Arab Board Surgery Final Written key terms

A coordinated perioperative pathway using preoperative counselling, avoidance of prolonged fasting, opioid-sparing analgesia, early feeding and early mobilisation to shorten hospital stay and reduce complications.

Sequestration of isotonic fluid into the peritoneal cavity, bowel wall and interstitial compartments after surgery, trauma or sepsis, producing hypovolaemia and dilutional hyponatraemia despite unchanged total body water.

Delivery of complete nutrition, including amino acids, glucose, lipids and micronutrients, into a central vein when the gut cannot be used, requiring monitoring for line infection, metabolic disturbance and refeeding syndrome.

Failure of a surgical join between two bowel or other tubular segments, allowing luminal contents into surrounding tissue; it presents with pain, fever, ileus or peritonitis and often requires reoperation.

Spontaneous full-thickness rupture of the distal oesophagus after violent vomiting, producing severe chest pain, mediastinitis and surgical emphysema, requiring urgent drainage and repair or stenting.

A staging system for complicated diverticular disease ranging from localised pericolic abscess through purulent peritonitis to faecal peritonitis, used to choose antibiotics, percutaneous drainage or emergency resection.

Necrotising fasciitis of the perineum and genitalia caused by mixed anaerobic and aerobic organisms, requiring urgent radical debridement, broad-spectrum antibiotics and intensive care support.

Biliary infection complicating obstruction, presenting with fever, jaundice and right upper quadrant pain; treatment combines antibiotics with urgent biliary drainage by endoscopic or percutaneous route.

Obstructive jaundice caused by a gallstone impacted in the cystic duct or Hartmann pouch and compressing the common hepatic duct, often with a cholecystobiliary fistula, making cholecystectomy hazardous.

A grading of cirrhotic liver reserve using bilirubin, albumin, prothrombin time, ascites and encephalopathy, predicting operative risk and survival and guiding decisions about resection or transplantation.

Raised pressure within the portal venous system, usually from cirrhosis, defined by a hepatic venous pressure gradient above 5 mmHg and complicated by varices, ascites and encephalopathy.

A life-threatening exaggeration of thyrotoxicosis with fever, tachycardia, agitation and heart failure, treated with beta-blockade, thionamide, iodine, steroids and supportive care before any thyroid operation.

Excess parathyroid hormone secretion, usually from a single adenoma, causing hypercalcaemia, renal stones, bone loss and constipation; parathyroidectomy is indicated for symptoms or complications.

Removal of a breast cancer with clear margins followed by whole-breast radiotherapy, offering survival equivalent to mastectomy in suitable patients and requiring careful imaging and margin assessment.

The three factors predisposing to venous thrombosis: stasis of blood flow, endothelial injury and hypercoagulability, explaining risk after surgery, immobility, malignancy and inherited thrombophilia.

Rest pain, ulceration or gangrene resulting from severe arterial occlusive disease, requiring urgent revascularisation by bypass or angioplasty to relieve pain and avoid major amputation.

Exclusion of an abdominal aortic aneurysm by a stent-graft delivered through the femoral arteries, offering lower early mortality than open repair but requiring lifelong imaging surveillance for endoleak.

A surgically created connection between an artery and a vein, usually in the forearm, that enlarges and thickens the vein to provide reliable access for repeated haemodialysis.

The ratio of heart rate to systolic blood pressure; a value above 0.9 suggests occult hypoperfusion and the need for urgent resuscitation even when blood pressure appears normal.

A pre-planned system for delivering balanced red cells, plasma and platelets rapidly in exsanguinating haemorrhage, with early tranexamic acid, warming and repeated coagulation testing to prevent the lethal triad.

A rapid bedside ultrasound examination of the pericardium, perihepatic, perisplenic and pelvic spaces during trauma resuscitation to detect free fluid and guide immediate operative or further imaging decisions.

Raised pressure within a closed fascial compartment that compromises capillary perfusion and threatens muscle and nerve; diagnosed clinically with pain on passive stretch and treated by urgent fasciotomy.

A staged strategy in which the abdomen is packed and temporarily closed after control of bleeding and contamination, allowing resuscitation in intensive care before planned reoperation and definitive repair.

A burn resuscitation guide giving four millilitres of crystalloid per kilogram body weight per percent total body surface area burned in the first 24 hours, half in the first eight hours.

Identification and removal of the first draining lymph node using dye or radiotracer to stage clinically node-negative breast cancer and melanoma, sparing patients without nodal disease from full dissection.

Systemic treatment given before definitive surgery to shrink a tumour, improve resectability and test biological response, commonly used in rectal, oesophageal and locally advanced breast cancer.

An international system describing cancer by primary tumour size and invasion, regional nodal involvement and distant metastasis, forming the basis for prognosis and treatment decisions.

Complete removal of visible peritoneal tumour deposits followed by heated intraperitoneal chemotherapy, used for selected peritoneal metastases from colorectal, appendiceal and ovarian primary tumours.

Sepsis with persisting hypotension requiring vasopressors to maintain a mean arterial pressure of at least 65 mmHg and lactate above 2 mmol/L despite adequate fluid resuscitation, carrying high mortality.

Acute non-cardiogenic hypoxaemic respiratory failure with bilateral infiltrates and reduced lung compliance developing within a week of a triggering insult, managed with lung-protective ventilation and prone positioning.

Pneumonia developing more than 48 hours after endotracheal intubation, diagnosed by new infiltrates, purulent secretions and cultures, and prevented by head elevation, sedation holds and early extubation.

Infection of the incision or deeper operative space within 30 days of surgery, classified as superficial, deep or organ-space, and reduced by aseptic technique, appropriate prophylaxis and normothermia.

A programme of coordinated actions ensuring antibiotics are given only when indicated, with the correct agent, dose and duration, to improve outcomes, limit resistance and reduce Clostridioides difficile infection.

Sustained intra-abdominal pressure above 20 mmHg with new organ dysfunction, most often after trauma, pancreatitis or massive fluid resuscitation, treated by decompressive laparotomy and temporary abdominal closure.

Progressive fibro-obliteration of the extrahepatic bile ducts presenting with neonatal jaundice and pale stools; Kasai portoenterostomy restores drainage if performed early, otherwise transplantation is required.

An acquired inflammatory necrosis of the premature neonatal bowel presenting with abdominal distension, bloody stools and pneumatosis intestinalis, treated by bowel rest, antibiotics and resection when perforation occurs.

Telescoping of a proximal bowel segment into the adjacent distal bowel, causing colicky pain, vomiting and redcurrant-jelly stool in infants; enema reduction is first line when there is no perforation.

Hypertrophy of the pyloric muscle causing non-bilious projectile vomiting at three to six weeks of age, with hypochloraemic alkalosis corrected before pyloromyotomy is performed.

The irreversible loss of brainstem function in a ventilated patient with a known cause, confirmed by absent cranial nerve reflexes and apnoea testing, permitting consideration of organ donation.

Twisting of the spermatic cord causing acute scrotal pain and testicular ischaemia; urgent exploration with detorsion and bilateral fixation is needed to save the testis.