Surgery and Allied Specialties
What you must understand
Surgery questions test assessment, diagnosis and operative principles. Know the acute abdomen causes by quadrant, the trauma ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure), and the principles of wound management and sepsis. Understand fluid and electrolyte balance in the perioperative period, anaesthesia basics, and postoperative complications (haemorrhage, infection, dehiscence, deep vein thrombosis). For each surgical condition, know the classic presentation, investigation of choice and definitive management.
Traps that appear in questions
- Confusing appendicitis (migratory pain to right iliac fossa) with other right lower quadrant causes.
- Forgetting that tension pneumothorax is a clinical diagnosis requiring immediate needle decompression, not a chest X-ray first.
- Mixing up incisional hernia vs inguinal hernia and their repair principles.
- Overlooking postoperative DVT prophylaxis in immobile patients.
Worked example (rule of thumb)
A patient with sudden severe abdominal pain, rigidity and absent bowel sounds has peritonitis until proven otherwise. Resuscitate, take bloods and imaging, and prepare for surgical exploration. Rule of thumb: rigid silent abdomen = surgical emergency.
Exam strategy
For each surgical stem, state the diagnosis, the immediate resuscitation step and the definitive procedure. Use ABCDE for any trauma question.