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Y6 Senior Surgery > General > Flashcards

General Flashcards

1
Q

what nerve roots supply the achilles reflex

A

S1-S2

BUCKLE MY SHOE

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2
Q

what nerve roots supply the patellar reflex

A

L3 L4 KICK THE DOOR

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3
Q

what nerve roots supply the biceps reflex

A

C5-C6 PICK UP STICKS

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4
Q

what nerve roots supply the triceps

A

C7-C8 close the gate

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5
Q

how is the axillary nerve commonly damaged?

A

shoulder dislocation

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6
Q

how is the radial nerve commonly damaged=

A

humoral shaft fractures

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7
Q

how is the ulnar nerve commonly damaged

A

fractures and dislocations of elbow joint

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8
Q

how is the median nerve commonly damaged

A

by supracondylar humeral fractures, dislocation of elbow joint

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9
Q

What nerve roots are damaged in Erb’s palsy

A

C5/C6

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10
Q

what does the hand/arm look like in Erbs palsy

A

Waiter’s tip

adducted and medially rotated
pronated, flexed wrist

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11
Q

What nerve roots are damaged in Klumfe’s palsy and what does hand looklike

A

C8/T1 damage

CLAW HAND

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12
Q

what can cause damage to the sciatic nerve in the leg

A

Poorly placed gluteal injections, post-hip dislocation

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13
Q

what are signs and symptoms of the sciatic nerve

A

foot drop, flail foot

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14
Q

what does loss of tibial nerve function cause

A

loss of plantarflexion

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15
Q

loss of common peroneal nerve injury

A

loss of dorsiflexion

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16
Q

what is the function of the ACL

A

prevents anterior displacement of tibia

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17
Q

function of PCL

A

prevents posterior displacement of tibia

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18
Q

when does a pt have to be NBM before surgery

A

6 hours for food
2 hours for fluids
same rules of diabetics and pregnant women

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19
Q

why do you need to compress the cricoid cartilage if a patient has eaten just before surgery?

A

it prevents aspiration of gastric contents during induction

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20
Q

what is the main cause of post-op pyrexia at day 1 post op

A

atelectasois

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21
Q

how does atelectasis present

A

pyrexia
reduced oxygen sats
reduced breath sounds at lung base

on day 1 post op

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22
Q

most common cause of pyrexia at day 3 post op

A

UTI

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23
Q

most common cause of pyrexia at day 5 post op

A

SSI (staph aureus), anastamotic leak

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24
Q

what scale do you use for anaesthetics

A

ASA grading

25
Q

what ASA having a BMI of 40 or over automatically mean

A

ASA 3

26
Q

what is ASA1

A

normal healthy patient

27
Q

ASA2 what is

A

mild systemic disease (smoker / alcohol user / ohter mild well controlled disease e.g. HTN)

28
Q

what is ASA 3

A

severe ssystemic disease, not incapacitating (pooorly coontrolleed DM; prior MI, COPD etc)

29
Q

what is ASA4

A

severe systemic disease that is.a THREAT TO LIFE

30
Q

ASA5

A

moribound patient not expected to survive without the operation (e.g. ruptured AAA)

31
Q

what is ASA6

A

Brain dead

Organs being removed fo transplant

32
Q

who needs to be screened for MRSA

A

all patients for elective admission (excpet TOP, opthalmic, psych)

all emergency surg

33
Q

how do you screen for MRSA

A

nasal swab + skin lesion

34
Q

what do you need to do prior to secondary anastamosty after resection of part of the bowel

A

perform a contrast enema

this is to ensure that the primary anastamosis is healedd and there are no perforatiions

35
Q

what marker is used to assess completeness of resection of thyroid tumour

A

calcitonin

36
Q

what marker is used to assess thyroid cancer recurrence

A

thyroglobulin antibodies

37
Q

what kind of referral do you need to do in children presenting with inguinal hernia, depending on age?

A

under 1yo: urgent referral

over 1yo: routine referral

38
Q

what age group is most at risk from inguinal hernia

A

young children (very high rikss of iincarceration

39
Q

when do you need to repair an inguinal hernia in chiildren (6weeks, 6m, 6y)

A

<6weeks orld: within 2 days
<6months: within 2 weeks
<6 years: withiin 2 months

40
Q

how do you manage umbilical hernia

A

conservative > will self resolve

41
Q

what are LFTs and inflammatory markers like in biliary colic

A

all normal!!

42
Q

triad of boerhave

A

vomiting
sudden onset chesst pain (from vomiting)
subcut emphysema (crepitus)

NO BLEEDING IN VOMIT!

43
Q

who can you refer for bariatric surgery

A

ANYONE with BMI above 50

Anyone with medical conditions + BMI >35

44
Q

wht is the mosst common organism to cause cholangitis

A

E. coli, followed by Klebsiella

45
Q

ix for suspected chronic pancreatitis

A

faecal elastase
USS
contrast-enhanced CT

46
Q

when do you use faecal elastase for diagnosing chronic pancreatiitis

A

oonly if CT is inconcvlusive

47
Q

how do you manage acute mesenteric ischaemia

A

URGENT laparotomy

48
Q

whi h infections mimic Chroons in the GI tract

A

TB

Yersinia

49
Q

what is the muscle relaxant of choice for rapid sequence induction for intubation

A

SUXAMETHONIUM

it is rapid onset + short acting

50
Q

what is suxamethonium used for

A

rapid induction in emergency procedure / GCS <8

51
Q

2 key complications of suxamethonium

A

APNOEA (due to AD mutation – lack of spontaneous ventilation folloring extubation – re intubate and weane off)

HYPERTHERMIA (temp >40)

52
Q

how do you treat malignant hyperthermia from suxamethonium

A

give daltrolene

53
Q

what is an epigastric hernia and what are RF

A

Lump in midline between umbilicus and xiphisternum

RF: extensive physical training or coughing (from lung diseases), obesity

54
Q

how do you manage wound dehischene

A

cover wound with saline-impregnated gauze (ensures abdo contents do not dry out)
IV broad-spectrum antibiotics
URGENT SENIOR REVIEW (needs to be taken to theatre urgently)

55
Q

what is boas sign

A

referred pain to the right scapula due to cholecystitis

56
Q

whhat is a bell clapper deformity of the testicle

A

testicle with a HORIZONTAL lie

57
Q

what does cryptorchidism mean

A

UNDESCENDED testicle

58
Q

what do yuo need to do if you suspect renal stone with features of systemic infection?

A

PERCUTAENOUS NEPHROSTOMY URGENT

+ IV ABx

59
Q

how do you split the fluid you aare required to give for burns

A

The 24hr fluid requirement for burns is given as 50% over 8hrs followed by 50% over 16hrs

Y6 Senior Surgery (10 decks)

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