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MRCS A(My Own) > GIT Surgery > Flashcards

GIT Surgery Flashcards

1
Q

Rockall Score is done for

A

To asses mortality rate after an upper GIbleed following endoscopy

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2
Q

Blatchford score

A

The need for admission and timing of endoscopic intervention may be predicted by using the Blatchford score. This considers a patients Hb, serum urea, pulse rate and blood pressure.

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3
Q

If liver or renal failure then which Rockallscore isit

A

Score 3

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4
Q

Post gastrectomy syndrome

A

Post gastrectomy syndrome

Rapid emptying of food from stomach into the duodenum: diarrhoea, abdominal pain, hypoglycaemia

Complications: Vitamin B12 and iron malabsorption, osteoporosis

Treatment: High protein, low carbohydrate diet. Replace B12/Fe/Ca

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5
Q

individuals who have undergone truncal vagotomy will tend to routinely require

A

her a pyloroplasty or gastro-enterostomy as they would otherwise have delayed gastric emptying.

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6
Q

Gastric emptying hormonal factors

A

Delay emptying
1Gastric inhibitory peptide
2Cholecystokinin
3Enteroglucagon

Increase emptyin
Gastrin

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7
Q

Pyloroplasty should not be performed in the presence of?

A

Pyloroplasty should not be performed in the presence of fibrosed and scarred pyloroduodenum in chronic duodenal ulcer.

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8
Q

Pro kineticc for gastro paresis is

A

Erythromycin

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9
Q

Congenital Hypertrophic Pyloric Stenosis

A

infancy around 6 weeks of age
hypochloraemic metabolic alkalosis
most important diagnostic test is an ultrasound

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10
Q

The most important diagnostic test for congenital Hypertrophic Pyloric Stenosis

A

Ultrasound

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11
Q

What Kind of surgery in distal gastric ulcer malignancy

A

gastroenterostomies constructed for bypass of malignancy are usually placed on the anterior wall of the stomach (in spite of the fact that they empty less well).

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12
Q

What does signet ring cell represents in gastric cancer

A

Signet ring cells are features of poorly differentiated gastric cancer associated with a increased risk of metastatic disease.

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13
Q

Billroth surgery

A

Billroth I gastrectomy. The lower half of the stomach is removed and the cut stomach anastomosed to the first part of the duodenum.
Billroth II. Two-thirds of the stomach is removed, the duodenal stump is closed and the stomach anastomosed to the jejunum.

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14
Q

What is Gastroenterostmy

A

Gastroenterostomy. The jejunum is anastomosed to the posterior, dependent, wall of the stomach.

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15
Q

Bormann Classification

A

4types for gastriccancer
Polypoid
fungating
Ulcerated
Flat

1st two are lowgrade and other two are highgrade

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16
Q

Relation of signet ceL L with stomach Ca

A

More signet cells means high grade Gastric ca

17
Q

Troisier’s sign).

A

This may be extensive, the tumour even appearing in the supraclavicular nodes (Troisier’s sign).

18
Q

Radical Total Gastrectomy

A

Radical total gastrectomy: (a) dissection of omentum off the transverse colon; (b) exposure of the lesser sac; (c) splenectomy; (d) division and oversewing of the duodenum; (e) dissection of the left gastric artery nodes (group 17); (f) mobilisation of the oesophagus.

19
Q

which surgery is most strongly associated with delayed gastric emptying?

A

Anterior gastro jejunostomy causes more delayed gastric emptying

20
Q

What to do if vagotony is doneduring a gastric resection

A

surgery to disrupt or bypass the pylorus was often needed. These procedures comprised pyloroplasty and gastro-jejunostomy respectively.

21
Q

why metaclopromide is notgiven to enhance gastric emptying after vegotomy

A

Metoclopramide increases the rate of gastric emptying but its effects are mediated via the vagus nerve

22
Q

How Erythromycin enhances gastric emptying

A

Erythromycin enhances gastric emptying by acting via the motilin receptor in the gut.

23
Q

What is McKeown procedure

A

McKeown procedure is a total oesophagectomy.

24
Q

CA 19-9 is the maker for

A

Pancreatic cancer

25
Q

Which Kind of lung cancer occurs in nonsmokers

A

Adenocarcinomas are the most common tumour type present in never smokers. They are usually located at the periphery.

26
Q

Fibrosis in upper GI endoscopy indicates

A

Fibrosis is usually a sign of chronic ulcer. It should be biopsied carefully, a proton pump inhibitor started and re endoscopy should occur at 6 weeks.

Improve

27
Q

upper GI endoscopy, a linitis plastica lesionShows

A

During upper GI endoscopy, a linitis plastica lesion may prevent gastric distension

28
Q

Most Diagnostic sign of acute cholecystitis on Ultrasound

A

Sonographic Murphy’s Sign(primary finding)

29
Q

Secondary finding of acute cholecystitis on Ultrasound

A

Pericholecystic fluid
Biliary sludge
GB wall thickness>3mm

30
Q

Boerhave syndrome surgery

A

Thoracotomy with lavage if <12 hours
T tibe if >12 hours

MRCS A(My Own) (28 decks)

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