GI surgery

Question 1

Pts with diverticulitis mx?

Answer 1

oral antibiotics

Question 2

Diverticulitis not settling
>72 hours?

Answer 2

Iv abx Cef and metronidazole

Question 3

anal cancer
strongest risk factor?

Answer 3

HPV infection
HPV 16/18

Question 4

what fistula is most likely to form?

Answer 4

colovesical fistula

Question 5

what mx enables to avoid a permanent stoma in UC?

Answer 5

panproctocolectomy and ileoanal pouch

Question 6

rectal crohns mx?

Answer 6

proctectomy

Question 7

fulminant UC mx?

Answer 7

sub total colectomy

Question 8

where do most anal fissures occur?

Answer 8

posterior midline

> if anywhere else investigate

Question 9

what is an ispaghula husk?

Answer 9

bulk forming laxative

Question 10

thrombosed haemorrhoid management?

Answer 10

anorectal pain and tender lump

stool softener
ice packs and analgesia

Question 11

management of anal fissure which does not respond to conservative measures?

Answer 11

sphincterotomy

Question 12

acute anal fissure management?

Answer 12

soften stool

dietary fibre
analgesia

topical aneasthetic cream

Question 13

emergency colorectal surgeyrg?

Answer 13

hartmans procedure

proximal bowel brought to surface as an end colostomy

distal bowel sewed up and left inside

can reverse and anastomse two ends together

Question 14

what is an end ileostomy?

Answer 14

de function bowel

rectum and anus

• spouted stoma

Question 15

Imaging is necessary for diagnostic of pancreatitis?

Answer 15

no

early uss can be important to aetiology

Question 16

what factors for pancreatitis?

Answer 16

> 55

hypocalcaemia

hyperglycaemia
hypoxia
neutrophilia

elevated LDH /AST

Question 17

reynolds pentad?

Answer 17

jaundice
RUQ pain
fever/rigors

shock
altered mental status

Question 18

mild acute pancreatitis mx?

Answer 18

IV fluids and opioid analgesia

Question 19

which drugs cause pancreatitis - acute?

Answer 19

aza
mesalazine
thiazide
furosemide
steroids
sodium valpro

Question 20

acute cholecystitis

Answer 20

inflammation of gallbladder
inspiratory arrest upon palpation of RUQ pain

LFTs normal

Question 21

Ix acute cholecystitis?

Answer 21

USS

LFTs

Question 22

mx of acute chole?

Answer 22

IV abx
> early laproscopic cholecystectomy within 1 week

Question 23

what is a pancreatic pseudocyst?

Answer 23

collection of fluid

enclosed by fibrous / granulation tissue

Question 24

pancreatic necrosis?

Answer 24

parenchyma / fat

Question 25

pigmented gallstones are seen with?

Answer 25

sickle cell

Question 26

boerhaaves syndrome
ix?

Answer 26

CT contrast swallow

Question 27

contraindications to laparoscopic surgery?

Answer 27

haemodynamic shock
uncorrected coagulopathy
raised intracranial pressure

dilated bowel loops

Question 28

gastric MALT lymphoma?

Answer 28

eradicate H pylori