Random facts

Question 1

what is the pathogenesis of adhesion formation

Answer 1

initial tissue injury to peritoneum recruits inflammatory cells which leads to coagulation and fibrin deposition.
Mesothelial cells are recruited and re-epithelialise surface within 7 days. Fibrin needs to be broken down through fibrinolysis (via factors such as tPA). If it does not occur then connective tissue scar and adhesions develop.
Surgery inhibits fibrinolysis by increasing plasminogen inhibiting factors and decreasing tissue oxygenation

Question 2

what is virchow’s triad

Answer 2

triad for thrombosis

• endothelial injury
• venous stasis/turbulence (haemodynamics)
• hypercoagulable

Question 3

What is the staging system for hydradenitis supprativa

Answer 3

Hurley system
1- inflammatory nodules or abscess without pits/scarring
2- abscesses with scarring and pits/sinuses
3- diffuse or almost diffuse involvement with extensive interconnected sinus tracts

Question 4

What are components and risks of chads vasc score

Answer 4

CCF +1
Hypertension +1
Age >75 +2
Diabetes +1
Stroke/tia +2

 Vasc +1
aged 65-74 +1
Female +1
Score 1-3 low less than 5%
4-5mod 5-10%
6 or more high greater than 10%

Question 5

Risk categories with mechanical valve while anticoagulated

Answer 5

Very high risk - two valve replacement. Aortic valve with prior stroke while anticoagulated.
High risk - aortic valve + AF. Ball and cage valve
Moderate risk - mechanical Aortic valve

Question 6

Staging system for pressure areas

Answer 6

Barczak stages
1 - red area not resolving after relief of pressure >1 h
2- blister/skin break
3- Sub cut destruction into muscle
4 - bone involvement

Question 7

8 tenets of screening

Answer 7

1. Early changes
2. Effective treatment available at halting progression
3. Easy test (acceptable)
4. Evidence - proven mortality/morbidity reduction
5. Enough resources available for diagnosis/follow up
6. Ethical considerations - important health problem
7. Benefit greater than harm
8. Cost benefit

Question 8

What are the components of the SOFA score

Answer 8

PaO2
Creatinine
Platelets
Jaundice (bilirubin)
GCS
MAP (?support)

Question 9

Degrees of Dysplasia in Barret’s

Answer 9

None
Indeterminant
Low
High
Intramucosal cancer

Question 10

Causes of splenomegaly

Answer 10

Congestive
- ccf, portal hypertension

Malignancy

• metastasis
• haematological malignancy

Haematological
Sickle cell
Haemolytic anaemia
ITP

Infection
Tb
Ebv
Parasite

Inflammatory
Sarcoid
SLE

Question 11

dietary requirements
Protein
total energy

Answer 11

protein - 1.5 g/day
25-30 kCal/kg
30% of energy from fat
50% from carbs