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DPD > Intro to General Surgery > Flashcards

Intro to General Surgery Flashcards

1
Q

A scar just left to the midline (left on the patient) is called?

A

Paramedian

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2
Q

What are the two scars at McBurney’s point?

A

Gridiron scar
Lanz scar

Both appendectomy scars

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3
Q

Name a scar resulting from transplant surgery

A

Rutherford Morrison scar

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4
Q

What is the key sign for appendicitis?

A

Rovsing’s sign - when pressing on left iliac fossa produces pain in the RIGHT iliac fossa

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5
Q

What is the psoas test and what does it suggest?

A

Extention of the right hip joint whilst patient lies on left elicits pain in RIF- retrocecal appendicitis can irritate psoas muscle causing pain

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6
Q

What is the obturator test?

A

Obturator test -flex hip and knee and rotate kneemedially, if it’s painful on RIGHT it’s positive for appendicitis

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7
Q

Name three signs for appendicitis

A

obturator test positive
rovsing’s sign
psoas test

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8
Q

What is Murphy’s sign?

A

Cholecystitis

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9
Q

What is Courvoisier’s law?

A

Painless jaundice plus palpable gallbladder - pancreatic cancer

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10
Q

What are the Grey Turner’s and Cullen’s sign suggestive of?

A

Haemmorhage due to pancreatitis

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11
Q

What is the surgical sieve mnemonic?

A

VITAMIN D

Vascular
Infective
Traumatic
Autoimmune
Metabolic
Iatrogenic
Neoplastic
Drugs
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12
Q

Classifications of investigations

A

Bedside
Non-invasive
Invasive

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13
Q

Describe the blood gas graph to work out whether someone is in acidosis/alkalosis and whether it’s respiratory or metabolic

A

y axis = pCO2
x axis = pH

1st down: RM acidosis
2nd down: MR alkalosis

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14
Q

What is the immediate management for all surgical patients?

A

Ted stockings
LMWH for VTE prophylaxis
Nill by mouth if pending surgery

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15
Q

What else might you need to do for management?

A

catheter

fluid balance chart

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16
Q

Management classificiations (as taught by Shyam)

A

Conservative e.g. watchful waiting
Medical
Interventional e.g. interventional radiology
Surgical

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17
Q

Mnemonic for presenting a condition

A

Dressed in a surgeon’s gown physicians might make some progress

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18
Q

What does this mnemonic stand for?

A 
Definition of condition 
Incidence 
Age
Sex 
Geography
Pathology (macro or micro) 
Symptoms and signs
Prognosis
19
Q

What are the five ‘f’s of biliary colic?

A 
Female
Forty
Fair
Fertile
Fat
20
Q

Febrile, tachycardic with worsening markers

A

Ascending cholangitis

21
Q

What is the diagnosis criteria for pancreatitis?

A

Clinical history and examination OR radiological finding consistent with pancreatitis PLUS amylase rise greater than 3 x upper limit of normal

22
Q

What might you see on the xray of someone with pancreatitis?

A

Calcified gallstones

Air in biliary tree

23
Q

Scoring of acute pancreatitis

A 
paO2<8kPa
Age>55 yeras
Neutrophils>15
Calcium <2
Raised Urea>16
Elevated enzymes LDH>600iU
Albumin <32
Sugar<10
24
Q

What counts as really bad?

A

A score above three?? CHECK BACK

25
Q

RLQ pain in female

A

Ovarian torsion
Ectopic
Appendicitis

26
Q

Besides USS and

A

CXR to look for free air under diaphragm

27
Q

What is post-op ileus?

A

Slow bowels after GI surgery

28
Q

Investigations for PE

A

CTPA

Ventilation perfusion scan

29
Q

What is atelectasis?

A

Bases of lungs collapse and don’t clear secretions, leading to bacterial growth

30
Q

Another name for wound infection

A

SSI

Surgical site infection

31
Q

Hiccups post bowel

A

diaphragmatic

32
Q

Where do you get fluid build up post op?

A

paracolic clutters

pelvic collection of fluid

33
Q

What is another name for period pain?

A

MIttelschmerz

34
Q

Seven Cs of post-op pyrexia

A 
Chest
Catheter
CVP 
Cannula
Cut
Collection 
Calves
35
Q

Post op pyrexia within 24 hours could be caused by

A

Infection? CHECK

36
Q

24-72 hours

A

Pulmonary atelectasis

CHest fineciton

37
Q

3-10 days

A 
UTI
DVT
PE
WOund
Colelction
anastomic leak
38
Q

Common causes of small bowel obstruction

A

Hernia

Adhesions

39
Q

Common causes of large bowel obstruction

A

Malignancy

Volvulus

40
Q

Complications of gallstones within the gallbladder

A

Biliary colic
Acute cholecystitis
Empyema/mucocele

41
Q

Complications of gallstones within the biliary tree

A

Obstructive jaundice

Ascending cholangitis

42
Q

Complications of gallstones outside the biliary tree

A 
Pancreatitis
Gallstone ileus (obstruction at terminal ileum)
43
Q

Surgery books

A

Mccloud’s general

Catherine partchment smith’s surgical cases

DPD (38 decks)

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