Surgery Quiz

Amoebic liver abscesses

• Typically occur in the right lobe of the liver

• Are always accompanied by jaundice

• Yield yellowish pus on aspiration

• Can be complicated by rupture into the pleuropulmonary cavity

• Are excluded by a negative history of amoebic dysentery in the past

In the patient with gastric outlet obstruction:

• The vomiting of gastric contents results in hypochloraemic alkalosis

• Vomitus usually contains bile

• The patient is hyponatraemic and dehydrated

• Urine may become paradoxically acid

• Physical examination may reveal succussion splash

The following are proven to reduce the risk of surgical infection

• Admission on the day of surgery

• Shaving the operation site prior to admission

• Early physiotherapy

• Prophylactic antibiotics

• Inserting an indwelling catheter

With antibiotics to antibiotic prophylaxis

• It should be given to a patient with a history of rheumatic fever

• Cefuroxime covers against anaerobic organism

• It is best administered before patient is transferred to the operating theatre

• Topical antibiotic application is practiced

• It is more effective if prescribed for 5 days

In colorectal cancers

• Carcinoma of the left colon classically presents with anaemia

• Obstruction is more common in the left than right sided tumours

• Tumours arising in patients with the hereditary non-polyposis colorectal cancer (HNPCC) gene are usually left sided.

• Patients with familial adenomatous polyposis coli will usually present before the age of 40

• Approximately 30% of patients will have occult liver metastases at the time of diagnosis

Perforated gastric ulcer

• Is caused by chronic abuse of NSAIDs

• Is a surgical emergency

• Is diagnosed by identifying presence of air under the diaphragm

• Is a diagnosis by exclusion

• May cause patient to develop gastric lymphoma after 2 years

Causes of cardiogenic shock include:

• Compound pelvic fracture

• Pulmonary embolism

• Bee sting

• Myocardial infarction

• Fluid overload

In resuscitation of hypovolemic shock

• Administration of inotropic agents will help to increase diastolic filling and coronary perfusion

• Hypovolemia must be addressed first

• Long, wide bore catheters allow rapid fluids

• There is no need to monitor urine output

• Hypotonic fluids should be used for resuscitation

Para-umbilical hernia

• Usually occurs around the umbilicus

• Is congenital in origin

• Does not resolve spontaneously

• Does not increase in size over time

• Requires surgical repair

Prognostic features of breast carcinoma include

• Size of primary tumour

• Pathological state of axillary nodes

• Oestrogen receptor status

• CA 19-9

• Presence of sentinel lymph node