Front,Back,Tags
"What is an Appendicectomy?","Surgical removal of the vermiform appendix. Indicated for acute appendicitis (uncomplicated or complicated). Can be open (McBurney's incision) or laparoscopic. Key landmark: McBurney's point (1/3 from ASIS to umbilicus).","General_Surgery High_Yield"
"What are the indications for Appendicectomy?","1. Acute appendicitis (most common) 2. Perforated appendicitis 3. Appendicular abscess/mass 4. Incidental removal during other abdominal surgery 5. Mucocele of appendix","General_Surgery High_Yield"
"What are the main complications of Appendicectomy?","1. Wound infection (most common) 2. Intra-abdominal abscess 3. Ileus/bowel obstruction 4. Stump leak/blowout 5. Bleeding 6. Fecal fistula 7. Right iliac fossa pain (post-operative)","General_Surgery High_Yield"
"What score is used to diagnose acute appendicitis?","Alvarado Score (MANTRELS): Migration of pain to RIF, Anorexia, Nausea/vomiting, Tenderness in RIF, Rebound tenderness, Elevated temperature, Leukocytosis, Shift to left. Score ≥7 = high probability. Also: Alvarado score ≥5 in children.","General_Surgery High_Yield"
"What is a Cholecystectomy?","Surgical removal of the gallbladder. Laparoscopic cholecystectomy (LC) is the gold standard. Open approach used for complicated cases. Calot's triangle must be clearly identified before clipping cystic duct and artery.","General_Surgery High_Yield"
"What are the indications for Cholecystectomy?","1. Symptomatic gallstones (biliary colic) 2. Acute cholecystitis 3. Chronic cholecystitis 4. Gallbladder polyps >1cm 5. Empyema of gallbladder 6. Mucocele 7. Porcelain gallbladder 8. Gallstone pancreatitis","General_Surgery High_Yield"
"What are the borders of Calot's triangle?","Superior: inferior surface of liver. Medial: common hepatic duct. Inferior/lateral: cystic duct. Contents: cystic artery (usually right hepatic artery branch). Critical view of safety (CVS) must be achieved before clipping.","General_Surgery"
"What are the complications of Cholecystectomy?","1. Bile duct injury (most feared) 2. Bile leak 3. Biliary peritonitis 4. Bleeding 5. Wound infection 6. Port-site hernia (laparoscopic) 7. Retained stones in CBD 8. Post-cholecystectomy syndrome","General_Surgery High_Yield"
"What is an Inguinal Hernia repair?","Surgical correction of protrusion of abdominal contents through the inguinal canal. Approaches: Lichtenstein tension-free mesh repair (open, gold standard), TEP/TAPP (laparoscopic). Bassini, Shouldice are suture-based repairs.","General_Surgery High_Yield"
"What is the difference between direct and indirect inguinal hernia?","Indirect: lateral to inferior epigastric vessels, through deep inguinal ring - congenital, more common in younger males. Direct: medial to inferior epigastric vessels, through Hesselbach's triangle - acquired (weakness of posterior wall), older males.","General_Surgery"
"What is Hesselbach's triangle?","Boundaries: Lateral - inferior epigastric vessels. Medial - lateral border of rectus abdominis. Inferior - inguinal ligament. Direct inguinal hernias pass through this triangle.","General_Surgery"
"What is a Femoral Hernia?","Hernia through the femoral canal, below and lateral to the pubic tubercle. More common in women. Has the highest risk of strangulation of all hernias. Repair: Lockwood (low approach), Lothiessen (inguinal), McEvedy (high approach - best for strangulated).","General_Surgery"
"What is an Umbilical Hernia?","Protrusion through the umbilical ring. In children: usually closes spontaneously by age 3-4 yrs. In adults: acquired, associated with obesity, ascites, pregnancy, multiparity. Treatment: Mayo repair (vest-over-pants) or mesh repair.","General_Surgery"
"What is a Hemorrhoidectomy?","Surgical excision of hemorrhoids (internal or external). Milligan-Morgan (open) and Ferguson (closed) techniques most common. Indicated for Grade 3-4 internal hemorrhoids not responding to conservative/office procedures.","General_Surgery High_Yield"
"What is the grading of internal hemorrhoids?","Grade 1: Bleed only, do not prolapse. Grade 2: Prolapse on straining, reduce spontaneously. Grade 3: Prolapse on straining, require manual reduction. Grade 4: Permanently prolapsed, irreducible. Treatment escalates with grade.","General_Surgery High_Yield"
"What is a Fistulotomy vs Fistulectomy?","Fistulotomy: laying open of the fistulous tract (preferred for low fistulas - below sphincter). Fistulectomy: excision of the entire tract. Risk of incontinence if sphincter involved. High fistulas may need seton placement.","General_Surgery"
"What is a Thyroidectomy?","Surgical removal of part or all of the thyroid gland. Total thyroidectomy removes entire gland. Hemithyroidectomy removes one lobe. Subtotal removes >95% of both lobes. Recurrent laryngeal nerve (RLN) and parathyroids must be identified and preserved.","General_Surgery High_Yield"
"What are the indications for Thyroidectomy?","1. Thyroid cancer (total thyroidectomy) 2. Multinodular goiter causing compressive symptoms 3. Graves' disease (medical/RAI failed) 4. Toxic adenoma 5. Suspicious thyroid nodule 6. Cosmetic reasons 7. Retrosternal goiter","General_Surgery High_Yield"
"What are the complications of Thyroidectomy?","1. RLN injury - unilateral: hoarseness; bilateral: stridor/emergency tracheostomy 2. Hypoparathyroidism - hypocalcemia (perioral tingling, tetany, Chvostek/Trousseau signs) 3. Thyroid storm 4. Hemorrhage/hematoma 5. Hypothyroidism 6. Wound infection","General_Surgery High_Yield"
"What is Chvostek's sign?","Twitching of facial muscles on tapping the facial nerve (just anterior to ear). Indicates hypocalcemia - seen post-thyroidectomy if parathyroids injured. Also seen in hypomagnesemia.","General_Surgery"
"What is Trousseau's sign?","Carpal spasm (main d'accoucheur) when BP cuff inflated above systolic for 3 minutes. Indicates hypocalcemia. More sensitive than Chvostek's sign.","General_Surgery"
"What is a Mastectomy?","Surgical removal of the breast. Types: Simple/total, Modified radical (MRM - breast + axillary nodes + pectoralis minor fascia), Radical (Halsted - includes pectoralis major), Skin-sparing, Nipple-sparing, Prophylactic (BRCA mutation carriers).","General_Surgery High_Yield"
"What are the indications for Mastectomy?","1. Breast cancer (unable/unwilling for BCS) 2. Multifocal/multicentric disease 3. Large tumor relative to breast size 4. Failed breast-conserving surgery 5. Prophylactic (BRCA1/2 mutation) 6. Paget's disease of nipple","General_Surgery High_Yield"
"What are the complications of Mastectomy?","1. Seroma (most common) 2. Wound infection 3. Flap necrosis 4. Lymphedema (after axillary dissection) 5. Nerve injury (intercostobrachial nerve - arm numbness) 6. Shoulder dysfunction 7. Phantom breast sensation","General_Surgery"
"What is a Colectomy?","Surgical resection of part or all of the colon. Right hemicolectomy (ascending colon/cecum), left hemicolectomy, sigmoid colectomy, subtotal/total colectomy. May be open or laparoscopic. Anastomosis or stoma formation.","General_Surgery Gastrointestinal_Surgery"
"What are the indications for Colectomy?","1. Colorectal cancer 2. Diverticular disease (complicated) 3. Inflammatory bowel disease (Crohn's/UC) 4. Volvulus 5. Intestinal obstruction 6. Trauma 7. Ischemic colitis 8. Familial adenomatous polyposis (FAP) - total colectomy","General_Surgery"
"What is a Gastrectomy?","Surgical removal of part or all of the stomach. Total gastrectomy (all), subtotal (partial). Billroth I: gastroduodenostomy. Billroth II: gastrojejunostomy. Roux-en-Y: used after total gastrectomy. Indications: gastric cancer, peptic ulcer disease (rarely).","General_Surgery"
"What is dumping syndrome?","Complication after gastrectomy. Early dumping (30 min post-meal): rapid gastric emptying → osmotic fluid shift → vasomotor symptoms (flushing, palpitations, diarrhea). Late dumping (2-3 hrs): reactive hypoglycemia. Treatment: small frequent meals, avoid simple carbs.","General_Surgery"
"What is a Splenectomy?","Surgical removal of the spleen. Open or laparoscopic. Post-splenectomy: risk of OPSI (Overwhelming Post-Splenectomy Infection) - especially encapsulated organisms (Streptococcus pneumoniae, H. influenzae, N. meningitidis). Vaccines must be given pre-op or post-op.","General_Surgery"
"What vaccines are needed post-Splenectomy?","1. Pneumococcal (Streptococcus pneumoniae) 2. Haemophilus influenzae type b (Hib) 3. Meningococcal vaccine. Given 2 weeks before elective splenectomy, or 2 weeks after emergency splenectomy. Lifelong penicillin prophylaxis in some patients (especially children).","General_Surgery"
"What is a Laparotomy?","Surgical opening of the abdominal cavity. Exploratory laparotomy used for diagnosis/treatment of abdominal emergencies. Damage control laparotomy: abbreviated surgery for hemostasis + contamination control in trauma, followed by ICU stabilization and re-look.","General_Surgery Emergency_Surgery"
"What is a Laparoscopic surgery?","Minimally invasive surgery using a camera (laparoscope) and ports. Advantages: smaller wounds, less pain, faster recovery, less infection, shorter hospital stay. Disadvantages: longer operative time, cost, technical difficulty, cannot always achieve hemostasis, CO2 pneumoperitoneum risks.","General_Surgery"
"What are contraindications to laparoscopic surgery?","Absolute: inability to tolerate GA, uncorrected coagulopathy. Relative: previous abdominal surgery (adhesions), bowel obstruction, pregnancy, severe cardiopulmonary disease, morbid obesity. Many are now relative only with experience.","General_Surgery"
"What is CABG?","Coronary Artery Bypass Grafting - surgical revascularization using conduit (LIMA to LAD preferred, saphenous vein grafts). Indicated when PCI is not suitable: left main disease, triple vessel disease, diabetes with multivessel disease, failed PCI. On-pump or off-pump.","Cardiothoracic_Surgery High_Yield"
"What conduits are used in CABG?","1. Left Internal Mammary Artery (LIMA) - best patency, anastomosed to LAD 2. Right Internal Mammary Artery (RIMA) 3. Radial artery 4. Saphenous vein graft (SVG) - most commonly used but lower long-term patency. LIMA has 90%+ patency at 10 years.","Cardiothoracic_Surgery High_Yield"
"What are the indications for CABG over PCI?","1. Left main coronary artery disease 2. Three-vessel CAD (especially with reduced EF) 3. Diabetes with multivessel disease (FREEDOM trial) 4. Complex lesions (high SYNTAX score) 5. Failed or unsuitable for PCI 6. Combined with valve surgery","Cardiothoracic_Surgery"
"What are the complications of CABG?","1. Stroke/neurological deficit 2. Myocardial infarction (perioperative) 3. Arrhythmias (atrial fibrillation most common) 4. Wound infection (especially sternal - mediastinitis) 5. Renal failure 6. Bleeding 7. Graft failure 8. Cognitive dysfunction","Cardiothoracic_Surgery"
"What is a Valve Replacement/Repair surgery?","Surgical correction of valvular heart disease. Repair preferred over replacement when possible (especially mitral). Replacement valves: mechanical (lifelong anticoagulation, durable) vs bioprosthetic (no anticoagulation after 3 months, shorter lifespan). TAVI: transcatheter aortic valve implantation.","Cardiothoracic_Surgery"
"What are the indications for aortic valve replacement?","1. Severe symptomatic aortic stenosis (angina, syncope, heart failure) 2. Severe aortic regurgitation with symptoms or LV dysfunction (EF <50%) 3. Severe AS undergoing other cardiac surgery 4. Severe AS with EF <50%. Valve area <1 cm² = severe AS.","Cardiothoracic_Surgery"
"What is a Heart Transplant?","Replacement of failing heart with donor heart. Indications: end-stage heart failure (NYHA III-IV despite maximal therapy), refractory arrhythmias, non-operable CAD. Contraindications include irreversible pulmonary hypertension (PVR >6 Wood units). Requires lifelong immunosuppression.","Cardiothoracic_Surgery Transplant"
"What is a Pericardiectomy?","Surgical resection of the pericardium. Indicated for constrictive pericarditis (most common indication: tuberculosis in developing countries, post-radiation, post-cardiac surgery). Clinical features: JVP raised, Kussmaul's sign, pericardial knock, ascites > peripheral oedema.","Cardiothoracic_Surgery"
"What is a Lobectomy?","Surgical removal of a lobe of the lung. Most common surgery for non-small cell lung cancer (NSCLC). Adequate pulmonary reserve required (FEV1 >40% predicted post-op). Video-Assisted Thoracoscopic Surgery (VATS) is minimally invasive approach. Complications: air leak, bronchopleural fistula, pneumonia.","Cardiothoracic_Surgery"
"What is a Pneumonectomy?","Removal of entire lung. Performed for centrally placed tumors not amenable to lobectomy. Right pneumonectomy higher mortality than left. Complications: post-pneumonectomy syndrome, empyema, bronchopleural fistula, cardiac herniation, respiratory failure.","Cardiothoracic_Surgery"
"What is a Thoracotomy?","Surgical opening of the chest. Approaches: posterolateral (most common, best access), anterolateral, median sternotomy, clamshell. Emergency thoracotomy (EDT): resuscitative procedure for cardiac arrest from penetrating chest trauma. Indications include great vessel injury, cardiac tamponade.","Cardiothoracic_Surgery Emergency_Surgery"
"What is a Lung Transplant?","Transplantation of one or both lungs. Indications: end-stage COPD/emphysema (most common), idiopathic pulmonary fibrosis, cystic fibrosis, pulmonary arterial hypertension. Single vs bilateral. Complications: primary graft dysfunction, bronchiolitis obliterans (chronic rejection), opportunistic infections.","Cardiothoracic_Surgery Transplant"
"What is a Craniotomy?","Temporary removal of a bone flap from the skull to access the brain; the bone is replaced at the end. Indications: brain tumor excision, aneurysm clipping, AVM resection, cerebral abscess drainage, trauma (hematoma evacuation). Bone is replaced at end (vs craniectomy).","Neurosurgery High_Yield"
"What is a Craniectomy?","Removal of a portion of the skull that is NOT replaced. Used for decompressive craniectomy (malignant cerebral edema after stroke/TBI) to reduce ICP. Bone stored subcutaneously in abdomen or frozen, replaced later (cranioplasty). Risk of 'syndrome of the trephined'.","Neurosurgery"
"What is a VP Shunt?","Ventriculoperitoneal shunt - diverts CSF from lateral ventricle to peritoneal cavity. Used for hydrocephalus. Components: ventricular catheter, valve (set pressure), peritoneal catheter. Complications: blockage/malfunction (most common), infection (Staph. epidermidis), over-drainage (subdural hematoma), slit ventricle syndrome.","Neurosurgery"
"What are the complications of VP Shunt?","1. Shunt obstruction/malfunction (most common - proximal > distal) 2. Shunt infection (Staphylococcus epidermidis most common) 3. Over-drainage - subdural hygroma/hematoma 4. Under-drainage - persistent hydrocephalus 5. Abdominal complications (pseudocyst) 6. Shunt migration","Neurosurgery"
"What is Aneurysm Clipping?","Surgical placement of a metal clip across the neck of an intracranial aneurysm to prevent rupture. Approach via craniotomy. Done for ruptured (SAH) or unruptured aneurysms. Alternative: endovascular coiling (ISAT trial - coiling preferred if both options feasible for ruptured aneurysms).","Neurosurgery"
"What is the ISAT trial significance?","International Subarachnoid Aneurysm Trial - compared neurosurgical clipping vs endovascular coiling for ruptured intracranial aneurysms. Coiling superior for outcomes at 1 year (better survival, less dependency). Clipping preferred for young patients, large/complex aneurysms, middle cerebral artery aneurysms.","Neurosurgery"
"What is a Laminectomy?","Removal of the lamina (posterior arch of vertebra) to decompress the spinal cord or nerve roots. Indications: spinal stenosis, disc herniation (if conservative fails), spinal cord compression, tumor, trauma. Also called decompressive laminectomy. Risk: spinal instability requiring fusion.","Neurosurgery"
"What is a Spinal Fusion?","Surgical union of two or more vertebrae using bone graft +/- instrumentation (screws, rods, cages). Indications: spinal instability, spondylolisthesis, degenerative disc disease (failed conservative), fractures, deformity (scoliosis). Approaches: ALIF, PLIF, TLIF, posterior fusion. Complication: adjacent segment disease.","Neurosurgery"
"What is Deep Brain Stimulation (DBS)?","Implantation of electrodes into specific brain nuclei connected to a pulse generator (pacemaker-like). Target for Parkinson's disease: subthalamic nucleus (STN) or globus pallidus internus (GPi). Also used for essential tremor (VIM of thalamus), dystonia, treatment-resistant depression/OCD.","Neurosurgery"
"What is ORIF?","Open Reduction Internal Fixation - surgical fracture management where fracture is exposed (open reduction), reduced, and fixed with implants (plates, screws, intramedullary nails). Indicated when closed reduction fails or for specific fractures requiring anatomic reduction (articular fractures, displaced neck of femur, etc.).","Orthopedic_Surgery High_Yield"
"What are the indications for ORIF?","1. Failed closed reduction 2. Intra-articular fractures (require anatomic reduction) 3. Fractures with neurovascular compromise 4. Open fractures (after debridement) 5. Multiple trauma/polytrauma 6. Pathological fractures 7. Specific fractures: femoral neck, displaced both-bone forearm in adults","Orthopedic_Surgery"
"What is a Total Hip Replacement (THR)?","Replacement of the femoral head and acetabulum with prosthetic components. Cemented vs uncemented fixation. Approaches: posterior (most common), anterolateral, anterior. Indications: osteoarthritis (most common), rheumatoid arthritis, AVN, femoral neck fracture (elderly). Lifetime implant restriction: avoid high-impact activities.","Orthopedic_Surgery High_Yield"
"What are the complications of Total Hip Replacement?","1. Dislocation (most common early complication - posterior approach highest risk) 2. DVT/PE 3. Periprosthetic fracture 4. Infection 5. Nerve injury (sciatic nerve) 6. Leg length discrepancy 7. Aseptic loosening (long-term, most common late complication) 8. Heterotopic ossification","Orthopedic_Surgery High_Yield"
"What is a Total Knee Replacement (TKR)?","Resurfacing of the distal femur, proximal tibia, and patella with metal/polyethylene components. Cruciate-retaining or posterior-stabilized designs. Indications: severe osteoarthritis, RA, post-traumatic arthritis. Active ROM required. Complications: infection, stiffness, PE/DVT, loosening, instability.","Orthopedic_Surgery High_Yield"
"What is Arthroscopy?","Minimally invasive joint surgery using an arthroscope. Joints: knee (most common), shoulder, hip, ankle, wrist. Diagnostic and therapeutic (meniscectomy, ACL reconstruction, rotator cuff repair, synovectomy, loose body removal, chondroplasty). Advantages: outpatient, faster recovery, less morbidity.","Orthopedic_Surgery"
"What is an Amputation?","Surgical removal of a limb or part of a limb. Levels: trans-tibial (below knee - better function), trans-femoral (above knee), Symes, digit. Indications: critical ischemia, non-healing diabetic foot, trauma, malignancy, infection (gas gangrene). Guillotine amputation: emergency open amputation for infection/gas gangrene.","Orthopedic_Surgery"
"What is ACL Reconstruction?","Surgical replacement of the torn anterior cruciate ligament with a graft. Grafts: patellar tendon (bone-tendon-bone - gold standard), hamstring tendon, quadriceps tendon, allograft. Indications: ACL rupture with instability in active patients. Timing: allow inflammation to settle first (~6 weeks). Return to sport: 9-12 months.","Orthopedic_Surgery"
"What is a Meniscectomy?","Arthroscopic removal of torn meniscal tissue. Partial meniscectomy preferred over total (preserves function, reduces OA risk). Repair preferred in younger patients with peripheral tears (good vascularity). The red-red zone heals; red-white zone may heal; white-white zone does not heal well.","Orthopedic_Surgery"
"What is a Cesarean Section (LSCS)?","Lower Segment Cesarean Section - surgical delivery of baby through incision in lower uterine segment. Pfannenstiel (transverse) incision most common. Layers: skin, fat, Scarpa's fascia, rectus sheath, rectus muscles, peritoneum, uterovesical fold, uterus. Indications: see below.","Obstetrics_Gynecology High_Yield"
"What are the indications for Cesarean Section?","Absolute: placenta praevia, brow presentation, contracted pelvis, previous classical CS. Relative/common: fetal distress, failure to progress, cephalopelvic disproportion, cord prolapse, previous lower segment CS (VBAC possible), breech presentation, multiple pregnancy, eclampsia.","Obstetrics_Gynecology High_Yield"
"What are the complications of Cesarean Section?","1. Hemorrhage (PPH) 2. Bladder/ureter injury 3. Wound infection/dehiscence 4. Thromboembolism 5. Adhesions 6. Uterine rupture in subsequent pregnancy 7. Placenta accreta/praevia in future pregnancies 8. Neonatal respiratory morbidity (transient tachypnea)","Obstetrics_Gynecology High_Yield"
"What is a Hysterectomy?","Surgical removal of the uterus. Total (uterus + cervix), subtotal (uterus only), radical (Wertheim's - uterus + cervix + upper vagina + parametria + pelvic LN). Routes: abdominal, vaginal, laparoscopic (LAVH). Most common reason: fibroids and abnormal uterine bleeding.","Obstetrics_Gynecology High_Yield"
"What are the indications for Hysterectomy?","1. Uterine fibroids (most common) 2. Endometriosis 3. Uterine cancer (radical) 4. Cervical cancer (radical) 5. Ovarian cancer 6. Abnormal uterine bleeding refractory to medical/conservative treatment 7. Uterine prolapse 8. Chronic pelvic pain","Obstetrics_Gynecology"
"What are the complications of Hysterectomy?","1. Bladder injury (most common - cystotomy) 2. Ureteric injury 3. Bowel injury 4. Hemorrhage 5. Vault haematoma 6. DVT/PE 7. Wound infection 8. Ovarian failure (if BSO) 9. Fistula (vesicovaginal, ureterovaginal) 10. Lymphocyst","Obstetrics_Gynecology"
"What is a Myomectomy?","Surgical removal of uterine fibroids (leiomyomas) while preserving the uterus. Preferred for women wishing to retain fertility. Can be open (abdominal), laparoscopic, or hysteroscopic (submucosal fibroids). Risk of recurrence (30% at 10 years). Conversion to hysterectomy if uncontrolled bleeding.","Obstetrics_Gynecology"
"What is an Oophorectomy?","Surgical removal of one (unilateral) or both (bilateral - BSO) ovaries. Indications: ovarian cyst/tumor, ovarian cancer, endometriosis, ovarian torsion, prophylactic (BRCA1/2). Bilateral removal causes surgical menopause - HRT usually offered to women <50 years.","Obstetrics_Gynecology"
"What is a Salpingectomy?","Surgical removal of the fallopian tube. Indications: ectopic pregnancy (most common emergency indication), hydrosalpinx (before IVF), salpingitis, sterilization, ovarian cancer risk reduction (opportunistic bilateral salpingectomy). Salpingostomy: opening tube to remove ectopic (tube-sparing, higher recurrence risk).","Obstetrics_Gynecology"
"What is a D&C (Dilation and Curettage)?","Cervical dilatation + uterine curettage. Uses: incomplete/missed abortion, retained products of conception, endometrial biopsy, menorrhagia diagnosis/treatment, gestational trophoblastic disease. Hysteroscopy + D&C more accurate for endometrial pathology. Complications: Asherman's syndrome (intrauterine adhesions), perforation, infection.","Obstetrics_Gynecology"
"What is Tubal Ligation?","Permanent surgical contraception - fallopian tubes cut, tied, burned, or blocked (Filshie clips, Hulka clips, Pomeroy technique). Most common female sterilization method. Failure rate ~1 in 200 over lifetime. Ectopic pregnancy risk increased if method fails. Reversal possible but low success rate.","Obstetrics_Gynecology"
"What is Pelvic Floor Repair?","Surgical correction of pelvic organ prolapse (cystocele, rectocele, uterine prolapse). Procedures: anterior colporrhaphy (cystocele), posterior colporrhaphy (rectocele), vaginal hysterectomy + repair, sacrocolpopexy (mesh - abdominal). Native tissue vs mesh repair. Mesh complications: erosion, pain.","Obstetrics_Gynecology"
"What is TURP?","Transurethral Resection of the Prostate - endoscopic removal of obstructing prostatic tissue using resectoscope via urethra. Gold standard for BPH. No external incision. TURP syndrome: hyponatremia from absorption of hypotonic irrigating fluid (glycine) - headache, confusion, visual disturbance, CVS changes.","Urology High_Yield"
"What is TURP syndrome?","Complication of TURP from absorption of large volumes of hypotonic irrigating fluid (glycine/water). Causes dilutional hyponatremia, fluid overload, glycine toxicity (transient blindness). Features: confusion, bradycardia, hypertension then hypotension, visual disturbance, seizures. Treatment: IV hypertonic saline if severe, furosemide.","Urology"
"What is a Nephrectomy?","Surgical removal of a kidney. Simple (kidney only), radical (kidney + adrenal + Gerota's fascia + regional LN). Open or laparoscopic. Partial nephrectomy for small renal tumors (nephron-sparing). Indications: renal cell carcinoma, transitional cell carcinoma, non-functioning kidney, renovascular hypertension, donor nephrectomy.","Urology High_Yield"
"What is a Cystectomy?","Surgical removal of the urinary bladder. Radical cystectomy (RC) = gold standard for muscle-invasive bladder cancer: bladder + prostate (males) or bladder + uterus + anterior vaginal wall (females) + pelvic LN. Urinary diversion required: ileal conduit (most common), orthotopic neobladder, continent pouch.","Urology"
"What is an Orchiectomy?","Surgical removal of a testicle. Radical (inguinal) orchiectomy: primary treatment for testicular cancer (avoid trans-scrotal to prevent lymphatic spread - scrotal lymphatics drain to inguinal nodes, not para-aortic). Simple orchiectomy: bilateral for prostate cancer (androgen deprivation). Indications also include torsion (non-viable testis), trauma.","Urology"
"What is a Vasectomy?","Male sterilization - vas deferens cut, tied, cauterized, or clipped bilaterally. Failure rate: <1%. Not immediately effective - requires post-vasectomy semen analysis at 3 months (2 azoospermic samples). Complications: hematoma, sperm granuloma, chronic pain (post-vasectomy pain syndrome), failure. Reversal possible but not guaranteed.","Urology"
"What is PCNL?","Percutaneous Nephrolithotomy - removal of large (>2cm), complex, or staghorn renal stones via percutaneous nephrostomy tract. Access: posterolateral calyx under fluoroscopic/ultrasound guidance. Advantages over ESWL/URS: higher stone-free rate for large stones. Complications: hemorrhage (most significant - may need angioembolization), urosepsis, pleural injury.","Urology"
"What is Ureteroscopy (URS)?","Endoscopic procedure to access and treat ureteric/renal stones using flexible or semi-rigid ureteroscope. Stones fragmented with holmium laser (laser lithotripsy). Indications: ureteric stones >10mm (or failed ESWL), renal stones <2cm, stones in special situations (pregnancy, anticoagulation, solitary kidney). JJ stent often placed post-procedure.","Urology"
"What is a Kidney Transplant?","Transplantation of donor kidney into iliac fossa (heterotopic). Anastomosed to iliac vessels; ureter to bladder. Living donor preferred (better outcomes). ABO compatible + crossmatch negative required. Immunosuppression: calcineurin inhibitors (tacrolimus/cyclosporine), mycophenolate, prednisolone. Rejection types: hyperacute, acute, chronic.","Urology Transplant High_Yield"
"What are the types of rejection in kidney transplant?","Hyperacute: minutes - hours (preformed antibodies, ABO/HLA incompatibility) - irreversible, must remove kidney. Accelerated acute: days (sensitized T cells). Acute cellular: weeks-months (T cell mediated, reversible with high-dose steroids/ATG). Chronic: months-years (antibody mediated, progressive fibrosis).","Urology Transplant"
"What is a Tonsillectomy?","Surgical removal of the palatine tonsils. Indications: recurrent tonsillitis (Paradise criteria: ≥7 episodes/year, or ≥5/year for 2 years, or ≥3/year for 3 years), peritonsillar abscess, obstructive sleep apnoea, suspected malignancy, chronic tonsillitis. Techniques: cold steel (dissection), electrocautery, coblation.","ENT High_Yield"
"What are the complications of Tonsillectomy?","1. Primary hemorrhage: within 24 hrs, reactionary (usually <6 hrs), primary (intraoperative) 2. Secondary hemorrhage: 5-10 days post-op (infection, sloughing of eschar) - most common significant complication 3. Pain 4. Airway obstruction (especially obese/OSA patients) 5. Nasopharyngeal stenosis (rare) 6. Referred otalgia","ENT"
"What is an Adenoidectomy?","Surgical removal of the adenoids (pharyngeal tonsil). Indications: adenoid hypertrophy causing nasal obstruction/mouth breathing, otitis media with effusion (OME/glue ear - with grommet insertion), OSA, recurrent rhinosinusitis. Often done with tonsillectomy (T&A) in children. Risk: velopharyngeal insufficiency (nasal voice).","ENT"
"What is a Septoplasty?","Surgical correction of a deviated nasal septum (DNS) to improve nasal airflow. Submucosal resection (SMR) or septoplasty (more conservative). Indications: symptomatic DNS causing nasal obstruction not responding to medical treatment, sinusitis, epistaxis. Can be combined with turbinate reduction. Rhinoplasty for cosmetic reshaping.","ENT"
"What is a Tympanoplasty?","Surgical repair of the tympanic membrane (eardrum) perforation +/- ossicular chain reconstruction. Type I (myringoplasty): repair of TM perforation only. Types II-V: include ossicular reconstruction. Materials: temporalis fascia, perichondrium, fat. Used for chronic suppurative otitis media (CSOM), hearing loss.","ENT"
"What is a Mastoidectomy?","Surgical removal of mastoid air cells. Cortical mastoidectomy: removes mastoid cells while preserving canal wall. Radical mastoidectomy: removes mastoid + posterior canal wall + ossicles (creates mastoid bowl). Modified radical: preserves some ossicles. Indications: cholesteatoma, chronic otitis media, mastoiditis, cochlear implant.","ENT"
"What is a Tracheostomy?","Surgical or percutaneous creation of an opening into the trachea. Indications: prolonged ventilation, upper airway obstruction, to facilitate weaning, secretion management, head/neck surgery. Emergency: cricothyroidotomy preferred if rapid airway access needed. Complications: hemorrhage, infection, tracheomalacia, tracheoesophageal fistula, tube displacement.","ENT General_Surgery High_Yield"
"What is FESS?","Functional Endoscopic Sinus Surgery - endoscopic surgery to open sinus drainage pathways and remove diseased tissue. Indications: chronic rhinosinusitis refractory to medical treatment, nasal polyps, sinus mucocele, fungal sinusitis, selected tumors. Complications: orbital injury (most serious - blindness), CSF leak, anosmia, epistaxis.","ENT"
"What is Cataract Surgery?","Removal of the clouded crystalline lens and replacement with an intraocular lens (IOL). Most common surgical procedure worldwide. Phacoemulsification (ultrasonic) + IOL insertion via small incision is standard. Extracapsular and intracapsular techniques also used. Most done under LA. Complications: posterior capsule opacification (most common late), endophthalmitis (most serious).","Ophthalmology High_Yield"
"What are the types of IOL used in cataract surgery?","Monofocal IOL: corrects for one distance (near or far). Multifocal IOL: corrects multiple distances. Toric IOL: corrects astigmatism. Accommodating IOL: mimics natural accommodation. Target refraction planned pre-operatively using biometry (IOLMaster). Most patients end up with monofocal IOL targeting distance.","Ophthalmology"
"What is Trabeculectomy?","Glaucoma filtering surgery - creates a new drainage pathway (bleb) for aqueous humour to bypass blocked trabecular meshwork and lower IOP. Used when medical/laser treatment fails. Antimetabolites (mitomycin C, 5-FU) used to prevent scarring. Complications: hypotony, bleb failure, bleb-related infection (blebitis), cataract, macular edema.","Ophthalmology"
"What is a Vitrectomy?","Surgical removal of the vitreous gel from the eye. Pars plana vitrectomy (PPV) via small incisions. Indications: vitreous haemorrhage, retinal detachment (complex), macular hole, epiretinal membrane, endophthalmitis, foreign body, diabetic tractional retinal detachment. Tamponades used: gas (SF6, C3F8) or silicone oil.","Ophthalmology"
"What is a Corneal Transplant (Keratoplasty)?","Surgical replacement of diseased cornea with donor cornea. Full thickness: Penetrating Keratoplasty (PK). Partial: Lamellar (DALK - anterior, DMEK/DSAEK - posterior/endothelial). Indications: keratoconus (most common in young), Fuchs endothelial dystrophy, corneal scarring, bullous keratopathy. Risk of rejection (immune privilege of cornea is relative).","Ophthalmology"
"What is LASIK?","Laser-Assisted In Situ Keratomileusis - refractive surgery to correct myopia, hyperopia, astigmatism. Corneal flap created (microkeratome or femtosecond laser), excimer laser reshapes stroma, flap replaced. Advantages: rapid recovery, minimal pain. Contraindications: thin cornea, keratoconus, severe dry eyes, unstable refraction. Alternative: LASEK, PRK, SMILE.","Ophthalmology"
"What is Retinal Detachment Repair?","Surgical reattachment of the retina. Types: rhegmatogenous (tear), tractional, exudative. Procedures: 1. Pneumatic retinopexy (gas bubble injection) 2. Scleral buckling (indent sclera to close break) 3. Vitrectomy + tamponade (gas/silicone oil). Macula-on detachment: surgical emergency (better prognosis). Symptoms: floaters, flashing lights, shadow/curtain.","Ophthalmology"
"What is Skin Grafting?","Transfer of skin from donor to recipient site. Split-thickness skin graft (STSG): epidermis + part dermis - harvested with dermatome, meshed to expand, used for large wounds, donor site heals. Full-thickness skin graft (FTSG): epidermis + full dermis - better cosmesis, no meshing, used for face/hands. Graft failure causes: infection, haematoma, shear, poor bed.","Plastic_Surgery High_Yield"
"What is Flap Surgery?","Transfer of tissue (skin + subcutaneous tissue +/- muscle, bone) with its own blood supply. Local flap: adjacent tissue rotated/transposed. Regional: pedicled (e.g., TRAM flap for breast). Free flap: completely detached and microsurgically anastomosed to recipient vessels. Common free flaps: TRAM, DIEP, latissimus dorsi, ALT (anterolateral thigh), fibula (jaw reconstruction).","Plastic_Surgery"
"What is Rhinoplasty?","Cosmetic or functional surgery to reshape the nose. Open (external incision at columella) or closed approach. Can address: dorsal hump, nasal tip, width, deviation. Functional rhinoplasty for DNS with cosmetic correction = septorhinoplasty. Complications: asymmetry, nasal obstruction, cartilage/bone irregularities, saddle nose deformity.","Plastic_Surgery"
"What is Cleft Lip/Palate Repair?","Cleft lip: repaired at ~3 months (rule of 10s: 10 weeks, 10 lbs, Hb >10). Cleft palate: repaired at 6-18 months (before speech development). Techniques: Millard rotation-advancement (cleft lip). Aims: restore Cupid's bow, philtrum. Team approach: surgeon, speech therapist, orthodontist, ENT. Cleft palate - Passavant's ridge, VPI.","Plastic_Surgery Pediatric_Surgery"
"What is Angioplasty?","Endovascular procedure to widen narrowed/blocked arteries. Balloon angioplasty +/- stent insertion (bare metal or drug-eluting). Coronary (PCI), peripheral, carotid, renal. Percutaneous Transluminal Coronary Angioplasty (PTCA/PCI): preferred for STEMI (primary PCI within 90 min), acute coronary syndromes, symptomatic CAD. Complications: restenosis, dissection, perforation, stroke (carotid).","Vascular_Surgery High_Yield"
"What is an Endarterectomy?","Surgical removal of atherosclerotic plaque from an artery. Carotid endarterectomy (CEA): for symptomatic carotid stenosis >50% (NASCET criteria) or asymptomatic >70%. Reduces stroke risk. CEA vs carotid stenting: CEA preferred in older patients, stenting for high surgical risk. Femoral endarterectomy also performed.","Vascular_Surgery"
"What is Bypass Grafting in Vascular Surgery?","Surgical creation of a new blood flow route around a blocked vessel. Aortobifemoral bypass (aortoiliac occlusion - Leriche syndrome), femoropopliteal bypass (SFA occlusion), femorodistal bypass. Conduit: autologous vein (long saphenous - best), PTFE/Dacron synthetic. Leriche syndrome: aortoiliac occlusion - claudication, impotence, absent femoral pulses.","Vascular_Surgery"
"What is an AV Fistula?","Surgically created connection between an artery and vein, usually for haemodialysis access. Sites: radiocephalic (Brescia-Cimino - wrist, preferred), brachiocephalic (elbow), brachiobasilic (transposed). Matures in 6-12 weeks. Complications: thrombosis (most common), steal syndrome, aneurysm, infection, high-output cardiac failure, venous hypertension.","Vascular_Surgery"
"What is Varicose Vein Surgery?","Treatment of dilated, tortuous superficial veins due to incompetent valves. Investigations: duplex ultrasound (map incompetent perforators and SFJ/SPJ reflux). Treatments: NICE guidelines prefer endovenous (EVLA/RFA) over surgery. Surgical: saphenofemoral ligation + stripping + stab avulsions. Complications: bruising, DVT, nerve injury (saphenous nerve), recurrence.","Vascular_Surgery"
"What is Aortic Aneurysm Repair?","Treatment of aortic aneurysm (AAA most common). Indications for repair: >5.5 cm (male), >5 cm (female), rapid expansion (>1 cm/year), symptomatic. EVAR (Endovascular Aneurysm Repair) preferred if anatomy suitable - less invasive, faster recovery. Open repair: aortic cross-clamping + Dacron graft. EVAR complications: endoleak (most common), graft migration, limb occlusion.","Vascular_Surgery"
"What is Hypospadias Repair?","Correction of hypospadias - congenital abnormality where urethral meatus opens on ventral surface of penis (glanular, penile, penoscrotal, perineal). Repair at 6-18 months. Objectives: straighten penis (chordee correction), create tubularized urethra, move meatus to tip. Techniques: MAGPI, TIP (Snodgrass), Mathieu. Circumcision must NOT be done before repair (foreskin used for reconstruction).","Pediatric_Surgery Urology"
"What is a Pyloromyotomy (Ramstedt's)?","Surgical splitting of the hypertrophied pyloric muscle without entering the mucosa. Treatment for infantile hypertrophic pyloric stenosis (IHPS). IHPS: presents at 3-6 weeks of age with projectile (non-bilious) vomiting, hungry baby, palpable 'olive' mass, hypochloraemic hypokalaemic metabolic alkalosis. Correct electrolytes BEFORE surgery. Can be open or laparoscopic.","Pediatric_Surgery"
"What are the metabolic abnormalities in pyloric stenosis?","Hypochloraemic, hypokalaemic metabolic alkalosis with paradoxical aciduria. Due to loss of HCl in vomit → metabolic alkalosis → kidney conserves H+ and excretes K+. Correct with IV normal saline + potassium chloride before surgery. Surgery is NOT an emergency - metabolic correction is the priority.","Pediatric_Surgery"
"What is a Herniotomy?","High ligation of the patent processus vaginalis (hernia sac) without floor repair. Used in children for indirect inguinal hernia. Unlike adult herniorrhaphy (floor repair needed), children have a strong posterior wall - only sac ligation required. Bilateral exploration may be needed in young children (high risk of contralateral patent processus).","Pediatric_Surgery"
"What is Hirschsprung Disease Surgery?","Surgical treatment of Hirschsprung disease (congenital absence of ganglion cells - aganglionic segment, always includes internal sphincter, extends proximally). Pull-through procedure: resect aganglionic bowel, pull normally innervated bowel to anus. Techniques: Swenson, Duhamel, Soave. Initial colostomy in sick neonates. Diagnose by suction rectal biopsy (absence of ganglion cells).","Pediatric_Surgery"
"What is an Ileostomy?","Surgical exteriorization of the ileum onto the abdominal wall. Loop ileostomy: temporary, defunctioning (commonly used before low anterior resection, ileal pouch-anal anastomosis). End ileostomy: permanent (after total colectomy + proctectomy). Brooke ileostomy - spout above skin. Complications: high output (dehydration), skin excoriation, prolapse, retraction, parastomal hernia.","Gastrointestinal_Surgery"
"What is a Colostomy?","Surgical exteriorization of the colon onto the abdominal wall. End colostomy: permanent - after AP resection of rectum (Hartmann's procedure). Loop colostomy: defunctioning, temporary. Site: transverse (right hypochondrium) or sigmoid (left iliac fossa - most common for Hartmann's). Flush with skin. Complications: prolapse, retraction, stenosis, parastomal hernia.","Gastrointestinal_Surgery"
"What is Bariatric Surgery?","Surgical treatment for morbid obesity. Types: 1. Restrictive - sleeve gastrectomy (most popular), adjustable gastric banding 2. Malabsorptive - biliopancreatic diversion 3. Combined - Roux-en-Y gastric bypass (RYGB, gold standard for type 2 DM remission). Indications: BMI ≥40 or ≥35 with comorbidities, failed conservative treatment.","Gastrointestinal_Surgery"
"What is the Whipple Procedure (Pancreaticoduodenectomy)?","Major resection for periampullary/pancreatic head malignancy. Removes: head of pancreas + duodenum + gallbladder + distal bile duct + distal stomach (standard) or pylorus-preserving Whipple. Reconstruction: pancreaticojejunostomy + hepaticojejunostomy + gastrojejunostomy. Highest morbidity pancreatic operation. Complications: delayed gastric emptying (most common), pancreatic fistula, haemorrhage, bile leak.","Gastrointestinal_Surgery Hepatobiliary_Surgery"
"What is Fundoplication (Nissen's)?","Surgical treatment for GORD - wraps gastric fundus 360° around lower oesophagus (Nissen 360°, Toupet 270° posterior, Dor 180° anterior). Laparoscopic approach preferred. Indications: GORD refractory to PPI, large hiatus hernia, complications (Barrett's). Complications: dysphagia (most common early), gas bloat syndrome, wrap disruption/slippage.","Gastrointestinal_Surgery"
"What is a Hepatectomy?","Surgical resection of part or all of the liver. Right hepatectomy (segments V-VIII), left hepatectomy (II-IV), extended hepatectomy, segmentectomy. Liver can regenerate (requires >25-30% functional remnant). Indications: hepatocellular carcinoma (HCC), colorectal liver metastases, cholangiocarcinoma, benign lesions (large haemangioma, adenoma). Pringle manoeuvre: occludes hepatoduodenal ligament to control intraoperative bleeding.","Hepatobiliary_Surgery"
"What is the Child-Pugh score?","Scoring system for liver disease severity and surgical risk. Parameters (each scored 1-3): Bilirubin, Albumin, PT/INR, Ascites, Encephalopathy. Total: A (5-6) = well-compensated; B (7-9) = significant; C (10-15) = decompensated. Child C = prohibitive surgical risk for major hepatectomy.","Hepatobiliary_Surgery"
"What is a Liver Transplant?","Transplantation of whole or partial liver from deceased or living donor. Orthotopic (replace native liver in same position). Indications: end-stage liver disease (cirrhosis), acute liver failure (paracetamol overdose), HCC (Milan criteria), metabolic liver disease (Wilson's, A1AT deficiency). MELD score used for allocation. Complications: primary non-function, hepatic artery thrombosis (most feared early complication).","Hepatobiliary_Surgery Transplant"
"What are the Milan Criteria for liver transplant in HCC?","Single nodule ≤5 cm OR up to 3 nodules, each ≤3 cm, with no vascular invasion or extrahepatic spread. Within Milan criteria: good outcomes with liver transplant. Beyond Milan: UCSF criteria (single ≤6.5 cm or ≤3 nodules, largest ≤4.5 cm, total ≤8 cm) used by some centres.","Hepatobiliary_Surgery Transplant"
"What is Biliary Reconstruction?","Surgical restoration of biliary drainage. Hepaticojejunostomy (Roux-en-Y): most common - joins bile duct to jejunum, bypasses duodenum. Indications: bile duct injury, biliary stricture, post-Whipple, PSC, biliary atresia (Kasai portoenterostomy). Choledochoduodenostomy: bile duct to duodenum (for distal CBD obstruction, less used).","Hepatobiliary_Surgery"
"What is a Radical Mastectomy?","Halsted radical mastectomy: removes breast + overlying skin + pectoralis major + pectoralis minor + axillary LN. Rarely performed today - replaced by Modified Radical Mastectomy (MRM) which preserves pectoralis major. Simple mastectomy + SLNB (sentinel lymph node biopsy) for early breast cancer. Radical mastectomy: historical, excessive morbidity.","Oncosurgery"
"What is a Radical Hysterectomy (Wertheim's)?","Extended hysterectomy for cervical cancer. Removes: uterus + cervix + upper 1/3 vagina + parametria + uterosacral ligaments + pelvic lymph nodes. Wertheim's hysterectomy (abdominal). Indications: FIGO Stage IB1-IIA cervical cancer. Complications: bladder/ureter/bowel injury, lymphoedema, bladder dysfunction (neurogenic), sexual dysfunction.","Oncosurgery"
"What is a Neck Dissection?","Surgical removal of lymph nodes in the neck for head and neck malignancy. Radical neck dissection (RND): removes all 5 node levels + SCM + IJV + CN XI. Modified radical (MRND): preserves some structures. Selective neck dissection: specific node levels based on primary site. CN XI injury: shoulder drop (trapezius dysfunction). Chyle leak: injury to thoracic duct (left neck).","Oncosurgery"
"What is Cytoreductive Surgery (Debulking)?","Surgical removal of as much tumor as possible when complete resection is not feasible. Used in ovarian cancer (primary debulking surgery + HIPEC in selected cases), mesothelioma. Goal: optimal debulking (<1 cm residual). Associated with HIPEC (Hyperthermic Intraperitoneal Chemotherapy) for peritoneal carcinomatosis. Improves survival when combined with chemotherapy.","Oncosurgery"
"What is a Pancreas Transplant?","Transplantation of whole or partial pancreas. Usually combined with kidney transplant (SPK - simultaneous pancreas-kidney, most common). Indications: Type 1 diabetes with end-stage renal disease (SPK), T1DM alone (PAK - pancreas after kidney). Aims to achieve insulin independence. Complications: graft thrombosis (most common early failure), rejection, pancreatitis.","Transplant"
"What is a Bone Marrow Transplant (HSCT)?","Haematopoietic Stem Cell Transplantation - infusion of HSCs to reconstitute haematopoiesis. Autologous (self - no GvHD risk, higher relapse) vs allogeneic (donor - GvHD risk, lower relapse - graft vs leukaemia effect). Indications: leukaemia, lymphoma, myeloma, aplastic anaemia, haemoglobinopathies. Conditioning: myeloablative or reduced intensity. GvHD: acute (<100 days) and chronic (>100 days).","Transplant"
"What is Graft-versus-Host Disease (GvHD)?","Complication of allogeneic HSCT where donor T cells attack recipient tissues. Acute GvHD (<100 days): skin (rash), liver (jaundice), GI (diarrhoea). Chronic (>100 days): resembles autoimmune disease (scleroderma-like). Treatment: high-dose steroids (first line), calcineurin inhibitors, MMF, ruxolitinib (refractory). Prevention: HLA matching, T cell depletion.","Transplant"
"What is Tooth Extraction?","Surgical removal of a tooth. Simple (forceps) or surgical (flap + bone removal). Complications: dry socket (alveolar osteitis - most common - 3-5 days post-op, dull aching pain, empty socket), haemorrhage, nerve injury (inferior alveolar nerve - numbness of lower lip), jaw fracture, oro-antral fistula (upper molar extraction).","Oral_Maxillofacial"
"What is Mandibular Fracture Fixation?","Surgical treatment of mandibular fractures. Most common facial fracture site: condyle/subcondylar, followed by body (angle and parasymphysis). Open Reduction Internal Fixation (ORIF) with mini-plates and screws. Intermaxillary fixation (IMF) - wiring jaws together - conservative approach. Signs: malocclusion, step deformity, hypoaesthesia of lower lip (inferior alveolar nerve).","Oral_Maxillofacial"
"What is TMJ Surgery?","Surgical treatment of temporomandibular joint disorders. Conservative: splint, physio, NSAIDs. Surgical: arthrocentesis (irrigation), arthroscopy, arthroplasty (disc repositioning/plication), condylectomy, total joint replacement. Indications: internal derangement not responding to conservative, ankylosis, OA, tumours, fractures.","Oral_Maxillofacial"
"What is Orthognathic Surgery?","Surgical repositioning of the jaws to correct skeletal discrepancies. Le Fort I osteotomy (maxilla), bilateral sagittal split osteotomy (BSSO - mandible), genioplasty (chin). Combined for bimaxillary surgery. Indications: Class II/III skeletal malocclusion, OSA, facial asymmetry, cleft-related deformities. Done after skeletal growth complete (~18 yrs female, ~21 yrs male).","Oral_Maxillofacial"
"What is Damage Control Surgery?","Abbreviated, staged operative strategy for severely injured/physiologically compromised patients. Phase 1: hemorrhage control (packing, vascular shunting) + contamination control (bowel stapling) - quick closure. Phase 2: ICU resuscitation (correct lethal triad: hypothermia, acidosis, coagulopathy). Phase 3: definitive repair 24-48 hrs later. Indications: lethal triad, massive transfusion, time-critical situation.","Emergency_Surgery Trauma"
"What is the 'Lethal Triad' in trauma?","Hypothermia + Acidosis + Coagulopathy. Each worsens the others in a vicious cycle. Hypothermia: impairs coagulation cascade enzymes. Acidosis: from poor perfusion and resuscitation with saline. Coagulopathy: dilutional, consumptive, hypothermic. Prevention/treatment: damage control surgery, massive transfusion protocol, warming, TXA (tranexamic acid).","Emergency_Surgery Trauma"
"What is an Exploratory Laparotomy?","Surgical exploration of the abdominal cavity when diagnosis is uncertain or for management of abdominal emergency. Indications: penetrating abdominal trauma, peritonitis, bowel obstruction with strangulation, mesenteric ischaemia, ruptured AAA, unclear cause of acute abdomen. Midline incision preferred for access. 'Trauma laparotomy' - damage control principles applied.","Emergency_Surgery"
"What is a Chest Tube Insertion (Intercostal Drain)?","Insertion of a tube into the pleural space to drain air, blood, fluid, or pus. Indications: pneumothorax (tension/large), haemothorax, pleural effusion, empyema, post-thoracic surgery. Site: 5th intercostal space, anterior to mid-axillary line (safe triangle). Insert over upper border of rib (to avoid neurovascular bundle - runs under lower rib).","Emergency_Surgery Bedside_Procedures"
"What is a Fasciotomy?","Surgical incision through fascia to relieve compartment syndrome. Compartment syndrome: pressure within closed compartment >30 mmHg (or within 30 mmHg of diastolic BP) causing ischaemia. 4 P's: Pain (disproportionate, with passive stretch), Pressure, Paresthesia, Paralysis (late). Fasciotomy must be done within 6 hours to prevent permanent muscle necrosis.","Emergency_Surgery Orthopedic_Surgery"
"What are the signs of Compartment Syndrome?","The 6 P's: Pain (on passive stretch - earliest and most reliable), Pressure (tense compartment), Paresthesia, Paralysis, Pallor, Pulselessness (late signs). Compartment pressure >30 mmHg or <30 mmHg of diastolic BP = indication for fasciotomy. Causes: fracture (most common - distal radius, tibial shaft), crush injury, circumferential burns, tight casts.","Emergency_Surgery Orthopedic_Surgery"
"What is an Emergency Craniotomy?","Urgent surgical opening of the skull for life-threatening intracranial pathology. Indications: acute extradural haematoma (EDH - 'talk and die' phenomenon, lens-shaped on CT, middle meningeal artery), acute subdural haematoma (ASDH - more severe brain injury, crescent-shaped), depressed skull fracture with brain compression, penetrating head trauma. EDH: burr hole on ipsilateral side to blown (dilated, unreactive) pupil.","Emergency_Surgery Neurosurgery"
"What is the CT appearance of Extradural vs Subdural Haematoma?","Extradural haematoma (EDH): biconvex (lens-shaped), hyperdense, does not cross suture lines, usually temporal (middle meningeal artery). Subdural haematoma (SDH): concave (crescent-shaped), follows brain contour, crosses suture lines. Acute SDH: hyperdense. Subacute: isodense. Chronic: hypodense (elderly, anticoagulated).","Emergency_Surgery Neurosurgery"
"What is Suturing technique?","Closure of wound edges using suture material. Simple interrupted: most common. Mattress: horizontal/vertical - stronger, for tension. Continuous/running: faster. Subcuticular: cosmetic (buried). Suture removal: face 3-5d, scalp 7-10d, trunk/limb 10-14d, joints 14d. Absorbable: Vicryl, PDS, catgut. Non-absorbable: nylon (Prolene/Ethilon), silk.","Bedside_Procedures"
"What is Incision and Drainage (I&D)?","Surgical drainage of an abscess. Incision made at point of maximum fluctuance, pus drained, cavity broken up (loculations), irrigated with saline, cavity packed with ribbon gauze or left open to heal by secondary intention. Antibiotics NOT routinely needed (pus drained). Send pus for culture. Exception: cellulitis without fluctuance - not an abscess, treat with antibiotics.","Bedside_Procedures"
"What is a Biopsy?","Tissue sampling for histological diagnosis. Types: Fine needle aspiration (FNA) - cytology, no architecture. Core/Tru-cut biopsy - histology, preserves architecture. Incisional: partial excision. Excisional: complete excision of lesion. Sentinel lymph node biopsy (SLNB): first draining node - if negative, axillary dissection avoided (breast cancer, melanoma).","Bedside_Procedures"
"What is a Central Venous Catheter (CVC)?","Catheter placed into large central vein (IJV, subclavian, femoral). Uses: CVP monitoring, drug/TPN infusion, haemofiltration. Seldinger technique: needle → guidewire → dilator → catheter. Complications: pneumothorax (subclavian/IJV), arterial puncture, haematoma, air embolism, infection (CLABSI), thrombosis. Ultrasound guidance recommended (reduces complications).","Bedside_Procedures"
"What is a PEG Tube?","Percutaneous Endoscopic Gastrostomy - feeding tube placed through abdominal wall into stomach under endoscopic guidance. Indications: inability to swallow (stroke, head/neck cancer, neurological disease, facial trauma), prolonged feeding requirement >4 weeks. Complications: peristomal infection/leakage (most common), buried bumper syndrome, aspiration pneumonia, bleeding, peritonitis.","Bedside_Procedures"
"What is the Sentinel Lymph Node Biopsy?","Sampling of the first lymph node to receive drainage from a primary tumour (sentinel node). Used in breast cancer and melanoma staging. Technique: radioactive colloid ± blue dye injected around tumour → identifies sentinel node → excised → if negative for metastasis → no further lymph node dissection needed. Reduces morbidity of axillary/groin clearance.","Oncosurgery Bedside_Procedures"
"What is a Whipple Procedure and what are its indications?","Pancreaticoduodenectomy - removes head of pancreas + duodenum + gallbladder + distal common bile duct + distal stomach. Reconstruction: three anastomoses. Indications: pancreatic head adenocarcinoma, periampullary tumors (ampullary carcinoma, cholangiocarcinoma, duodenal cancer), chronic pancreatitis (Frey/Beger alternatives). 5-year survival for pancreatic cancer: ~25% with resection.","Gastrointestinal_Surgery Hepatobiliary_Surgery High_Yield"
"What is Spinal Fixation?","Surgical stabilization of the spine using screws, rods, plates, or cages. Indications: fractures with instability, tumors, spinal deformity (scoliosis - Harrington rods), failed conservative treatment of disc disease. Pedicle screws most common. Can be posterior (most common), anterior, or circumferential (360°). Complications: hardware failure, adjacent segment disease, infection, neurological injury.","Orthopedic_Surgery Neurosurgery"
"What is the difference between Oophorectomy and Salpingo-oophorectomy?","Oophorectomy: removal of ovary only. Salpingo-oophorectomy: removal of fallopian tube + ovary together. Bilateral salpingo-oophorectomy (BSO) causes surgical menopause. BSO indicated for ovarian cancer, endometriosis, prophylactic in BRCA1/2 mutation carriers (reduces ovarian cancer risk by ~80%). Risk-reducing surgery in BRCA1 at age 35-40, BRCA2 at 40-45.","Obstetrics_Gynecology"
"What is Deep Brain Stimulation used for in Parkinson's Disease?","DBS of subthalamic nucleus (STN) or globus pallidus internus (GPi) reduces motor symptoms in advanced PD. Benefits: reduces 'off' time, allows medication reduction, improves tremor/rigidity/bradykinesia/dyskinesia. Best for: patients with motor fluctuations/dyskinesia despite optimal medical therapy, preserved cognition. NOT for patients with dementia, psychiatric comorbidities, or atypical parkinsonism.","Neurosurgery"
"What is the ABCDE approach in trauma relevant to emergency surgery?","A - Airway + C-spine protection. B - Breathing + ventilation. C - Circulation + haemorrhage control. D - Disability (GCS, pupils). E - Exposure + Environment (remove clothes, prevent hypothermia). Primary survey aims to identify life-threatening injuries. Massive transfusion protocol: blood + FFP + platelets in 1:1:1 ratio. TXA within 3 hours of injury.","Emergency_Surgery Trauma"
"What are the indications for Emergency Splenectomy vs Splenic Conservation?","Emergency splenectomy: haemodynamically unstable splenic injury, grade IV-V (AAST) injury with active bleeding not responding to angioembolization. Splenic conservation (NOM - non-operative management): haemodynamically stable, grades I-III, CT confirms injury. Success rate of NOM: ~90%. Post-splenectomy vaccination mandatory. NOM preferred to preserve immune function.","Emergency_Surgery General_Surgery"