Surgery
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SNI SURGERY / PUBLIC SAMPLE

See it. Explain it.

Recognise the findings, practise the examination and prepare a clear viva answer.

2 stationsPage 1 of 1
Observed stations · Surgical principles

Examination of lymph nodes

Examine a patient with a persistent neck swelling.

2 questions
1. How do you examine a node?
  • Confirm its anatomical group, number, size, tenderness, warmth, consistency, mobility and fixation.
  • Look for matting, fluctuance and overlying skin change.
  • Examine the drainage territory and other nodal groups; look for hepatosplenomegaly when appropriate.
References & source

SNI source: Surgery SNI 2nd edition print version.pdf · PDF page 88 · OSPE blueprint / Station 5 / lymph nodes

Expanded from the SNI OSPE blueprint; station wording and model answers prepared for this collection.

Bailey & Love links locate relevant chapters in the 28th edition. Page numbers are omitted where the textbook pagination has not been verified.

2. Which findings warrant further assessment?
  • Persistent unexplained lymphadenopathy, supraclavicular nodes, hard fixed nodes or associated constitutional symptoms.
  • Differentiate local infection, tuberculosis, lymphoma and metastatic disease using history, examination and targeted tests.
  • Choose tissue sampling based on suspected disease; suspected lymphoma generally requires tissue architecture, not cytology alone.
References & source

SNI source: Surgery SNI 2nd edition print version.pdf · PDF page 88 · OSPE blueprint / Station 5 / lymph nodes

Expanded from the SNI OSPE blueprint; station wording and model answers prepared for this collection.

Bailey & Love links locate relevant chapters in the 28th edition. Page numbers are omitted where the textbook pagination has not been verified.

Observed stations · Surgical principles

General examination before a surgical case

Demonstrate a focused general physical examination before the system examination.

2 questions
1. Which signs will you assess?
  • General appearance, distress, nutrition, hydration and observations.
  • Hands for clubbing, pallor, cyanosis, koilonychia, tremor or muscle wasting; then eyes and mouth for relevant signs.
  • Jaundice, anaemia, lymphadenopathy and oedema; examine only with appropriate exposure and consent.
References & source

SNI source: Surgery SNI.numbers.zip · GPE · ospe

Expanded from the SNI OSPE blueprint; station wording and model answers prepared for this collection.

Bailey & Love links locate relevant chapters in the 28th edition. Page numbers are omitted where the textbook pagination has not been verified.

2. How do you make the examination clinically useful?
  • Select findings relevant to the surgical presentation and comorbidity.
  • Inspect lines, drains, wounds and medication charts in a postoperative patient.
  • Report positive findings precisely and avoid treating a normal general examination as exclusion of serious disease.
References & source

SNI source: Surgery SNI.numbers.zip · GPE · ospe

Expanded from the SNI OSPE blueprint; station wording and model answers prepared for this collection.

Bailey & Love links locate relevant chapters in the 28th edition. Page numbers are omitted where the textbook pagination has not been verified.

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For undergraduate revision. Management decisions should follow current clinical guidance and local practice.