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General Surgery
Gen Surg cases
Fellowship clinical-examination encounters with assessor keys.
34
Units
5
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Chapters · 5
breast
7
vascular
6
trauma
9
surgical-critical-care
11
endocrine
1
01
breast
7 entries
1.8 cm breast cancer with one positive sentinel node — Z0011 omission, AMAROS swap and SOUND boundary
Bilateral risk-reducing mastectomy with DIEP request plus PMRT-conditional implant plan — bilateral consent, radiotherapy sequencing and nipple-margin gate
Bloody nipple discharge with papilloma on core — atypia fork, predictors and excision plan
Palpable 32 mm calcification field with intermediate-grade DCIS on 14-gauge core — upgrade, extent, axilla and adjuvant plan
Recurrent subareolar abscess with periareolar fistula in a smoker — ducts, classification and cessation
Screen-detected asymmetry at 62 with BI-RADS 4B core biopsy — assessment, discordance, DCIS counsel and recall craft
Two-year persistent painful bilateral gynaecomastia — tamoxifen course, surgical plan and cancer counselling
02
vascular
6 entries
Active venous ulcer with superficial-plus-segmental-deep reflux — stratum, timing, and staying healed
Aortoiliac claudicant with a diabetic foot ulcer in the family — exercise prescription, revascularisation restraint, and arterial assessment of every ulcer
Day-6 post-colectomy cancer leg swelling on 1-week prophylaxis — Wells-gated duplex, 4-week extension, and provoked-duration counselling
Febrile tunneled catheter with prior ipsilateral line — lock, exchange, culture, and contralateral planning
Fit 68-year-old with a 5.8 cm infrarenal AAA — EVAR versus open repair choice with the 15-year crossover
Probeable plantar ulcer with equivocal X-ray — workup, duration, and the surgical threshold
03
trauma
9 entries
Anterior stab selected for observation, scoped for breach, repaired for colon injury — the full selective pathway in one patient
ATLS primary survey — the under-triaged elderly fall
Blunt aortic injury grade II with flail chest and retained haemothorax — sequence the aorta, fix the wall, clear the blood
Field P2 Sort arrival who deteriorates at the door — re-triage, secondary workup, and hospital flow under load
Grade V liver injury with destructive transverse colon injury — pack, staple, transfuse, return and close
Moderate isolated contusion selected for early surgery — STITCH numbers, TXA, drains and VTE timing
Open-book pelvis with perineal communication and shock — haemorrhage now, sepsis next, fixation last
Over-resuscitated burn with rising pressures and missed referral — down-titration, sepsis trigger, and transfer rescue
Stable soft-sign neck with negative CTA but persistent dysphagia — the gullet workup and the carotid blush plan
04
surgical-critical-care
11 entries
Blunt polytrauma with hypotension at 50 minutes — activation, ratios, TXA clock, calcium and after-haemostasis vigilance
Blunt polytrauma with pelvic fracture and hypotension — MTP, whole blood, calcium and TXA timing
Damage-control laparotomy with rising MOD scores, oliguria and a tense abdomen — trajectory, IAH and SIC
Day-2 post-laparotomy failure with basal collapse, overnight FFP and an epidural — fork, reverse, relieve and rescue
Emergency laparotomy in an 81-year-old — delirium prediction, prevention bundle and cause-hunt
Emergency laparotomy with septic shock and oliguria — bundle, fluids, dialysis timing and follow-up
Polytrauma with bleeding and cord injury — competing shocks, ratio blood, early TXA
Post-gastrectomy refractory hypoxemia — lung-protective reset, proning, source hunt and ECMO referral
Post-laparotomy oozing with consumption — bleeding DIC, JAAM-2 start, product resuscitation
Post-laparotomy shock with AKI, refeeding risk and hyperglycaemia — feed, bridge, restrict and cap
Postoperative healthcare-associated intra-abdominal infection after colectomy — shock predictors, urgent control, and the rescue pathway
05
endocrine
1 entry
cT2N0 papillary cancer with stridor-free airway — extent, prophylactic neck, ablation and calcium consent