Exam Prep
High yield
1. Injuries: definition and classification
Tissue damage from an external agent exceeding tissue resistance; classified by agent, skin integrity, cavity, number and severity.
High yield
2. Closed mechanical injuries
Mechanical injuries with intact skin: contusion, haematoma, sprain, dislocation, subcutaneous rupture, concussion and compression.
High yield
3. Open injuries (wounds)
Breach of skin or mucosa by a mechanical agent; three damage zones; types by agent and contamination.
High yield
4. Thermal burns
Heat injury graded by depth and extent; burn disease runs through shock, toxaemia, septicotoxaemia and convalescence.
High yield
5. Electrical injury
Current through the body causes heat damage along its path, arrhythmias and rhabdomyolysis; the skin hides deep injury.
High yield
6. Frostbite
Freezing injury from ice crystals and microvascular thrombosis; four degrees; rapid rewarming at 37–39 °C, late amputation.
High yield
7. Haemostasis
Spontaneous haemostasis by spasm, platelet plug and clotting; artificial haemostasis is temporary or definitive.
High yield
8. Wound healing
Healing runs through haemostasis, inflammation, proliferation and remodelling; by primary, secondary or tertiary intention to a scar.
High yield
9. Wound treatment and primary surgical treatment
Primary surgical treatment turns a contaminated wound into a clean one; closure is primary, delayed primary or secondary.
High yield
10. Blood transfusion and blood groups
ABO and Rh groups decide compatibility; group, screen, crossmatch and bedside checks before transfusion; haemolysis is the worst complication.
High yield
11. Blood products and blood substitutes
Red cells, platelets, plasma and cryoprecipitate replace specific deficits; crystalloids and colloids restore volume.
High yield
12. Postoperative period and complications
Postoperative care and observation, and complications classified by time, system and Clavien-Dindo grade, with prevention and treatment.
High yield
13. Shock
Circulatory failure causing inadequate tissue perfusion and oxygenation; hypovolaemic, cardiogenic, obstructive or distributive.
High yield
14. Acute purulent infection
Pyogenic bacteria entering through skin or mucosa cause local suppurative inflammation and a systemic response.
High yield
15. Hot abscess
Localised collection of pus walled off by a pyogenic membrane; fluctuation, systemic signs; treated by incision and drainage.
High yield
16. Phlegmon
Diffuse purulent inflammation spreading through tissue planes without a limiting wall; wide incision, drainage and antibiotics.
High yield
17. Osteomyelitis
Bone infection by haematogenous, contiguous or post-traumatic spread; acute disease evolves to sequestrum and chronic infection.
High yield
18. Erysipelas
Streptococcal infection of the dermis and superficial lymphatics; bright red plaque with a sharp raised border; penicillin.
High yield
19. Tetanus
Clostridium tetani toxin blocks inhibitory neurones, causing trismus, rigidity and spasms; prevented by toxoid and immunoglobulin.
High yield
20. Sepsis and SIRS
Dysregulated host response to infection causing organ dysfunction; SIRS, sepsis, septic shock; source control and the 1-hour bundle.
High yield
21. Anaerobic gas infection
Clostridial myonecrosis in devitalised muscle; toxins cause gas, oedema, necrosis and shock; radical debridement and penicillin.
High yield
22. Necrosis and gangrene
Tissue death in a living body; dry gangrene mummifies and demarcates, wet gangrene putrefies and spreads.
High yield
23. Ulcers
Chronic skin or mucosal defect with no tendency to heal; mainly venous, arterial, neuropathic or pressure ulcers.
High yield
24. Fistulas
Abnormal communication between two epithelial surfaces; congenital or acquired, external or internal; FRIENDS factors prevent closure.
High yield
25. Cleft lip and cleft palate
Failed fusion of facial processes causes cleft lip and cleft palate; staged repair by a cleft team.
High yield
58. Peptic ulcer: modern surgical treatment
Mucosal defect beyond the muscularis mucosae from acid-pepsin; H. pylori and NSAIDs cause most; surgery mainly for complications.
High yield
60. Perforated peptic ulcer
Gastric or duodenal ulcer perforating into the peritoneum; resuscitation, omental patch repair and H. pylori eradication.
High yield
61. Bleeding peptic ulcer
Commonest cause of upper gastrointestinal bleeding; endoscopic dual therapy and PPI first; surgery or embolisation if endoscopy fails.
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New
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