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SAQ-Surgery-Chest & Abdomen

The boxed questions are the four you are to do to time and bring to teaching.
Please use a timer (60 min for 4 questions) as a perfect 18 minute answer is an incomplete and failing 15 minute answer.

Discuss the emergency department management of spontaneous pneumothorax (100%).

1994/2/SAQ7: An obese 80 year old man presents having collapsed with sudden onset sever back pain. He is sweaty with a pulse of 120bpm and a BP of 100/60mmHg. The periumbilical area is tender, with no obvious expansile mass in the abdomen. Discuss the investigations to assist you in the diagnosis (100%).

2000/2/SAQ2: A 72 year old man presents with tearing chest pain suggestive of dissection of her aorta. Discuss the utility of chest x-ray in this situation (50%). Outline the emergency department management of proven aortic dissection (50%)

A 64 year old man presents with increased abdominal pain following a barium enema for investigation of constipation. Describe your assessment of this man (50%). Xray shows free intraperitoneal air; describe your management (50%)

worked answers

2010/2/SAQ6: A surgical registrar would like to admit an 85 year old woman with constipation to your observation ward. Describe the issues involved in considering this request (100%)            .

examiner's comments

2007/2/SAQ3: A 72 year old man presents to the emergency department with a two day history of abdominal pain. A CT scan undertaken to investigate recent weight loss and jaundice shows a pancreatic mass lesion. On examination, he is confused and jaundiced with maximal tenderness in the right upper quadrant. His observations are; Temp: 39.8oC, PR: 120 per min, BP: 100/65mmHg, RR: 22 per min. O2 Sat: 98% on oxygen 6 LPM. Describe your management.(100%) 

examiner's comments

2007/1/SAQ6: A 19 year old woman presents with a 12 hour history of right iliac fossa pain and tenderness. a) List your main differential diagnoses. (30%) b) Compare and contrast the utility of computerised axial tomography and ultrasound for these conditions.(70%)

examiner's comments

2006/1/SAQ7: List and justify the investigations you would consider in a 79 year old woman who presents with poorly localised abdominal pain.(100%)

examiner's comments

2005/1/SAQ2: A 76 year old female with a history of controlled atrial fibrillation presents to the emergency department with severe central abdominal pain of 2 hours duration. Describe your assessment of this patient. (100%)

examiner's comments

2003/2/SAQ7: An 74 year old man is brought in by ambulance with light headedness and malaena. He reports a 24 hour history of malaena, with a small amount of bright bleeding prior to calling an ambulance. He has a past history of abdominal aortic aneurysm treated by endoluminal stenting 10 months previously at another hospital. His vital signs are a pulse of 80, blood pressure of 135/85 and a GCS of 15. Describe your assessment of this man (50%). Describe your management of this man (50%).

examiner's comments

2002/1/SAQ2: A 65 year old female presents 10 days following coronary artery bypass surgery at your regional referral hospital. On examination she has a clean median sternotomy wound, P 105, BP 145/90, RR 24, SaO2 94% (room air). There is dullness to percussion and reduced breath sounds at the left lung base. ECG shows a sinus tachycardia with ST changes present on her pre discharge ECG. CXR shows a moderate left pleural effusion. Outline your assessment and management of this patient. (100%)

examiner's comments

2001/2/SAQ7: A 70 y.o. woman with paraesthesia and acute pain in her right leg. She has a past history of smoking and hypertension. On examination, the leg is cool to touch and there are no pulses beneath the groin. Describe your assessment and management of this patient in the emergency department. (100%)

examiner's comments