Surgical Handicraft

The evolution of MRCS Q pattern 2014-2026 !!!
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📘 EXPANDED SURGERY – BROAD SYLLABUS COVERAGE
🔴 1. PRINCIPLES OF SURGERY
Asepsis & antisepsis
Sterilisation & disinfection methods
Wound healing (phases, factors affecting)
Acute & chronic inflammation
Surgical infections (cellulitis, abscess, necrotising infections)
Sinus, fistula, ulcer (classification & principles)
Shock (types, pathophysiology, management)
Fluid, electrolyte & acid-base balance
Blood transfusion (indications, reactions, complications)
Nutrition in surgery (enteral, parenteral, malnutrition, refeeding)
🔵 2. PERIOPERATIVE CARE & ANAESTHESIA
Preoperative assessment & optimisation
Risk stratification (ASA grading)
Preoperative investigations (routine vs selective)
Postoperative complications (early & late)
Pain management
DVT prophylaxis
Basics of anaesthesia (GA, regional, local)
🟢 3. GASTROINTESTINAL SURGERY
Upper GI
Dysphagia (approach & causes)
Dyspepsia & alarm symptoms
Peptic ulcer disease
Gastric outlet obstruction
Gastric carcinoma
Lower GI
Acute abdomen
Intestinal obstruction
Appendicitis
Colorectal carcinoma
Inflammatory bowel disease
GI Bleeding
Upper vs lower GI bleed
Causes, evaluation, initial management
🟡 4. HEPATOBILIARY & PANCREAS
Jaundice (types & evaluation)
Obstructive jaundice
Gallstone disease
Cholecystitis
Pancreatitis (acute & chronic)
Hepatobiliary imaging (USG, CT, MRCP, ERCP)
🟣 5. BREAST SURGERY
Breast lump (benign vs malignant)
Carcinoma breast (risk factors, staging, management)
Infections (mastitis, abscess)
Screening principles
🟠 6. ENDOCRINE SURGERY
Thyroid disorders (goitre, nodules, malignancy)
Thyroid investigations (TFT, FNAC, imaging)
Thyroid surgery (types & complications)
Adrenal tumours (including functional tumours)
⚫ 7. VASCULAR SURGERY
Peripheral arterial disease
Venous diseases (varicose veins, DVT)
Ischaemic ulcers vs venous ulcers
Amputation principles
🔶 8. UROLOGY
Urinary retention
Urolithiasis
Prostate enlargement
Haematuria
Basic urological investigations
🔷 9. PAEDIATRIC SURGERY
Congenital anomalies (cleft lip/palate, pyloric stenosis)
Undescended te**is
Intestinal obstruction in children
Paediatric surgical infections
🟥 10. ORTHOPAEDICS & TRAUMA
Fractures
General principles (classification, healing)
Common fractures (hip, wrist, long bones)
Joint Disorders
Osteoarthritis
Rheumatoid arthritis
Spine
Low back pain
Disc prolapse
Bone Infection
Osteomyelitis
🟫 11. TRAUMA & EMERGENCY SURGERY
Primary survey (ABCDE approach)
Head injury (concussion, extradural haemorrhage)
Chest trauma (including tamponade)
Abdominal trauma
Burns (classification & management)
⚪ 12. RADIOLOGY & DIAGNOSTICS (BASICS)
X-ray interpretation basics
Ultrasound indications
CT scan role
Endoscopy basics
Interventional procedures (e.g., ERCP)

MRCS Debatable Q
Question 200 :@ J23@ Vascular Trauma

A 32-year-old trauma patient presents following a road traffic accident with a severe injury to the knee. Examination shows extensive bruising around the knee joint, but no haemarthrosis is present. The leg distal to the injury appears cold and pale, although a femoral pulse is still palpable.
Which of the following injuries is most likely responsible for this presentation?
A) Knee dislocation
B) Supracondylar femur fracture
C) Popliteal artery injury
D) Tibial plateau fracture
E) Tibial shaft fracture

Ans A or C ??

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MRCS @ Question 79 :@ J-23 @ Physiology – Renal Pharmacology
FCPS @ Q 87

Frusemide primarily acts on which part of the renal nephron?

A) Glomerulus
B) Proximal Convoluted Tubule
C) Ascending Limb Of The Loop Of Henle
D) Distal Convoluted Tubule
E) Collecting Duct

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MRCS Question 29 :@ S-25 @ Orthopaedics

Following tourniquet release during orthopaedic surgery, a patient develops severe pain and numbness in the affected limb. What is the most likely cause?

A) Nerve Injury
B) Ischaemia–Reperfusion Injury
C) Infection
D) Haematoma Formation
E) Compartment Syndrome

MRCS Question 28 :@ S-25 @ Breast and Endocrine Surgery

A 45-year-old woman presents with a 3 cm mobile breast lump associated with mild discomfort. Fine-needle aspiration cytology (FNAC) demonstrates benign cells. What is the most appropriate management?

A) Wide Local Excision
B) Core Biopsy
C) Observation with Follow-up
D) Mastectomy
E) Discharge with No Follow-up