hodder Arnold
www.hoddereducation.com
First published in Great Britain in 2008 by
Hodder Arnold, an imprint of Hodder Education, part of Hachette Livre UK,
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© 2008 Irfan Syed and Mohammed Keshtgar
All rights reserved. Apart from any use permitted under UK copyright law, this publication may
only be reproduced, stored or transmitted, in any form, or by any means with prior permission
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Whilst the advice and information in this book are believed to be true and accurate at the date
of going to press, neither the authors nor the publisher can accept any legal responsibility or
liability for any errors or omissions that may be made. In particular, (but without limiting the
generality of the preceding disclaimer) every effort has been made to check drug dosages;
however it is still possible that errors have been missed. Furthermore, dosage schedules are
constantly being revised and new side-effects recognized. For these reasons the reader is
strongly urged to consult the drug companies’ printed instructions before administering any
of the drugs recommended in this book.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record for this book is available from the Library of Congress
ISBN-13 978-0-340-94153-9
1 2 3 4 5 6 7 8 9 10
Commissioning Editor: Sara Purdy
Project Editor: Jane Tod
Production Controller: Andre Sim
Cover Design: Laura de Grasse
Indexer: Lisa Footit
Typeset in 9.5/12 RotisSerif by Charon Tec Ltd (A Macmillan Company), Chennai, India
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Printed and bound in India
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Dedication
To Mum and Dad for their continuing support.
Irfan Syed
Contents
Contributors x
Preface xi
Acknowledgements xii
The Plate section appears between pages 212 and 213
SECTION 1: EMQS IN GENERAL SURGERY 1
Questions
1 Abdominal pain (i) 2
2 Abdominal pain (ii) 3
3 Small bowel obstruction 4
4 Abdominal masses 5
5 Anorectal conditions 6
6 Management of colorectal cancer 7
7 Management of inflammatory bowel disease 8
8 Investigation of gastrointestinal bleeding 9
9 Paediatric surgery 10
10 Splenomegaly 11
11 Ulcers 12
12 Abnormal abdominal x-rays 13
13 Complication of gallstones 14
14 Breast conditions 15
15 Treatment of breast cancer 16
16 Skin lesions 17
17 Presentation with a lump 18
18 Pathology terminology 19
19 Thyroid conditions (i) 20
20 Thyroid conditions (ii) 21
21 Feeding the surgical patient 22
22 The shocked surgical patient 23
23 Chest trauma 24
24 Glasgow Coma Scale 25
25 Complications of blood transfusion 26
26 Head injury 27
Answers 28
SECTION 2: EMQS IN ORTHOPAEDIC SURGERY 61
Questions
27 Hand conditions 62
28 Arthritis 63
29 Joint pain 64
30 Pain in the hip 65
31 Back pain 66
32 Complications of fractures 67
33 Management of fractures 68
34 Fall on the outstretched hand 69
35 Shoulder conditions 70
36 Knee conditions 71
37 Management of painful joints 72
38 Foot conditions 73
Contents vii
39 Lower limb nerve lesion 74
40 Upper limb nerve injury (i) 75
41 Upper limb nerve injury (ii) 76
Answers 77
SECTION 3: EMQS IN VASCULAR SURGERY 93
Questions
42 Management of abdominal aortic aneurysm 94
43 Treatment of peripheral vascular disease 95
44 Complications of vascular surgery 96
45 Treatment of peripheral arterial disease 97
Answers 98
SECTION 4: EMQS IN UROLOGY 103
Questions
46 Haematuria 104
47 Testicular conditions 105
48 Bladder outlet obstruction 106
49 Management of prostate cancer 107
50 Urinary incontinence (diagnosis/management) 108
51 Management of renal stones 109
52 Lumps in the groin 110
53 Urological imaging/intervention 111
54 Renal masses/tumours 112
Answers 113
SECTION 5: EMQS IN EAR, NOSE AND THROAT SURGERY 127
Questions
55 Vertigo 128
56 Sore throat 129
57 Nasal blockage 130
58 Hoarse voice 131
59 Dysphagia 132
60 Ear pain 133
61 Acute paediatric airway obstruction 134
62 Swelling in the neck 135
Answers 136
SECTION 6: EMQS IN OPHTHALMOLOGY 149
Questions
63 Red eye 150
64 Diseases causing cataracts 151
65 Neuro-ophthalmology: pupils 152
66 Neuro-ophthalmology: visual fields 153
67 Ocular pharmacology 154
68 Ocular motility and ptosis 155
69 Ocular and orbital pathology 156
viii Contents
70 Retinal pathology 157
71 Optic nerve pathology 158
72 Inherited eye disease 159
Answers 160
SECTION 7: EMQS IN ANAESTHESIA AND CRITICAL CARE 170
Questions
73 Arterial blood gases 171
74 Airway management 172
75 Anaesthetic emergencies 173
76 Intravenous access 174
77 Pain relief 175
78 Drugs for anaesthesia 176
79 Oxygen therapy 177
80 Preoperative investigation 178
81 Support in critical care 179
Answers 180
SECTION 8: EMQS IN PLASTIC SURGERY 192
Questions
82 Assessment of burns 193
83 Complications of burns 194
84 Skin cover 195
Answers 196
SECTION 9: DATA INTERPRETATION QUESTIONS IN SURGERY 201
Questions
85 Chest problem (i) 202
86 Chest problem (ii) 203
87 Abdominal CT 204
88 Perioperative problem 205
89 CT colon 206
90 Chest x-ray 207
91 Skin lesion 208
92 Bowel problems 209
93 Hand deformity 211
94 Knee pain 212
95 Hip x-ray 213
96 Headache (i) 214
97 Headache (ii) 215
98 Collapse 216
99 Abdominal pain 217
100 Arterial stenosis 218
101 Femoral angiogram 219
102 Loin pain 220
103 Renal imaging 221
104 Electrocardiogram 223
105 Perioperative optimization 224
106 Transthoracic echocardiogram 225
Contents ix
107 Electrolytes 226
108 Lung function 227
Answers 228
SECTION 10: EMQ REVISION BOXES 246
Abdominal pain 248
Weight loss 249
Hepatobiliary surgery 250
Chronic liver disease 251
Paediatric surgery 252
Surgical radiology 253
Inflammatory bowel disease 254
Skin lesions 255
Thyroid malignancy 256
Thyroid disease 257
Urology investigations 258
Renal calculi 259
Lump in the groin 260
Dizziness/vertigo 261
Sore throat 262
Dysphagia 263
Neck lumps 264
The paediatric hip 265
Upper limb nerve injury 266
Lower limb nerve injury 267
Reflexes and motor nerve roots 268
Upper limb orthopaedic conditions 269
Lower limb orthopaedic conditions 270
Red eye 271
Retinal signs 272
Pupils 273
Ocular movements 274
Visual field defects 275
Hypertensive retinopathy 276
Diabetic retinopathy 277
Neurosurgery/head injury 278
Arterial blood gases 279
Classical EMQ descriptions of blood gases 280
Skin cover in plastic surgery 281
Index 283