FRCS Cheat Sheet 2026

The 30 highest-yield FRCS facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which proton pump inhibitor is preferred for use via the intravenous route in the acute management of upper gastrointestinal bleeding? → Omeprazole or pantoprazole
2. During consent for surgery, which element is NOT required for the consent to be legally valid in the UK? → The patient must sign a written consent form for all procedures
3. Which sterilisation method is most appropriate for heat-sensitive surgical equipment such as fibreoptic endoscopes? → Ethylene oxide (ETO) gas sterilisation
4. The Triangle of Calot is defined by which three structures? → Common hepatic duct, cystic duct, and inferior edge of liver
5. Which nerve is at risk during a modified radical mastectomy due to its course along the chest wall? → Long thoracic nerve of Bell
6. Which antibiotic is currently the first-line treatment for severe Clostridioides (Clostridium) difficile infection? → Oral vancomycin or fidaxomicin
7. A surgeon notices a colleague appears intoxicated in the operating theatre. According to GMC Good Medical Practice, what is the surgeon's primary duty? → Raise a concern to protect patient safety
8. Which antiemetic acts primarily as a serotonin 5-HT3 receptor antagonist and is commonly used for post-operative nausea and vomiting? → Ondansetron
9. Which cells are the primary effector cells of innate immunity? → Neutrophils and macrophages
10. In a patient with a large ventral hernia, which mesh position has the lowest recurrence rate? → Retromuscular (Rives-Stoppa: posterior to rectus muscle, preperitoneal)
11. What type of study design provides the highest level of evidence in a hierarchy of evidence? → Systematic review and meta-analysis of RCTs
12. Which vasopressor is recommended as first-line in the management of septic shock according to the Surviving Sepsis Campaign guidelines? → Noradrenaline (norepinephrine)
13. A patient develops hypotension, tachycardia, and cold extremities with raised CVP following cardiac surgery. What type of shock is this? → Cardiogenic shock
14. Which of the following analgesic drugs inhibits both serotonin and noradrenaline reuptake in addition to being a weak opioid agonist? → Tramadol
15. What is primary intention wound healing? → Healing by direct apposition of wound edges with sutures, clips, or glue
16. A patient is in Class III haemorrhagic shock. What is the estimated blood loss and the expected physiological response? → 1500–2000 mL; marked tachycardia, decreased BP, decreased urine output
17. What is the primary mechanism of action of ciclosporin in post-transplant immunosuppression? → Inhibition of calcineurin, preventing NFAT-mediated IL-2 gene transcription
18. Which type of allograft rejection occurs within minutes to hours of transplantation and is mediated by pre-formed donor-specific antibodies? → Hyperacute rejection
19. Which intravenous fluid most closely resembles the electrolyte composition of plasma and is recommended as first-line for fluid resuscitation in the UK? → Hartmann's solution (compound sodium lactate)
20. What is the principal aim of prophylactic antibiotics administered in clean-contaminated surgery? → To reduce the bacterial inoculum at the operative site below the threshold for infection
21. A patient presents to the emergency department with a Glasgow Coma Scale (GCS) score of 8. According to ATLS principles, what airway intervention is indicated? → Definitive airway (endotracheal intubation)
22. Following major abdominal surgery, a patient develops oliguria with a urine sodium concentration of 8 mmol/L. What is the most likely cause? → Appropriate physiological response to surgery (ADH and aldosterone secretion)
23. In colorectal cancer staging using the TNM system, what does a T4b classification indicate? → Tumour directly invades or adheres to adjacent organs
24. Which organism is the most common cause of catheter-associated urinary tract infections (CAUTI) in hospitalised surgical patients? → Escherichia coli
25. What is the number needed to treat (NNT) if a treatment reduces the absolute risk of complication from 20% to 15%? → 20
26. In the fasting state, which organ is the primary consumer of ketone bodies for energy? → Brain
27. A 45-year-old man presents with a painless testicular mass. Serum AFP is markedly elevated but beta-hCG is normal. Which testicular tumour is most likely? → Yolk sac tumour (endodermal sinus tumour)
28. A post-operative patient develops a pulmonary embolism with haemodynamic instability (systolic BP 70 mmHg). What is the definitive pharmacological treatment? → Systemic thrombolysis with alteplase
29. What type of collagen is predominantly synthesised during the proliferative phase of wound healing and replaced in the remodelling phase? → Type III collagen
30. Which growth factor is the primary driver of the proliferative phase of wound healing? → Platelet-derived growth factor (PDGF)