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GENERAL SURGERY > PassMed Question Bank > Flashcards

PassMed Question Bank Flashcards

1
Q

what can cause a rise in faecal calprotectin

A
  • IBD
  • bowel malignancy
  • coeliac disease
  • infectious colitis
  • use of NSAIDs
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2
Q

what is zollinger-ellison syndrome

A

condition characterised by excessive levels of gastrin secondary to a gastrin-secreting tumour
- majority found in 1st part of duodenum, then pancreas

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3
Q

what are features of zollinger-ellison syndrome

A
  • multiple gastroduodenal ulcers (epigastric pain)
  • diarrhoea
  • malabsorption
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4
Q

how can zollinger-ellison syndrome be diagnosed

A
  • fasting gastrin levels
  • secretin stimualtion test
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5
Q

what are risk factors of femoral hernias

A
  • female gender
  • pregnancy
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6
Q

what are the key features of inguinal hernias

A
  • groin lump superior and medial to the pubic tubercle and disappears on pressure
  • discomfort and ache, severe pain is uncommon
  • strangulation is rare
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7
Q

what are desmoid tumours

A

fibrous neoplasms arising from musculoaponeurotic structures
- typically arise from myofibroblasts
- occur in 15% pt with FAP
- commonly occur in women after childbirth in the rectus abdominus muscle
- treated by radical surgical resection
- high tendency to local recurrence

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8
Q

describe the blood supply to the pancreas

A
  • head: pancreaticoduodenal
  • tail: branches of splenic
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9
Q

what is the most common causative organism of threadworms

A

enterobius vermicularis

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10
Q

what is the most common complication of ERCP

A

acute pancreatitis

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11
Q

what is Beckwith-Wiedemann syndrome

A

an overgrowth disorder characterised by: macrosomia, macroglossia and abdo wall defects e.g. omphalocele
- also visceromegaly, hypogylc, inc risk of childhood tumours

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12
Q

what is Prader-Willi syndrome

A

genetic disorder caused by loss of function of specific genes on Chr 15
- neonatal hypotonia
- feeding disabilities
- intellectual disability
- hyperphagia
- obesity

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13
Q

what are the actions of BNP

A
  • vasodilation: decrease cardiac afterload
  • diuretic & natriuretic
  • suppress sympathetic tone + RAAS
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14
Q

what does damage to the anterior interosseous nerve cause

A
  • pain in forearm
  • loss of pincer movement as it innervates FPL & FDP
  • minimal loss of sensation due to lack of cutaneous branch
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15
Q

what is the consequence of over corrected severe hyponatremia

A

osmotic demyelination syndrome
- typically presents with dysarthria, dysphagia, seizures, confusion

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16
Q

what is Courvoisier’s sign

A

a palpable gallbladder RUQ in the presence of painless jaundice is unlikely to be gallstones
- most common cancers causing this sign are cholangiocarcinoma and adenocarcinoma of the pancreatic head

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17
Q

what sign is indicative of carpal tunnel syndrome

A

positive Phalen’s test
- provoking numbness and pain in the thumb and index finger by maintaining wrist flexion for 60 s

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18
Q

what are the requirements for routine IV fluids

A
  • 25-30 ml/kg/day of water
  • 1mmol/kg/day of K+, Na+, Cl-
  • 50-100g/day of glucose
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19
Q

what would bloating and abdo cramps in females > 50 raise suspicion of

A

ovarian cancer
- serum CA125 levels then if raised arrange an USS abdo + pelvis

20
Q

what are the functions of insulin

A
  • secreted in response to hyperglycaemia
  • inhibits lipolysis
  • reduces muscle protein loss
  • inc cellular uptake of K+ via Na+/K+ ATPase pump)
21
Q

what is a recognised feature of RCC

A

polycythaemia

22
Q

what is a collapsing pulse typically indicative of and what type of murmur does it lead to

A

aortic regurgitation
- diastolic murmur in the aortic area

23
Q

what are the features of Klinefelter syndrome 47, XXY

A
  • taller than average
  • lack of secondary sexual characteristics
  • small, firm testes
  • gynaecomastia
  • poor coordination + muscle weakness
  • rounded body
  • microorchidism
  • diagnose with karyotyping
24
Q

how does Turner syndrome present 45, X0

A
  • short stature
  • widely spaced nipples
  • webbed neck
  • high arched palate
  • phenotypically female due to absence of Y chromosome
25
Q

during an oesophagectomy for carcinoma of the lower 1/3, which structure is divided to allow mobilisation of the oesophagus

A

azygous vein
- it arches anteriorly to insert into the SVC on the right side

26
Q

what is the most common cause of hypothyroidism and what antibodies are most likely to be positive

A

Hashimoto’s
- anti-thyroid peroxidase antibodies present in 90% cases

27
Q

what clinical features lead point to rheumatic fever and how does this infection develop

A

polyarthritis, chest pain (suggestive of pericarditis), raised ESR/leucocytosis
- cross reactive immune response with Strep pyogenes M protein (type II) mediated by molecular mimicry
- Aschoff bodies are granulomatous nodules found in rheumatic heart fever

28
Q

how does excess alcohol lead to poyluria

A

ADH suppression in the posterior pituitary

29
Q

what condition might parietal lobe lesions cause

A

astereognosis:
inability to recognise or identify objects through sense of touch
- typically arises due to damage to the somatosensory cortex

30
Q

why do children with tetralogy of fallot adopt a squatting position

A

increases systemic vascular resistance and decreases the L-R shunt so improves cyanosis

31
Q

what sign is visible on x-ray in tetralogy of fallot

A

boot shaped heart due to RV hypertrophy

31
Q

what is a rare complication from a NOF fracture and what are its associated features

A

sciatic nerve lesion
- ankle and plantar reflex lost but knee jerk is intact

32
Q

what is the most common cause of sepsis in neonates

A

group B strep

33
Q

what does trisomy 21 increase the risk of and why

A

Alzheimer’s disease
- APP gene is located on Chr 21 and Down syndrome patients have an extra copy
- results in overproduction of amyloid-beta plaques

34
Q

what type of reaction is hyperacute transplant rejection

A

type II hypersensitivity

35
Q

what is the typical history of a patient with primary hyperaldosteronism

A

high BP
tired & weak
bloods show hypokalaemia

36
Q

where is ischaemic colitis most likely to affect

A

splenic flexure - located at the borders of the territory supplied by superior and inferior mesenteric arteries

37
Q

what are the clinical features of ischaemic colitis

ARRR

A
  • abdo pain
  • rectal bleeding
  • raised WCC
  • raised lactate
38
Q

what is a risk factor of ischaemic colitis

A

atrial fibrillation

39
Q

what would an AXR of ischaemic colitis show

A

thumbprinting - mucosal oedema

40
Q

what areas of the brain are most affected by Wilson’s disease and what sign does this create

A

basal ganglia (motor control)
thalamus
midbrain
pons
- double panda sign on T2 MRI

41
Q

which abx is associated with a high risk of c.diff

A

clindamycin

42
Q

what is the gold standard for diagnosis of coeliac disease

A

endoscopic intestinal biopsy

43
Q

what is Budd-Chiari syndrome and what triad of symptoms does it lead to

A

occlusion of the hepatic veins
- abdo pain, ascites, hepatomegaly

44
Q

what organism is responsible for majority of duodenal ulceration cases and how can it be diagnosed

A

H.pylori
- serology, microbiology, histology, CLO testing

45
Q

describe what kind of organism H.pylori is

A

gram negative, oxidase positive, catalase positive comma-shaped rod

46
Q

how is TPN adminstered and what are its complications

A
  • into a central vein as it can result in thrombophlebitis if infused peripherally
  • sepsis, re-feeding syndrome and hepatic dysfunction

GENERAL SURGERY (10 decks)

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