Surgery
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
13. Shock
Circulatory failure causing inadequate tissue perfusion and oxygenation; hypovolaemic, cardiogenic, obstructive or distributive.
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
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.
High yield
Acute appendicitis
A surgical emergency. Early recognition and prompt surgery prevent perforation and peritonitis.
Peritonitis
Causes, presentation and management of inflammation of the peritoneum.
Emergency medical preparedness in India
A practical preparedness guide for emergencies, written for the Indian context.