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THE SURGICAL FORMULA COMMITTEE
DR SHIRAZ JAMSHAID MBBS (HONS), BSC (HONS) FY2- UNIVERSITY COLLEGE LONDON HOSPITAL- LONDON
DR SAMAD WAHID MBBS (HONS), BSC (HONS)
FY2- BARNET HOSPITAL- LONDON
DR MUMTA KANDA MBBS (HONS), BSC (HONS) F2- ROYAL LONDON HOSPITAL- LONDON
DR MUHESH TAHEEM MBBS (HONS), BSC (HONS) FY2- ROYAL LONDON HOSPITAL- LONDON
DR YASIR ASHRAF MBBS (HONS), BSC (HONS) FY1- QUEEN ELIZABETH HOSPITAL- BIRMINGHAM
NATIONAL SURGICAL FINALS COURSE
HELD AT IMPERIAL COLLEGE LONDON
12TH AND 13th OCTOBER 2019
Saturday 12th October
08:30-09:00 Registration
09:00-09:15 Introduction
09:15-10:30 Colorectal 1
10:30-10:40 Break
10:40-12:00 Colorectal 2 + Quiz
12:00-13:00 Lunch
13:00-14:15 Vascular 1
14:15-14:25 Break
14:25-15:40 Vascular 2 + Quiz
15:40-15:55 Break
15:55-16:30 Urology 1
16:30-16:40 Break
16:40-17:15 Urology 2 + Quiz
17:15-17:30 Feedback and questions
Sunday 13th October
08:30-09:00 Registration
09:00-10:30 Upper GI/ Hpb 1
10:30-10:45 Break
10:45-12:15 Upper GI/ Hpb 2 + Quiz
12:15-13:15 Lunch
13:15-14:30 T&O 1
14:30-14:45 Break
14:45-15:45 T&O 2 + Quiz
15:45-16:00 Break
16:00-17:15 Mock Surgical exam + Answers
17:15-17:30 Feedback and questions
Table of Contents
COLORECTAL ........................................................................................................................................... 5
ANATOMY ........................................................................................................................................... 5
KEY CLINICAL SIGNS ............................................................................................................................ 6
BOWEL CANCER .................................................................................................................................. 8
BOWEL OBSTRUCTION ........................................................................................................................ 9
DIVERTICULAR DISEASE ..................................................................................................................... 10
ACUTE APPENDICITIS ........................................................................................................................ 11
HERNIAS- INGUINAL .......................................................................................................................... 12
HERNIAS- FEMORAL .......................................................................................................................... 13
FISTULA-IN-ANO ................................................................................................................................ 14
HAEMORRHOIDS ............................................................................................................................... 15
VASCULAR ............................................................................................................................................. 16
ANATOMY ......................................................................................................................................... 16
ARTERIAL EXAM ................................................................................................................................ 17
VENOUS EXAM .................................................................................................................................. 18
PERIPHERAL ARTERIAL DISEASE ........................................................................................................ 19
ACUTE LIMB ISCHAEMIA ................................................................................................................... 20
ANEURYSMS (AAA) ............................................................................................................................ 21
AORTIC DISSECTION .......................................................................................................................... 22
VARICOSE VEINS ................................................................................................................................ 23
ULCERS .............................................................................................................................................. 24
UROLOGY .............................................................................................................................................. 25
ANATOMY ......................................................................................................................................... 25
KEY CLINICAL SIGNS .......................................................................................................................... 25
HAEMATURIA .................................................................................................................................... 26
UROLITHIASIS .................................................................................................................................... 27
RENAL CELL CANCER (RCC) ................................................................................................................ 28
BLADDER CANCER (TCC) .................................................................................................................... 29
PROSTATE CANCER ........................................................................................................................... 30
GROIN LUMPS ................................................................................................................................... 31
UPPER GI ............................................................................................................................................... 32
ANATOMY ......................................................................................................................................... 32
KEY CLINICAL SIGNS .......................................................................................................................... 33
GORD ................................................................................................................................................. 34
OESOPHAGEAL CANCER .................................................................................................................... 35
ACHALASIA ........................................................................................................................................ 36
PEPTIC ULCER DISEASE ...................................................................................................................... 37
GASTRIC CANCER .............................................................................................................................. 38
HEPATOBILIARY ..................................................................................................................................... 39
ANATOMY ......................................................................................................................................... 39
KEY CLINICAL SIGNS .......................................................................................................................... 39
HEPATOCELLULAR CARCINOMA (HCC) ............................................................................................. 40
GALLSTONES ..................................................................................................................................... 41
ACUTE CHOLECYSTITIS ...................................................................................................................... 42
ASCENDING CHOLANGITIS ................................................................................................................ 43
ACUTE PANCREATITIS ....................................................................................................................... 44
CHRONIC PANCREATITIS ................................................................................................................... 45
PANCREATIC CARCINOMA ................................................................................................................ 46
TRAUMA & ORTHOPAEDICS .................................................................................................................. 47
SHOULDER EXAM .............................................................................................................................. 47
HAND EXAM ...................................................................................................................................... 48
HIP EXAM .......................................................................................................................................... 49
KNEE EXAM ....................................................................................................................................... 50
FRACTURES ........................................................................................................................................ 51
FRACTURE NECK OF FEMUR .............................................................................................................. 52
OSTEOARTHRITIS ............................................................................................................................... 53
RHEUMATOID ARTHRITIS .................................................................................................................. 53
HIP REPLACEMENT ............................................................................................................................ 54
KNEE REPLACEMENT ......................................................................................................................... 55
INJURIES ............................................................................................................................................ 56
CARPEL TUNNEL SYNDROME ............................................................................................................ 57
MOCK EXAM- SPACE FOR NOTES + ANSWERS ...................................................................................... 58
COLORECTAL
ANATOMY
KEY CLINICAL SIGNS
BOWEL CANCER
CAUSES
FEATURES
1
2
3
COMPLICATIONS
IX
MX
BOWEL OBSTRUCTION
CAUSES
1
2
3
FEATURES
1
2
3
IX
MX
1
2
3
DIVERTICULAR DISEASE
DEFINITIONS
FEATURES
COMPLICATIONS
1
2
3
IX
MX
ACUTE APPENDICITIS
DEFINITIONS
FEATURES
1
2
3
COMPLICATIONS
IX
1
2
3
MX
1
2
3
HERNIAS- INGUINAL
IGUINAL HERNIA TYPES
HERNIAS- FEMORAL
MX
FISTULA-IN-ANO
FEATURES
1
2
3
MX
1
2
3
HAEMORRHOIDS
FEATURES
1
2
3
MX
1
2
3
VASCULAR
ANATOMY
ARTERIAL EXAM
Three signs of arterial disease on:
General inspection?
1)
2)
3)
Close inspection?
1)
2)
3)
Where can the aorta be palpated?
What is buerger’s angle?
What is a positive buerger’s test?
VENOUS EXAM
Three main signs of venous disease on:
General inspection?
1)
2)
3)
Closer inspection?
1)
2)
3)
What is a positive tourniquet test?
PERIPHERAL ARTERIAL DISEASE
DEFINITION
CAUSES
1
2
3
FEATURES- FONTAINE CLASSIFICATION
1
2
3
4
COMPLICATIONS
IX
1
2
3
MX
1
2
3
ACUTE LIMB ISCHAEMIA
CAUSES
1
2
3
FEATURES- THE 6 P’S
P
P
P
P
P
P
IX
1
2
3
MX
1
2
3
ANEURYSMS (AAA)
DEFINITION
RISK FACTORS
1
2
3
TYPES
1
2
3
COMPLICATIONS
IX
1
2
3
MX
1
2
3
AORTIC DISSECTION
CAUSES
1
2
3
STANFORD CLASSIFICATION SYSTEM
i)
ii)
COMPLICATIONS
1
2
3
IX
1
2
3
MX
1
2
3
VARICOSE VEINS
CAUSES
1
2
3
COMPLICATIONS
1
2
3
IX
1
2
3
MX
1
2
3
ULCERS
Three types of ulcer and three features of each:
__________________________ Ulcer
1)
2)
3)
__________________________ Ulcer
1)
2)
3)
__________________________ Ulcer
1)
2)
3)
Extra Note Space for Ulcers:
UROLOGY
ANATOMY
KEY CLINICAL SIGNS
HAEMATURIA
TYPES
1
2
CAUSES
1
2
3
FEATURES
1
2
3
IX
MX
UROLITHIASIS
TYPES OF STONES
FEATURES
1
2
3
4
IX
1
2
3
MX
1= ( <5mm)
2= (5-10mm/ pain)
3= ( >10mm/ obstruction/ renal impairment)
RENAL CELL CANCER (RCC)
TRAD
1
2
3
IX
STAGING
T1
T2
T3
T4
MX
BLADDER CANCER (TCC)
CAUSES
1
2
3
KEY FEATURE
IX
STAGING
Ta-
T1-
T2-
T3-
T4-
MX
Ta/ T1
T2/T3
T4
PROSTATE CANCER
FEATURES
1
2
3
IX
MX
GROIN LUMPS
VARICOCELE
HYDROCELE
EPIDIDYMO-ORCHITIS
UPPER GI ANATOMY
KEY CLINICAL SIGNS
GORD
CAUSES
FEATURES
1
2
3
COMPLICATIONS
IX
MX
OESOPHAGEAL CANCER
CAUSES
SCC:
ADWNOCARCINOMA:
FEATURES
1
2
3
IX
1
2
3
MX
1
2
3
ACHALASIA
CAUSES
FEATURES
1
2
3
COMPLICATIONS
IX
1
2
3
MX
1
2
3
PEPTIC ULCER DISEASE
CAUSES
FEATURES
1
2
3
COMPLICATIONS
IX
1
2
3
MX
1
2
3
GASTRIC CANCER
CAUSES
FEATURES
1
2
3
COMPLICATIONS
IX
1
2
3
MX
1
2
3
HEPATOBILIARY ANATOMY
WHAT MAKES THE BORDERS OF CALOT’S TRIANGLE?
WHAT IS HARTMANS POUCH?
WHAT IS THE ARTERIAL SUPPLY TO THE GALLBLADDER?
KEY CLINICAL SIGNS
HEPATOCELLULAR CARCINOMA (HCC)
CAUSES
FEATURES
1
2
3
COMPLICATIONS
IX
MX
GALLSTONES
TYPES
PREDISPOSING FACTORS
FEATURES
COMPLICATIONS
IX
MX
ACUTE CHOLECYSTITIS
CAUSES
FEATURES
1
2
3
COMPLICATIONS
IX
1
2
3
MX
IMMEDITAELY
SURGICAL
ASCENDING CHOLANGITIS
CAUSES
FEATURES
1
2
3
COMPLICATIONS
IX
1
2
3
MX
IMMEDIATELY
SURGICAL
ACUTE PANCREATITIS
CAUSES – I GET SMASHED
FEATURES
COMPLICATIONS
IX- MODIFED GLASGOW SCORE
MX
CHRONIC PANCREATITIS
CAUSES
1
2
3
FEATURES
COMPLICATIONS
IX-
1
2
3
MX
1
2
3
PANCREATIC CARCINOMA
TYPES
MAIN-
OTHER-
FEATURES
1- SYSTEMIC
2- PANCREATIC
3- COURVOISIERS LAW
IX-
1
2
3
MX
1
2
3
TRAUMA & ORTHOPAEDICS
SHOULDER EXAM
LOOK
FEEL
MOVE
SPECIAL TESTS
HAND EXAM
LOOK
FEEL
MOVE
SPECIAL TESTS
HIP EXAM
LOOK
FEEL
MOVE
SPECIAL TESTS
KNEE EXAM
LOOK
FEEL
MOVE
SPECIAL TESTS
FRACTURES
FEATURES
1
2
3
DESCRIPTION OF XR
i. PATIENT AND RADIOGRAPH DETAILS
ii. FRACTURE TYPE + PATTERN
iii. LOCATION (Which bone?)
iv. DISTAL PORTION DISPLACEMENT
v. ANY SOFT TISSUE ABNORMALITY (OPEN/CLOSED)
MX
REDUCTION
RESTRICTION
REHABILITATION
FRACTURE NECK OF FEMUR
CLASSIFICATION
MANAGEMENT
OSTEOARTHRITIS RISK FACTORS
PRESENTATION
MANAGEMENT
RHEUMATOID ARTHRITIS
RISK FACTORS
PRESENTATION
MANAGEMENT
HIP REPLACEMENT INDICATIONS
1
2
TYPES
1
2
TECHNIQUES
1
2
COMPLICATIONS
IMMEDIATE
EARLY
LATE
KNEE REPLACEMENT INDICATIONS
1
2
TYPES
1
2
3
COMPLICATIONS
IMMEDIATE
EARLY
LATE
INJURIES
KNEE
ANKLE
CARPEL TUNNEL SYNDROME
ANATOMY
CAUSES
FEATURES
MANAGEMENT
MOCK EXAM- SPACE FOR NOTES + ANSWERS
