Surgery

Front 1

Amyand's hernia

Back 1

Appendix

Front 2

Herniorrhaphy vs hernioplasty

Back 2

Herniorrhaphy: herniotomy + inguinal floor reconstruction with sutures

Hernioplasty: herniotomy + inguinal floor reconstruction with MESH

Front 3

Gold standard for inguinal hernia repair

Back 3

Lichtenstein repair i.e. anterior tension free repair

Front 4

Primary tension free repair of inguinal hernia

Back 4

1. Bassini

2. Shouldice

Front 5

Bassini's repair

Back 5

✓ Triple layer repair

✓ Internal oblique + transverse abdominis + fascia transversalis

✓ increased tension in tissue ---> increased recurrence rate

Front 6

Shouldice

Back 6

✓ Four layered repair

✓ double breasting of fascia transversalis

✓ relatively low tension in tissues ----> low recurrence rate

Front 7

Modified Shouldice

Back 7

✓ Double breasting of internal oblique, transverse abdominis, fascia transversalis

✓ Aka six layered repair

Front 8

Space of Bogros

Back 8

Aka retroinguinal space

Extra peritoneal space located deep to inguinal ligament

Situated laterally and cranially to the space of Retzius

Front 9

1. Diameter of femoral ring

2. Length of femoral canal

3. Ln in femoral canal

Back 9

1. 1.25 cm

2. 1.25 cm

3. Cloquet group of nodes

Front 10

Inguinal floor reconstruction techniques

1. Primary tissue repair

2. Anterior tension free repair

3. Lap

Back 10

1. Bassini's repair and shouldice repair

2. Lichtenstein

3. TEP & TAPP

Front 11

Approaches for repair of femoral hernia

Back 11

1. Sub inguinal incision: Lockwood

2. Inguinal incision: Lothiessen

3. Supra inguinal : Mc Evedy

Front 12

TOC of femoral hernia

Back 12

Henry's procedure ( midline abdominal extraperitoneal femoral hernioplasty)

Front 13

Variants of femoral hernia

Back 13

1. Laugier

2. Narath

3. Cloquet

Front 14

Management of lumbar hernia

Back 14

DOWD'S OPERATION

Front 15

Boundaries of superior and Inferior lumbar triangle

Back 15

Superior triangle

P: para spinal muscle

A: internal oblique

S: 12th rib

Inferior triangle

P: lattisimus dorsi

A: external oblique

I: iliac crest

Front 16

Skinny old lady hernia

Back 16

Obturator hernia

Front 17

French hernia

Back 17

Obturator hernia

Front 18

1. Howship Romberg sign

2. Hannington Kiff sign

Back 18

Both seen in obturator hernia

1. Compression of obturator nerve: pain along the medial aspect of thigh radiating to I/L knee joint

2. Absence of obturator reflex

Front 19

Fatty hernia of linia alba

Back 19

Epigastric hernia

Front 20

Mesh is used in case of epigastric hernia if

Back 20

Defect is > 4cm

Front 21

Indications of surgery in umbilical hernia

Back 21

1. If it persists beyond 5yrs of age

2. Symptomatic pts

3. Strangulation

4. Size > 2cm

5. Progressive enlargement of hernia after 1-2 yrs

Small defects are closed primarily

If size > 3cm: prosthetic mesh used

Front 22

Vests over pants repair

Back 22

Aka Mayo's repair

Used in umbilical hernia

Front 23

Bechwidth wiedeman syndrome

Back 23

Hemihypertrophy

Macroglossia

Visceromegaly

Omphalocele

Hepatoblastoma

Front 24

Gastroschisis is associated with

Back 24

Intestinal atresia

Front 25

Maternal drug intake associated with gastroschisis

Back 25

Aspirin during first trimester

Ibuprofen

Pseudoephedrine

Front 26

Gold standard treatment of incisional hernia

Back 26

IPOM ( Intra Peritoneal Onlay Mesh repair)

Front 27

1. Risk of desmoid tumor is increased in ____ syndrome

2. IOC in desmoid tumor

Back 27

1. Gardner's syndrome

2. MRI - bcz it is a soft tissue tumor ( arises from musculoaponeurotic structure in infra umbilical region )

Front 28

Named hernias

1. Gibbons

2. Berger's

3. Beclar's

4. Ogilvie's

5. Stammer's

6. Peterson

7. Velpaeu's

8. Serafini's

9. Holthosue

# Ogilvie's Syndrome

Back 28

1. Hernia + hydrocele

2. Hernia into pouch of Douglas

3. Hernia through saphenous opening

4. Hernia through defect in conjoint tendon

5. Hernia through transverse mesocolon after retrocolic Gastro-jejunostomy

6. Hernia behind Roux limb after Roux-en-Y gastric bypass ( mc bariatric surgery)

7. Prevascular hernia ( sac is in front of femoral vessels)

8. Retrovascular hernia ( sac is behind femoral vessels)

9. Type of inguinal hernia; extension of bowel along inguinal ligament

# colonic pseudo obstruction

Front 29

Pendred syndrome

Back 29

Congenital SNHL + Goitre

Chr 7q

Front 30

Retetoff syndrome

Back 30

End organ resistance to T4

Front 31

Thyroglossal cyst

1. Age of presentation

2. Mc location

3. Increased risk of ____ carcinoma of thyroid

4. TOC

Back 31

1. 15-30yrs

2. Subhyoid

3. Papillary ca of thyroid

4. Sistrunk operation ( en Bloc removal of central part of body of hyoid bone + cyst )

Front 32

Retrosternal goiter

Back 32

If > 50% of thyroid tissue is located below the opening of thoracic cage

Front 33

Pemberton sign

Back 33

If b/l upper limb elevated above forehead , facial puffiness and facial congestion seen.

Goiter

Front 34

Radioisotopes used in relation to goiter

Back 34

1. I-123: t1/2= 13hrs ; diagnostic purpose

2. I-131: t1/2 = 8 days; treatment... ablation

Front 35

1. I-131 emits

2. Depth of penetration

Back 35

1. Beta rays - 90%

Gamma rays - 10%

Beta rays are responsible for the therapeutic effects ( ablation)

Gamma rays are responsible for side effects and used in tracer studies

2. 0.5mm ; ablates only thyroid , even parathyroid are unaffected

Front 36

Hartley- Dunhill Procedure

Back 36

Type of thyroidectomy leaving behind 4-6 gms of thyroid in one lobe with removal of rest of thyroid gland

Front 37

Subtotal vs near total thyroidectomy

Back 37

Subtotal : 3-4 gms of thyroid tissue left in each lobe superiorly

Near total: < 1gm of thyroid tissue adjacent to recurrent laryngeal nerve near ligament of berry

Front 38

Only indication of subtotal thyroidectomy

Back 38

Multinodular goiter in elderly pt

Front 39

Mv solitary thyroid nodule

Back 39

Colloid goiter > follicular adenoma

Front 40

Solitary thyroid nodule

1. First investigation

2. IOC

Back 40

1. TFT

2. FNAC

Front 41

Side effects of

1. methimazole

2. Propylthiouracil

Back 41

Increased risk of choanal atresia

1. Increased risk of Aplasia cutisIncreased risk of choanal atresiaAgranulocytosis2. Hepatic failure in females and children

Agranulocytosis

cutisIncreased risk of choanal atresiaAgranulocytosis2. Hepatic failure in females and children

2. Hepatic failure in females and children

Front 42

Antithyroid DOC

ds

2. In pregnancy

1. In Graves ds2. In pregnancy3. In thyrotoxic crisis

3. In thyrotoxic crisis

Back 42

1. Methimazole

2. Carbimazole

3. Propylthiouracil

Front 43

Mcc

1. Large bowel obstruction

2. Small bowel obstruction

Back 43

1. Malignancy

2. Adhesions

Front 44

First symptom of small bowel obstruction

Back 44

Colicky abdominal pain

Front 45

After adequate tissue perfusion, urine output should be ___ in

1. Adults

2. Children

Back 45

1. 1ml/min

2. 0.5-1ml/min

Front 46

Normal air fluid levels in adult

Back 46

3-5

Front 47

IOC for small bowel obstruction

Back 47

X-ray ( supine > erect)

In low grade intermittent SBO - IOC is Enteroclysis

Front 48

Named hernia 2

1. Romberg hernia

2. Hesselbach's hernia

3. Serofini

4. Teale

5. Maydl's

6. Mery's

7. Barth's

8. Holthouse's

9. De Garengeot's

10. Ritcher's

Back 48

1. Saddle hernia

2. Lateral to femoral artery

3. Behind femoral vessels

4. In front of femoral vessels

5. 'W' hernia

6. Perineal hernia

7. Between abdominal wall and persistent vitellointestinal duct

8. Inguinal hernia that has turned outwards into the groin

9. Incarcerated appendix in femoral hernia

10. Part of circumference of bowel wall is gangrenous

Front 49

Categorisation of GCS

A. COMA

B. Mild head injury

C. Moderate head injury

D. Severe head injury

Back 49

A. No eye opening, no ability to follow commands, no word verbalizations ( 3-8)

B. 13-15

C. 9-12

D. 8 or less