General Surgery Flashcards
List potential complications of laparotomy
Wound breakdown Wound dehiscence Infection Haematoma Smoking leads to poor healing
List potential complications of biliary surgery
Fistula Cholangitis Bleeding Jaundice Peritonitis
List potential complications of arterial surgery
Bleeding Thrombosis Embolism Graft infection Fistula Ischaemia
List potential complications of colon surgery
Sepsis Ileus Fistula Anastomotic leak Haemorrhage
List potential complications of small bowel surgery
Short gut syndrome (less than 250 cm)
Malabsorption (ADEK, B12, bile salts)
List potential complications of total parenteral nutrition
Sepsis (Staph, Candida, Pseudomonas)
Thrombosis
Metabolic disturbance
Refeeding syndrome (hypophosphatemia)
List conditions typically presenting as an acute abdomen in the RUQ
Ruptured spleen/colon
Gastric ulcer
AAA
Pyelonephritis
List conditions typically presenting as an acute abdomen in the epigastrum
Pancreatitis
Peptic ulcer perforation
List conditions typically presenting as an acute abdomen in the LUQ
Cholecystitis
Duodenal ulcer perforation
Hepatitis
Pyelonephritis
List conditions typically presenting as an acute abdomen in the RLQ
Appendicitis Salpingitis Ruptured ectopic pregnancy Strangulated hernia Psoas abscess
List conditions typically presenting as an acute abdomen in the LLQ
Divericulitis Abscess Ruptured ectopic pregnancy Strangulated hernia Perforated colon IBD Renal stones
What investigations would you generally do for an acute abdomen?
FBC, U+E, amylase, LFT, CRP, ABG Urinalysis Erect CXR, AXR Laparoscopy USS
Outline general management of an acute abdomen
Treat shock Crossmatch/G+S blood Antibiotics (amox met gent) Pain relief IV fluids
List clinical features of colorectal carcinoma
Can depend on site
Left: PR bleed, altered bowels, obstructive symptoms, tenesmus, PR mass
Right: weight loss, low Hb, abdo pain
What investigations would you do for colorectal carcinoma?
FBC
FOB test screening every 2 years
Sigmoidoscopy/colonoscopy
CEA monitoring
Outline management of colorectal carcinoma
Hemicolectomy Anterior resection if low sigmoid/high rectal AP resection if low rectal Hartmann's procedure in emergency Radio/chemotherapy adjuvant
What is a hydrocele?
Fluid in tunica vaginalisis surrounding testes, usually due to patent processus vaginalis
Visceral pain from foregut organs is usually perceived where?
Epigastrium
Visceral pain from midgut organs is usually perceived where?
Periumbilical region/centre of abdomen
Visceral pain from hindgut organs is usually perceived where?
Suprapubic region
What are the two main types of hiatus hernia?
Sliding
Paraoesophageal/rolling
What is a sliding hiatus hernia?
Gastro-oesophageal junction slides upwards into chest
List aetiology/risk factors for sliding hiatus hernia
Obesity
Ageing
Ineffective lower oes sphincter
List clinical features of sliding hiatus hernia
Heartburn Waterbrash Regurgitation Worst at night Reflux
What investigations would you do for hiatus hernia?
Barium swallow
Endoscopy + biopsy to query Barrett’s
Oesophageal function tests (manometry, pH)
CXR
Outline management of hiatus hernia
Antacids, PPI
Lifestyle - stop smoking, reduce alcohol
Surgery to strengthen sphincter/repair hiatus defect
What is a paraoesophageal hiatus hernia?
All or part of stomach herniates through oesophageal hiatus
Gastro-oesophageal junction remains in position
List clinical features of paraoesophageal hiatus hernia
Asymptomatic
Obstructive symptoms
Distention
