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Y4 GI / Surgery > General Surgery > Flashcards

General Surgery Flashcards

1
Q

“Number of deaths occurred due to a specific condition” is the definition of

A

Mortality

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2
Q

“State of having a specific disease or condition” is the definition of

A

Morbidity

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3
Q

What is the ASA classification?

A

Grades severity of morbidity

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4
Q

If a patient doesn’t want to hear the risks of a procedure and says they consent anyway, can you let them go through with the procedure?

A

No

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5
Q

What is the name of the surgical risk scoring system used to compare morbidity/mortality?

A

P-POSSUM

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6
Q

Operating at wrong site, using wrong implants/prosthesis or leaving foreign object retained post procedure are all examples of what?

A

Surgical never events

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7
Q

What is a central venous catheter also known as?

A

Central line

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8
Q

A central line is placed in US guidance - T or F

A

True

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9
Q

‘Used for infusion of chemotherapy, nutrition, long term ABx’ describes what?

A

PICC line

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10
Q

Are veins or arteries compressible on US?

A

Veins compressible

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11
Q

What are the 3 moments for the WHO surgical safety checklist?

A

Before induction of anaesthesia
Before first skin incision
Before patient leaves room

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12
Q

Diathermy is contraindicated in patients with what PMH?

A

Pacemaker

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13
Q

Put the stages of wound healing in the correct order

  • Proliferative phase
  • Remodeling
  • Inflammation
  • Haemostasis
A

Haemostasis > inflammation > proliferative phase > remodeling

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14
Q

The BRAN system is used for explaining surgery do a patient, what does it involves?

A

Benefits
Risks
Alternatives
What if we do nothing

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15
Q

NSAIDs inhibit ______ which decreases ______

A

Cyclooxygenase

Prostaglandins

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16
Q

What is telemetry?

A

Constant cardiac monitoring ECG

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17
Q

What is a pan scan?

A

CT head - mid femur (done in trauma)

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18
Q

What drug class is ondansetron in?

A

5HT3 antagonist

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19
Q

What drug class is hyoscine in?

A

Anticholinergic AKA antimuscarinic

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20
Q

What drug class is cyclizine in?

A

H1 antihistamine

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21
Q

What drug class is metoclopramide in?

A

D2 antagonist prokinetic

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22
Q

What drug class is haloperidol in?

A

D2 antagonist

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23
Q

Which D2 antagonists are prokinetic?

A

Metoclopramide and domperidone

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24
Q

What type of laxative is lactulose?

A

Osmotic laxative

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25
Q

What type of laxative is senna?

A

Stimulant laxative

26
Q

What is the mechanism of a stimulant laxative?

A

Increases intestinal motility

27
Q

What type of laxative is fibrogel and bran powder?

A

Bulk laxative

28
Q

What is a contraindication to stimulant laxatives?

A

Obstruction

29
Q

What is the management of a capsulated splenic haematoma?

A

Embolization

done by interventional radiology

30
Q

When our immediate, early and late surgical complications?

A

Immediate <24hr
Early <30d
Late >30d

31
Q

Pyrexia less than 24 hours after surgery is a red flag - true or false

A

False - less than 24hr after is not too worrying

32
Q

Anastomotic leak, chest infections and intra-abdo collections all generally occurs after how many days post surgery?

A

4 days

33
Q

Incontinence is a complication of perianal abscesses if there is damage to what structure?

A

Anal sphincter

34
Q

What is an anastomotic leak?

A

From bowel anastomosis - if there is a leak bowel contents can get into the abdomen

35
Q

What is a stoma?

A

An opening to divert stool/urine out the body

36
Q

Name 3 examples of stomas

A

Urostomy, ileostomy, colostony

37
Q

A stoma may be loop or end - what does this mean?

A 
Loop = temporary planning on reversing (2 holes)
Permanent = end
38
Q

Colostomy / ileostomy

  • which is on left / right hand side
  • which sticks out and which is flush with the skin?
  • which is higher output?
A
  • ileostomy LHS
  • colostomy RHS
  • ileostomy sticks out
  • colostomy flush
  • ileostomy higher output (need to empty more often)
39
Q

What is the Hb threshold for transfusion? What if in CVD?

A

<70 transfuse

<80 if CVD

40
Q

What % of the body fluid is intravascular and extravascular?

A

2/3 intravascular

1/3 extravascular

41
Q

What are the 2 main types of non-blood IV fluids?

A

Crystalloids

Colloids

42
Q

What is the fluid of choice for ABCDE fluid resuscitation? What volume? How fast? After what volume should you seek expert help?

A

500ml bolus crystalloid 0.9% NaCl saline over 15min
Reassess + repeat
After 2L seek expert help

43
Q

Name 2 examples of colloid fluids

A

Albumin

Gelofusin

44
Q

What risk should you be aware of with colloid fluids?

A

Anaphylaxis

45
Q

Name 3 examples of crystalloid fluids

A

NaCl saline
Hartmann’s solution
Dextrose

46
Q

What is the concentration of Na, Ca, K, Cl and lactate in saline?

A 
Na 154
Ca 0
K 0
Cl 154
Lactate
47
Q

What is the concentration of Na, Ca, K, Cl and lactate in Hartmann’s solution?

A 
Na 131
Ca 2
K 5
Cl 111
Lactate 29
48
Q

What is the concentration of Na, Ca, K, Cl and lactate in dextrose fluid?

A

No ions or electrolytes

all 0

49
Q

Is saline 0.9% NaCl hypo or hypertonic?

A

Isotonic

50
Q

Is dextrose hypo or hypertonic? What does this mean?

A

Hypotonic - most leaks into interstitial space, doesn’t stay in vessels

51
Q

True or false - seek expert help for calculating fluid requirements for obese patients BMI >40

A

True

52
Q

Elderly patients, CKD and HF patients all have _____ fluid requirement

A

Reduced

53
Q

Fluid requirement = _____ + _____

A

Routine maintenance + abnormal losses

54
Q

What is normal urine output?

A

0.5ml/kg/hr

55
Q

Give 5 examples of abnormal fluid losses

A 
Reduced oral intake
Sweating
D+V
Polyuria
Stoma loss
Haematemesis
Leaking wound
Melena
NGT
56
Q

How do you calculate routine maintenance fluids? What volume is that for a 70kg human?
How much Na + K + Cl + glucose?

A

25-30ml/kg/day water
1mmol/kg/day K + Na + Cl
50-100g/day glucose

57
Q

Is 0.18% NaCl / 4% glucose hypo or hypertonic? What is it used for

A

Hypotonic

For maintenance

58
Q

What is the definition of massive transfusion?

A

Replacement of total blood volume in <24hr
or
Half of total blood volume in <3hr

59
Q

What is the ratio of platelets to FFP transfused in massive haemorrhage?

A

1 : 1

60
Q

In transfusion, blood products need to be warmed using a blood warmer. True or false

A

True

61
Q

Tranexamic acid is used with transfusion in the management of trauma patients. True or false

A

True

62
Q

Rapid massive transfusion complications:

  • low or high calcium
  • low or high potassium
  • low or high temperature
  • acidosis or alkalosis
A

Hypocalcaemia
Hyperkalaemia
Hypothermia
Acidosis

Y4 GI / Surgery (11 decks)

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