GI / gen surgery Flashcards
Investigation of choice for Boerhaave’s syndrome?
CT contrast swallow
Mackler’s triad?
Lower sternal chest pain, vomiting and subcutaneous emphysema
= Boerhaave’s syndrome
Investigations for acute cholecystitis?
Ultrasound is first line
If diagnosis still unclear - technetium-labelled HIDA scan
Treatment for acute cholecystitis?
IV antibiotics
early laparoscopic cholecystectomy within 1 week of diagnosis
Burn fluid resuscitation formula:
4ml x total burn surface area (%) x body weight
= 50% given in first 8 hours and 50% given over next 16 hours
Indication for fluid resuscitation following burns:
> 15% of total body area in adults
>10% in children
Managment for thrombosed haemorrhoids?
<72 hour history: analgesia and referral for consideration of excision
>72 hours: stool softeners, ice packs and analgesia
Managment for thrombosed haemorrhoids?
<72 hour history: analgesia and referral for consideration of excision
>72 hours: stool softeners, ice packs and analgesia
Management of anal fissures:
<1 week: soften stool: dietary advice, bulk forming laxatives, lubricants, topical anaesthetics, analgesia
Chronic anal fissure: topical GTN, if not effective after 8 weeks then secondary care referral and consideration for SPHINCTEROTOMY or BOTULINUM TOXIN
Management of sigmoid volvulus?
Rigid sigmoidoscopy with rectal tube insertion
Management of diverticulitis flares:
oral antibiotics at home - if don’t improve within 72 hours, admission to hospital for IV ceftriaxone and metronidazole
Antibiotics for life-threatening C.diff infection?
oral vancomycin and metronidazole
Antibiotics for life-threatening C.diff infection?
oral vancomycin and metronidazole
Faecal Immunochemical test: what is the national screening programme (when/who)?
All men and women aged 60-74 - every 2 years
