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YEAR 3 Manchester Medicine > Block 1 - vascular surgery + (general surgery) > Flashcards

Block 1 - vascular surgery + (general surgery) Flashcards

1
Q

What is ankle brachial pressure index (ABPI)?

A

Posterior tibial BP / brachial BP - patient lying down - using ultrasound and cuff inferior to patella

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2
Q

What ABPI indicates critical leg ischaemia?

A

<0.5

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3
Q

What ABPI is normal?

A

0.8-1.2

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4
Q

When may a ABPI be false?

A

Diabetics with calcification in arteries leading to them being less easily occluded

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5
Q

What are the red flag symptoms for critical leg ischeamia?

A
  • pain at rest - pian at night (think gravity and leg dangling out of bed) - necrosis
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6
Q

What are the indicators of acute limb ischaemia?

A

The 6 Ps: - Pain - Pulseless - Pallor - Perishing in cold - Powerless - Paratheasia

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7
Q

What is claudication distance?

A
  • distance walking until patient has to stop due to pain
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8
Q

Thrombus acute limb ischaemia:

A
  • hour to days of onset - collateral make less severe ischaemia - history of claudication
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9
Q

Embolism of acute limb ischaemia

A
  • s/ mins of onset - pulsless - no history of claudication
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10
Q

Treat AAA:

A
  • greater than 5.5cm - rapidly growing
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11
Q

What are the features of a venous ulcer?

A

History of venous insufficency (varicous, DVT)

Medial gaiter area

Superficial

Irregular edges

Extrudating fluid

Some pain

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12
Q

What are the features of a arterial ulcer?

A

History of peripheral vascular disease

Moderate/severe pain

Deep

Puncted out

Necrotic

lateral malleaolus and metatarsal heads

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13
Q

What are the features of diabetic ulcer?

A

Due to diabetic neuropathy

At pressure points

No pain

Surronding callus

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14
Q

What are the two types of gal stones?

A

Pigmented ( formed from bilirubin)

cholesteol

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15
Q

What are the risk factors for gal stones?

A

Fat

  • *F**emale
  • *F**orty
  • *F**ertile
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16
Q

What is Murphys sign?

A

RUQ pain during inspiration that is not present in the LUQ

This indicates cholecystitis

17
Q

How are gal stones clinical represented?

A

Asymptomatic (most common)

Biliary colic

Cholecystitis

Cholangitits

18
Q

What is Biliary colic?

A

> 6 hours of RUQ pain

+/- nausea and vomiting

Gals stones are present in the body and fundus

19
Q

What is cholecystitis?

A

> 6 hours of RUQ pain

+/- nausea and vomiting

Gal stone present in the neck occluding the gal bladder, this leads to more violeent contraction and pain.

20
Q

What is cholangitis?

A

> 6 hours of RUQ pain

+/- nausea and vomiting

Fever

jaundice

MEDICAL EMERGENCY - ERCP in 24 horus

Gal stones occulding common bile duct

21
Q

What is Charcots triad?

A

RUQ pain

Fever

Jaundice

22
Q

What are the risk factors for pancreatitis

A

Idiopathic

Gal stones

Ethenol

Trauma

Steroids

Mumps vaccine

Autoimune

Scorpion venom

Hyper -lipideamia -calceamia -parathyroid

ERCP

Drugs

I GET SMASHED

23
Q

What is Crohns?

A

An idiopathic, chronic transmural inflammation of the GI tract

24
Q

What is ulcerative collitis?

A

Conitneous

only mucosa/ submucosa

mosty in terminal rectum, sigmoid colon and desceding colon

25
Q

What is Lanz scar?

A

Scar over Mc Burney’s point

Transverse inscision

Not diagnoal (Langer’s lines)

For appendectomy

26
Q

What is a midline abdominal scar?

A

Through the midline however circumnavigates the umbilicus.

Used for laparotomy, AAA etc.

Superior portion alone for foreforgut etc.

27
Q

What is a Kochers incision?

A

Below the right costal margin

Used for cholesystitis

28
Q

What is a chevron/ Roof top incision?

A

Follows left and right costal margin towards the xiphisternum

For Wipples procedure

29
Q

What is a Mercedez benze incision?

A

Chervron and a midline sternotomy

For diapramatic hernias and esophagealectomy

30
Q

What would a C shaped scar in the RLQ indicate?

A

Kidney transplant

31
Q

Match the numbers to the type of incision:

A

1 - midline

2 - para midline

3 - Kochers incision

4 - Chevron incision

5 - mercedez benz incision

32
Q

What is a medial stenotomy?

A

Midline incision throught the sternunu

Open heart surgery: CAGAB, valve replacement

33
Q

What is a pacemaker incision?

A

Incision at the left upper oprtion of the chest

34
Q

What is the posterior lateral incision?

A

Thoroctomy as described inferior to the scapular

This is the Gold standard in order to access the pleural cavity

35
Q
A

YEAR 3 Manchester Medicine (34 decks)

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