# 61 STONES IN UROLOGY Detailed notes Urolithiasis is one of the most frequently examined urology topics in MRCS Part A. The lifetime risk is around 10–15%, with a male-to-female ratio of roughly 3:1, and peak incidence in the third to fifth decade. Most stones form in

# 60 PAEDIATRIC ORTHOPAEDIC SURGERY Children are not small adults. Their bones contain growth plates, their cortex is plastic, their joints remodel, and their differential diagnosis is dominated by a handful of high-yield conditions clustered by age. MRCS Part A loves this topic precisely because pattern-recognition by age, sex,

PAEDIATRIC CARDIAC SURGERY Congenital heart disease (CHD) affects roughly 8 in 1,000 live births and is the commonest group of birth defects. For MRCS Part A you are not expected to operate on these children, but you are expected to know the embryology, recognise the classic lesions, understand the

PAEDIATRIC GENERAL SURGERY Paediatric surgical emergencies are an MRCS Part A favourite because each condition has a tight age window, a pathognomonic clinical sign, and a single best investigation. Master those three columns for each disease and you will answer most SBAs on sight. The master table — group by age

# 57 HERNIAS What is a hernia? A hernia is the abnormal protrusion of an organ or tissue through a defect in the wall that normally contains it — usually abdominal viscera (small bowel, omentum, pre-peritoneal fat) through a weakness in the abdominal wall. Every hernia has a sac (peritoneum), contents,

# 56 TRANSPLANT Transplantation is heavily examined because it sits at the intersection of immunology, pharmacology and infection. Most MRCS questions hinge on three patterns: matching the timing of rejection to its mechanism, matching the timing of post-transplant infection to its pathogen, and recognising the physiology of the denervated heart.

# GYNAECOLOGY 👩‍⚕️ For MRCS Part A, gynaecology is mostly tested through pelvic anatomy and the pathology of the ovary, uterus and Fallopian tube. The high-yield areas are: nerve injuries during pelvic surgery, ligamentous support of the uterus, the ureter's relationship to the uterine artery, ectopic pregnancy, ovarian tumours

# 55 DERMATOLOGY Detailed notes Surgical dermatology is dominated by three malignancies — BCC, SCC and melanoma — plus a handful of benign mimics and pre-malignant lesions. The MRCS Part A examiner is interested in pattern recognition (which lesion is this?), prognostic factors (especially Breslow thickness) and management principles (margins, biopsy type,

# 52 SMALL BOWEL Detailed notes The small bowel runs roughly six metres from the pylorus to the ileocaecal valve and is where the bulk of digestion and absorption actually happen. It has three parts — duodenum, jejunum and ileum — but examiners rarely ask about the duodenum in this context (covered in

# COLORECTAL SURGERY Colorectal surgery is one of the most heavily examined territories in MRCS Part A. Questions cluster around blood supply (which artery to ligate, where watershed ischaemia bites), cancer staging and genetics, which operation for which segment, and anorectal pathology. Anatomy The large bowel is recognised by three features