25 Common Surgical Conditions Prof Hill Lecture

Appendicitis
o Might come as long case
o Usually patient is post-op
o Determine in the history how they presented
o Inspection: scars/ports
o Complications of the surgery
Cellulitis
o OSCE
o Clinical features
o Organism: staph aureus
o Abx: flucox
o Complication: necrotizing fasciitis
Diabetic foot
o OSCE or long case
o Know HBA1C
o Examine the eyes and say what you are expecting to see
o Pulses
o Treatment
Venous ulcer
o OSCE
o Usually in gaiter area
o Slopping edges
o Know how to describe it: presence of granulation tissue and
slough (yellow tissue)
o For every lump/ulcer
4Ss: site, size, shape, surrounding skin
4Ts: temperature, tenderness, texture, transillumination
o Say you want to check for associated lymphadenopathy and
general condition of the patient
o Remember the ddx for a venous ulcer could be a malignant lesion
like SCC
Arterial ulcer
o OSCE/Long case
o History: IC, atherosclerotic RF,
o Ulcer: punched out
Diverticular disease
o Long case
o Mx: IV abx, once it settles down colonoscopy in 6 weeks
Acute cholecystitis
o Long case
o Patient will be tender in RUQ and on IV abx
GORD
o Data OSCE
o Severe oesophagitis
Upper GI bleed
 o Mx of acute bleed Data OSCE, short notes
Colonic hemorrhage
o Long case
o Bleeding PR
Acute pancreatitis
o Long case
o Know the scoring system, causes, treatment
Obstructive jaundice
o OSCE/long case
o Painful = gallstones
o Painless = pancreatic ca
o Could be a medical cause e.g. hepatitis
Colorectal cancer
o Can present as bowel obstruction Hartmans
o Long case
o MCQ questions
PUD
o Long case
o Someone presenting with vague abdominal pain
Intestinal obstruction
o Post-op long case
o SBO causes: adhesions, hernia, cancer
o Large bowel: tumour, diverticulitis
Inguinal hernia repair
o OSCE
Laparascopic chole
o Long case
Open chole
o Long case but very rare
o Know T tube
Right hemicolectomy
o Long case
o Present with anaemia
Left/sigmoid colectomy
o Long case
o Present with abdominal pain
Anterior resection
o Long case
Hartmanns operation
o Long case
Emergency laparatomy
Femoral hernia repair
o Rare
o Examined in MCQs
Incisional hernia repair
o Know the risk factors for it
In addition to the 25 common surgical conditions

Orthopaedics
o One station in clinical OSCE: knee or hip
o MCQs, short notes
Breast
o OSCE or long case
o Know the scars and the reconstruction options
Thyroid
o OSCE or long case
Neurosurgery
o Data OSCE- CT scan
o Short notes brain injury