CRUX OF SURGERY

CRUX OF SURGERY

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Latest — 23 Feb 2026

Biliary System

👩‍⚕️ It's easiest to learn by working through the MCQs. Get to grips with the anatomy, physiology, and management of the different pathologies. A 30-year-old woman has RUQ pain after eating fatty meals. Bilirubin is normal. Diagnosis? * ((Biliary colic::☑️ Intermittent post-prandial RUQ pain with normal bilirubin suggests transient cystic

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Pancreas

👩‍⚕️ Work your way through this list of MCQs. Hover over each option for the answers and explanations. Which enzyme is responsible for autodigestion in acute pancreatitis? * ((Lipase::Causes fat necrosis but is activated downstream)) * ((Elastase::Causes vascular damage and haemorrhage but not the initiating enzyme)) * ((Trypsin::☑️ Premature activation of trypsinogen

Trauma Scenario #2

You are the on-call surgical SHo. A male in his forties arrives to A&E following an RTA. He was in a car. He has a respiratory rate of 30, saturations of 84%, heart rate of 121 and blood pressure of 95/60. How do you proceed? Ensure the

Trauma Scenario #1

You are the on-call surgical SHo. A male in his forties arrives to A&E following an RTA. He was in a car. He is complaining of severe abdominal pain. He has a respiratory rate of 25, saturations of 94%, heart rate of 128 and blood pressure of 100/

GENERAL ATLS

Ensure the patient is managed in the resuscitation bay and that a trauma call has been put out Immediately perform a rapid primary survey in an A to E manner with simultaneous resusctiation following the ATLS protocol Prescribe adequate analgesia using the WHO pain ladder Airway Maintenance with Restriction of

Post-Operative Shortness of Breath

You are called by the physiotherapist to assess a 75-year-old female patient who is had a hemiarthroplasty three days ago for a right neck of femur fracture. Oxygen saturations were 89% and heart rate was 115. How would you approach this patient? * I would immediately go to the patient, asking

Research fraud

Your colleague has edited the raw data to produce more impressive results for your research on long-term outcomes following different operative approaches. How do you proceed? Issues * Research ethics * Integrity * Professionalism * Patient safety Seek information * Discuss with your colleague what you noticed - is there an explanation for what the

Drunk colleague

Your registrar is behaving like they may be under the influence of drugs. He's supposed to be doing a list. How do you proceed? Issues * Patient safety * Professionalism * Trust in the profession * Colleague wellbeing Seek information * Talk privately immediately with the registrar - directly ask if they are

Lost notes

You took patient notes home to work on an audit but when you get home you realise they're not in your bag - you don't know where they are. How do you proceed? Issues 1. Patient confidentiality 2. Data security 3. Patient safety 4. Duty of