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MRCS B > Essential Facts > Flashcards

Essential Facts Flashcards

1
Q

SIRS Criteria

A
  • Temp >38 or <36
  • P >90
  • RR > 20
  • WCC >12 or <4
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2
Q

GLASGOW Score

A
  • PO2 < 8
  • Age > 55
  • Neut > 15
  • Ca < 2
  • Ur > 16
  • LDH > 600
  • Alb < 32
  • Glu > 10
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3
Q

Characteristics of ARDS

A
  • Diffuse pulmonary infiltrates
  • Normal PAWP
  • PO2:FiO2 < 200
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4
Q

Henderson Hasselbach Equation

A

CO2 + H2O <-> HCO3- + H+

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5
Q

Anion Gap

A

(Na + K) - (HCO3- + Cl)

(Normal Range 12 +/- 2)

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6
Q

Normal Infrarenal Aortic Diameter

A

2cm

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7
Q

When to consider AAA for repair

A

>4.5cm or growing >1cm per year

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8
Q

Follow up for AAA

A

If < 3cm require no further follow up
3-4cm = annual USS
4-5.4cm = 6 monthly USS
>5.5 cm = immediate referral for repair

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9
Q

Breast Screening

A

Three yearly screening to all females 50 - 70y

(Currently being extended 47 to 73y)

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10
Q

Hormonal Therapy in Breast Cancer

A

Oestrogen dependant in 70% of cases
Pre-menopausal: Tamoxifen for five years (Selective oestrogen receptor modulator)
Post-menopausal: Aromatase inhibitors (eg Anastrazole) - block peripheral conversion only

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11
Q

Branchial cyst location

A

Anterior Triangle

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12
Q

Cystic Hygroma Location

A

Posterior Traingle

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13
Q

CVP Trace

A

ACXVY
A - Atrial Contraction
C - Tricuspid closure
X - Atrial relaxation
V - Venous return
Y - Opening of tricuspid

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14
Q

Surface area for burns

A

Rule of nines - Head, Arms, half leg, half torso 9% Genitals 1%
Hand - Patient’s hand = ~1%

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15
Q

Parkland Formula

A

4 x wt x surface area
Half over 8 hours
Half over 16 hours
Note: timer starts from time of burn, not time of assessment - inc rate of resuscitation appropriately.

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16
Q

Mount Vernon Formula

A

(wt x surface area) / 2

Give over 4,4,4,6,6,12

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17
Q

Charcot’s traid

A

Fever, Jaundice and RUQ pain

(Suggests ascending cholangitits)

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18
Q

Indications for central line

A

Monitoring fluid balance / resuscitation
TPN
Certain medication infusions
Failed peripheral access
Haemodialysis
Transvenous cardiac pacing

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19
Q

Hartmann’s Contents

A

Na 131,

K 5,

Cl 111,

Ca 2,

Bicarb (as lactate) 29

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20
Q

Normal Saline Contents

A

Na 150,

Cl 150

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21
Q

Formula for MAP

A

MAP = (CO x SVR) + CVP

22
Q

Distribution of body fluids

A

1/3 Extra cellular
25% Intravascular
75% Interstitial
2/3 Inta-cellular

23
Q

ECG Axis

A

Normal: -30deg to +90deg

Leads 1+2 both positive = Normal
Lead 1 positive, Lead 2/3 negative = Left axis deviation
Lead 1 negative = Right axis deviation

24
Q

Pain transmition pathway / fibres

A

Sharp pain - A-delta fibres
Dull pain - C-fibres
Spinothalamic tract

25
Q

Classification of blood loss

A

Class % P BP RR UO Mental

1 <15 <100 Norm <20 >30ml Anxious

2 15-30 <120 Wide PP <30 <30ml Anxious

3 30-40 <140 Red. <40 <15ml Confused

4 40+ >135 Red >35 Nil Lethargic

26
Q

Anterior Pituitary Hormones

A

ACTH

TH

LH

FSH

GH

Prolactin

27
Q

Posterior Pituitary Hormones

A

Oxytoncin

ADH

28
Q

Parotid Gland Neoplasias

A

80% benign. (Pleomorphic adenoma (70%), Warthin’s tumor)
15% malignant. (Mucoepidermoid carcinoma, adenoid cystic carcinoma) - Facial nerve palsy suggests malignancy.

29
Q

FAP + Gardner’s Syndrome

A

FAP: Predisposes to hundreds of adenomatous polyps. Autosomal dominant, due to loss of APC gene. 100% risk GI Ca by 40y. Associated with small bowel polyps and mandibular osteomas.

Gardner syndrome: Associated with FAP - Osteomas of skull, epidermoid cyst, multiple desmoid tumours

30
Q

Peutz-Jegher’s Syndrome

A

Multiple hamartomatous polyps, autosmal dominant

31
Q

Stages of organ rejection

A

Hyper-acute
Due to presence of recipient anti-bodies. Kidney swells and becomes necrotic, requires nephrectomy.

Acute
T-cell mediated diffuse lymphocytic infiltration. Reversible with high dose steroids

Chronic
Humoral system responsible for graft fibrosis and atrophy.

32
Q

Testicular Ca

A
  • Germ Cell Tumours
  • Seminoma
  • Non-Seminomatous
  • Teratoma
  • Embryonal Carcinoma
  • Choriocarcinoma
  • Yolk Sac Tumour
  • Mixed Germ Cell Tumour
  • Non Germ Cell
33
Q

Seminoma

A

Peak Age - 30-40
Placental Alk Phos
Radiotherapy effective (In effective for all non-seminomas)
B-HCG and lactate for monitoring following treatment

34
Q

Teratoma

A

Peak Age 20 - 30
markers: B-HCG, CEA, AFP (Also found in HCC)

35
Q

Melanoma Margins

A

<0.75mm = 1cm margin
< 1mm = 2cm
> 1mm = 3cm

36
Q

Primary / Secondary / Tertiary healing

A

Primary healing
Wound closed within hours of formation, usually with sutures or clips

Secondary Healing
Left open without formal closure - spontaneous closure via contraction and re-epithelialisation

Tertiary Healing
Initial debridement with normal closure at a later date.

37
Q

Vaccines required post splenectomy

A

Pneumococcal
H. Influenza B
Meningococcal

Flu

38
Q

Duke’s Staging (and 5yr survivals)

A

A - Confined to tumour wall (95 - 100%)
B - Through bowel wall (65 - 75%)
C - Lymph node Mets (30 - 40%)
D - Distant mets (5 - 10%)

Nb Modified:

C1 = Upper LN not involved

C2 = Upper LN is involved

39
Q

TNM Staging

A

Tis - Mucosa
T1 - Submucosa
T2 - Muscularis
T3 - Serosa
T4 - Adjacent Organs
N1 - <=3
N2 - > 3

40
Q

Virchow’s Triad

A

Abnormal blood flow
Hypercoagulable state
Endothelial Injury

Causes of thrombus

41
Q

MEN

A

I - Pancreatic (usually gastrinoma), Parathyroid (hyperplasia), Pituitary (usually prolactinoma)
IIa - Phaeochromocytoma, Parathyroid adenoma, Medullary Thyroid Ca
IIb - As IIa with Marfanoid features + Mucosal Neuromatosis

42
Q

AFP Associations

A

Hepatocellular Carcinoma, Teratoma

43
Q

CEA Associations

A

Colon, Teratoma

44
Q

PSA Associations

A

Prostate

45
Q

CA 125 Associations

A

Ovarian

46
Q

CA 19-9 Associations

A

Pancreatic

47
Q

B-HCG Associations

A

Teratoma

48
Q

Placental Alk Phos Associations

A

Seminoma

49
Q

Autograft

A

Graft from host

eg skin grafting

50
Q

Allograft

A

Transplant between two individuals who are not genetically identicle

51
Q

Isograft

A

Transplant between genetically identicle individuals

52
Q

Xenograft

A

Transplant between species

MRCS B (7 decks)

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