general surgery

Question 1

what is atelectasis?

Answer 1

total/partial collapse of the lung

Question 2

whats an ileus?

Answer 2

lack of movement that leads to a buildup or blockage

Question 3

where is mcburneys point?

Answer 3

1/3 of way between asis and umbilicus

Question 4

what nerve damage can you get during appendicectomy ?

Answer 4

ilioinguinal

Question 5

why do you get air under the diaphragm in an erect cxr?

Answer 5

perforation and air gets out of organs

Question 6

what is the mesentery?

Answer 6

tissue that attach intestines to abdominal wall

Question 7

AF with abdominal pain =

Answer 7

mesenteric ischaemia

Question 8

diagnostic ?

Answer 8

mesenteric angiogram

Question 9

what is an ileus?

Answer 9

adynamic bowel due to absence of normal peristalsis

Question 10

if wind is still being passed, what kind of obstruction is this?

Answer 10

incomplete

Question 11

vomitus of semi digested food with no bile?

Answer 11

gastric outlet obstruction

Question 12

small bowel obstruction ?

Answer 12

more acute - onset over hours - severe ado pain with copious amounts of bile stained vomit
minimal distension

Question 13

large bowel obstruction, onset of symptoms?

Answer 13

more insidious

Question 14

how does large bowel obstruction present?

Answer 14

abdominal colic with obvious distension

later onset of minimal/faecal vomit

Question 15

absolute obstruction indicates?

Answer 15

more distal obstruction

Question 16

coffee bean sign on x ray

Answer 16

sigmoid volvulus (localised tenderness on right or left iliac fossa)

Question 17

absent bowel sounds =

Answer 17

ileus

Question 18

you get no passage of ? with complete obstruction ?

Answer 18

faeces or wind

Question 19

what is an incarcerated adhesion?

Answer 19

stuck down by adhesions

Question 20

how would a strangulated hernia present?

Answer 20

acute abdomen

Question 21

surgical management of hernias?

Answer 21

open repair

Question 22

superior and medial to pubic tubercle?

Answer 22

inguinal

Question 23

scrotal mass that you are unable to get above?

Answer 23

indirect inguinal

Question 24

what is at higher risk of strangulation, direct or indirect?

Answer 24

indirect

Question 25

management of indirect hernia in boy under 1

Answer 25

urgent surgery

Question 26

what direction does an inguinal hernia point?

Answer 26

towards groin

Question 27

femoral points towards?

Answer 27

leg

Question 28

who gets femoral hernias and how do you fix them?

Answer 28

females need fixed with surgery they can strangulate

Question 29

main purpose of GGT?

Answer 29

to confirm raised ALP is hepatic in nature

Question 30

what is GGT used to monitor?

Answer 30

alcoholic liver disease

Question 31

why does coagulation give best immediate measure of functional capacity of liver?

Answer 31

clotting factors have a short half life

Question 32

why does albumin give a more intermediate measure of liver function ?

Answer 32

the half life is about 20 days, so its more likely to go down later

Question 33

when would you get low albumin, high protein ?

Answer 33

myeloma

Question 34

when do you get low albumin and low protein?

Answer 34

``` alcoholism cirrhosis protein malnutrition chronic inflammation nephrotic syndrome ```

Question 35

Hep A - who gets this

Answer 35

children and travellers

Question 36

how is hep A spread

Answer 36

faecal oral route

Question 37

what is hep a associated with ?

Answer 37

children travellers poor hygiene

Question 38

what antibody in hep a is indicative of present and past infection

Answer 38

present igm | past igg

Question 39

management of hep A

Answer 39

supportive care (help out)

Question 40

is hep B a DNA or RNA infection

Answer 40

DNA

Question 41

how is hep b spread

Answer 41

blood sexual mother to child

Question 42

what marker has to be raised for 6 months for chronic infection

Answer 42

hbsag

Question 43

the two types of chronic hep b infection

Answer 43

inactive (have it but dormant) | active (viral load high and have it)

Question 44

what is hbsag

Answer 44

surface antigen

Question 45

what marker indicates current acute infection

Answer 45

hbesag

Question 46

what marker shows you're immune or have had a vaccination ?

Answer 46

HBs

Question 47

what is the DNA load like in acute infection ?

Answer 47

very high

Question 48

is there a vaccination for hep b

Answer 48

yes

Question 49

what can you give in hep b

Answer 49

peg interferon or anti virals

Question 50

hep c - rna or dna infection

Answer 50

rna

Question 51

how can you get it

Answer 51

unprotected sex blood contact transfusion and needle sharing

Question 52

what are they symptoms of hep c usually like

Answer 52

mild symptoms then liver failure

Question 53

which antibodies are associated with PSC?

Answer 53

ANA, pANCA, anti smooth muscle

Question 54

onion skinning fibrosis?

Answer 54

PSC

Question 55

what do you need to monitor for in PSC?

Answer 55

cholangiocarcinoma and colorectal cancer if related to UC

Question 56

treatment of wilsons disease?

Answer 56

penicillamine

Question 57

what do people with wilsons need to avoid?

Answer 57

foods high in copper

Question 58

cancer of the biliary tree?

Answer 58

cholangiocarcinoma

Question 59

by far the biggest cause of liver cancer?

Answer 59

mets

Question 60

encephalopathy develops as a result of ?

Answer 60

ammonia not being broken down into ammonium in the liver