Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

5th Year > General Surgery Stuff > Flashcards

General Surgery Stuff Flashcards

1
Q

What do high pitched bowel sounds indicate?

A

Possible obstruction - get Abdo CT with contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which nerve is at risk of damage during posterior triangle LN biopsy?

A

Accessory nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which nerve is at risk of damage on Lloyd Davies stirrups?

A

Common peroneal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which nerve is at risk of damage during a thyroidectomy?

A

Recurrent laryngeal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which nerve is at risk of damage during an anterior resection of the rectum?

A

Hypogsastric autonomic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which nerves are at risk of damage during axillary node clearance? (3)

A

Long thoracic nerve
Thoracodorsal nerve
Intercostobrachial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which nerve is at risk of damage during inguinal hernia repair?

A

Ilioinguinal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which nerves are at risk during varicose vein surgery? (2)

A

Sural nerve

Saphenous nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which nerve is at risk during the posterior approach to the hip?

A

Sciatic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which nerve is at risk during carotid endarterectomy?

A

Hypoglossal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should the maximum diameter of the small bowel be?

A

35mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should the maximum diameter of the large bowel be?

A

55mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What diagnosis would progressive dysphagia of solids and liquids, without GORD suggest?

A

Achalasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What cancer is achalasia associated with?

A

Squamous cell carcinoma of the oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the features of Stage I Haemorrhagic shock?

A

<750ml
HR <100
<15% loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the features of Stage II Haemorrhagic shock?

A

750-1500ml
HR >100
BP normal
15-30% loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the features of Stage III Haemorrhagic shock?

A

1500-2000ml
HR >120
BP reduced
30-40% loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the features of Stage IV Haemorrhagic shock?

A 
>2000ml
HR >140
BP reduced
RR >35
>40% loss
Lethargic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the classification of an UPPER GI bleed?

A

Proximal to ligament of Treitz aka suspensory muscle of the duodenum
Boundary between the duodenum and jejunum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Parkland’s formula?

A

The volume of Hartman’s solution required for 2nd/3rd degree burns victims over first 24hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is Parkland’s formula calculated?

A

4ml x BSA x weight

1/2 over 8hrs, 1/2 over next 16hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a FAST scan?

A

Assesses for free fluid around kidneys, spleen, liver, bladder and pericardium (+pneumothroax)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the general management for haemorrhoids? (3)

A

Stool softeners

Topical Diltiazem or GTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are some specific managements for small and large haemorrhoids?

A 
Small = phenolic solution injection
Large = haemorrhoidectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the general management options for anal fissures?

A

1st line = Topical Diltiazem or GTN for 6wks
2nd line = Botox injection
Sphincterectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the surgical management of a fistula in ano?

A

Low/not involving sphincter/non-IBD = lay open

High/complex/IBD = seton suture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What kind of surgery is appropriate for large external haemorrhoids?

A

Miller-Morgan style conventional haemorrhoidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the disadvantages of a Miller-Morgan haemorrhoidectomy?

A

Very painful

Lots of tissue removal -> risk of anal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the surgical management of fissure in ano?

A

Lateral internal sphincterectomy (most effective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why is a lateral internal sphincterectomy not ideal for females?

A

Causes pelvic floor damage which may be exacerbated by pregnancy -> faecal incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Where are anal fissures usually located?

A

Posterior midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What must be consider if multiple or unusually located fissures are present?

A

Investigation for IBD or internal prolapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What artery is most at risk with a perforated duodenal ulcer on posterior wall?

A

Gastroduodenal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the most likely cause of major duodenal haemorrhage?

A

Perforated posterior ulcer damaging the gasproduodenal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the definition of congenital cryptorchidism?

A

Undescended testis at 3 months of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the management of congenital cryptorchidism?

A

Wait until 6 months, if not descended, need orchidoplexy at 6-18 months of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Why must congenital crytorchidism be corrected before 2yrs of life?

A

Sertoli cells degrade after 2yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the function of Sertoli cells?

A

Secrete ABP -> promotes spermatogenesis

Secrete inhibib -> negative feedback on pituitary -> decreases FSH secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What stimulates Sertoli secretion of ABP?

A

FSH from pituitary and testosterone from Leydig cells

Must be in combination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How may retroperitoneal fibrosis appear on CT?

A

Medially displaced ureters with a para-aortic mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What may indicate a hypoglossal nerve injury?

A

Tongue pointing TOWARDS the lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which cells may be present on a post-splenectomy blood film? (4)

A

Howell-Jolly cells
Pappenheimer cells
Target cells
Irregular contracted erythrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Where are femoral hernias found?

A

Below and lateral to pubic tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Who gets femoral hernias?

A

Multiparous women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are the risks of femoral hernias?

A

High risk of obstruction and strangulation -> require surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Where are inguinal hernias found?

A

Above and medial to pubic tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Who gets inguinal hernias?

A

95% are male

25% lifetime risk for males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How common is strangulation in inguinal hernias?

A

Rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is Cowden disease?

A

Macrocephaly and multiple intestinal hamartomas

PTEN mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is FAP?

A

Autosomal dominant APC gene mutation causing many colonic adenomas (generally >100)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the lifetime cancer risk for FAP?

A

100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the management of FAP?

A

Annual flexible sigmoidoscopy from 15yrs
Then 5 yearly from 20yrs if no polyps found
If polyps found = colonic resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is Peutz-Jegher’s syndrome?

A

Autosomal domination STK11 mutation (Chr19) causing multiple benign intestinal hamartomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the management of Peutz-Jegher’s syndrome?

A

2-3 yearly pan-intestinal endoscopy

55
Q

What is a classic extra-intestinal feature of Peutz-Jeghers syndrome?

A

Pigmentation spots around mouth

56
Q

What may be the diagnosis for someone who presents with persistent hypotension following a deceleration injury?

A

Aortic rupture

57
Q

What CXR feature may be present with aortic rupture?

A

Widened mediastinum

58
Q

What is a Dieulafoy lesion?

A

Bleeding caused by a SINGLE large tortuous arteriole in submucosa (of stomach)

59
Q

What are the classic features of a duodenal ulcer?

A

Pain several hours after eating, relieved with food

60
Q

What is Bevacizumab?

A

Anti-VEGF

Used in colorectal ca, renal ca and glioblastoma management

61
Q

What is Basiliximab?

A

IL-2 binding site

Used in renal transplants

62
Q

What is Cetuximab?

A

Epidermal GF inhibitor

Used in EGF +ve colorectal ca management

63
Q

What is normal Central Venous Pressure?

A

2-6mmHg

64
Q

What is a general surgical cause of bubbly urine with recurrent UTIs?

A

Enterovesical fistula

Often secondary to colorectal cancer

65
Q

What may cause haematuria and polycythaemia?

A

Renal vein thrombosis

Often secondary to renal cell cancer

66
Q

What is Li Fraumeni syndrome?

A

p53 mutation causing sarcomas, breast cancer, leukaemia and adrenal tumours

67
Q

What may be the diagnosis for a patient with a lower GI bleed and portal hypertension?

A

Rectal varices

68
Q

What investigation is required is an anal fistula is diagnosed?

A

Pelvic MRI

In order to characterise fistula course

69
Q

What causes a Sine wave ECG?

A

Severe hyperkalaemia >9

70
Q

What is the management of congenital inguinal hernias?

A

Prompt surgical repair

High complication rate if not

71
Q

What is the management of congenital umbilical hernias?

A

Managed conservatively

72
Q

What may be the diagnosis for a stable patient who is found to have free abdominal fluid after a deceleration injury?

A

Duodenal-jejunal flexure disruption

73
Q

The risk of what type of cancer is increased in patients with UC and PSC?

A

Cholangiocarcinoma

74
Q

What tumour marker is raised in cholangiocarcinoma?

A

CA19-9 raised in 80%

Also CEA and CA125

75
Q

What is a Ritcher’s hernia?

A

Hernia of only anti mesenteric border of bowel

Can present with strangulation in absence of obstruction

76
Q

What is used in vatical management?

A

Terlipressin

Sengstaken-Blakemore tubes

77
Q

What should be considered if a bleeding ulcer cannot be repaired endoscopically after 2+ attempts?

A

Laparotomy and ulcer underrunning

78
Q

What are the indications for laparotomy and ulcer underrunning? (4)

A

> 60yrs
Continued bleeding despite endoscopy
Recurrent bleeding
Known CVD with poor response to hypotension

79
Q

What is the annual risk of strangulation of inguinal hernias?

A

3%

More common in indirect

80
Q

What is flail chest associated with?

A

Pulmonary contusion

81
Q

What is the classic feature of colonic angiodysplasia?

A

Brisk PR bleeding

82
Q

How does colonic angiodysplasia appear on colonoscopy?

A

Small erythematous lesions

Generally in right colon

83
Q

What is the likely cause of post-AAA PR bleeding?

A

Ischaemic colitis

Secondary to inferior mesenteric artery ligation

84
Q

What is the cause of a pyogenic liver abscess in a Middle Eastern background?

A

Entamoeba histiolytica abscess

85
Q

What is the management of entamoeba histiolytica abscess?

A

Metronidazole

86
Q

What are the causes of hyper-echoic liver lesions on USS? (2)

A

Hepatocellular carcinoma

Haemangioma

87
Q

How do you differentiate between HCC and haemangioma?

A 
HCC = raised AFP
Haemangioma = normal AFP
88
Q

What is a haemangioma?

A

Benign mesenchymal tumour

89
Q

What is a mesenchymal hamartoma?

A

Congenital benign tumour
Generally present in infants
May compress normal liver

90
Q

What is the difference between a hamartoma and a haemangioma?

A 
Hamartoma = benign growth of normal mature cells in abnormal distribution
Haemangioma = type of hamartoma composed of vascular tissue
91
Q

What kind of cyst appears as a unilocular lesion with no epithelial lining and a thick cyst wall?

A

Hyatid cyst

92
Q

What causes a hydatid cyst?

A

Echinococcus granulosus infection

Found in Middle East

93
Q

How do hydatid cysts appear on USS?

A

Uniloculated lesion with no epithelial lining and a thick cyst wall

94
Q

What feature may be present on an FBC with a hydatid cyst?

A

Eosinophilia (33%)

95
Q

What is the management of a hydatid cyst?

A

Cyst sterilisation with mebendazole THEN +/- surgical excision

96
Q

What is contraindicated in hydatid cyst management?

A

Percutaneous aspiration

97
Q

What investigation best differentiates between hydatid and amoebic cysts?

A

CT

98
Q

What is a cystadenoma?

A

Rare solitary multilocular lesion with malignant potential

99
Q

What do the blood results show with a cystadenoma?

A

LFTs generally normal

100
Q

How do cystadenomas appear on USS?

A

Large anechoic, fluid-filled area with irregular margins

101
Q

What is the management of ALL cystadenomas?

A

Surgical resection

Due to malignant potential

102
Q

What causes a hydatid cyst?

A

Echoinococcus granulosus infection

Due to Type I Hypersensitivity

103
Q

Where, other than the liver, are hydatid cysts commonly found?

A

Lungs

104
Q

What are the 5 types of thyroid cancer?

A 
Papillary
Follicular adenoma
Follicular carcinoma
Medullary carcinoma 
Anaplastic carcinoma
105
Q

What percentage of thyroid cancer is papillary?

A

70%

106
Q

Who gets papillary thyroid cancer?

A

Young females

Good prognosis

107
Q

How does papillary thyroid cancer appear on histology?

A

Pale empty nuclei

108
Q

How does papillary thyroid cancer metastasize?

A

Via lymphatics

109
Q

What is the management of papillary thyroid cancer?

A

Total thyroidectomy with adjuvant radioiodine

110
Q

What monitoring is required post-thyroidectomy in papillary thyroid cancer?

A

Yearly thyroglobulin levels to detect recurrence

111
Q

What percentage of thyroid cancer is follicular adenoma/carincoma?

A

20%

112
Q

What is the management of follicular thyroid cancer?

A

Same as papillary

113
Q

What is the difference between follicular adenoma and carcinoma?

A

Both solitary nodules

Follicular carcinomas show microscopic capsular and vascular invasion

114
Q

What percentage of thyroid cancer is medullary?

A

5%

115
Q

Which cells do medullary thyroid cancers originate from/

A

Parafollicular C cells

These are neural crest cells, not thyroid tissue

116
Q

What is used as a tumour marker in medullary thyroid cancer?

A

Serum calcitonin raised

117
Q

What percentage of medullary thyroid cancer is familial?

A

20%

Part of MEN-2

118
Q

What would indicate a poor prognosis for medullary thyroid cancer?

A

Nodal disease

119
Q

What percentage of thyroid cancer is anaplastic?

A

1%

More common in elderly females

120
Q

What is the management of anaplastic thyroid cancer?

A

Resection
Unresponsive to chemotherapy
Often require palliation with isthmusectomy and radiotherapy
Local invasion is common

121
Q

What malignancy is associated with Hashimoto’s?

A

Lymphoma

122
Q

What would suggest a psoas abscess? (3)

A

Systemic infection features
Groin swelling
Pain exacerbated with hip extension

123
Q

What is Boas’ sign?

A

Hyperaesthesia beneath right scapula in acute cholecystitis

124
Q

What are the 3 indications for an emergency splenectomy?

A

Uncontrollable splenic bleeding
Hilar vascular injuries
Devascularised spleen

125
Q

What must you be aware of with TPN?

A

Can cause deranged LFTs and refeeding syndrome

126
Q

What are common causes of diaphragm rupture?

A

RTA and blunt trauma

Cause large radial tears

127
Q

Which side are diaphragm ruptures more common on?

A

Left

128
Q

How may a diaphragm rupture appear on CXR?

A

Indistinct left hemidiaphragm

129
Q

What is Meckel’s diverticulum?

A

Congenital diverticula in terminal ileum

130
Q

What is a complication of Meckel’s diverticulum?

A

May contain gastric mucosa
Over time causes ulceration and bleeding
Causes iron-deficient anaemia

131
Q

What symptom may indicate gastric mucosa in a Meckel’s diverticulum?

A

Pain after eating

132
Q

What is Meckel’s diverticulum a remnant of?

A

Omphalomesenteric duct (yolk stalk)

133
Q

What is the rule of 2s for Meckel’s diverticulum?

A 
2% of population
2 feet proximal to ileocaecal junction
2 inches long
Presents at 2yrs
2 types of mucosa (gastric and pancreatic)
2:1 M:F
134
Q

How does Meckel’s diverticulum most commonly present?

A

PR bleeding followed by obstruction, volvulus and intussusception

5th Year (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions