Any Flashcards
What is an abscess?
An abscess is a collection of pus in any part of the body. It often results in localised swelling and inflammation, in addition to pain and tenderness over the area. systemic symptoms can include bacterial showers (rigors), swinging fevers or sweating.
pyogenic organisms can be staphylococcus aureus, streptococcus pyogenes or ecoli.
What is cancer staging?
Cancer staging is a description of the extent of spread and invasiveness within the body. It is described using the TNM staging system.
T = local invasion and involvement of tumour with surrounding structures
N = lymph node involvement
M = metastasis involvement
What modalities are used to stage cancer?
physical examination, FBC, cancer markers, endoscopy, colonoscopy, ERCP TNM system T = CT scan, core biopsy, USS N = CT scan, PET scan, node biopsy/FNAc M = PET scan, MRI, CT
What is the purpose of staging a patient’s cancer?
Cancer staging is standardised through the TNM system. The benefits of this include a standardised approach that guidelines can be applied to. This will direct correct treatment modalities, provide more accurate prognosis figures and assist in classifying for research purposes.
What is neoplasia? Give examples of benign and malignant neoplasms.
Neoplasia refers to the new growth of new or abnormal tissue, where the growth exceeds and is uncoordinated from the normal tissue. Benign neoplasms do not metastasise, are well encapsulated and typically grow more slowly.
Benign tumours -> fibroma, adenoma, lipoma osteochondroma
Malignant tumours -> carcinoma (epithelial), sarcoma (mesenchymal), lymphoma, teratoma, melanoma
What is a fistula?
Give some examples
A fistula is an abnormal connection between two epithelial surfaces, such as between two hollow organs or between an organ and the exterior. They are lined by granulation tissue and colonised by bacteria. The formation of a fistula requires the presence of pressure and inflammation.
Fistulas are caused by inflammation/infection, trauma, neoplasm, or iatrogenically (e.g. surgical therapy)
examples include anal fistula, rectovesicle fistula, rectovaginal fistula, tracheo-oesophageal fistula, enterocutaneous
What is a stoma?
A stoma is the diversion of a hollow viscus organ such as the bowel to the skin’s surface to allow for drainage and a modicum of normal functionality for the patient. It is typically formed on surgery for bowel resection, as an adjunct to colectomy. It can be either permanent or temporary. Permanent stomas are used for when the anus has been removed. Temporary stomas allow greater healing of the created anastomosis.
What are the potential complications of a surgical procedure?
Surgical procedure complications can be categorised into intra-operative and post operative complications.
Intra-operative: anaesthetic risk, haemorrhage, damage to adjacent structures, contamination
post-operative: SSI, deep infection, post-surgical haemorrhage, nausea/vomiting, pain, fluid imbalances, ileus, atelectasis, wound dehiscence, pneumonia, DVT/PE, pressure ulcers,
post operative (late): incisional hernias, adhesive obstruction, scarring, chronic pain
What are the risk factors for a superficial wound infection?
A superficial wound infection only affects the skin and subcutaneous tissue.
Risk factors can be broken into host and operative factors.
Host factors include: immunocompromised (chemo, HIV, DM, malnutrition), poor vascular supply (DM, PVD), appropriate cleaning/dressing of wound, repeat trauma, antibiotic usage.
Operative factors: contamination of wound site, wash out technique, application of antiseptic/antibiotics, wound dressing, emergency/trauma, soiled/abscess drainage.
How do you treat a superficial wound infection?
History -> what caused the wound, has there been proper care, is it painful, fevers, rigors, sweats
Examination -> colour, size, temperature, HR, discharge, odour
Investigations -> swab/culture
Management -> remove sutures/staples, re-wash the wound, re-dress. Consider Abx (especially if cellulitis)
What are the indications for antibiotic prophylaxis?
Antibiotic prophylaxis is indicated in procedures where the risk of SSI is high (cholecystectomy, urological), in immunocompromised patients, and in pregnant women. These procedures are all high risk.
They are given before or at the start of surgery to ensure potency is strongest during operation. Ensure antibiotics will cover suspected organisms.
Why do surgical wounds fail?
Local causes: infection, contamination, foreign body, poor dressing, trauma, necrotic tissue
Host factors: smoking, alcohol abuse, compliance, arterial insufficiency, venous insufficiency
Systemic: malnutrition, DM, immunocompromised, poor antibiotics, anaemia, autoimmune disorders
What is the difference between the tissue obtained by fine needle aspiration and core biopsy?
Core biopsy requires local anaesthetic and takes a sample of tissue. Is useful for skin cancers
Fine needle aspiration does not always require local and samples a collection of cells rather than tissue. Is useful for cystic/abscess
