General surgery Flashcards
Parkland formula calculation
When to do a resection in splenic trauma?
Hilar injuries
Major haemorrhage
Major associated injurie
If a person has anti-HBs what does this suggest?
Previous hepatitis immunisation or immunity
Most common benign tumour of mesenchymal origin?
Haemamgioma
Definitive diagnostic investigation got small bowel obstruction?
Ct abdomen
What is the best investigation to characterise the fistula course in an anal fistula if not clinically unwell?
Pelvic MRI
What is an indirect hernia?
travels ‘indirectly’ through the deep AND superficial inguinal ring to where it presents
What is a direct hernia?
Bowel enters the inguinal canal directly through a weakness in the posterior wall of the canal, termed Hesselbachs triangle
UC with sclerosing cholangitis increases the risk of what?
Cholangiocarcinoma
When does BP fall in haemorrhage shock?
When about 30% of blood volume is lost
What kind of shocks cause warm periperhies?
Neurogentic, septic and anaphylatic shock
What is Boas sign seen in?
Cholecytitis
What is cullens sign seen in?
Pancreatitis
What is grey-turners sign?
Pancreatitis
What is a Kocher’s incision?
Incision under right subcostal margin
What is a lanz incision?
Incision in the right iliac fossa (appendectomy_
What is a gridiron incision?
Oblique incision centre over McBurneys point
What is a gable incision?
Rooftop inicison
What is a pfannenstiel incision?
Transverse supra pubic, primarily used to access pelvic organs
What is a McEvedy’s incision?
Groin incision e.g. Emergency repair strangulated femoral herni
What is a rutherford morrison excision?
Extraperitoneal approach to left or right lower quadrants. Gives excellent access to iliac vessels and is the approach of choice for first time renal transplantation.
Most common urothelial malignancy?
Transitional cell carcinoma
The 24hr fluid requirement for burns is given as what?
50% over 8hrs followed by 50% over 16hrs
Mneumonic for hernias?
MILF
Medial inguinal
Lateral femoral
Signs of an aorta disruption?
Deceleration injuries
Contained haematoma
Widened mediastinum
What does achalsia increase risk of?
SCC
Management of a hiatus hernia?
all patients benefit from conservative management e.g. weight loss
medical management: proton pump inhibitor therapy
surgical management: only really has a role in symptomatic paraesophageal hernias
What is angiodysplasia?
Abnormal, tortuous, dilated small blood vessel in the mucosal and submucosal layers of the GI tract. It is the most common vascular abnormality in the GI tract
What is a Richter Hernia?
occurs when the anti-mesenteric wall of the intestine protrudes, causing strangulation without obstruction
Post splenectomy blood film features:
Howell- Jolly bodies
Pappenheimer bodies
Target cells
Irregular contracted erythrocytes