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Surgery > Exam > Flashcards

Exam Flashcards

1
Q

Functions of bile salts? (2)

A

Excretion of cholesterol

Emulsification of fat

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2
Q

Commonest causes of gallstones? (2)

A 
Excess of cholesterol excretion
Chronic haemolysis (pigment stones)
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3
Q

Signs associated with cholecystitis?

A

RUQ tenderness and rigidity

Murphy’s sign- catching of breath at maximal inspiration while RUQ is being palpated

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4
Q

Antibiotic therapy for biliary tree infection?

A

Amox met gent

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5
Q

Investigations in suspected gallstones?

A

Ultrasound

MRCP

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6
Q

Surgical treatment of gallstones? (2)

A

Laparoscopic or open cholecystectomy if causing cholecystitis;
ERCP if impacted in the CBD

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7
Q

Acute abdomen:

a) sudden pain that is constant
b) pain on coughing/moving
c) helped by drawing knees up to chest; patient writhes around

A

a) suggests perforation of a viscus
b) peritonism
c) colicky pain

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8
Q

Higher volume, frequency and pitch of bowel sounds?

A

Obstruction

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9
Q

Absence of bowel sounds?

A

Ileus

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10
Q

Clinical signs:

a) Bruising around the umbilicus
b) bruising in the left flank
c) LIF palpation producing RIF pain

A

a) Cullen’s sign (pancreatitis)
b) Grey Turners sign (pancreatitis)
c) Rosving’s sign appendicits

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11
Q

Condition which presents similarly to appendicitis and may follow an URTI?

A

Mesenteric adenitis

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12
Q

Inflammatory bowel disease: cobblestoning, fissures, transmural inflammation

A

Crohn’s disease

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13
Q

Inflammatory bowel disease: rose-thorn ulcers, non-caseating granulomas, mucosal inflammation

A

Ulcerative colitis

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14
Q

Systemic manifestations of IBD? (4)

A

Anterior uveitis
Ankylosing spondylitis
Erythema nodosum
Pyoderma gangrenosum

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15
Q

Investigation of suspected IBD? (3)

A

Faecal calprotectin
CRP
Colonscopy and biopsy

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16
Q

Scoring system used to assess the severity of a flare of UC?

A

Truelove and Witt’s

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17
Q

Treatment of perianal fistula?

A

Seton suture

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18
Q

Medical management of IBD?

A

Induction of remission (steroids, mesalamine)

Maintenance of remission (AZT, mercaptopurine, mesalamine)

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19
Q

Transverse colon diameter greater than 6cm indicates…

A

Toxic megacolon

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20
Q

The levels of which enzyme should be assayed before commencing azathioprine?

A

TPMT

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21
Q

What are haemorrhoids?

A

Prolapsed and enlarged anal cushions containing AV communications

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22
Q

How are haemorrhoids clinically classified? (4)

A

I- don’t prolapse
II- prolapse during defaecation, reduce spontaneously
III- always prolapsed, manually reducible
IV- irreducible

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23
Q

Management of haemorrhoids?

a) conservative
b) surgical

A

a) fluids, stool softener, dietary fibre

c) haemorrhoidectomy

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24
Q

Management of anal fissure? (3)

A

Conservative management of constipation
GTN/diltiazem cream to relax sphincter
Lateral sphincterotomy

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25
Q

Rectal bleeding + abnormal vessels on colonoscopy?

A

Angiodysplasia of the colon

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26
Q

Causes of acute pancreatitis (6)

A 
Gallstones
Alcohol
ERCP
Trauma
Hypercalcaemia
Cancer
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27
Q

Radiological investigation in suspected pancreatitis?

A

Contrast enhanced CT abdomen

28
Q

Management of acute pancreatitis? (3)

A

Opiate pain relief
Fluids
Enteral feeding if unable to eat/drink within 48-72 hrs

29
Q

Complications of acute pancreatitis? (3)

A

Infected necrosis
Pseudocyst
Abscess

30
Q

Epigastric pain worsened by eating + steatorrhoea + diabetes in an alcoholic

A

Chronic pancreatitis

31
Q

CT finding in chronic pancreatitis?

A

Speckles of calcification

32
Q

Diameter cut-off for surgery in AAA?

A

5.5cm

33
Q

Investigation of AAA? (3)

A

Ultrasound
CT
MR angiography

34
Q

Surgical options for AAA repair? (2)

A

Open aneurysm repair

EVAR

35
Q

Jaundice with elevated ALP, moderately elevated ALT/AST

A

Obstructive jaundice

36
Q

Pyrexia + rigors + jaundice + tender liver

A

Pyogenic liver abscess

37
Q

How can chronic liver disease cause anaemia, thrombocytopenia and leucopenia?

A

Portal hypertension leading to splenomegaly

38
Q

Definitive management of bleeding oeseophageal varices (3)

A

Terlipressin
Endoscopic variceal band ligation
(Sengstaken-Blakemore tube as a temporary holding measure)

39
Q

Procedure which can be used to decompress the portal system?

A

Transjugular intrahepatic portosystemic shunt (TIPSS)

40
Q

Prevention of variceal bleeding (3)

A

Beta blockers
Sclerotherapy
Band ligation

41
Q

Herniation of mucosa through the circular colon wall at the sites of arterial penetration

A

Diverticular disease

42
Q

Complications of diverticular disease? (4)

A

Diverticulitis/pericolic abscess
Obstruction
Fistula formation
Bowel perforation

43
Q

Dysuria + cloudy urine + pneumaturia

A

Colovesical fistula

44
Q

Definitive treatment of diverticular haemorrhage?

A

Angiographic embolization

or surgical resection

45
Q

Solitary thyroid nodule- DDx? (3)

A

Cyst
Adenoma
Cancer

46
Q

Four types of thyroid cancer in order of prevalence?

A

Epithelial: Papillary and Follicular
Anaplastic
Medullary

47
Q

Rapidly-growing, highly malignant thyroid cancer

A

Anaplastic

48
Q

Which thyroid cancer has the highest cure rate?

A

Papillary

49
Q

Thyroid tumour arising from parafollicular cells, secretes calcitonin?

A

Medullary cancer

50
Q

Medullary cancer and pharochromocytoma often arises as part of what syndrome?

A

MEN 2

51
Q

Primary hyperparathyroidism is usually due to…

A

Solitary adenoma of the parathyroid gland

52
Q

Psammoma calcification is diagnostic of…

A

Papillary thyroid cancer

53
Q

Chovstek and Trosseau are signs of…

A

Hypocalcaemia

54
Q

Parathyroid, pancreatic and pituitary adenomas- which MEN?

A

MEN 1

55
Q

Waterhosue-Friderichsen syndrome

A

Diffuse adrenal haemorrhage

56
Q

AXR- central gas shadows with valvulae conniventes

A

Small bowel obstruction

57
Q

AXR- peripheral gas shadows with haustra (do not cross lumen)

A

Large bowel obstruction

58
Q

Management of bowel obstruction?

A

Keep NBM, NG tube and IV fluids

59
Q

“Coffee bean” sign

A

Sigmoid volvulus

60
Q

Commonest locations of colorectal Ca? (2)

A

Rectum (45%) and sigmoid (25%)

61
Q

Staging for confirmed colon Ca?

A

Contrast enhanced CT chest, abdo pelvis

62
Q

Colorectal cancer- surgery for low sigmoid or high rectal cancer?

A

Anterior resection

63
Q

Colorectal cancer- surgery for tumours low in the rectum?

A

Abdominoperineal resection + permanent colostomy

64
Q

Numerous hamartmaous polyps in GI tract + pigmented lesions on lips, oral mucosa, face, palm and soles

A

Peutz Jeugher syndrome

65
Q

Abd pain + bloody diarrhoea + fever in a known vasculopath

A

Mesenteric ischaemia

66
Q

Adhesions usually cause obstruction of which segment of bowel?

A

Small bowel

67
Q

Which is the only thyroid cancer that spreads haematogenously?

A

Follicular

Surgery (21 decks)

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