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Gen Surg > Chapter 1: Pre-op > Flashcards

Chapter 1: Pre-op Flashcards

1
Q

During Surgical Examination, you look out for

A 
Jaundice
Anaemia
Cyanosis
Clubbing
Oedema
Lymphadenopathy
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2
Q

During Medical Examination, you look out for

A

Dressed In a Surgeon’s Gown A Physician Should Succeed In Treatment

Definition
Incidence
Sex
Geography
Aetiology
Pathogenesis
Signs
Symptoms
Investigation
Treatment
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3
Q

During a Pathological Examination, you look out for

A

Dressed in a Sugeon’s Gown A Physician Might Make Progress

Definition
Incidence
Sex
Geography
Aetiology
Pathogenesis
Macroscopic Pathogenesis
Microscopic Pathogenesis
Prognosis
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4
Q

What are the different kinds/categories of Surgical Complications?

A 
CIMETIDINE
Congenital
Inflammation
Metabolic
Endocrine
Trauma
Ischaemia
Drug induced
Iatrogenic
Neoplasm
Everything else
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5
Q

Name 11 different kinds of incisions/scars

A 
Kocher
Ramstedts Pyloromyotomy scar
McBurneys
Periumbilical
Lateral thoracolumbar scar
Upper Midline incision
Inguinal incision
Renal transplant scar
Point incision scar
Periumbilical scar
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6
Q

Define Abscess

A

A cavity containing pus

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7
Q

Define Cyst

A

A fluid filled cavity surrounded by epi/endometrium

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8
Q

Define Fistula

A

A connection made between two epithelial surfaces

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9
Q

Define Hernia

A

A weakness in the abdominal wall that ruptures and allows a viscus or part of a viscus through the defect

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10
Q

Define Ileus

A

Adynamic Bowel

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11
Q

Define Colic

A

Intermittent Pain caused by an obstruction of a hollow viscus

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12
Q

Define Sinus

A

A blind-ending tract, lined with epithelium or granulation tissue, which opens up to an epithelial surface.

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13
Q

Define Stent

A

An artificial tube placed inside a biological one to keep it open

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14
Q

Define Stoma

A

An artificial union between two conduits (or a conduit and the outside).

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15
Q

Define Ulcer

A

An interruption in the continuity of an epi/endothelial surface

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16
Q

Define Volvulus

A

Twisting of a structure around itself

17
Q

Define Pre-Op Care

A

Provides diagnositc and prognostic information, to understand the nature, aims and outcome of surgery

18
Q

Name the 4 aims of Pre-Op Care

A

Ensure pt gets the right surgery
Get informed consent
Assess/balance risks of anaesthesia while maximising fitness
Check Anaesthesia type with Anaesthetist
Note: optimise O2 to improve outcome of surgery

19
Q

How would you assess a pt for Pre-Op Checks

A

1: asses cardiovascular risk, exercise tolerance, check illnesses, drugs taken, allergies
2: Take pt history: MI, Diabetes, HT, Asthma, Rhematic fever, Epilepsy
3: Assess risks: pregnancy, complications DVT, previous anaesthesia, Neck stability

20
Q

When taking Family History in Surgery, you must take note of

A 
Malignant Hyperpyrexia
Dystrophy myotonica
Porphyria
Cholinesterase problems
Sickle-cell disease
21
Q 
What should you look out for in drug history and allergies for:
ABx
Anticoagulants
Anticonvulsants
B-blockers
Contraceptive Steroids
Digoxin
Diuretics
Levodopa
Lithium
Tricyclics
A

plaster/antiseptic/drugs
ABx: Tetracyclin and neomycin = NM blockade
ACoag: do not give it regional, epidural and spinal blocks
AConv: Give as usual pre-op, but give them IV post op
B-block:
Contraceptive Steroids
Digoxin: keep as normal, since it excludes labile cardiovascular response.
Diuretics: check for hypokalaemia and dehydration - do U&E
Levodopa: arrhythmias
Lithium: NM blockade and arrhythmias
Tricyclics: enhance adrenaline and arrhythmias

22
Q

Which part of the drugs in drug history should you be aware of?

A 
ABx
Anticoagulants
Anticonvulsants
B-blockers
Contraceptive Steroids
Digoxin
Diuretics
Levodopa
Lithium
Tricyclics
23
Q

As a house officer, how would you prepare a pt for a surgery in the ward (before he goes to theatre)?

A
  1. Fast patient
  2. Bowel/Skin prep and prophylactic ABx
  3. Start DVT prophylaxis
  4. Write up pre-meds and book X-rays + Frozen sections
  5. Book post-op physio
  6. Catheterise + insert ng tube before induction
24
Q

Pre-Op Checklist for bloods

A

U+E
FBC
Blood glucose test
Amylase: if acute abdomen
LFT: if jaundice, liver disease or alcoholic
Drug test: if suspected abuser
Clotting studies: if liver/renal disease, blood losses, high risk patients

25
Q

pre-op checklist for Drug Chart

A 
regular meds
anaesthesia
antiemetic
ABX
LMWH
26
Q

Exactly right Pre-op Checklist

A 
Blood count
IV cannula
ECG (<55yo, poor exercise tolerance, history of MI, HT, Rheumatic fever)
CXR (cardio resp disease or symptoms, suspected lung mets)
Drug Chart
Compression stockings
Consent
Marked site
Anaesthetists informed
Theatres informed
Infection risk
27
Q

Aim of prophylactic ABx

A

to counter risk of wound infection (20% of elective GI surgery)
given 15-60 mins prior to surgery to have maximum skin concentration
given as a single dose

28
Q

How do you minimise risk of wound infection?

A

time administration of ABx
use of peri-op supplemental O2
strict sterile surgical technique

29
Q

Aim to bowel prep in Colorectal surgery

A

to visualise the lumen of the bowel

to minimise post-op infection if elective open procedures are done

30
Q

Complications of elective open procedures of the bowel, should there not be bowel prep

A

Liquefying bowel contets which are spilled during surgery
Perforation
Dehydration
Electrolyte loss leading to hyponatraemia and seizures
high rate of post op anatomotic leakage

31
Q

Name the hierarchy of sutures

A

Absorbable vs Non-Absorbable
Natural vs Synthetic
Natural (has a vigorous reaction with the body)

Braided (filaments are braided, can have infections)
Monofilament (sleek and slippery, minimises infections, little to no reactions with the body)
Twisted filament (filaments are twisted strands, similar to braided)

Most used: 3,0 and 4,0

Gen Surg (6 decks)

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