Surgery is one of the highest-weightage subjects in the FMGE. Based on an analysis of question patterns from the last decade, the topics listed below are consistently high-yield. They are categorized to help you prioritize your revision. ### **Core General Surgery** * **Wound Healing:** Stages of healing, types of wounds, and suture materials (absorbable vs. non-absorbable). * **Shock & Fluid Resuscitation:** Types of shock (hypovolemic, septic, cardiogenic), Parkland formula for burns, and fluid management. * **Trauma:** ATLS protocol (ABCDE), Glasgow Coma Scale (GCS), FAST ultrasound, and grading of splenic/liver trauma. * **Surgical Infections:** Principles of sterilization, surgical site infections, and conditions like necrotizing fasciitis or gas gangrene. ### **Gastrointestinal & Hepatobiliary Surgery** * **Acute Abdomen:** Appendicitis (Alvarado score), peritonitis, and intestinal obstruction (X-ray findings). * **Hernia:** Inguinal (direct vs. indirect), femoral (most common in females), umbilical, and surgical management. * **Hepatobiliary/Pancreas:** Gallstones (USG investigations), acute cholecystitis (Murphy’s sign), obstructive jaundice, and pancreatic carcinoma (Whipple procedure). * **Stomach/Esophagus:** Peptic ulcer disease (complications), Achalasia cardia, and gastric carcinoma (staging and nodes). * **Colorectal:** Hemorrhoids, fissures, fistula-in-ano, and colorectal carcinoma (Duke’s staging). ### **Oncology & Endocrine Surgery** * **Breast Surgery:** Fibroadenoma vs. fibrocystic disease, triple assessment, and carcinoma breast (staging and management). * **Thyroid:** Thyroid nodules, thyroid cancers (Papillary is most common), and management of thyroidectomy complications (recurrent laryngeal nerve injury). * **Endocrine Emergencies:** Pheochromocytoma (alpha-blocker prep) and Zollinger-Ellison syndrome. ### **Urology & Vascular Surgery** * **Urology:** BPH vs. prostate carcinoma (PSA levels), renal calculi (imaging/gold standard), and testicular torsion vs. epididymo-orchitis. * **Vascular:** DVT (Virchow’s triad), varicose veins (Trendelenburg test), and aortic aneurysms (signs of rupture). ### **Strategic Revision Tips** * **Focus on Clinical Scenarios:** FMGE frequently asks about "next best step" or "most likely diagnosis" based on patient presentation (e.g., a patient with calf pain while walking, or a post-mastectomy patient with limb swelling). * **Prioritize Repeat Themes:** Topics like the "Rule of Nines," GCS, and specific hernia anatomy appear in almost every cycle. * **Use PYQs:** Because many FMGE questions are repeated or based on recurring concepts, practicing the last 10 years of question papers is the most effective way to identify the "must-know" facts. High-Yield Surgery Topics for FMGE This video is relevant because it provides a consolidated, high-yield revision list of the most frequently asked surgery topics in the FMGE, making it an excellent tool for quick final preparation.
mkdir -p /home/daytona/workspace/fmge-surgery && ls /home/daytona/workspace/fmge…
~/fmge-surgery/build_cheatsheet.py
from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import mm
from reportlab.platypus import (
SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
HRFlowable, KeepTogether
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT
from reportlab.platypus import PageBreak
OUTPUT = "/home/daytona/workspace/fmge-surgery/FMGE_Surgery_Cheatsheet.pdf"
# ── Colour palette ────────────────────────────────────────────────────────────
C_NAVY = colors.HexColor("#1A237E") # section headers
C_TEAL = colors.HexColor("#00695C") # subsection headers
C_AMBER = colors.HexColor("#F57F17") # highlight / key numbers
C_LTBLUE = colors.HexColor("#E3F2FD") # table row shade 1
C_LTGRN = colors.HexColor("#E8F5E9") # table row shade 2
C_LTYELL = colors.HexColor("#FFFDE7") # table row shade 3
C_WHITE = colors.white
C_LTRED = colors.HexColor("#FFEBEE")
# ── Document ──────────────────────────────────────────────────────────────────
doc = SimpleDocTemplate(
OUTPUT,
pagesize=A4,
leftMargin=12*mm, rightMargin=12*mm,
topMargin=14*mm, bottomMargin=14*mm,
title="FMGE High-Yield Surgery Cheat Sheet",
author="Orris Medical"
)
W, H = A4
CONTENT_W = W - 24*mm
# ── Styles ────────────────────────────────────────────────────────────────────
base = getSampleStyleSheet()
def ps(name, parent="Normal", **kw):
return ParagraphStyle(name, parent=base[parent], **kw)
S = {
"title" : ps("title", fontSize=20, textColor=C_WHITE, alignment=TA_CENTER,
fontName="Helvetica-Bold", spaceAfter=0),
"subtitle": ps("subtitle",fontSize=10, textColor=colors.HexColor("#CFD8DC"),
alignment=TA_CENTER, fontName="Helvetica", spaceAfter=0),
"sec" : ps("sec", fontSize=11, textColor=C_WHITE, fontName="Helvetica-Bold",
spaceAfter=2, spaceBefore=6),
"subsec" : ps("subsec", fontSize=9, textColor=C_TEAL, fontName="Helvetica-Bold",
spaceAfter=2, spaceBefore=4),
"body" : ps("body", fontSize=7.5, leading=11, spaceAfter=1),
"bullet" : ps("bullet", fontSize=7.5, leading=11, leftIndent=10,
firstLineIndent=-8, spaceAfter=1),
"key" : ps("key", fontSize=7.5, leading=11, textColor=C_AMBER,
fontName="Helvetica-Bold"),
"cell" : ps("cell", fontSize=7, leading=9.5),
"cellb" : ps("cellb", fontSize=7, leading=9.5, fontName="Helvetica-Bold"),
"tip" : ps("tip", fontSize=7, leading=10, textColor=colors.HexColor("#4A148C"),
fontName="Helvetica-Oblique"),
}
def bullet(text, style="bullet"):
return Paragraph(f"• {text}", S[style])
def kv(k, v):
return Paragraph(f"<b>{k}:</b> {v}", S["body"])
# ── Section banner ─────────────────────────────────────────────────────────────
def section_banner(title, colour=C_NAVY):
data = [[Paragraph(title, S["sec"])]]
t = Table(data, colWidths=[CONTENT_W])
t.setStyle(TableStyle([
("BACKGROUND", (0,0), (-1,-1), colour),
("TOPPADDING", (0,0), (-1,-1), 4),
("BOTTOMPADDING", (0,0), (-1,-1), 4),
("LEFTPADDING", (0,0), (-1,-1), 8),
("RIGHTPADDING", (0,0), (-1,-1), 8),
("ROUNDEDCORNERS", [4]),
]))
return t
# ── Two-column layout helper ───────────────────────────────────────────────────
def two_col(left_items, right_items, col_ratio=(1, 1)):
cw = [CONTENT_W * col_ratio[0]/(col_ratio[0]+col_ratio[1]),
CONTENT_W * col_ratio[1]/(col_ratio[0]+col_ratio[1])]
data = [[left_items, right_items]]
t = Table(data, colWidths=cw)
t.setStyle(TableStyle([
("VALIGN", (0,0), (-1,-1), "TOP"),
("LEFTPADDING", (0,0), (-1,-1), 4),
("RIGHTPADDING", (0,0), (-1,-1), 4),
("TOPPADDING", (0,0), (-1,-1), 0),
("BOTTOMPADDING",(0,0), (-1,-1), 0),
]))
return t
# ── Generic mini-table ─────────────────────────────────────────────────────────
def mini_table(headers, rows, col_widths=None, row_colors=None):
if col_widths is None:
n = len(headers)
col_widths = [CONTENT_W / n] * n
data = [[Paragraph(h, S["cellb"]) for h in headers]]
for row in rows:
data.append([Paragraph(str(c), S["cell"]) for c in row])
t = Table(data, colWidths=col_widths)
style_cmds = [
("BACKGROUND", (0,0), (-1,0), C_NAVY),
("TEXTCOLOR", (0,0), (-1,0), C_WHITE),
("FONTNAME", (0,0), (-1,0), "Helvetica-Bold"),
("FONTSIZE", (0,0), (-1,-1), 7),
("ROWBACKGROUNDS",(0,1), (-1,-1), [C_LTBLUE, C_WHITE]),
("GRID", (0,0), (-1,-1), 0.3, colors.HexColor("#B0BEC5")),
("TOPPADDING", (0,0), (-1,-1), 2),
("BOTTOMPADDING", (0,0), (-1,-1), 2),
("LEFTPADDING", (0,0), (-1,-1), 3),
("RIGHTPADDING", (0,0), (-1,-1), 3),
("VALIGN", (0,0), (-1,-1), "TOP"),
]
if row_colors:
for ri, c in row_colors:
style_cmds.append(("BACKGROUND", (0, ri), (-1, ri), c))
t.setStyle(TableStyle(style_cmds))
return t
# ═════════════════════════════════════════════════════════════════════════════
# CONTENT BUILD
# ═════════════════════════════════════════════════════════════════════════════
story = []
# ── TITLE BLOCK ───────────────────────────────────────────────────────────────
title_data = [
[Paragraph("FMGE HIGH-YIELD SURGERY", S["title"])],
[Paragraph("Quick-Reference Cheat Sheet | Last-Decade Question Pattern Analysis", S["subtitle"])],
]
title_t = Table(title_data, colWidths=[CONTENT_W])
title_t.setStyle(TableStyle([
("BACKGROUND", (0,0), (-1,-1), C_NAVY),
("TOPPADDING", (0,0), (-1,-1), 8),
("BOTTOMPADDING", (0,0), (-1,-1), 8),
("ROUNDEDCORNERS", [6]),
]))
story.append(title_t)
story.append(Spacer(1, 4*mm))
# ═══════════════════════════════════════════════════════
# SECTION 1 – CORE GENERAL SURGERY
# ═══════════════════════════════════════════════════════
story.append(section_banner("SECTION 1 — CORE GENERAL SURGERY"))
story.append(Spacer(1, 2*mm))
# ── 1A WOUND HEALING ──────────────────────────────────
wound_left = [
Paragraph("WOUND HEALING", S["subsec"]),
kv("Phase 1 – Haemostasis", "Immediate; platelets + clot"),
kv("Phase 2 – Inflammation", "Days 1–4; neutrophils → macrophages"),
kv("Phase 3 – Proliferation", "Days 4–21; fibroblasts, collagen III, angiogenesis"),
kv("Phase 4 – Remodelling", "Day 21 – 2 yr; collagen III → I; max tensile strength ~80%"),
Spacer(1, 2*mm),
Paragraph("Healing Types", S["subsec"]),
bullet("<b>1° (Primary intention)</b> – clean wound, edges apposed"),
bullet("<b>2° (Secondary intention)</b> – open wound, granulates"),
bullet("<b>3° (Delayed 1°)</b> – contaminated; closed after 3–5 days"),
Spacer(1, 2*mm),
Paragraph("KEY FACTS", S["subsec"]),
bullet("Collagen synthesis: Vitamin C dependent"),
bullet("Tensile strength peaks at 3 months"),
bullet("Keloid: beyond wound margin; Hypertrophic: within margin"),
]
suture_rows = [
["Absorbable", "Catgut (plain/chromic), Vicryl, PDS, Monocryl"],
["Non-absorbable", "Silk, Nylon, Prolene, Ethibond"],
["Longest absorption", "PDS (~180 days)"],
["Fastest absorption", "Plain catgut (~10–14 days)"],
["Monofilament NAS", "Nylon, Prolene – least infection risk"],
]
wound_right = [
Paragraph("SUTURE MATERIALS", S["subsec"]),
mini_table(["Type", "Examples"], suture_rows,
col_widths=[CONTENT_W*0.18, CONTENT_W*0.37]),
Spacer(1, 3*mm),
Paragraph("SURGICAL SITE INFECTION (SSI)", S["subsec"]),
bullet("Superficial incisional – skin/SQ tissue, <30 days"),
bullet("Deep incisional – fascia/muscle, <30 days"),
bullet("Organ/space – any anatomy opened"),
kv("Prophylaxis", "Cefazolin 60 min before incision"),
]
story.append(two_col(wound_left, wound_right))
story.append(Spacer(1, 3*mm))
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#CFD8DC")))
story.append(Spacer(1, 2*mm))
# ── 1B SHOCK ──────────────────────────────────────────
story.append(Paragraph("SHOCK & FLUID RESUSCITATION", S["subsec"]))
shock_rows = [
["Class I", "< 750", "< 15%", "> 100", "Normal", "Normal", "14–20", "Anxious", "Crystalloid"],
["Class II", "750–1500","15–30%","100–120", "Normal", "Decreased","20–30", "Agitated", "Crystalloid"],
["Class III","1500–2000","30–40%","120–140","Decreased","Decreased","30–40", "Confused", "Crystalloid+Blood"],
["Class IV", "> 2000", "> 40%", "> 140", "Decreased","Decreased","< 5", "Lethargic/Obtunded","Blood+Surgery"],
]
story.append(mini_table(
["Class", "Blood Loss (mL)", "% Vol", "HR", "SBP", "Pulse Pressure", "UO (mL/hr)", "CNS", "Fluid"],
shock_rows,
col_widths=[CONTENT_W*0.065, CONTENT_W*0.115, CONTENT_W*0.065, CONTENT_W*0.065,
CONTENT_W*0.075, CONTENT_W*0.11, CONTENT_W*0.085, CONTENT_W*0.15, CONTENT_W*0.17],
))
story.append(Spacer(1, 2*mm))
shock_types_rows = [
["Hypovolemic", "↓ CO, ↑ SVR, ↓ PCWP", "Crystalloid / Blood"],
["Septic (warm)","↑ CO, ↓ SVR, ↓ PCWP", "Fluids + Antibiotics + Noradrenaline"],
["Cardiogenic", "↓ CO, ↑ SVR, ↑ PCWP", "Inotropes (Dobutamine) + treat cause"],
["Neurogenic", "↓ CO, ↓ SVR, ↓ PCWP", "Vasopressors + fluids"],
["Obstructive", "↓ CO, ↑ SVR (PE/tamponade)", "Treat cause (thrombolyse / pericardiocentesis)"],
]
parkland_data = [[
Paragraph("PARKLAND FORMULA (Burns)", S["subsec"]),
Paragraph("4 mL × kg × TBSA(%)\n½ in first 8 h from time of burn\n½ in next 16 h\nFluid: Ringer's Lactate\nChildren: add maintenance (D5RL)", S["body"]),
]]
parkland_t = Table(parkland_data, colWidths=[CONTENT_W*0.28, CONTENT_W*0.72])
parkland_t.setStyle(TableStyle([
("BACKGROUND", (0,0), (0,0), C_TEAL),
("BACKGROUND", (1,0), (1,0), C_LTGRN),
("TEXTCOLOR", (0,0), (0,0), C_WHITE),
("VALIGN", (0,0), (-1,-1), "MIDDLE"),
("TOPPADDING", (0,0), (-1,-1), 4),
("BOTTOMPADDING", (0,0), (-1,-1), 4),
("LEFTPADDING", (0,0), (-1,-1), 5),
("BOX", (0,0), (-1,-1), 0.5, colors.HexColor("#80CBC4")),
]))
story.append(two_col(
mini_table(["Type", "Haemodynamics", "Management"],
shock_types_rows,
col_widths=[CONTENT_W*0.15, CONTENT_W*0.3, CONTENT_W*0.27]),
parkland_t,
col_ratio=(75, 25)
))
story.append(Spacer(1, 3*mm))
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#CFD8DC")))
story.append(Spacer(1, 2*mm))
# ── 1C TRAUMA ─────────────────────────────────────────
story.append(Paragraph("TRAUMA – ATLS PROTOCOL", S["subsec"]))
atls_rows = [
["A – Airway", "Protect cervical spine; jaw thrust; chin lift; OPA/NPA; RSI if needed"],
["B – Breathing", "Look/listen/feel; treat tension PTX (needle decompression 2nd ICS MCL) → chest drain 5th ICS AAL"],
["C – Circulation", "2 large-bore IVs; 1 L RL bolus; haemorrhage control; FAST exam"],
["D – Disability", "GCS; pupils; lateralising signs; blood glucose"],
["E – Exposure", "Log roll; examine back; prevent hypothermia"],
]
story.append(mini_table(["Step", "Action"], atls_rows,
col_widths=[CONTENT_W*0.12, CONTENT_W*0.88]))
story.append(Spacer(1, 2*mm))
gcs_rows = [
["Eye", "4 – Spontaneous", "3 – To voice", "2 – To pain", "1 – None", ""],
["Verbal","5 – Oriented", "4 – Confused", "3 – Words", "2 – Sounds","1 – None"],
["Motor", "6 – Obeys", "5 – Localises","4 – Withdraws","3 – Abnormal flexion","2–1 Extend/None"],
]
splenic_rows = [
["Grade I", "Haematoma < 10% surface; laceration < 1 cm depth"],
["Grade II", "Haematoma 10–50%; laceration 1–3 cm"],
["Grade III","Haematoma > 50% or expanding; laceration > 3 cm"],
["Grade IV", "Laceration involving segmental/hilar vessels"],
["Grade V", "Shattered spleen / hilar devascularisation"],
]
story.append(two_col(
[
Paragraph("GLASGOW COMA SCALE (max 15, min 3)", S["subsec"]),
mini_table(["Component", "5/6", "4/5", "3/4", "2/3", "1"],
gcs_rows,
col_widths=[CONTENT_W*0.07, CONTENT_W*0.13, CONTENT_W*0.12,
CONTENT_W*0.12, CONTENT_W*0.14, CONTENT_W*0.13]),
Spacer(1,2*mm),
Paragraph("Severe TBI: GCS ≤ 8 → intubate", S["key"]),
],
[
Paragraph("SPLENIC TRAUMA GRADING (AAST)", S["subsec"]),
mini_table(["Grade","Description"], splenic_rows,
col_widths=[CONTENT_W*0.07, CONTENT_W*0.35]),
kv("Mgmt", "Grade I–III → NOM if haemodynamically stable; Grade IV–V → surgery"),
],
col_ratio=(62, 38)
))
story.append(Spacer(1, 3*mm))
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#CFD8DC")))
story.append(Spacer(1, 2*mm))
# ── 1D SURGICAL INFECTIONS ────────────────────────────
infect_left = [
Paragraph("STERILISATION vs DISINFECTION", S["subsec"]),
kv("Sterilisation", "Kills ALL organisms incl. spores"),
kv("Disinfection", "Kills most pathogens, NOT spores"),
Spacer(1,1*mm),
Paragraph("METHODS", S["subsec"]),
bullet("<b>Autoclave</b> – 134°C/3 min or 121°C/15 min (gold standard for instruments)"),
bullet("<b>Dry heat</b> – 160°C/60 min (oils, powders)"),
bullet("<b>ETO gas</b> – heat-sensitive items (scopes, plastics)"),
bullet("<b>Glutaraldehyde</b> – 2% for endoscopes (high-level disinfection)"),
bullet("<b>Gamma radiation</b> – single-use disposables"),
Spacer(1,1*mm),
Paragraph("PRION inactivation: 134°C autoclave × 18 min", S["key"]),
]
infect_right = [
Paragraph("NECROTISING FASCIITIS (NF)", S["subsec"]),
bullet("<b>Type I</b> – polymicrobial (Clostridium + aerobes)"),
bullet("<b>Type II</b> – Group A Strep (GAS) → toxic shock"),
kv("Signs", '"Dish-water" fluid, woody induration, pain disproportionate'),
kv("Dx", "CT scan + surgical exploration"),
kv("Rx", "Urgent surgical debridement + broad-spectrum Abx (Pip-Tazo + Clinda) + ICU"),
Spacer(1,2*mm),
Paragraph("GAS GANGRENE (Clostridial Myonecrosis)", S["subsec"]),
kv("Organism", "C. perfringens (most common)"),
kv("Signs", "Rapid spreading, gas in tissue, bronze skin, crepitus"),
kv("Rx", "Debridement + High-dose Penicillin G + Hyperbaric O2"),
]
story.append(two_col(infect_left, infect_right))
story.append(Spacer(1, 4*mm))
# ═══════════════════════════════════════════════════════
# SECTION 2 – GASTROINTESTINAL & HEPATOBILIARY SURGERY
# ═══════════════════════════════════════════════════════
story.append(PageBreak())
story.append(section_banner("SECTION 2 — GASTROINTESTINAL & HEPATOBILIARY SURGERY", C_TEAL))
story.append(Spacer(1, 2*mm))
# ── 2A ACUTE ABDOMEN ──────────────────────────────────
story.append(Paragraph("ACUTE ABDOMEN", S["subsec"]))
alvarado_rows = [
["Migratory RIF pain", "1"], ["Anorexia", "1"], ["Nausea/Vomiting", "1"],
["RIF tenderness", "2"], ["Rebound tenderness", "1"],
["Elevated temp (>37.3°C)", "1"],
["Leukocytosis (WBC > 10k)", "2"], ["Neutrophilia (shift left)", "0"],
]
obstruction_rows = [
["Small bowel obstruction (SBO)", "Central/periumbilical; ladder pattern; no gas in colon"],
["Large bowel obstruction (LBO)", "Peripheral; inverted U frame; haustral markings"],
["Sigmoid volvulus", '"Coffee bean" / "bent inner tube" sign; apex at LUQ'],
["Caecal volvulus", "Kidney-shaped air shadow; displaced to LUQ"],
]
story.append(two_col(
[
Paragraph("ALVARADO SCORE (Appendicitis) – MANTRELS", S["subsec"]),
mini_table(["Feature", "Score"], alvarado_rows,
col_widths=[CONTENT_W*0.35, CONTENT_W*0.08]),
Paragraph("Score: ≤4 Unlikely | 5–6 Possible | 7–8 Probable | ≥9 Almost certain", S["key"]),
Spacer(1,2*mm),
Paragraph("PERITONITIS", S["subsec"]),
bullet("Primary – no perforation (SBP in cirrhosis; ascites PMNs > 250)"),
bullet("Secondary – perforated viscus (PUD, appendix, diverticulitis)"),
bullet("Tertiary – recurrent, resistant organisms post-surgery"),
],
[
Paragraph("INTESTINAL OBSTRUCTION – X-RAY SIGNS", S["subsec"]),
mini_table(["Pattern","X-Ray Finding"], obstruction_rows,
col_widths=[CONTENT_W*0.22, CONTENT_W*0.38]),
Spacer(1,2*mm),
bullet("<b>Rigler's sign</b> – pneumoperitoneum (both sides of bowel wall visible)"),
bullet("<b>Air under diaphragm</b> – erect CXR → perforation"),
bullet("<b>String of pearls</b> – air trapped between plicae circulares (SBO)"),
],
col_ratio=(45, 55)
))
story.append(Spacer(1, 2*mm))
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#CFD8DC")))
story.append(Spacer(1, 2*mm))
# ── 2B HERNIA ─────────────────────────────────────────
story.append(Paragraph("HERNIA", S["subsec"]))
hernia_rows = [
["Indirect inguinal", "Lateral to IEA; through deep ring", "Young males; most common overall"],
["Direct inguinal", "Medial to IEA; through Hesselbach's triangle", "Older males; weakness of floor"],
["Femoral", "Below & lateral to pubic tubercle; through femoral ring", "Most common in females; highest strangulation risk"],
["Umbilical", "Through umbilical ring", "Infants; adults with ascites/obesity"],
["Paraumbilical", "Adjacent to umbilicus", "Multiparous women"],
["Spigelian", "Through spigelian fascia (lateral border rectus)", "Interparietal; difficult to diagnose"],
]
story.append(mini_table(
["Type", "Anatomy", "Notes"],
hernia_rows,
col_widths=[CONTENT_W*0.15, CONTENT_W*0.42, CONTENT_W*0.43]
))
story.append(Spacer(1, 1*mm))
story.append(Paragraph("Hesselbach's triangle: Rectus medially | IEA laterally | Inguinal ligament inferiorly", S["key"]))
story.append(Spacer(1, 1*mm))
hernia_eponyms = [
["Richter's", "Only part of bowel wall trapped; no obstruction but strangulation possible"],
["Maydl's", '"W" hernia – loop within loop in sac; middle loop strangulates intra-abdominally'],
["Littre's", "Meckel's diverticulum in sac"],
["Amyand's", "Appendix in inguinal sac"],
["Pantaloon", "Both direct & indirect components astride IEA"],
]
story.append(mini_table(["Eponym", "Description"], hernia_eponyms,
col_widths=[CONTENT_W*0.12, CONTENT_W*0.88]))
story.append(Spacer(1, 2*mm))
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#CFD8DC")))
story.append(Spacer(1, 2*mm))
# ── 2C HEPATOBILIARY ──────────────────────────────────
hb_left = [
Paragraph("GALLSTONES & CHOLECYSTITIS", S["subsec"]),
kv("Imaging", "USG – gold standard (95% sensitivity for stones)"),
kv("Murphy's sign", "Tenderness + inspiratory arrest on palpation RHC"),
kv("Charcot's triad", "Fever + jaundice + RHC pain → cholangitis"),
kv("Reynold's pentad", "Charcot's + shock + altered consciousness → suppurative cholangitis"),
Spacer(1,1*mm),
Paragraph("OBSTRUCTIVE JAUNDICE", S["subsec"]),
bullet("Dark urine, pale stools, pruritis, steatorrhoea"),
bullet("ALP ↑↑, GGT ↑, conjugated bilirubin ↑"),
kv("Courvoisier's law", "Palpable GB + painless jaundice → malignant obstruction (NOT stones)"),
Spacer(1,1*mm),
Paragraph("PANCREATIC CARCINOMA", S["subsec"]),
bullet("CA 19-9 – tumour marker"),
bullet("Head (70%) → early obstructive jaundice"),
bullet("Whipple (pancreaticoduodenectomy) – for resectable head Ca"),
bullet("5-year survival < 5% overall"),
]
hb_right = [
Paragraph("ACUTE PANCREATITIS – RANSON'S CRITERIA", S["subsec"]),
Paragraph("<b>At admission:</b>", S["cellb"]),
bullet("Age > 55"),
bullet("WBC > 16,000"),
bullet("Glucose > 200 mg/dL"),
bullet("LDH > 350 IU/L"),
bullet("AST > 250 IU/L"),
Paragraph("<b>Within 48 hours:</b>", S["cellb"]),
bullet("Hct fall > 10%"),
bullet("BUN rise > 5 mg/dL"),
bullet("Ca < 8 mg/dL"),
bullet("PaO2 < 60 mmHg"),
bullet("Base deficit > 4 mEq/L"),
bullet("Fluid sequestration > 6 L"),
Paragraph("Score ≥ 3 → severe (mortality ↑↑)", S["key"]),
Spacer(1,1*mm),
Paragraph("Grey-Turner (flank) & Cullen (periumbilical) signs → haemorrhagic pancreatitis", S["tip"]),
]
story.append(two_col(hb_left, hb_right))
story.append(Spacer(1, 2*mm))
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#CFD8DC")))
story.append(Spacer(1, 2*mm))
# ── 2D STOMACH / OESOPHAGUS ───────────────────────────
gi_left = [
Paragraph("PEPTIC ULCER DISEASE", S["subsec"]),
kv("DU : GU ratio", "4:1; DU – H. pylori > 95%"),
kv("Complications", "Bleeding (MC), Perforation, Obstruction, Malignancy (GU)"),
kv("Perforated DU", "Commonest – anterior wall; treated: Graham's patch"),
kv("Haemorrhage", "Spurting artery – gastroduodenal artery (posterior DU)"),
Spacer(1,2*mm),
Paragraph("ACHALASIA CARDIA", S["subsec"]),
bullet("Failure of LES relaxation + absent peristalsis"),
bullet("Barium swallow: 'Bird's beak' / 'Rat-tail' appearance"),
bullet("Manometry – gold standard; high LES pressure"),
bullet("Rx: Heller's myotomy (surgical); Pneumatic dilatation; Botox injection"),
]
gi_right = [
Paragraph("GASTRIC CARCINOMA", S["subsec"]),
bullet("<b>Most common type</b>: Adenocarcinoma"),
bullet("<b>Location</b>: Antrum > Lesser curve"),
bullet("<b>Virchow's node</b>: Left supraclavicular LN"),
bullet("<b>Krukenberg tumour</b>: Ovarian metastasis"),
bullet("<b>Sister Mary Joseph nodule</b>: Umbilical metastasis"),
bullet("<b>Blumer's shelf</b>: Pouch of Douglas metastasis"),
Spacer(1,1*mm),
Paragraph("COLORECTAL CANCER – DUKE'S STAGING", S["subsec"]),
mini_table(["Stage","Description","5-yr Survival"],[
["A","Mucosa/submucosa only","90%+"],
["B","Through muscle wall","70%"],
["C","LN involvement","30–50%"],
["D","Distant metastasis","< 5%"],
], col_widths=[CONTENT_W*0.07, CONTENT_W*0.28, CONTENT_W*0.1]),
Spacer(1,1*mm),
bullet("<b>Haemorrhoids</b>: 3, 7, 11 o'clock (Lateral, Right ant, Right post)"),
bullet("<b>Goodsall's rule</b>: Posterior fistulae → curved track; Anterior → straight"),
]
story.append(two_col(gi_left, gi_right))
story.append(Spacer(1, 4*mm))
# ═══════════════════════════════════════════════════════
# SECTION 3 – ONCOLOGY & ENDOCRINE
# ═══════════════════════════════════════════════════════
story.append(PageBreak())
story.append(section_banner("SECTION 3 — ONCOLOGY & ENDOCRINE SURGERY", colors.HexColor("#880E4F")))
story.append(Spacer(1, 2*mm))
# ── 3A BREAST ─────────────────────────────────────────
breast_left = [
Paragraph("BREAST – TRIPLE ASSESSMENT", S["subsec"]),
bullet("<b>1. Clinical examination</b>"),
bullet("<b>2. Imaging</b> – USG (< 35 yr) / Mammography (≥ 35 yr)"),
bullet("<b>3. Biopsy</b> – FNAC or Core needle biopsy (CNB preferred)"),
Spacer(1,1*mm),
Paragraph("FIBROADENOMA vs FIBROCYSTIC", S["subsec"]),
mini_table(["Feature","Fibroadenoma","Fibrocystic"],[
["Age", "15–35 yr", "35–50 yr"],
["Consistency", "Rubbery, firm", "Nodular, tender"],
["Cyclical pain","No", "Yes"],
["Malignancy Rx","Very low", "Slightly ↑"],
], col_widths=[CONTENT_W*0.12, CONTENT_W*0.15, CONTENT_W*0.15]),
]
breast_right = [
Paragraph("BREAST CARCINOMA – TNM STAGING", S["subsec"]),
mini_table(["Stage","Description"],[
["Stage 0", "DCIS / LCIS – in situ"],
["Stage I", "T ≤ 2 cm, N0, M0"],
["Stage II", "T 2–5 cm or N1 (mobile axillary LN)"],
["Stage III","T > 5 cm or N2/N3 (fixed/internal mammary LN)"],
["Stage IV", "Distant metastasis"],
], col_widths=[CONTENT_W*0.08, CONTENT_W*0.34]),
Spacer(1,1*mm),
Paragraph("MANAGEMENT", S["subsec"]),
bullet("Early (I/II): BCS + Sentinel LN biopsy + Radiotherapy"),
bullet("Locally advanced (III): Neo-adjuvant chemo → surgery"),
bullet("Paget's disease of nipple → underlying DCIS/invasive Ca"),
bullet("Post-mastectomy lymphoedema → Stewart-Treves syndrome (angiosarcoma)"),
bullet("Hormone receptor +ve → Tamoxifen (pre-menopausal) / Aromatase inhibitor (post-menopausal)"),
]
story.append(two_col(breast_left, breast_right))
story.append(Spacer(1, 2*mm))
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#CFD8DC")))
story.append(Spacer(1, 2*mm))
# ── 3B THYROID ────────────────────────────────────────
thyroid_left = [
Paragraph("THYROID CANCERS", S["subsec"]),
mini_table(["Type","Frequency","Marker","Spread","Prognosis"],[
["Papillary", "MC (~80%)", "None specific", "Lymphatics", "Best"],
["Follicular", "10–15%", "Thyroglobulin", "Blood (lung/bone)","Good"],
["Medullary", "5%", "Calcitonin", "Both", "Moderate"],
["Anaplastic", "< 1%", "None", "Direct invasion","Worst"],
], col_widths=[CONTENT_W*0.1, CONTENT_W*0.1, CONTENT_W*0.15, CONTENT_W*0.14, CONTENT_W*0.1]),
Spacer(1,1*mm),
bullet("Papillary Ca – Orphan Annie eye nuclei; Psammoma bodies"),
bullet("Medullary Ca – Amyloid stroma; associated with MEN 2A/2B"),
bullet("FNAC – investigation of choice for thyroid nodule"),
bullet("Solitary cold nodule – higher malignancy risk"),
]
thyroid_right = [
Paragraph("THYROIDECTOMY COMPLICATIONS", S["subsec"]),
mini_table(["Complication","Structure","Manifestation"],[
["RLN injury (unilateral)","Recurrent laryngeal nerve","Hoarseness"],
["RLN injury (bilateral)","Both RLN","Stridor → emergency airway"],
["Hypocalcaemia","Parathyroid glands removed/devascularised","Chvostek's + Trousseau's; tetany"],
["Thyroid storm","Excess T3/T4 release","Hyperpyrexia, tachycardia, AF"],
["External LN injury","External laryngeal nerve","Loss of high-pitched voice (cricothyroid)"],
], col_widths=[CONTENT_W*0.2, CONTENT_W*0.22, CONTENT_W*0.14]),
]
story.append(two_col(thyroid_left, thyroid_right))
story.append(Spacer(1, 2*mm))
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#CFD8DC")))
story.append(Spacer(1, 2*mm))
# ── 3C ENDOCRINE EMERGENCIES ──────────────────────────
endo_left = [
Paragraph("PHAEOCHROMOCYTOMA", S["subsec"]),
bullet("Tumour of adrenal medulla → excess catecholamines"),
bullet("<b>Rule of 10</b>: 10% bilateral, 10% malignant, 10% extra-adrenal"),
kv("Symptoms", "Paroxysmal hypertension, headache, sweating, palpitations (classic triad)"),
kv("Investigation", "24-hr urine metanephrines + VMA; CT/MRI adrenal; MIBG scan"),
kv("Pre-op Rx", "<b>Alpha-blocker FIRST</b> (Phenoxybenzamine × 2 wk), then beta-blocker"),
kv("Surgery", "Laparoscopic adrenalectomy"),
Paragraph("NEVER give beta-blocker before alpha-blocker → hypertensive crisis!", S["key"]),
]
endo_right = [
Paragraph("ZOLLINGER-ELLISON SYNDROME (ZES)", S["subsec"]),
bullet("Gastrin-secreting tumour (gastrinoma) in pancreas/duodenum"),
bullet("<b>Whipple's triad</b>: Fasting hypoglycaemia + symptoms + relief with glucose (for insulinoma – not ZES)"),
kv("ZES features", "Multiple, recurrent, atypical PUD; secretory diarrhoea; acid hypersecretion"),
kv("Diagnosis", "Fasting serum gastrin > 1000 pg/mL + secretin stimulation test"),
kv("Association", "MEN-1 (20–25% of ZES cases)"),
kv("Rx", "High-dose PPI + surgical excision if localised"),
Spacer(1,2*mm),
Paragraph("MEN SYNDROMES AT A GLANCE", S["subsec"]),
mini_table(["MEN","Components"],[
["MEN-1","3 P's: Parathyroid + Pituitary + Pancreas (ZES, insulinoma)"],
["MEN-2A","Phaeochromocytoma + Medullary thyroid Ca + Parathyroid hyperplasia"],
["MEN-2B","Phaeochromocytoma + Medullary thyroid Ca + Mucosal neuromas + Marfanoid"],
], col_widths=[CONTENT_W*0.06, CONTENT_W*0.5]),
]
story.append(two_col(endo_left, endo_right))
story.append(Spacer(1, 4*mm))
# ═══════════════════════════════════════════════════════
# SECTION 4 – UROLOGY & VASCULAR
# ═══════════════════════════════════════════════════════
story.append(PageBreak())
story.append(section_banner("SECTION 4 — UROLOGY & VASCULAR SURGERY", colors.HexColor("#1B5E20")))
story.append(Spacer(1, 2*mm))
# ── 4A UROLOGY ────────────────────────────────────────
uro_left = [
Paragraph("BPH vs PROSTATE CARCINOMA", S["subsec"]),
mini_table(["Feature","BPH","Prostate Ca"],[
["Age", "50–70 yr", "> 60 yr"],
["Location", "Periurethral (transitional zone)","Peripheral zone"],
["PSA", "Mildly ↑ (< 10)", "Markedly ↑ (> 10; free PSA ↓)"],
["DRE", "Smooth, rubbery", "Hard, nodular, irregular"],
["Symptom", "LUTS – obstructive", "LUTS + haematuria + bone pain"],
["Met", "None", "Osteoblastic bone mets (spine)"],
], col_widths=[CONTENT_W*0.1, CONTENT_W*0.2, CONTENT_W*0.22]),
Spacer(1,1*mm),
bullet("PSA < 4 – Normal; 4–10 – Grey zone; > 10 – High suspicion"),
bullet("Gleason score – grading of prostate Ca (1–10); > 7 = aggressive"),
bullet("TURP – gold standard Rx for BPH"),
]
uro_right = [
Paragraph("RENAL CALCULI", S["subsec"]),
mini_table(["Type","Composition","Radio-opacity","Association"],[
["Calcium oxalate","Ca oxalate monohydrate","Radio-opaque (MC)","Hyperoxaluria"],
["Calcium phosphate","Ca phosphate","Radio-opaque","RTA type I"],
["Struvite","Mg-NH4-phosphate","Radio-opaque (staghorn)","Urease organisms (Proteus)"],
["Uric acid","Uric acid","Radiolucent","Gout, low urine pH"],
["Cystine","Cystine","Faintly opaque","Cystinuria (AR)"],
], col_widths=[CONTENT_W*0.11, CONTENT_W*0.18, CONTENT_W*0.1, CONTENT_W*0.17]),
Spacer(1,1*mm),
bullet("<b>Gold standard</b> – Non-contrast CT KUB"),
bullet("USG – first-line in pregnancy / children"),
bullet("ESWL – stones < 2 cm; PCNL – staghorn / > 2 cm"),
Spacer(1,2*mm),
Paragraph("TESTICULAR TORSION vs EPIDIDYMO-ORCHITIS", S["subsec"]),
mini_table(["Feature","Torsion","Epididymo-orchitis"],[
["Age","Adolescents (12–18)","Adults"],
["Onset","Sudden (at rest/sleep)","Gradual"],
["Cremasteric reflex","Absent","Present"],
["Prehn's sign","Pain not relieved on elevation","Pain relieved on elevation"],
["Rx","Emergency surgical exploration < 6 hr","Antibiotics (ciprofloxacin)"],
], col_widths=[CONTENT_W*0.12, CONTENT_W*0.16, CONTENT_W*0.18]),
]
story.append(two_col(uro_left, uro_right))
story.append(Spacer(1, 2*mm))
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#CFD8DC")))
story.append(Spacer(1, 2*mm))
# ── 4B VASCULAR ───────────────────────────────────────
vasc_left = [
Paragraph("DEEP VEIN THROMBOSIS (DVT)", S["subsec"]),
Paragraph("<b>Virchow's Triad:</b>", S["cellb"]),
bullet("1. Stasis (immobility, CCF, pregnancy)"),
bullet("2. Endothelial injury (trauma, surgery, catheter)"),
bullet("3. Hypercoagulability (malignancy, OCP, thrombophilia)"),
Spacer(1,1*mm),
kv("Wells score", "≥ 2 → high probability; < 2 → low probability"),
kv("D-dimer", "High sensitivity, low specificity; useful to RULE OUT"),
kv("Gold standard", "Duplex USG (compression USG)"),
kv("Rx", "LMWH → transition to Warfarin (INR 2–3) OR DOAC (Rivaroxaban)"),
kv("Provoked DVT", "3 months anticoagulation"),
kv("Unprovoked/recurrent", "6–12 months or indefinite"),
]
vasc_right = [
Paragraph("VARICOSE VEINS", S["subsec"]),
bullet("Dilated, tortuous, superficial veins (GSV most common)"),
kv("Trendelenburg test", "Tourniquet at SFJ; stand up → no filling = SFJ incompetence"),
kv("Perthe's test", "Exercise with tourniquet; pain = deep vein obstruction"),
kv("Complications", "Phlebitis, ulcer (gaiter area), haemorrhage, lipodermatosclerosis"),
kv("Rx", "Surgery (saphenofemoral ligation + stripping) / EVLT / Foam sclerotherapy"),
Spacer(1,2*mm),
Paragraph("AORTIC ANEURYSM", S["subsec"]),
bullet("AAA: > 3 cm diameter; repair if > 5.5 cm (males) or > 5 cm (females)"),
bullet("Ruptured AAA: Triad – sudden severe back pain + hypotension + pulsatile abdominal mass"),
bullet("Screening: USG in males 65–74 yr (one-time)"),
bullet("Rx: EVAR (endovascular) or Open repair"),
bullet("Leriche syndrome: Aortoiliac occlusion → bilateral claudication + impotence"),
]
story.append(two_col(vasc_left, vasc_right))
story.append(Spacer(1, 4*mm))
# ═══════════════════════════════════════════════════════
# SECTION 5 – MUST-KNOW MNEMONICS & RAPID FACTS
# ═══════════════════════════════════════════════════════
story.append(section_banner("SECTION 5 — MUST-KNOW MNEMONICS & RAPID FACTS", colors.HexColor("#4A148C")))
story.append(Spacer(1, 2*mm))
mnemonic_rows = [
["FAST FACTS", "BURNS – RULE OF NINES"],
[
Paragraph(
"<b>HACEK organisms</b> (endocarditis): Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella\n\n"
"<b>Ortolani</b> – relocates dislocated hip (click OUT)\n"
"<b>Barlow</b> – dislocates unstable hip (click IN)\n\n"
"<b>Chvostek</b> – tapping facial nerve → facial twitch (hypocalcaemia)\n"
"<b>Trousseau</b> – BP cuff inflation → carpal spasm (hypocalcaemia)\n\n"
"<b>Buerger's disease</b> – young male smoker; digital ischaemia; stop smoking!\n\n"
"<b>Battle's sign</b> – bruising mastoid (base of skull #)\n"
"<b>Raccoon eyes</b> – periorbital bruising (anterior fossa #)\n"
"<b>CSF rhinorrhoea</b> – halo sign on gauze; β2-transferrin confirms",
S["body"]
),
Paragraph(
"<b>Adult Rule of Nines:</b>\n"
"Head & Neck = 9%\n"
"Each Arm = 9% (total 18%)\n"
"Chest = 9% | Abdomen = 9% (Ant trunk 18%)\n"
"Upper back = 9% | Lower back = 9% (Post trunk 18%)\n"
"Each Thigh = 9% | Each Lower leg = 9% (Each leg 18%)\n"
"Perineum = 1%\n\n"
"<b>Children:</b> Lund & Browder chart (head is larger)\n\n"
"<b>Burn depth:</b>\n"
"• Superficial (1°) – erythema only; no fluid loss\n"
"• Partial thickness (2°) – blisters; painful; re-epithelialise\n"
"• Full thickness (3°) – leathery; painless; needs grafting\n\n"
"<b>Inhalation injury</b> – suspect if singed nares, hoarseness, carbonaceous sputum → early intubation",
S["body"]
),
],
]
mn_table_data = [
[Paragraph("MNEMONICS & KEY EPONYMS", S["subsec"]),
Paragraph("BURNS – RULE OF NINES", S["subsec"])],
[mnemonic_rows[1][0], mnemonic_rows[1][1]],
]
mn_t = Table(mn_table_data, colWidths=[CONTENT_W*0.5, CONTENT_W*0.5])
mn_t.setStyle(TableStyle([
("BACKGROUND", (0,0), (-1,0), colors.HexColor("#EDE7F6")),
("BACKGROUND", (0,1), (0,1), colors.HexColor("#F3E5F5")),
("BACKGROUND", (1,1), (1,1), colors.HexColor("#FFF8E1")),
("VALIGN", (0,0), (-1,-1), "TOP"),
("TOPPADDING", (0,0), (-1,-1), 4),
("BOTTOMPADDING",(0,0),(-1,-1), 4),
("LEFTPADDING",(0,0), (-1,-1), 6),
("RIGHTPADDING",(0,0),(-1,-1), 6),
("BOX", (0,0), (-1,-1), 0.5, colors.HexColor("#B39DDB")),
("INNERGRID", (0,0), (-1,-1), 0.3, colors.HexColor("#CE93D8")),
]))
story.append(mn_t)
story.append(Spacer(1, 3*mm))
# ── STRATEGIC TIPS BOX ────────────────────────────────
tips_data = [[
Paragraph("FMGE STRATEGIC TIPS", S["subsec"]),
Paragraph(
"1. <b>Next best step</b> questions: Always secure Airway first in trauma; rule out life-threats before definitive diagnosis.\n"
"2. <b>Repeat themes</b>: GCS scoring, Rule of Nines, Alvarado score, Virchow's triad, Duke's staging – memorise numbers cold.\n"
"3. <b>Clinical scenario approach</b>: Identify key words – 'calf pain + swelling after long flight' = DVT; 'painless jaundice + palpable GB' = malignancy (Courvoisier).\n"
"4. <b>Investigations hierarchy</b>: USG first (gallstones, DVT, appendicitis); CT for trauma grading; Manometry for achalasia; Non-contrast CT KUB for renal stones.\n"
"5. <b>Pre-op prep order</b>: Phaeochromocytoma → alpha-blocker FIRST, then beta-blocker. Never reverse.\n"
"6. <b>PYQ strategy</b>: Last 10 years papers contain ~40% directly repeated questions. Focus on 2014–2024 cycle questions.",
S["body"]
),
]]
tips_t = Table(tips_data, colWidths=[CONTENT_W*0.22, CONTENT_W*0.78])
tips_t.setStyle(TableStyle([
("BACKGROUND", (0,0), (0,0), colors.HexColor("#0D47A1")),
("BACKGROUND", (1,0), (1,0), colors.HexColor("#E3F2FD")),
("TEXTCOLOR", (0,0), (0,0), C_WHITE),
("VALIGN", (0,0), (-1,-1), "MIDDLE"),
("TOPPADDING", (0,0), (-1,-1), 6),
("BOTTOMPADDING",(0,0),(-1,-1), 6),
("LEFTPADDING",(0,0), (-1,-1), 8),
("BOX", (0,0), (-1,-1), 0.8, colors.HexColor("#1565C0")),
]))
story.append(tips_t)
story.append(Spacer(1, 3*mm))
# ── FOOTER NOTE ───────────────────────────────────────
footer = Paragraph(
"Prepared by Orris Medical | FMGE 2026 Surgery High-Yield Revision | Based on last-decade question pattern analysis | For educational use only",
ParagraphStyle("footer", fontSize=6, textColor=colors.HexColor("#90A4AE"), alignment=TA_CENTER)
)
story.append(HRFlowable(width=CONTENT_W, thickness=0.5, color=colors.HexColor("#B0BEC5")))
story.append(Spacer(1, 1*mm))
story.append(footer)
# ── BUILD ──────────────────────────────────────────────
doc.build(story)
print(f"PDF saved to {OUTPUT}")
cd /home/daytona/workspace/fmge-surgery && python build_cheatsheet.py 2>&1
ls -lh /home/daytona/workspace/fmge-surgery/FMGE_Surgery_Cheatsheet.pdf
FMGE Surgery Cheatsheet
PDF Document · PDF
- Wound healing phases with exact timelines, suture materials table (absorbable vs. non-absorbable), SSI classification
- Haemorrhagic shock classification table (Class I–IV) with HR, SBP, UO, and fluid management
- Parkland formula box (burns fluid resuscitation)
- ATLS A-B-C-D-E protocol, GCS scoring table, AAST splenic trauma grading
- Necrotising fasciitis (Type I vs II) and Gas Gangrene management
- Alvarado/MANTRELS score, intestinal obstruction X-ray signs (coffee bean, string of pearls, Rigler's)
- Hernia anatomy table (direct vs indirect, femoral, spigelian) + all eponyms (Richter's, Maydl's, Littre's, Amyand's, Pantaloon)
- Gallstones, Charcot's triad, Reynold's pentad, Courvoisier's law
- Ranson's criteria for pancreatitis (admission + 48-hr), Duke's staging for colorectal Ca
- Achalasia cardia, gastric carcinoma metastatic eponyms (Virchow, Krukenberg, Blumer's shelf)
- Breast triple assessment, fibroadenoma vs fibrocystic disease comparison, breast Ca TNM staging
- Thyroid cancer types (frequency, marker, spread, prognosis), thyroidectomy complications table
- Phaeochromocytoma Rule of 10, pre-op alpha-then-beta sequence, MEN syndromes
- ZES diagnosis criteria, MEN-1/2A/2B components
- BPH vs prostate Ca comparison (PSA, DRE, zone, mets), Gleason score, renal calculi types + radio-opacity
- Testicular torsion vs epididymo-orchitis (age, cremasteric reflex, Prehn's sign)
- DVT - Virchow's triad, Wells score, Duplex USG as gold standard, anticoagulation duration
- Varicose veins tests, AAA repair thresholds, Leriche syndrome
- Rule of Nines (burns), burn depth classification, key eponyms (Battle's sign, Raccoon eyes), strategic revision tips
For FMGE surgery, the exam emphasizes clinical recognition and "next-best-step" management over complex operative techniques. Image-Based Questions (IBQs) are a major component, often appearing in clusters related to specific high-yield systems. ### **High-Yield IBQ Patterns (Must-Know)** * **Imaging:** * **X-rays:** Signs of intestinal obstruction (air-fluid levels, stack of coins), pneumoperitoneum (gas under the diaphragm), and tension pneumothorax (tracheal deviation, absent lung markings). * **CT Scans:** Epidural (lentiform/biconvex) vs. Subdural (crescentic) hematomas, and pancreatitis staging (Balthazar score). * **Ultrasound:** Gallstones (acoustic shadowing), FAST protocol images, and testicular masses (seminoma vs. other tumors). * **Clinical Signs/Instruments:** * **Instruments:** Familiarize yourself with common surgical tools (forceps, retractors, trocars). * **Signs:** Murphy’s sign (cholecystitis), McBurney’s point tenderness (appendicitis), and classic appearance of ulcers (trophic vs. venous). * **Pathology Slides:** * **Thyroid:** "Orphan Annie" nuclei (papillary CA), Psammoma bodies. * **Breast:** Features of inflammatory carcinoma (peau d'orange), Paget’s disease (nipple erosion). ### **High-Yield Surgery Topics for Repeat Questions** | Category | Priority Topics | |---|---| | **Trauma** | ATLS protocol (ABCDE), GCS scoring, fluid resuscitation (Parkland formula), and tension pneumothorax management. | | **Gastrointestinal** | Appendicitis (Alvarado score), cholecystitis (Charcot/Reynolds triad), and intestinal obstruction. | | **Oncology** | Thyroid nodules (TIRADS, management), Breast cancer (TNM staging, triple assessment), and tumor markers (CEA, AFP, CA-19.9). | | **Hernia** | Direct vs. Indirect inguinal hernia (anatomical differentiation), femoral hernia, and strangulation signs. | | **Urology** | BPH (IPSS, PSA), prostate carcinoma, and urinary stones (imaging and metabolic workup). | | **Vascular/Infection** | DVT (Wells score), Gas gangrene, Tetanus prophylaxis, and Necrotizing fasciitis. | ### **Revision Strategy for IBQs** 1. **Use Visual Databases:** Don't just read about signs; view them. Practice identifying the "classic" appearance of conditions like appendicular lumps or breast lumps. 2. **Focus on "The First Step":** Most FMGE questions ask for the *initial* investigation (e.g., USG for gallstones) versus the *gold standard* investigation (e.g., CT or MRCP for biliary pathology). 3. **Active Recall for PYQs:** Since many surgical concepts and images repeat, use your last 10 years of PYQs specifically to build an "image bank." If an X-ray or CT has appeared once, be prepared for it to return in a slightly modified clinical scenario. Surgery High-Yield Topics & IBQs for FMGE This video provides a focused review of high-yield surgical concepts and image-based patterns that are frequently tested in the FMGE, making it an excellent resource for your revision.
"FOOTER NOTE" in ~/fmge-surgery
~/fmge-surgery/build_cheatsheet.py
Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/fmge-surgery/build_cheatsheet.py'
cd /home/daytona/workspace/fmge-surgery && python build_cheatsheet.py 2>&1
ls -lh /home/daytona/workspace/fmge-surgery/FMGE_Surgery_Cheatsheet.pdf
FMGE Surgery Cheatsheet
PDF Document · PDF
Is there anything important left out for required and important for fmge if there's more then add it to the existing pdf
Perform a comprehensive gap analysis for FMGE (Foreign Medical Graduates Examination, India) Surgery subject. The existing cheat sheet already covers these topics: SECTION 1 - Core General Surgery: - Wound healing (phases, types, suture materials, SSI) - Shock & fluid resuscitation (haemorrhagic shock classes I-IV, shock types, Parkland formula) - Trauma (ATLS ABCDE, GCS, splenic trauma grading AAST) - Surgical infections (sterilisation, NF, gas gangrene) SECTION 2 - GI & Hepatobiliary: - Acute abdomen (Alvarado score, intestinal obstruction X-ray signs) - Hernia (all types, eponyms) - Hepatobiliary (gallstones, cholecystitis, obstructive jaundice, pancreatitis-Ranson's, Whipple) - Stomach/Oesophagus (PUD, achalasia, gastric Ca eponyms) - Colorectal (Duke's staging, haemorrhoids, Goodsall's rule) SECTION 3 - Oncology & Endocrine: - Breast (triple assessment, fibroadenoma vs fibrocystic, TNM staging, management) - Thyroid (cancer types, complications of thyroidectomy) - Endocrine emergencies (phaeochromocytoma, ZES, MEN syndromes) SECTION 4 - Urology & Vascular: - BPH vs prostate Ca, renal calculi, testicular torsion - DVT (Virchow's triad, Wells score), varicose veins, AAA SECTION 5 - Mnemonics & Rapid Facts: - Rule of Nines, burns depth, key eponyms SECTION 6 - IBQ Master Guide: - X-ray signs, CT patterns (EDH/SDH, pancreatitis Balthazar), USG (gallstones, FAST, testicular, TIRADS) - Pathology slides (thyroid, breast, appendix, skin) - Surgical instruments (12 instruments) - Clinical signs & ulcer types - Tumour markers (12 markers) - IBQ strategy tips Your task: Identify ALL important FMGE surgery topics that are MISSING or insufficiently covered in the above list. Focus on topics that: 1. Commonly appear in FMGE PYQs (previous year questions) 2. Are part of the standard MCI/NBE surgery curriculum tested in FMGE 3. Are high-yield clinical/exam topics Please research this thoroughly using web search to find FMGE surgery syllabus, PYQ analysis, and coaching resources. Then compile a precise list of missing topics organized by category, with specific details about what facts/numbers/concepts need to be included. Return a structured list of missing topics with enough detail that another agent can write the actual content for the PDF. Be specific - include the key facts, numbers, classifications, and mnemonics for each missing topic.
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