Clinical Surgery Syllabus

Surgery syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Surgery in Clinical, not a summary of it.

1. 1

   General Surgery

   4 topics

   • Preoperative Care
     • Patient Assessment
     • Risk Stratification
     • Preoperative Investigations
     • Informed Consent
   • Postoperative Care
     • Monitoring and Support
     • Pain Management
     • Wound Care
     • Complications and Management
   • Surgical Infections
     • Types of Infections
     • Antibiotic Prophylaxis
     • Management of Surgical Site Infections
   • Surgical Techniques
     • Aseptic Techniques
     • Suturing and Knot Tying
     • Hemostasis
2. 2

   Trauma Surgery

   5 topics

   • Initial Assessment and Management
     • Primary Survey (ABCDE)
     • Secondary Survey
     • Trauma Resuscitation
   • Head and Neck Trauma
     • Scalp Lacerations
     • Facial Fractures
     • Neck Injuries
   • Thoracic Trauma
     • Chest Wall Injuries
     • Pulmonary Contusion
     • Cardiac Injuries
   • Abdominal Trauma
     • Solid Organ Injuries
     • Hollow Viscus Injuries
     • Retroperitoneal Hematoma
   • Orthopedic Trauma
     • Fracture Management
     • Dislocations
     • Compartment Syndrome
3. 3

   Gastrointestinal Surgery

   5 topics

   • Esophageal Surgery
     • Achalasia
     • Esophageal Cancer
     • Gastroesophageal Reflux Disease (GERD)
   • Gastric Surgery
     • Peptic Ulcer Disease
     • Gastric Cancer
     • Bariatric Surgery
   • Hepatobiliary Surgery
     • Liver Cirrhosis
     • Hepatocellular Carcinoma
     • Cholecystitis and Cholelithiasis
   • Pancreatic Surgery
     • Pancreatitis
     • Pancreatic Cancer
     • Cystic Neoplasms
   • Colorectal Surgery
     • Colorectal Cancer
     • Inflammatory Bowel Disease
     • Diverticular Disease
4. 4

   Cardiothoracic Surgery

   3 topics

   • Cardiac Surgery
     • Coronary Artery Bypass Grafting (CABG)
     • Valve Replacement Surgery
     • Congenital Heart Defects
   • Thoracic Surgery
     • Lung Cancer Surgery
     • Thoracoscopic Surgery
     • Pleural Diseases
   • Vascular Surgery
     • Aortic Aneurysm
     • Peripheral Arterial Disease
     • Carotid Endarterectomy
5. 5

   Neurosurgery

   3 topics

   • Cranial Surgery
     • Brain Tumors
     • Traumatic Brain Injury
     • Hydrocephalus
   • Spinal Surgery
     • Spinal Cord Injury
     • Degenerative Spine Disease
     • Spinal Tumors
   • Peripheral Nerve Surgery
     • Nerve Repair
     • Carpal Tunnel Syndrome
     • Peripheral Nerve Tumors
6. 6

   Pediatric Surgery

   3 topics

   • Neonatal Surgery
     • Congenital Diaphragmatic Hernia
     • Esophageal Atresia
     • Imperforate Anus
   • Pediatric Oncology
     • Wilms' Tumor
     • Neuroblastoma
     • Rhabdomyosarcoma
   • Pediatric Trauma
     • Pediatric Fractures
     • Abdominal Trauma
     • Head Injuries
7. 7

   Plastic Surgery

   3 topics

   • Reconstructive Surgery
     • Burn Management
     • Cleft Lip and Palate
     • Breast Reconstruction
   • Cosmetic Surgery
     • Rhinoplasty
     • Liposuction
     • Facelift
   • Hand Surgery
     • Carpal Tunnel Release
     • Dupuytren's Contracture
     • Tendon Repair
8. 8

   Urology

   3 topics

   • Renal Surgery
     • Kidney Stones
     • Renal Cell Carcinoma
     • Nephrectomy
   • Bladder Surgery
     • Bladder Cancer
     • Cystectomy
     • Urinary Diversion
   • Prostate Surgery
     • Benign Prostatic Hyperplasia
     • Prostate Cancer
     • Prostatectomy
9. 9

   Orthopedic Surgery

   3 topics

   • Joint Replacement
     • Hip Replacement
     • Knee Replacement
     • Shoulder Replacement
   • Spine Surgery
     • Spinal Fusion
     • Disc Herniation
     • Scoliosis Surgery
   • Sports Injuries
     • ACL Reconstruction
     • Meniscal Repair
     • Rotator Cuff Repair

Surgery flashcards for Clinical

18 of 50 cards from the Surgery deck — real questions with worked answers.

1. What are the six essential components of a preoperative assessment?

   History and physical exam, laboratory/diagnostic testing, cardiac and pulmonary risk assessment, medication review, informed consent, and optimization of comorbidities (e.g., glycemic and blood pressure control).

2. According to fasting (NPO) guidelines, what are the minimum fasting times before elective surgery for clear liquids, a light meal, and fried/fatty foods?

   Clear liquids: 2 hours; light meal (toast/clear liquids): 6 hours; fried or fatty foods and meat: 8 hours or more.

3. In the ASA Physical Status Classification, what do classes I through V represent?

   I: normal healthy patient; II: mild systemic disease; III: severe systemic disease; IV: severe systemic disease that is a constant threat to life; V: moribund patient not expected to survive without the operation. (VI = brain-dead organ donor.)

4. What is the Revised Cardiac Risk Index (RCRI/Lee index) and what are its six predictors?

   A tool predicting major cardiac complications in noncardiac surgery. Predictors: high-risk surgery, ischemic heart disease, congestive heart failure, cerebrovascular disease, insulin-dependent diabetes, and creatinine $> 2\,\text{mg/dL}$ ($>176\,\mu\text{mol/L}$).

5. When should chronic anticoagulants and antiplatelets typically be managed before surgery: warfarin, clopidogrel, and aspirin?

   Warfarin: stop about 5 days before (bridge high-risk patients with heparin); clopidogrel: stop about 5-7 days before; aspirin: often continued for cardiac patients but stopped 7 days before for high-bleeding-risk surgery.

6. What is the classic timing and presentation of the five postoperative fever causes ('5 Ws')?

   Wind (atelectasis/pneumonia, days 1-2), Water (UTI, days 3-5), Wound (infection, days 5-7), Walking (DVT/PE, days 5+), Wonder drugs/What did we do (drug fever, IV lines, anytime).

7. What is the most common cause of fever in the first 24-48 hours after surgery?

   Atelectasis (though evidence links early fever more to inflammatory cytokine response); managed with incentive spirometry, early mobilization, and deep breathing.

8. What are the key elements of postoperative VTE prophylaxis?

   Early ambulation, mechanical prophylaxis (intermittent pneumatic compression, graduated stockings), and pharmacologic prophylaxis with low-molecular-weight heparin or unfractionated heparin, risk-stratified by the Caprini score.

9. What is postoperative ileus, and when does normal bowel function typically return by segment?

   Transient impairment of GI motility after surgery. Normal recovery: small bowel within 24 hours, stomach 24-48 hours, and colon 48-72 hours. Prolonged ileus beyond 3-5 days warrants workup.

10. Distinguish wound dehiscence from evisceration.

    Dehiscence is partial or complete separation of the fascial layers of a surgical wound; evisceration is protrusion of abdominal viscera through the dehisced wound—a surgical emergency requiring sterile moist covering and return to OR.

11. What is SIRS and what four criteria define it (two or more required)?

    Systemic Inflammatory Response Syndrome. Criteria: temperature $>38^{\circ}\text{C}$ or $<36^{\circ}\text{C}$; heart rate $>90$/min; respiratory rate $>20$/min or $\text{PaCO}_2 <32\,\text{mmHg}$; WBC $>12{,}000$ or $<4000/\mu\text{L}$ or $>10\%$ bands.

12. How is a surgical site infection (SSI) classified by depth?

    Superficial incisional (skin/subcutaneous), deep incisional (fascia/muscle), and organ/space SSI (any part deeper than fascia manipulated during surgery). Occurs within 30 days (or 90 days with implants).

13. What is the wound classification system and expected infection rates for clean, clean-contaminated, contaminated, and dirty wounds?

    Clean ($<2\%$), clean-contaminated (controlled entry into hollow viscus, $\sim3$-$11\%$), contaminated (gross spillage/fresh trauma, $\sim10$-$17\%$), dirty (established infection/perforated viscus, $>27\%$).

14. When should prophylactic antibiotics be administered relative to surgical incision, and when should they be redosed?

    Within 60 minutes before incision (120 minutes for vancomycin/fluoroquinolones); redose intraoperatively after 2 half-lives or with significant blood loss ($>1500\,\text{mL}$). Discontinue within 24 hours postop.

15. What organism causes necrotizing fasciitis type I versus type II, and what is the treatment?

    Type I: polymicrobial (aerobes + anaerobes); Type II: monomicrobial, usually Group A Streptococcus ($\pm$ S. aureus). Treatment: emergent surgical debridement plus broad-spectrum antibiotics and supportive care.

16. What are the classic clinical signs suggesting necrotizing soft tissue infection?

    Pain out of proportion to exam, skin crepitus, hemorrhagic bullae, rapidly spreading erythema, systemic toxicity, and 'dishwater' gray drainage. LRINEC score aids diagnosis.

17. What are the four phases of wound healing?

    Hemostasis (immediate, clot formation), inflammation (days 1-4, neutrophils then macrophages), proliferation (days 4-21, fibroblasts, collagen, angiogenesis, epithelialization), and remodeling/maturation (weeks to years, collagen type III replaced by type I).

18. Compare healing by primary, secondary, and tertiary intention.

    Primary: wound edges approximated directly (sutured). Secondary: wound left open to heal by granulation and contraction. Tertiary (delayed primary): wound left open initially then closed later once infection risk falls.

See more Surgery flashcards →

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