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General Surgery > passmed 2 go you > Flashcards

passmed 2 go you Flashcards

1
Q

What is a desmoid tumour and who would you find them in?

A

Occur most commonly in the rectus abdominus muscle in women after childbirth

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2
Q

What do you need to do with lipomas >5cm?

A

Must scan to rule out liposarcoma

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3
Q

Ureters displaced medially

A

Retroperitoneal fibrosis
-nobody really knows what causes retroperitoneal fibrosis, hypertension is a common finding and patients may complain of sore back

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4
Q

Ureters displaced laterally

A

Retroperitoneal malignancy

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5
Q

You find lots of gelatinous substance in someone’s tummy. They have had a difficult appendicectomy previously

A

Pseudomyxoma peritonei

-associated with mucinous production

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6
Q

Rare mucinous tumour most commonly arising from the appendix

A

Pseudomyxoma peritonei

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7
Q

Commonest neurological manifestation of sarcoid?

A

Facial nerve palsy

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8
Q

A 22-year-old man presents with symptoms of lethargy and bilateral facial nerve palsy. On examination he has bilateral parotid gland enlargement.

A

Sarcoid

  • affects right and left sides equally
  • typically resolves in up to 80% of cases
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9
Q

Infection with what bacteria can make cholesteatoma smelly?

A

Pseudomonas

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10
Q

Which lesion of the ear does cholesteatoma usually affect?

A

Pars flaccida

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11
Q

Battle’s sign

A

Base of skull fracture

bruising behind the ear

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12
Q

What side is Boearhaave’s syndrome commonly?

A

Commonly on left side

-diagnosis with CT and contrast surgery

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13
Q

Tearing intrascapular pain

A

Dissection of thoracic aorta

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14
Q

Discrepancy in arterial blood pressures taken in both arms

A

Dissection of thoracic aorta

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15
Q

Nutcracker oesophagus

A

Diffuse oesophageal spasm

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16
Q

Diagnosis of achalasia

A

pH and manometry studies, along with contrast swallow and endoscopy

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17
Q

What may predispose someone to developing ureteric stones?

A

Dehydration

e.g. if someone is vomiting lots then they might become dehydrated and develop stones

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18
Q

When does duodenal ulcer pain occur?

A

Occurs several hours after eating

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19
Q

When is duodenal ulcer pain better?

A

Better when eating food

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20
Q

Why can you get malaena following ruptured varices?

A

Becaase you might swallow the blood

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21
Q

What is the psoas stretch sign?

A

When you extend the right thigh - if it is sore it is because the psoas is inflamed (caused by an inflamed retrocaecal appendix)

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22
Q

When would you see Boas sign?

A

Cholecystitis

area of hyperasthesia between 9th and 11th rib posteriorly

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23
Q

Asides from pancreatitis, when might you see Cullen’s sign?

A

Intra-abdominal haemorrhage

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24
Q

Asides from pancreatitis, when might you see Grey-turners sign?

A

Retroperitoneal haemorrhage

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25
Q

When might biliary colic be worse?

A

E.g. following a meal (particularly if it is a fatty meal)

26
Q

Investigation of choice for pancreatic cancer?

A

High resolution CT (pretty sure you give contrast as well)

27
Q

Areola and Paget’s disease?

A

Areola is spared usually

28
Q

Diagnosis of Paget’s disease of the nipple?

A

Punch biopsy, mammography and ultrasound of breast

29
Q

The most common cause of cardiac abnormality occurring in pregnant women?

A

Mitral stenosis
-patients may usually be asymptomatic however physiological changes may cause an asymptomatic patient to deteriorate rapidly

30
Q

Beck’s triad

A

Suggests cardiac tamponade:

  • hypotension
  • muffled heart sounds
  • raised JVP
31
Q

What is the most sensitive blood test for acute pancreatitis?

A

Serum lipase

32
Q

Common presenting feature of renal cell cancer?

A

Renal vein thrombosis (e.g. haematuria and loin pain)

33
Q

A 62 year old man presents with an aysmptomatic inguinal hernia what should you do?

A

Routine referral for surgical care - will likely need surgery in the long term so no point doing watchful waiting

34
Q

Achalasia increases your risk of what?

A

Squamous cell cancer

squamous cell carcinoma of oesophagus usually has little to no previous history of GORD

35
Q

What is Boas’ sign?

A

In cholecystitis there is hyperaesthesia beneath the right scapula

36
Q

What is Rosving’s sign?

A

In appendicitis, when you palpate the LIF, there is pain in the RIF

37
Q

Annual probability of inguinal hernia strangulation?

A

~3%

38
Q

Boundaries of hesselbach’s triangle?

A

Medially - rectus abdominus
Laterally -inferior epigastric vessels
Inferior - inguinal ligament

39
Q

Apart from pancreatic cancer, what other conditions might CA19-9 be elevated in?

A

Cholangiocarcinoma

40
Q

Biggest risk factor for cholangiocarcinoma?

A

Primary sclerosing cholangitis

41
Q

Markers which may be elevated in cholangiocarcinoma?

A

CA19-9, CEA, CA125

42
Q

Most common type of renal cancer?

A

Renal adenocarcinoma

43
Q

Which type of cancer is cancer of the ureters and renal pelvis?

A

Transitional cell cancer

44
Q

What would you see in a blood film of someone who has just had their spleen taken out?
HPIT

A

Howell-jolly bodies
Pappenheimer bodies
Irregularly contracted erythrocytes
Target cells

45
Q

If you have a duodenal ulcer on the posterior wall, which vessel is most at risk? (e.g. if the ulcer erodes through)

A

The gastroduodenal

46
Q

Marker most useful for identifying hepatocellular cancer?

A

Serum AFP

47
Q

What are lynch syndrome tumours like?

A

More likely to be right sided and mucinous

48
Q

Skin lesion that is often larger than it appears, may occur at a site of previous trauma (e.g. insect bite(

A

Dermatofibroma

49
Q

A skin lesion that contains foul smelling cheesy material and surrounded by the outer part of a hair follicle

A

Pilar cyst

50
Q

Where would you find junctional melanocytic naevi?

A

Palms, soles and mucous membranes

51
Q

Where are paracetamol and morphine metabolised?

A

Metabolised in the liver

52
Q

Where are epigastric hernia and who are most likely to get them?

A

Most common in men aged 20-30 years

They are a lump in the midline between the umbilicus and the xiphisternum

53
Q

How might an obturator hernia present?

A

Typically presents with bowel obstruction

54
Q

What is trastzumab?

A

Herceptin

55
Q

What does it mean when something is KIT positive?

A

KIT = tyrosine kinase

56
Q

Tyrosine kinase inhibitor

A

Imatinib

57
Q

Biologic commonly used in Crohn’s?

A

Infliximab

58
Q

Biologic used for treatment of gastrointestinal stromal tumour?

A

Imatinib

59
Q

Investigation for hydatid cysts?

A 
CT abdomen
(percutaneous aspiration is conrtraindicated)
60
Q

PTEN gene mutation

A

Cowdens

General Surgery (25 decks)

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