------------------------------------------------------
OLLSCOIL NA hÉIREANN, GAILLIMH
NATIONAL UNIVERSITY OF IRELAND, GALWAY
------------------------------------------------------
SUMMER EXAMINATION, 2010
------------------------------------------------------
FINAL MEDICAL EXAMINATION
------------------------------------------------------
SURGERY
Professor R.K.S. Phillips
Professor M.J. Kerin
------------------------------------------------------
Time Allowed: 3 Hours.
Each answer to be written in a separate answer book.
6 questions must be attempted.
------------------------------------------------------
1. A 25 year old motorcyclist presents to the emergency department
resuscitation room unconscious following a collision with a wall. Outline
your assessment and initial management.
2. Write short notes on each of the following
a) Complications of abdominal aortic aneurysm surgery
b) Treatment of chronic venous ulcers
c) Medical treatment of peripheral vascular disease.
d) Blue Toe Syndrome
3. A 65 year old man has been diagnosed with peritonitis and shock. He
requires an emergency laparotomy. He is confused, aggressive, has a blood
pressure of 80/40mmHg and is in considerable pain. You have been asked to
resuscitate this patient and prepare him for his emergent laparotomy.
Please answer the following questions in short answer form.
a) What type of shock does this patient have and what is the classic
haemodynamic pattern of this type of shock?
b) Describe how you would resuscitate this patient.
c) What additional steps would you take to prepare this patient for his
emergency laparotomy including appropriate investigations?
d) Describe the precautions that are necessary in the management of this
patient’s airway during the induction of anaesthesia and give reasons why.
e) How would you manage this patient’s pain post-operatively? Are there any
modes of analgesia or classes of analgesics for which special care is required
in this patient?
