General Flashcards
Which respiratory measurements are reduced in the obese?
Tidal volume
Vital capacity
TLC
FRC
minute ventilation increased
Where in relation to the uterine artery does the ureter pass?
Posterior - ‘water under the bridge’
30d mortality of Haemorrhagic peptic ulcer?
8.6%
What is the required skin margin for a BCC?
5mm (95% clearance - 85% at 3mm)
If recurrent - 5-10mm
What is the most common cause of upper GI bleeding (in patients who have an OGD)?
Peptic ulcer (26%)
Then oesophagitis (17%)/gastritis (16%)/duodenitis (9%)
Varices (9%)
Malignancy (3%)
MW-tear (3%)
12% no cause found
Which nerve is often sacrificed in malignant parotid surgery?
Facial nerve
Which trace element is most important for wound healing?
Zinc
-copper less so
Within which ligament do the ovarian vessels run?
Suspensory ligament of ovary
May anastomose with uterine arteries in broad ligament
How do you insert a Sengstaken Blakemore tube (7)?
1) Insert to 50cm
2) inflate gastric balloon with increments of 100ml ensuring in stomach not oesophagus (i.e. gradual pressure increase), with IR to confirm position
3) Apply traction to balloon to OG junction (0.5-1kg)
4) If persistent bleeding inflated oesophageal balloon to 35-45mmHg
5) consider further traction up to 1.1kg if necessary
6) once haemostasis achieved, reduce pressure by 5mmHg every 3 hours and maintain at 24mmHg for 24 hours
7) Deflate balloon every 6 hours
What type Choledochal cyst is found with Caroli’s disease?
Type 5
What is the reversal agent for Dabigatran?
Idarucizumab
What are the characteristics of the Truelove and Witts criteria?
For acute severe colitis Frequency of blood stools >6 Temperature >37.8 Heart rate >90 Haemoglobin <10.5 ESR >30 (can exchange for CRP>30)
If signs of systemic toxicity the rate of colectomy goes from 8.5% –> 30% –> 48%
What is the typical threshold for radiological drainage of diverticular abscess?
4cm
What is the most common pathological organism in SBP in adults?
E.Coli and Klebsiella.
Consider prophylaxis with fluoroquinolones in high risk.
What is the eponymous name for a femoral hernia occurring behind the vessels?
Narath hernia
What is the evidence for use of SEMS for obstructing cancer?
The CREST trial (2019) - better short term outcomes and lower permanent stoma rate
What Ig crosses the placenta in RHD?
IgG
What is the daily recommended protein?
0.75g/kg
What is the most common site of sarcoma?
Extremeties in 40%
What cancers are associated with HPV 16/18?
Cervical cancer Anal cancer Penile cancer Vulval cancer Oropharyngeal cancer
What is the most common cause of visceral ischaemia?
Embolism (50%)
What are the types of BCC?
Nodular (commonest 60%, frequently on face)
Superficial (can use 5-FU)
Morpheaform (more aggressive, needs Mohs)
Cystic
Basosquamous (also more aggressive)
Which ovarian tumour type is most frequently associated with torsion?
Teratoma
What is the most common USS finding in ectopic pregnancy?
Adnexal mass (50-60%) Extrauterine gestational sac (35-50%) 20% can have intrauterine fluid collection - pseudosac