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General Surgery > general > Flashcards

general Flashcards

1
Q

90% of varicose are on which side

A

left

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2
Q

is pain common in variocele

A

no, 3% will have heavy or dragging sensation

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3
Q

are abnormal semen parameters associated with variocele

A

yes

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4
Q

what should you do with a right sided variocele?

A

this is rare and should be referred to urologist

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5
Q

Epididymal cysts are the most common cause of scrotal swellings seen in primary care?

A

epididymal cysts

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6
Q

where are epididymal cysts found in relation to the testicle ?

A

posterior to the testicle (separate to the body of the testicle)

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7
Q

accumulation of fluid within the tunica vaginalis?

A

hydrocele

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8
Q

Hydroceles may develop secondary to? (3)

A

epididymo-orchitis
testicular torsion
testicular tumours

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9
Q

hydrocele is a clinical diagnosis but what should be done if there is doubt about diagnosis?

A

US

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10
Q

what are varicose associated with?

A

subfertility

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11
Q

a bag of worms?

A

variocele (80% are left sided)

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12
Q

management of variocele?

A

usually conservative

surgery can be considered if patient troubled by pain

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13
Q

bilateral variocele occurs in what percentage of cases?

A

10

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14
Q

what head injury is associated with fluctuating consciousness?

A

subdural haematoma

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15
Q

majority of extradural haematomas occur where?

A

temporal region as bones are thinner

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16
Q

features of extradural haematoma

A

lucid intervals

features of raised inter cranial pressure

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17
Q

risk factors for subdural haematoma

A

Risk factors include old age, alcoholism and anticoagulation. (subd)

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18
Q

Classically causes a sudden occipital headache

A

SAH

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19
Q

groin lump: disappears on pressure or when the patient lies down?

A

inguinal hernia

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20
Q

for inguinal hernias, what is associated with lowest recurrence rate

A

mesh repair

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21
Q

green-brown discharge and an abscess with puss discharging from the nipple?

A

duct ectasia

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22
Q

nipple discharge Blood stained discharge is most likely to be associated with

A

duct papilloma

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23
Q

what is discharge typically like in duct ectasia?

A

thick, green/brown purulent

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24
Q

in intraductal papilloma you usually get blood stained discharge. is there usually a palpable lump?

A

no

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25
what kind of patients is duct papilloma more common in ?
younger
26
what needs to be performed twice after a vasectomy before a man can have sex?
semen analysis
27
can vasectomy be reversed?
yes, success rate is around 55%
28
1st line for chronic anal fissure?
topical GTN
29
the inflammation in thrombophlebitis is associated with what?
thrombus in the vein
30
what do you need to suspect in thrombophlebitis?
DVT
31
management of thrombophlebitis?
NSAIDS compression stockings topical heparinoids
32
prostate cancer - why do they not cause symptoms early on ?
they tend to develop in the periphery of the prostate so don't cause obstruction etc
33
what might you find on PR exam in prostate cancer?
asymmetrical hard nodular enlargement with loss of median sulcus
34
which scan would be used to look for osteoblastic mets in prostate cancer?
isotope bone scan
35
>= 60 with recurrent or persistent UTI ?
referral for suspected bladder cancer
36
analgesia of choice for renal colic?
diclofenac
37
imaging for renal colic ?
US then CT
38
which diuretics cause increased risk of calcium stones?
thiazide
39
which ethnic groups have increased risk of prostate cancer?
afro carribean
40
40% of men presenting with infertility have a ?
variocele
41
patient with thrombophlebitis should be referred for ?
ultrasound to rule out DVT
42
testicular swelling that you cannot get above?
inguinal hernia
43
what is seen in more than 5% of patients following a vasectomy ?
chronic testicular pain
44
PSA levels may be raised in ?
benign prostatic hyperplasia (BPH) prostatitis and urinary tract infection (NICE recommend to postpone the PSA test for at least 1 month after treatment) ejaculation (ideally not in the previous 48 hours) vigorous exercise (ideally not in the previous 48 hours) urinary retention instrumentation of the urinary tract
45
circumcision reduces rate of transmission of ?
HIV
46
indications for circumcision ?
phimosis paraphimosis BXO recurrent balanitis
47
acute management of renal colic?
IM diclofenac
48
when do you use trustuzamab?
HER2 positive
49
epigastric pain relieved by eating ?
duodenal ulcer
50
which ulcer causes epigastric pain worse after eating?
duodenal
51
AAA - diameter greater than ? is considered aneurysmal
3cm
52
pathophysiology of AAA?
loss of the intima with loss of elastic fibres from the media
53
most widely used LA?
lidocaine
54
what percentage of men with raised PSA have prostate cancer?
1/3
55
non specific dermatitis causing balanitis. treatment ?
topical hydrocortisone 1% once daily and an imidazole cream
56
95% of testicular tumours are germ cell. How can germ cell tumours be categorised?
seminomas and non seminomas
57
non seminomas - example ?
embryonal, yolk sac, teratoma and choriocarcinoma
58
examples of non germ cell tumours?
leydig and sarcomas
59
most common presentation of testicular cancer?
painless testicular lump in young man
60
other possible features of testicular cancer?
gynaecomastia and hydrocele
61
Klinefelter's syndrome is a risk factor for testicular cancer. what is this?
condition where men have an extra X chromosome
62
what kind of biopsy do you do in suspected prostate cancer?
TRUS guided biopsy
63
BPH typically presents with what sort of symptoms ?
lower urinary tract
64
what medications can be used in BPH?
alpha 1 antagonists (tamsulosin/alfuzosin) | 5ar inhibitors eg finasteride
65
how does tamsulosin work in BPH?
decreases smooth muscle tone in the prostate and bladder
66
what is considered first line in BPH?
tamsulosin
67
side effects of alpha 1 antagonists?
diziness, postural hypotension, dry mouth and depression
68
how does finasteride work?
inhibits conversion of testosterone into 5HT, which is known to induce BPH
69
adverse effects of finasteride ?
erectile dysfunction, reduced libido, ejaculation problems and gynaecomastia
70
Adjuvant hormonal therapy for ER +ve breast cancer?
anastrazole
71
if breast tumours are positive for hormone receptors, what adjuvant hormonal therapy is offered?
in pre and peri menopausal women - tamoxifen is used | in post menopausal women - anastrozole
72
tests you carry out for erectile dysfunction
LFT Lipids Fasting glucose Testosterone
73
when can you go back to work after an inguinal hernia repair?
2-3 weeks
74
acute and chronic prostatitis time frame?
3 months
75
painless prostate, with a smooth and enlarged prostate on examination in combination with lower urinary tract symptoms.
BPH
76
chronic prostatitis tx
quinolone
77
what has better prognosis - seminoma or teratoma?
seminoma (teratoma terrible compared to seminoma)
78
a new hydrocele may be first sign of?
testicular malignancy (need to ultrasound)
79
wihch tumour marker can be used to monitor patients with colorectal cancer?
CEA
80
what is usually found along with anal fissures?
skin tag
81
men and women aged 50-74 get screening for colorectal cancer every ? years?
2 years
82
what clock positions do haemarrhoids usually appear?
3 o'clock, 7 o'clock and 11 o'clock | three seven eleven
83
symptomatic AAA have high risk of ?
rupture and should undergo endovascular repair (EVAR)
84
what size is an AAA considered high rupture risk?
>5.5cm, or rapidly enlarging at over 1 cm per year
85
treatment of epididymo orchitis?
ceftriaxone 500mg intramuscularly single dose, plus doxycycline 100mg by mouth twice daily for 10-14 days
86
epididymo orchitis - presentation
pain and swelling of the testicle
87
example of quinolone antibiotics?
floxacin (ciprofloxacin, ofloxacin)
88
treatment of prostatitis?
quinolone for 28 days
89
most common pathogen for acute prostatitis?
e coli
90
what drugs are not helpful in anal fissures?
ss | steroids
91
management of an umbilical hernia in an infant ?
conservative management (most resolve by age 4-5)
92
2 examples of anti muscarinic drugs used in over active bladder?
oxybutanin, tolterodine
93
compression bandaging may be used as long as ABPI is above ?
0.8
94
most likely diagnosis in a man with chronic balanitis who has Reiter's syndrome and has a well-demarcated erythematous plaque with a ragged white border on his penis
Circinate balanitis
95
how often is breast cancer screening done (and between what ages)
every three years between 50-70
96
does surgery for varicose improve pregnancy rates?
no - it should not be offered as a form of fertility treatment
97
most likely diagnosis for a lady who has recently given birth, who has painful, bright red rectal bleeding
anal fissure
98
red flag symptoms for BPH?
weight loss and back pain

General Surgery (26 decks)

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