general surgery amk 20/5

Question 1

gord can lead to oesophageal cancer

Answer 1

true

Question 2

alarm symtpoms for oesphageal cancer

Answer 2

anaemai, loss of weight, anoxeria, recent onsent, melena and swalloign difficulty

Question 3

h.pylori posive what abx

Answer 3

metronidazoel and amox

Question 4

variceal prophylaxis

Answer 4

non-slective beta blockers propanolol then you can also give endoscopic band ligation

to release the pressure you can have transjugular intrahepatic porotosystmeic shunt TIPSS

Question 5

cx of varciies

have often do you screen for varicies pts

Answer 5

portal hypertension secondary to cirrhosis

need to screen for cirrhosis pts for every 2-3years

Question 6

acute management of varicies

Answer 6

blood transfusion/vik/ffp/platelts
terlipression ( vasopressin analgous) - splanchic vasoconstriction and reduces tempoary portial pressur eso will decrease the variceal bleeding

VBL - nil by mouth
broad spce abx -prevent bacteriaemia or peritonitis
thiamine b1 - deficiecny for pts with alcholism
uncotnrollable beleding - sengstaken - blakemore tube - tamponade bleeding variceie s

Question 7

apple core sign

Answer 7

colorectal cancer

Question 8

pancreatic cancer - malaise abdo pain and nauesa and weigth loss
painless palpable gallabladder with j

what other unlikely features would i think of

Answer 8

diabetes - lederly person new diabetes and weight loss

pancreatitis - exocrine dysfucntion with steatorrhoea
pareneoplastic syndrome - trosseuaas syndrome 0 migratory thrombophelibits extremeities of body

DIC - severe inflammation, endothelial injury

Question 9

tx of p cancer

Answer 9

resection ( radical pancreaticduodectomy ) with adjuvant chemo

criteria for thsi - no involvent with SMA and coelaiac arteries
if you do not need to go for pallaitve

Question 10

gastric cancer - 2 groups

Answer 10

intestinal - h pylori smoking chornic gastrisits high alochol and adenomatorus polps and found lesser cruvature of stoamch

diffuse - signet cells

Question 11

what are the pre-cancerous forms of gastric cancer

Answer 11

menetrirer disease

krukenberg tumour - signet ring secrete mucin - bloating, ascites, pain durin intercourse and mets to ovaries and breasts and lungs

sister mary joseph noduel - subcut peri-umbilical mets associated with intestianl gastric ncance r

linitis plastica

Question 12

carcinoid tumours where are they usually

Answer 12

appendics or small intstine
but can be anywhere in small intestine
endrocrine secreating

Question 13

carcinod tumoru secrete what

Answer 13

serotonin

give octreotide - inhbitis somatostating secreaton

Question 14

angiodysplasia

Answer 14

leaky vessels in the colon that can cause GI bleeds
usuallu caecum adn ascending colon

Question 15

anything that increases abdominal pressure risk factor for what

Answer 15

haemorrhoids ng

Question 16

cant eat seeds

Answer 16

diverticular disease