Edited by Julie Brittenden MBChB MD FRCS Consultant Vascular Surgeon, Aberdeen Royal Infirmary, Professor of Vascular Surgery, University of Aberdeen, UK David Smith MD FRCSEd Consultant Surgeon and Honorary Senior Lecturer, Ninewells Hospital, Dundee; Convener of Education, Royal College of Surgeons of Edinburgh, UK
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JP Medical Ltd is a subsidiary of Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India
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Indexed, copy edited, typeset, printed and bound in India.Foreword
This book recognises that assessment drives learning. It provides the opportunity to reinforce understanding, practise exam technique and fill in the gaps in your knowledge. The questions presented utilise the assessment style of the FRCS General Surgery: Section 1 written exam offered by the Intercollegiate Specialty Board (ISB). It introduces and familiarises candidates with the Single Best Answer (SBA) and Extended Matching Item (EMI) question formats. Understanding the nuances of choosing the best answer available in contradistinction to the preconception of a correct answer is a technique best practised before it is employed on the day of the exam itself.
Format apart, this book is also a useful source of information in respect of the subject matter covered in the exam, and provides familiarity with the spectrum of topics. As a resource, therefore, this book is rich in content. It provides exemplars of the requisite facts and knowledge, supported by references and illustrated to consolidate learning objectives.
The exam aspires to test beyond the basic level of knowledge possessed by candidates. By careful construction of questions, the exam tests higher-order thinking and explores the use of facts at numerous levels beyond the foundation level of Bloom's taxonomy. The questions in this book adhere to this aspiration, testing of higher-order thinking, and provide a valuable adjunct to exam preparation.
The authors, all of whom have recent experience of the exam and are therefore well-placed to write this book, have provided a fit-for-purpose educational item. Not in itself a replacement for the fundamental knowledge acquisition needed for success in the exam, this book is nonetheless an easy-to-read and easy-to-use companion which offers valuable preparation prior to sitting the exam and will support and advance candidates' chances of success.
Professor George G Youngson cbe mbchb phd frcpe frcsed
Emeritus Professor, University of Aberdeen;
Vice President, Royal College of Surgeons of Edinburgh, UKPreface
The purpose of this book is to provide practice questions for candidates sitting the FRCS General Surgery: Section 1 written exam. Each author and editor has successfully sat this exam (or its equivalent), some within the last year or two. We were all aware of a deficiency of reputable practice question material. This book aims to redress the balance, by offering well-researched questions that accurately represent the exam style and, importantly, the expected level of difficulty. Each question has been meticulously reviewed by a team of editors and chosen experts, to ensure that it delivers on both style and standard.
The book is divided into surgical specialities (general and emergency, breast, colorectal, endocrine, hepatobiliary, transplantation, upper gastrointestinal, and vascular and endovascular), to aid structured revision and attention to referenced material. Questions that cover topics such as statistics and ethics are also included, since personal experience has taught us that these subjects crop up frequently. The answers feature full explanations, illustrations and further reading.
Section 1 of the exam comprises two papers. Paper 1 consists of 110 single best answer (SBA) questions, to be answered within 2 hours. Paper 2 consists of 135 extended matching item (EMI) questions, to be answered within 2 hours and 30 minutes. We include both types of question and cover all the specialities. We suggest that readers use this book ‘against the clock’ to practise exam timings in preparation for exam day, when it can be easy to run out of time.
Further details of the exam regulations can be found on the ISB website: www.intercollegiate.org.uk. We recommend reading the content of this website in advance of the exam, since it provides important information on registration for the day of the exam.
We cannot emphasise strongly enough the need to practise, practise and practise some more. We hope that our book provides a wealth of practice questions and an invaluable resource for your exam preparation.
July 2012Glossary AAT
Alanine amino transaminaseABPI
Ankle brachial pressure indexαFP
Analysis of varianceAPACHE II
Acute physiology & chronic health evaluationASA
American Society of AnaesthesiologistsATLS
Advanced trauma life supportβ-hCG
Beta-human chorionic gonadotrophinBMI
Body mass indexCBD
Common bile ductCABG
Coronary artery bypass graftCEA
Cardiopulmonary exercise testingCRP
Computed tomography angiographyDSA
Digital subtraction angiographyELISA
Enzyme-linked immunosorbent assayERCP
Endoscopic retrograde cholangiopancreatographyFDG-PET
Fluorodeoxyglucose positron emission tomographyGGT
Gamma glutamyl transaminaseHDU
High dependency unitISS
Injury severity scoreIVDA
Intravenous drug abuserkPa
Liver function testMETS
Metabolic equivalent task scoreMODS
Multiple organ dysfunction syndromeMRA
Magnetic resonance angiographyMRCP
Magnetic resonance cholangiopancreatographyMUGA
Multi-gated acquisition scanO-POSSUM
Oesophagogastric physiological and operative score for the numeration of mortality and morbidityP-POSSUM
Physiological and operative score for the numeration of mortality and morbidityPaO2/CO2
Partial arterial pressure of oxygen/carbon dioxidePFT
Pulmonary function testPTA
Percutaneous transluminal angioplastyPTC
Percutaneous transhepatic cholangiographyRTS
Simplified acute physiology scoreSIRS
Systemic inflammatory response syndromeTNM
Thoracic outlet syndromeUNOS
United Network for Organ SharingVACTERL
Vertebral anomalies, anal atresia, cardiovascular anomalies, tracheo-oesophageal fistula, renal abnormalities, limb defects.Recommended reading
Beard JD and Gaines PA (eds). Vascular and Endovascular Surgery: A Companion to Specialist Surgical Practice, 4th edition. Philadelphia: Saunders, Elsevier, 2009.
Dixon JM (ed). Breast Surgery: A Companion to Specialist Surgical Practice, 4th edition. Philadelphia: Saunders, Elsevier, 2009.
Forsyth JLR (ed). Transplantation Surgery: A Companion to Specialist Surgical Practice, 4th edition. Philadelphia: Saunders, Elsevier, 2009.
Garden OJ (ed). Hepatobiliary and Pancreatic Surgery: A Companion to Specialist Surgical Practice, 4th edition. Philadelphia: Saunders, Elsevier, 2009.
Griffin SM and Raimes SA (eds). Oesophagogastric Surgery: A Companion to Specialist Surgical Practice, 4th edition. Philadelphia: Saunders, Elsevier, 2009.
Jones PF, Krukowski ZH and Youngson GG (eds). Emergency Abdominal Surgery, 3rd edition. London: Chapman and Hall Medical, 1998.
Lennard TWJ (ed). Endocrine Surgery: A Companion to Specialist Surgical Practice, 4th edition. Philadelphia: Saunders, Elsevier, 2009.
Paterson-Brown S (ed). Core Topics in General and Emergency Surgery: A Companion to Specialist Surgical Practice, 4th edition. Philadelphia: Saunders, Elsevier, 2009.
Philips RKS (ed). Colorectal Surgery: A Companion to Specialist Surgical Practice, 4th edition. Philadelphia: Saunders, Elsevier, 2009.
Further details of the exam regulations can be found on the ISB website: www.intercollegiate.org.uk. We recommend reading the content of this website in advance of the exam, since it provides important information on registration for the day of the exam.Acknowledgements
With special thanks to our editors, Mr David Smith and Professor Julie Brittenden, without whom the preparation of this book would not have been possible. Their efforts and organisation have made this process relatively painless. We would also like to thank Professor George Youngson for his insightful Foreword.
Thank you to Louise Smart and Professor Zygmunt Krukowski for their intellectual input and supply of pathology images and illustrations.
We are grateful to Mr Douglas Brown and Mr Pradeep Patil for reviewing the breast surgery and transplant surgery sections and providing editorial support.
Thanks also to JP Medical, our supportive and understanding publisher.
AW, WC, LS