INI CET Surgery And Allied Specialties Flashcards

24 sample cards from the Surgery And Allied Specialties deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. What is the Duke's classification for colorectal cancer (stages A-D)?

   A: confined to bowel wall (mucosa/submucosa, not through muscularis); B: through bowel wall, no nodes; C: regional lymph node involvement; D: distant metastasis.

2. Define Salter-Harris classification Type II fracture.

   Fracture through the growth plate (physis) and metaphysis, sparing the epiphysis — the most common type (mnemonic SALTER: Type II = Above/Above the physis).

3. What is the most commonly fractured carpal bone and its feared complication?

   Scaphoid; complication is avascular necrosis of the proximal pole (due to retrograde blood supply) and nonunion.

4. What nerve is most commonly injured in a surgical neck of humerus fracture?

   Axillary nerve — leads to deltoid weakness and loss of sensation over the 'regimental badge' area.

5. What is the unhappy triad (O'Donoghue's triad) of the knee?

   Injury to the anterior cruciate ligament (ACL), medial collateral ligament (MCL), and medial meniscus (classically; some texts cite lateral meniscus).

6. What is the most common type of hip dislocation and the associated nerve injury?

   Posterior dislocation (~90%); associated with sciatic nerve injury — limb is flexed, adducted, and internally rotated.

7. What is the Gartland classification used for?

   Classification of supracondylar fractures of the humerus in children (Type I: undisplaced; Type II: displaced with intact posterior cortex; Type III: completely displaced).

8. What is the gold-standard treatment and a classic radiographic sign of osteosarcoma?

   Treatment: neoadjuvant chemotherapy + limb-salvage surgery (wide resection); classic X-ray signs: Codman's triangle and 'sunburst/sunray' appearance.

9. What deformity characterizes Developmental Dysplasia of the Hip and which tests screen for it?

   Acetabular dysplasia with hip instability/dislocation; screened with Ortolani (relocation) and Barlow (dislocation) tests in neonates.

10. What is the characteristic deformity of avascular necrosis of the femoral head and a common cause?

    Collapse/flattening of the femoral head with crescent sign on X-ray; common causes include corticosteroid use, alcohol, and femoral neck fractures.

11. What is the ASA Physical Status classification for a patient with severe systemic disease that is a constant threat to life?

    ASA IV (e.g., recent MI, severe symptomatic heart failure, sepsis, end-stage renal disease).

12. What are the components of the Mallampati classification and what does it predict?

    Classification (I-IV) based on visibility of the soft palate, uvula, and pillars when the patient opens the mouth and protrudes the tongue; predicts difficulty of laryngoscopy/intubation (higher class = more difficult airway).

13. What is the standard preoperative fasting guideline (clear fluids, breast milk, solids)?

    Clear fluids: 2 hours; breast milk: 4 hours; light meal/formula/solids: 6 hours (the '2-4-6' rule).

14. What does the LEMON assessment evaluate?

    Difficult airway prediction — Look externally, Evaluate 3-3-2 rule, Mallampati, Obstruction, Neck mobility.

15. What is the mechanism of action of local anesthetics?

    They reversibly block voltage-gated sodium (Na+) channels on the internal surface of nerve membranes, preventing depolarization and impulse conduction.

16. What is the maximum safe dose of lidocaine with and without adrenaline?

    Lidocaine without adrenaline: 3 mg/kg (max ~200-300 mg); with adrenaline: 7 mg/kg (max ~500 mg).

17. What is the triad of general anesthesia?

    Hypnosis (unconsciousness), analgesia, and muscle relaxation (areflexia).

18. What is the difference between spinal and epidural anesthesia in terms of injection site?

    Spinal (subarachnoid): injected into the CSF in the subarachnoid space below L1/L2; Epidural: injected into the epidural (extradural) space, outside the dura, can be at any level.

19. What is the analgesic ladder of the WHO for cancer pain?

    Step 1: non-opioid (paracetamol/NSAID) ± adjuvant; Step 2: weak opioid (codeine/tramadol) ± non-opioid ± adjuvant; Step 3: strong opioid (morphine) ± non-opioid ± adjuvant.

20. What is the antidote for opioid overdose and benzodiazepine overdose?

    Naloxone for opioids; Flumazenil for benzodiazepines.

21. What is malignant hyperthermia, its trigger, and treatment?

    A hypermetabolic crisis triggered by volatile anesthetics (e.g., halothane, sevoflurane) and succinylcholine in genetically susceptible (RYR1 mutation) patients; treated with dantrolene plus supportive cooling and management of hyperkalemia/acidosis.

22. In critical care, what does the SOFA score assess?

    Sequential Organ Failure Assessment — degree of organ dysfunction across 6 systems: respiratory (PaO2/FiO2), coagulation (platelets), liver (bilirubin), cardiovascular (MAP/vasopressors), CNS (GCS), and renal (creatinine/urine output).

23. Which imaging modality is the investigation of choice for suspected acute appendicitis in children and pregnant women (no radiation)?

    Ultrasonography (USG) — first-line to avoid ionizing radiation; MRI is used if ultrasound is inconclusive in pregnancy.

24. In radiation oncology, what is the standard fractionation principle and the unit of absorbed radiation dose?

    Fractionation delivers the total dose in small daily fractions to exploit the 4 R's (Repair, Reassortment/Redistribution, Repopulation, Reoxygenation) sparing normal tissue; the SI unit of absorbed dose is the Gray (Gy = 1 J/kg).

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