FC Orth(SA) Intermediate

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Intermediate Examination for the Fellowship of the

College of Orthopaedic Surgeons of South Africa

23 August 2012

Paper 1 Principles of Surgery in General & Orthopaedics (3 hours)

All questions are to be answered. Each question to be answered in a separate book (or books if more than one is
required for the one answer)

1 Write short notes on the following

a) Mechanism-based fracture types. (25)
b) Compare CT scan and MRI scan use in orthopaedic surgery. (50)
c) Types of bone formation. (25)
[100]

2 Discuss
a) Prophylactic antibiotic therapy in Orthopaedic Surgery. (40)
b) The use of blood and blood products in Orthopaedic Surgery. (40)
c) Intra-articular steroid therapy. (20)
[100]

3 What is your peri operative management of a 65-year-old lady who sustained a fragility
of her wrist and is going to theater for a locking plate? [100]
 FC Orth(SA) Intermediate

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Intermediate Examination for the Fellowship of the

College of Orthopaedic Surgeons of South Africa

24 August 2012

Paper 2 Orthopaedic Surgery (3 hours)

All questions are to be answered. Each question to be answered in a separate book (or books if more than one is
required for the one answer)

1 Describe in a detailed stepwise manner how you would manage a 15-years-old male
with severe acute hyperkaleamia. [100]

2 A 76-year-old female has fracture of the neck of her left femur. She was admitted a
week ago and is booked for hip replacement. She is on treatment for hypertensive heart
disease and diabetes mellitus, and has chronic liver disease. Regarding this patient,
please
a) Discuss the coagulation pathway/cascade. (15)
b) Critically discuss plausible risk factors for deep vein thrombosis (DVT). (25)
c) Discuss mechanism of action of modalities which would be appropriate to use for
DVT prophylaxis. (15)
d) Peri-operative management if she is on anti-coagulants. (20)
e) Critically discuss further evaluation if she is noted to be confused and
tachypnoeic 48 hours post hip replacement and pulmonary embolism is
suspected. (25)
[100]

3 A 24-year-old male patient collapses in your ward following an intramedullary nailing of

a fractured femur. He is profoundly short of breath and haemodynamically unstable
a) Describe the two phases in the pathophysiology of Fat Embolus Syndrome. (25)
b) List the clinical features of Fat Embolus Syndrome. (15)
c) Describe the acute management of Fat Embolus Syndrome. What, if any, is the
role of steroids in the acute management of fat embolus syndrome. (30)
d) Write short notes on thrombo-prophylaxis in the immobilised patient. (30)
[100]