General Surgery Principles Flashcards

A patient on long-term steroids requires major surgery. What perioperative concern is most important?

Answer: Risk of adrenal crisis requiring stress-dose steroids

Chronic steroid use suppresses the adrenal axis, requiring stress-dose cover to prevent perioperative adrenal crisis.

What is the most reliable clinical sign of established compartment syndrome in a limb?

Answer: Pain on passive stretch out of proportion to injury

Pain on passive stretch is the earliest and most reliable sign; pulselessness is a late finding.

Which VTE prophylaxis is appropriate for a high-risk patient after major abdominal cancer surgery?

Answer: Low-molecular-weight heparin plus mechanical prophylaxis

High-risk cancer surgery patients need combined pharmacological and mechanical VTE prophylaxis.

A patient develops oliguria with urine output under 0.5 mL/kg/hr postoperatively. What is the first step?

Answer: Assess volume status and give a fluid challenge if hypovolaemic

Postoperative oliguria is most often pre-renal, so volume assessment and a fluid challenge come first.

What does ERAS (Enhanced Recovery After Surgery) primarily aim to achieve?

Answer: Reduce surgical stress and speed functional recovery

ERAS protocols minimise the stress response and accelerate recovery through evidence-based perioperative care.

Which nutritional route is preferred in a postoperative patient with a functioning gut?

Answer: Enteral nutrition

Enteral feeding maintains gut integrity and has fewer complications than parenteral routes when the gut works.

A patient has signs of malignant hyperthermia under general anaesthesia. What is the specific treatment?

Answer: Dantrolene

Dantrolene is the specific antidote for malignant hyperthermia, alongside stopping triggers and active cooling.