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Ethics guidelines

https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/candour—openness-and-honesty-when-things-go-wrong/the-professional-duty-of-candour

Vascular Notes & Protocols

Vascular Links

Topics that have appeared in previous exams which are covered in syllabus

1. Brainstem death
2. Jehovah’s witness and bleeding in child
3. Retroperitoneal level of injury. Stable patient – ? explore / angiography / conservative
4. Venous access and collapse – cannot haemodialyse – ? cause.
5. Axillary stab injury – approach for exploration ? extend wound, horizontal axillary, supraclavicular, infraclavicular, median sternotomy
6. Splenic injury, stable. Where should patient be monitored? Level 1/2/3 ward, discharge
7. Fistula post-episiotomy – management
8. Investigations / treatment post renal transplant with rising creatinine
9. Inflammatory breast disease – pre-op treatment / surgery
10. 3.5cm cancer in A cup breasts – management ? WLE / mastectomy / SLNB yes or no
11. Mucus, PR bleeding, tenesmus, 35 female. ? cause
12. Liver injury management. 700mls blood, no active bleeding, stable patient.
13. Thoracic pain, 5 years post breast cancer. Which investigation? Bone scan / CT etc
14. 1cm rectal anastomotic defect following lap sigmoid colectomy with some pelvic contamination
15. Prasurgel – which blood products for laparotomy. FFP / platelets / blood / no treatment / cryo
16. Itchy veins in 20 yr old female following op for varicose veins. Which investigation? Venous duplex / arterial duplex / ABPI /lymphoscintigraphy
17. 65 male bicycle injury, hypotension, mild peripheral cyanosis, no long bone fractures or obvious injury – ? type of shock (maybe haemorrhagic until proven otherwise)
18. Swelling inferior to inguinal canal – 65 female, 35 female post-partum (inguinal / femoral / saphena varix)
19. Routine blood screening on donations (HIV, hep b, hep c, vcjd, cmv)
20. Fluid resuscitation in unwell patient
21. Appropriate steps for designing an RCT
22. Two surgeons comparing binomial outcome after surgery (one has 32, one has 7)-which statistical test to use?
23. Renal vein anatomy
24. Splenic artery anatomy
25. Nerve transverse in floor of axilla and resultant defect
26. Popliteal fossa- tibial nerve anatomy in relation to vessels
27. Toe extension nerve root
28. Placement of diathermy plate for patient with inactivated PPM and hip replacement having inguinal hernia
29. Description of measures of central tendency
30. Breast cancer-2.5cm, Sentinel node micromet , ER+ve, HER2+ve, which most important prognostic factor
31. After reconstruction- breast plant exposed- management
32. Fluid around previous implant from 10y before-management
33. Infected post op implant -management
34. Male breast cancer- management
35. Male breast lump diagnosis management
36. Male bilateral inguinal hernia- one symptomatic-management (open unilateral, lap etc)
37. Lobular breast cancer in patient with scleroderma- management
38. Post-op expanding hematoma following breast surgery with 4 point hb drop and empty drains
39. Post-op pale flap following TRAM flap reconstruction -management
40. Fibrosarcoma breast management
41. Phyllodes breast management
42. Post cardiac catheterisation femoral pseudo-aneurysm -management
43. Popliteal aneurysm thrombosed with limb ischaemia -management
44. Benefits of conventional haemorrhoidectomy over stapled (less recurrence)
45. Benefits of rubber banding over haemorrhoidal injection (less risk prostatitis)
46. Iron deficiency anaemia in patient with FAP post panprocto- best investigation
47. 40ish female patient with diarrhoea, abdo pain, IDA. Already had colon and OGd. Next best invx.
48. CT of dilated bowel upper abdomen post Whipple’s ?cause
49. CT of ?devascularised spleen in tachycardic hypotensive pt 5 days post injury
50. Management of grade 3 splenic injury with haemoperitoneum in stable patient
51. Management of stab injury causing isolated 1cm SB injury 80cm distal to DJ with contamination
52. Management of stab causing isolated transverse colon injury with contamination
53. Management of peripheral limb trauma with ischaemic limb
54. Endoscopy picture of white plaques post NA chemo for oesophageal cancer- management
55. Gallbladder polyp 7mm management
56. Gallbladder cancer T1b found. Next step in management
57. Gallbladder cancer described on imaging- next invx
58. Female pregnant patient with LUQ pain and signs of hypovolaemic shock – likeliest cause
59. Female pregnant refugee patient not had any obstetric caregrossly thyrotoxic 22 weeks, ?management
60. CT of large ?pseudocyst post GS pancreatitis -management
61. Management with GS pancreatitis in terms of timing of lap chole (x2)
62. Post lap chole complications- one ERCP picture of ?clipped CBD -management
63. Management of oesophageal perforation post trans oesophageal echo
64. Management of boerhaave’s x2 in young female pt with DKA induced vomiting and supraclavicular subcut emphysema and leak on contrast swallow
65. Management of 3cm FNH confirmed on MRI in pregnancy
66. Management of hyper plastic gastric polyps
67. Feature in FH most inkeeping with diagnosis of Lynch (differing family and personal histories)
68. Management after emergency right hemi for obstructing hepatic flexure cancer -investigation
69. Description of solitary rectal ulcer -management in younger man and older woman (x2)
70. Management of painful anal lesions seen in clinic not typical for simple fissure (x2) -one ‘ulcer’ one subtle erythema at 11 o clock
71. Man with HIV post chemo for lymphoma with right sided abdo pain ?cause
72. Hinchey I with 6cm paracolic abscess management
73. Surgical management of acute severe localised left sided colitis
74. Elderly man with cardiac failure with large AAA with favourable neck etc. Management
75. Elderly man with suspected renal colic-management (?Imaging before admission)
76. 32 yo woman severe abdo pain, loading R colon, empty rectum, normal bloods and obs management (?flexi, ?laxatives ?CT ?NGT with IVF)
77. Patient with cystic pancreatic lesions and previous kidney cancer- most common other site for tumour
78. Patient with recurrent colorectal cancer with inoperable liver met with wild type K-RAS mutation. What to give to downstage.
79. CT of patient with newly diagnosed proximal DVT- solid mesenteric mass (?ovarian cyst/ lymphoma etc)
80. Newly diagnosed ileofemoral DVT next step (CxR, bloods NAD)-?pelvic USS ?CTAP
81. Patient with BG of AAA repair, 30u ETOH weekly. Haematemesis. Invx/ management
82. CT of ?liver abscess -next step/ invx
83. Diabetic foot infection with gangrene and oedema- appropriate initial management
84. GCS calculation
85. Solution of adrenaline calculation
86. AXR of volvulus post orthopaedic surgery -management
87. AXR of vomiting patient with abdo pain-looked like sentinel loop, lactate OK, amylase N ?management
88. SBO patient 12 hrs after onset of drip and suck- still high aspirates. Next step.
89. SBO patient 48 hrs in-failed conservative. Develops unwell/ fever-?chest infection. Management (?proceed, ?delay ?TPN