General Flashcards
what nerve roots supply the achilles reflex
S1-S2
BUCKLE MY SHOE
what nerve roots supply the patellar reflex
L3 L4 KICK THE DOOR
what nerve roots supply the biceps reflex
C5-C6 PICK UP STICKS
what nerve roots supply the triceps
C7-C8 close the gate
how is the axillary nerve commonly damaged?
shoulder dislocation
how is the radial nerve commonly damaged=
humoral shaft fractures
how is the ulnar nerve commonly damaged
fractures and dislocations of elbow joint
how is the median nerve commonly damaged
by supracondylar humeral fractures, dislocation of elbow joint
What nerve roots are damaged in Erb’s palsy
C5/C6
what does the hand/arm look like in Erbs palsy
Waiter’s tip
adducted and medially rotated
pronated, flexed wrist
What nerve roots are damaged in Klumfe’s palsy and what does hand looklike
C8/T1 damage
CLAW HAND
what can cause damage to the sciatic nerve in the leg
Poorly placed gluteal injections, post-hip dislocation
what are signs and symptoms of the sciatic nerve
foot drop, flail foot
what does loss of tibial nerve function cause
loss of plantarflexion
loss of common peroneal nerve injury
loss of dorsiflexion
what is the function of the ACL
prevents anterior displacement of tibia
function of PCL
prevents posterior displacement of tibia
when does a pt have to be NBM before surgery
6 hours for food
2 hours for fluids
same rules of diabetics and pregnant women
why do you need to compress the cricoid cartilage if a patient has eaten just before surgery?
it prevents aspiration of gastric contents during induction
what is the main cause of post-op pyrexia at day 1 post op
atelectasois
how does atelectasis present
pyrexia
reduced oxygen sats
reduced breath sounds at lung base
on day 1 post op
most common cause of pyrexia at day 3 post op
UTI
most common cause of pyrexia at day 5 post op
SSI (staph aureus), anastamotic leak
what scale do you use for anaesthetics
ASA grading
what ASA having a BMI of 40 or over automatically mean
ASA 3
what is ASA1
normal healthy patient
ASA2 what is
mild systemic disease (smoker / alcohol user / ohter mild well controlled disease e.g. HTN)
what is ASA 3
severe ssystemic disease, not incapacitating (pooorly coontrolleed DM; prior MI, COPD etc)
what is ASA4
severe systemic disease that is.a THREAT TO LIFE
ASA5
moribound patient not expected to survive without the operation (e.g. ruptured AAA)
what is ASA6
Brain dead
Organs being removed fo transplant
who needs to be screened for MRSA
all patients for elective admission (excpet TOP, opthalmic, psych)
all emergency surg
how do you screen for MRSA
nasal swab + skin lesion
what do you need to do prior to secondary anastamosty after resection of part of the bowel
perform a contrast enema
this is to ensure that the primary anastamosis is healedd and there are no perforatiions
what marker is used to assess completeness of resection of thyroid tumour
calcitonin
what marker is used to assess thyroid cancer recurrence
thyroglobulin antibodies
what kind of referral do you need to do in children presenting with inguinal hernia, depending on age?
under 1yo: urgent referral
over 1yo: routine referral
what age group is most at risk from inguinal hernia
young children (very high rikss of iincarceration
when do you need to repair an inguinal hernia in chiildren (6weeks, 6m, 6y)
<6weeks orld: within 2 days
<6months: within 2 weeks
<6 years: withiin 2 months
how do you manage umbilical hernia
conservative > will self resolve
what are LFTs and inflammatory markers like in biliary colic
all normal!!
triad of boerhave
vomiting
sudden onset chesst pain (from vomiting)
subcut emphysema (crepitus)
NO BLEEDING IN VOMIT!
who can you refer for bariatric surgery
ANYONE with BMI above 50
Anyone with medical conditions + BMI >35
wht is the mosst common organism to cause cholangitis
E. coli, followed by Klebsiella
ix for suspected chronic pancreatitis
faecal elastase
USS
contrast-enhanced CT
when do you use faecal elastase for diagnosing chronic pancreatiitis
oonly if CT is inconcvlusive
how do you manage acute mesenteric ischaemia
URGENT laparotomy
whi h infections mimic Chroons in the GI tract
TB
Yersinia
what is the muscle relaxant of choice for rapid sequence induction for intubation
SUXAMETHONIUM
it is rapid onset + short acting
what is suxamethonium used for
rapid induction in emergency procedure / GCS <8
2 key complications of suxamethonium
APNOEA (due to AD mutation – lack of spontaneous ventilation folloring extubation – re intubate and weane off)
HYPERTHERMIA (temp >40)
how do you treat malignant hyperthermia from suxamethonium
give daltrolene
what is an epigastric hernia and what are RF
Lump in midline between umbilicus and xiphisternum
RF: extensive physical training or coughing (from lung diseases), obesity
how do you manage wound dehischene
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)
what is boas sign
referred pain to the right scapula due to cholecystitis
whhat is a bell clapper deformity of the testicle
testicle with a HORIZONTAL lie
what does cryptorchidism mean
UNDESCENDED testicle
what do yuo need to do if you suspect renal stone with features of systemic infection?
PERCUTAENOUS NEPHROSTOMY URGENT
+ IV ABx
how do you split the fluid you aare required to give for burns
The 24hr fluid requirement for burns is given as 50% over 8hrs followed by 50% over 16hrs
