CSHK Part 1 MCQ flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Alvarado score

A 10-point clinical score for appendicitis combining migratory pain, anorexia, nausea, tenderness, rebound, fever, and leukocytosis; scores of 7 or more favour surgery.

Ranson criteria

A scoring system for acute pancreatitis using admission and 48-hour values including age, white cell count, glucose, LDH, AST, calcium, and fluid sequestration.

Femoral hernia risk

Femoral hernias pass through the femoral canal bounded by the lacunar ligament, giving a narrow neck and the highest risk of strangulation among groin hernias.

Sentinel lymph node biopsy

A staging procedure in breast cancer using blue dye or radioisotope to identify the first draining node, avoiding unnecessary axillary dissection when negative.

Beck's triad

The classic features of cardiac tamponade: hypotension, distended neck veins, and muffled heart sounds, caused by fluid compressing the heart.

Stanford type A dissection

An aortic dissection involving the ascending aorta; it is a surgical emergency because of risks of rupture, tamponade, and coronary or cerebral malperfusion.

Tension pneumothorax

Air trapped in the pleural space causing mediastinal shift and obstructive shock; diagnosed clinically and treated immediately with needle decompression and chest drain.

LIMA to LAD graft

Left internal mammary artery anastomosed to the left anterior descending coronary artery; it has the best long-term patency of coronary bypass conduits.

Glasgow Coma Scale

A 3-15 score summing eye, verbal, and motor responses; a score of 8 or less indicates severe impairment and need for airway protection.

Extradural haematoma

A biconvex collection on CT, usually from middle meningeal artery injury, often with a lucid interval; it requires urgent neurosurgical evacuation.

Subarachnoid haemorrhage

Sudden severe thunderclap headache from ruptured aneurysm; CT is sensitive early, and lumbar puncture for xanthochromia is used if CT is negative.

Cauda equina syndrome

Compression of the lumbosacral nerve roots causing saddle anaesthesia, bladder dysfunction, and leg weakness; it requires emergency surgical decompression.

Pyloric stenosis

Hypertrophy of the pyloric muscle causing projectile non-bilious vomiting in infants; ultrasound confirms and metabolic alkalosis must be corrected before pyloromyotomy.

Intussusception

Telescoping of bowel in infants causing colicky pain and redcurrant jelly stool; air or contrast enema is diagnostic and often therapeutic.

Malrotation with volvulus

Abnormal gut rotation allowing midgut twisting; bilious vomiting in a neonate is a surgical emergency, and upper GI contrast shows a corkscrew sign.

Orchidopexy timing

Surgical fixation of an undescended testis, ideally performed between 6 and 18 months of age to reduce malignancy and fertility risks.

Ankle-brachial index

Ratio of ankle to brachial systolic pressure; a value below 0.9 indicates peripheral arterial disease, and below 0.4 suggests critical limb ischaemia.

Six Ps of acute ischaemia

Pain, pallor, pulselessness, paraesthesia, paralysis, and perishing cold; they describe acute limb ischaemia requiring urgent heparin and revascularisation.

AAA repair threshold

Elective repair of an abdominal aortic aneurysm is considered at 5.5 cm diameter in men or growth exceeding 1 cm per year.

Carotid endarterectomy indication

Offered for symptomatic carotid stenosis of 70-99%, and considered for 50-69%; greatest benefit occurs when performed within two weeks of symptoms.

Parkland formula

Adult burn resuscitation using 4 mL/kg per percent total body surface area of crystalloid over 24 hours, with half given in the first 8 hours.

Rule of nines

Adult burn surface estimate: each arm 9%, each leg 18%, anterior trunk 18%, posterior trunk 18%, head 9%, and perineum 1%.

Split-thickness graft healing

Graft survival proceeds by imbibition, inosculation, and revascularisation; it contracts more than a full-thickness graft but survives more reliably.

Cleft lip repair timing

Cleft lip is usually repaired around 3 months of age with rotation-advancement, while cleft palate repair is performed around 6-12 months.

Renal colic imaging

Non-contrast CT of the kidneys, ureters, and bladder is the gold standard for suspected stones, detecting radiolucent uric acid stones and obstruction.

Testicular torsion

Twisting of the spermatic cord causing acute scrotal pain; it is a clinical emergency requiring immediate exploration, with best salvage within 6 hours.

Fournier's gangrene

Necrotising fasciitis of the perineum and genitalia requiring urgent surgical debridement and broad-spectrum antibiotics; it is more common in diabetics.

Painless visible haematuria

Blood in urine without pain that is the classic presentation of bladder cancer; cystoscopy and upper tract imaging are required for assessment.

Glasgow-Imrie criteria

A pancreatitis severity score using arterial oxygen, albumin, calcium, glucose, urea, and enzyme levels to predict severe disease and mortality.

Flail chest

Multiple rib fractures creating a free segment with paradoxical movement; management centres on analgesia, physiotherapy, and ventilatory support for contusion.

Ventriculoperitoneal shunt

A catheter diverting cerebrospinal fluid from the ventricle to the peritoneum, used for communicating hydrocephalus; blockage presents with headache and vomiting.

VACTERL association

A cluster of vertebral, anal, cardiac, tracheo-oesophageal, renal, and limb anomalies that must be screened for when oesophageal atresia is diagnosed.