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Intro to medicine, surgery, history taking and examination > Introduction to surgery > Flashcards

Introduction to surgery Flashcards

Demonstrate the relevance of common surgical problems in dental patients. Understand the implications of surgery and their associated conditions when undertaking dentistry

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1
Q

What is surgery?

A

The art of healing by manual operation

The branch of medical science that treats disease or injury by operative procedures

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2
Q

Surgical subspecialities

A 
Maxillofacial
ENT
Plastics
Neurosurgery
Cardiac
Thoracic
Gynaecology
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3
Q

“General” sugery

A 
Paediatric
Urology
Vascular
Minimally invasive
Oncology
Trauma
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4
Q

Anaesthetics

A

“Shared airway” (by pt and surgeon mechanically)
Anaesthesia and sedation
Management of co-morbidities (one or more additional diseases/ disorder co-occurring with a primary disease/ disorder)
CPR and medical emergency algorithms

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5
Q

Types of surgery

A 
Elective (planned in advance)
Emergency (immediate, urgent - 12 hours)
Expedited (usually within days)
Laparoscopic, microsurgery
Day surgery - must be stable and have chaperone etc.
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6
Q

Classifications of surgery

A

Major - cancer resection
Intermediate - hernia repair
Minor - excision of lipoma

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7
Q

What does a surgeon do?

A 
Diagnosis
-evaluate pt problem
-investigations
Treatment options - surgical/ non-surgical
Operate
Post-op care
-immediate post-op care
-rehabilitation
-follow-up care
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8
Q

Methods

A 
Clinical approach
-history, exam, special investigations
Decision making
-balance morbidities, consider QOL
-team working
Leadership of operating team
Leadership of ward team
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9
Q

Types of histories

A 
Emergency
-diagnosis oriented
-HPC paramount; account for time
Elective
-diagnosis (usually) known
-safety for operative procedure
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10
Q

History

A 
Structured
Presenting complaint
Medical history
Drug history
Family history
Social history
-e.g. smokers susceptible to post-op chest infections after GA
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11
Q

Examination

A

General
Vital signs
-pulse rate and rhythm, BP, resp. rate, T
System Specific Exam

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12
Q

System Specific Exam

A 
Abdo
Orthopaedic
Neuro
Head and Neck
Vascular
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13
Q

Pre-op care

A 
Safe surgery
-informed consent
-anticipate complications (blood loss prevention/ replacement, infection issues)
Safe anaesthetic
-airway
-assess co-morbidities
-specific heart/ lung investigation
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14
Q

Physiological classification - ASA

A

I - healthy px
II - mild systemic disease with no functional limitation - controlled hypertension
III - severe systemic disease with definite functional limitation - COPD
IV - severe systemic disease that is a constant threat to life - unstable angina
V - moribund px not expected to survive for 24 hours with or without surgery - ruptured aortic aneurysm
Suffix E emergency procedure

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15
Q

Reasons for physiological classification

A

Estimate risk of complications

Guide choice of treatment

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16
Q

Other physiological classification used in combination with ASA

A

WHO performance status

-premorbid state of pt e.g. before operation how far could they walk? Could they do their own shopping

17
Q

General principles of surgery

A

Accurate diagnosis
Surgical skills
Wound healing and wound care
Appropriate care of px

18
Q

Perioperative care

A 
Dealing with emergencies
Airway
Bleeding
Vital signs
Sedation
19
Q

Postoperative care - general

A

Pain
Fluid intake/ loss
Nausea and vomiting
DVT prevention

20
Q

Postoperative care - organ systems

A

CVS (arrhythmia, hypotension, hypertension)
RS (hypoxia, difficulty breathing, hypertension)
GI (nutrition, voiding, diarrhoea)
GU (retention urine, diuresis)
MS (mobility, pressure areas)

21
Q

Surgical emergencies - airway

A

Tracheostomy

22
Q

Surgical emergencies - bleeding

A

Pressure, elevation
Monitor P, BP
Suture?
*trauma, vascular disease

23
Q

Surgical emergencies - trauma

A

Stop bleeding
Stabilise fracture
Relieve pain
Arrange transportation for surgery without delay

24
Q

Surgical emergencies - blockages

A

Repiratory
Intestinal
Biliary
Vascular

25
Q

Surgical emergencies - perforations

A

Intestinal

Vascular

26
Q

Surgical emergencies - infections

A

Abscesses, internal organs (pleura, peritoneum), soft tissues, bone

Intro to medicine, surgery, history taking and examination (3 decks)

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