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OSCE Examinations > Surgary 👩🏻‍⚕️💚 > Flashcards

Surgary 👩🏻‍⚕️💚 Flashcards

1
Q

What is the description of venous ulcers?

A

Shallow ulcers with a granulated base.

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2
Q

What causes venous ulcers?

A

Venous insufficiency leading to valvular incompetence, impaired venous return, venous hypertension, and trapping of WBCs.

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3
Q

What are the risk factors for venous ulcers?

A
  • Old age
  • Varicose veins
  • Pregnancy
  • Obesity
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4
Q

What is the pathophysiology of venous ulcers?

A

Activation of WBCs releases inflammatory mediators, resulting in tissue injury and poor healing.

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5
Q

What investigations are used for venous ulcers?

A
  • US of the veins
  • Ankle Brachial Pressure Index
  • Swab cultures
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6
Q

What are the management steps for venous ulcers?

A
  • Leg elevation
  • Exercise to promote calf muscle pump action
  • Weight reduction
  • Compression bandaging, changed 2-3 times per week
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7
Q

What is the description of arterial ulcers?

A

Small, deep lesions with well-defined borders and a necrotic base.

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8
Q

What causes arterial ulcers?

A

Reduction in arterial blood flow leading to decreased perfusion.

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9
Q

What are the risk factors for arterial ulcers?

A
  • Smoking
  • Diabetes
  • Hypertension
  • Hyperlipidemia
  • Old age
  • Obesity
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10
Q

What are the clinical features of arterial ulcers?

A
  • Intermittent claudication (pain when walking)
  • Critical limb ischemia (pain at night)
  • Cold limbs with reduced or absent pulses
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11
Q

What investigations are used for arterial ulcers?

A
  • Ankle Brachial Pressure Index
  • US
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12
Q

What are the management options for arterial ulcers?

A
  • Conservative: Lifestyle changes (smoking cessation, weight loss, exercise)
  • Medical: Pharmacological management for cardiovascular disease risk modification
  • Surgical: Angioplasty or bypass grafting
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13
Q

What causes neuropathic ulcers?

A

Peripheral neuropathy leading to loss of protective sensation.

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14
Q

What are the risk factors for neuropathic ulcers?

A

Diabetes.

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15
Q

What are the clinical features of neuropathic ulcers?

A

Burning/tingling, painless ulcers on pressure points.

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16
Q

What investigations are used for neuropathic ulcers?

A
  • HbA1c
  • Microbiology swab
  • Touch/vibration tests
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17
Q

What is the management for neuropathic ulcers?

A

HbA1c optimization, diet/exercise improvement.

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18
Q

What is cellulitis?

A

Bacterial infection of the dermis and subcutaneous fat.

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19
Q

What are the risk factors for cellulitis?

A
  • Obesity
  • Old age
  • Diabetes
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20
Q

What are the signs and symptoms of cellulitis?

A
  • Red, hot, painful area
  • Increases in size
  • Borders not sharp
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21
Q

What causes cellulitis?

A

Bacteria entering through cuts/abrasions (Streptococci, Staph aureus).

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22
Q

How is cellulitis diagnosed?

A

Clinical; differential diagnosis includes DVT.

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23
Q

What is the treatment for cellulitis?

A
  • Antibiotics
  • Analgesia
  • Elevation
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24
Q

What are the causes of postoperative fever categorized as ‘Wind’?

A
  • Pneumonia
  • Atelectasis
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25
Q

What are the causes of postoperative fever categorized as ‘Water’?

A

UTI.

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26
Q

What are the causes of postoperative fever categorized as ‘Walking’?

A

DVT/PE.

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27
Q

What are the causes of postoperative fever categorized as ‘Wound’?

A
  • Surgical site infection
  • Abscess
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28
Q

What are the causes of postoperative fever categorized as ‘Wonder drugs’?

A
  • Drug fever
  • IV line infections
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29
Q

What is the management for postoperative fever?

A

Assess and treat each cause, IV fluids, analgesia, antibiotics.

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30
Q

What are the SIRS criteria?

A
  • Temp > 38°C
  • RR > 20
  • HR > 90 BPM
  • WCC > 12
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31
Q

What is septic shock?

A

Severe sepsis with resistant hypotension.

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32
Q

What is involved in the clinical assessment for sepsis?

A

ABCDEs, vital signs, history, exam.

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33
Q

What investigations are used for sepsis?

A
  • Bloods
  • Cultures
  • Radiology
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34
Q

What is the management for sepsis?

A
  • High-flow O2
  • IV fluids
  • Broad-spectrum antibiotics
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35
Q

What are the characteristics of acute ischaemia in PAD?

A

Urgent management; pain, pallor, pulselessness.

36
Q

What are the risk factors for peripheral arterial disease (PAD)?

A
  • Hyperlipidaemia
  • Smoking
  • Diabetes
37
Q

What are the characteristics of chronic ischaemia in PAD?

A

Claudication during exertion or rest pain.

38
Q

What management options are available for PAD?

A
  • Lifestyle changes
  • Pharmacological
  • Surgical options
39
Q

What is the lifetime incidence of appendicitis?

A

6%.

40
Q

What are the symptoms of appendicitis?

A
  • Central abdominal pain → RLQ pain
  • Nausea/vomiting
41
Q

What are the signs of appendicitis?

A
  • McBurney’s point tenderness
  • Low-grade fever
42
Q

What investigations are used for appendicitis?

A
  • WCC
  • hCG
  • USS
  • CT scan
43
Q

What is the treatment for appendicitis?

A
  • IV fluids
  • Appendectomy
  • Perioperative antibiotics
44
Q

What are the aetiologies of pancreatitis?

A
  • Idiopathic
  • Gallstones
  • Ethanol
  • Autoimmune
  • Etc.
45
Q

What is the pathophysiology of pancreatitis?

A

Activation of proteolytic enzymes leading to inflammation.

46
Q

What are the symptoms of pancreatitis?

A
  • Fever
  • Epigastric pain
  • Nausea and vomiting
47
Q

What are the signs of pancreatitis?

A
  • Tender rigid abdomen
  • Guarding
48
Q

What investigations are used for pancreatitis?

A
  • Increased amylase/lipase
  • Imaging
49
Q

What is the management for pancreatitis?

A

Supportive care, address underlying causes.

50
Q

What is an incisional hernia?

A

Protrusion of abdominal contents through a previous surgical incision.

51
Q

What causes incisional hernias?

A

Surgical incisions weaken the abdominal wall, leading to herniation under increased intra-abdominal pressure.

52
Q

What are the risk factors for incisional hernias?

A
  • Emergency surgery
  • BMI > 25
  • Midline incisions
  • Wound infection
  • Pre-operative chemotherapy
  • Older age
  • Smoking
53
Q

What are the clinical features of incisional hernias?

A

Non-pulsatile, reducible, soft, and non-tender mass at the incision site.

54
Q

How are incisional hernias diagnosed?

A

Primarily clinical diagnosis; ultrasound or CT may assist.

55
Q

What is the management for incisional hernias?

A

Surgical repair (laparoscopic with mesh); associated with high recurrence rates.

56
Q

What does peripheral vascular disease (PVD) refer to?

A

Peripheral arterial disease (PAD) from atherosclerosis; venous equivalent is chronic venous insufficiency (CVI).

57
Q

What are the risk factors for arterial and venous conditions in PVD?

A
  • Arterial: Smoking, diabetes, CVD factors.
  • Venous: Pregnancy, trauma, surgery, hormones, history of DVT/PE, varicose veins.
58
Q

What are the arterial signs in PVD?

A
  • Pallor
  • Mottling
  • Gangrene
  • Deep/painful ulcers
59
Q

What are the venous signs in PVD?

A
  • Swelling
  • Eczema
  • Shallow/painless ulcers
60
Q

What tests are used for PVD?

A
  • Palpate pulses
  • Buerger’s test for arterial
  • Cough impulse and Trendelenburg tests for venous
61
Q

What are the differential diagnoses for arterial and venous conditions in PVD?

A
  • Arterial: Neurogenic claudication, osteoarthritis, peripheral neuropathy.
  • Venous: Heart failure, liver cirrhosis.
62
Q

What investigations are used for arterial conditions in PVD?

A
  • Duplex ultrasound
  • CT/MR angiography
  • ABPI
63
Q

What investigations are used for venous conditions in PVD?

A
  • Duplex ultrasound
  • CT/MR venography for complex cases
64
Q

What is the management for arterial conditions in PVD?

A
  • Risk factor management
  • Antiplatelet therapy (clopidogrel)
  • Surgical options
65
Q

What is the management for venous conditions in PVD?

A
  • Weight loss
  • Exercise
  • Compression stockings
  • Education on leg elevation
66
Q

What is a diverticulum?

A

Sac-like protrusion from a hollow organ.

67
Q

What is diverticulosis?

A

Multiple diverticula, mainly in the sigmoid colon.

68
Q

What is diverticulitis?

A

Inflammation of diverticula.

69
Q

What are the risk factors for diverticulitis?

A
  • Low-fibre diet
  • Obesity
  • Inactivity
  • Age-related muscle weakness
70
Q

What is the pathophysiology of diverticulitis?

A

Increased pressure leads to erosion, inflammation, and possible perforation.

71
Q

What are the clinical features of diverticulitis?

A
  • LLQ pain
  • Constipation/diarrhoea
  • Nausea/vomiting
  • Low-grade fever
72
Q

What investigations are used for diverticulitis?

A
  • AXR: Thickened wall, free air if perforated
  • CT Scan: Assesses severity
73
Q

What is the treatment for uncomplicated diverticulitis?

A

Clear fluids and antibiotics.

74
Q

What is the treatment for complicated diverticulitis?

A

Admit for IV antibiotics and NPO.

75
Q

What is the surgical intervention for recurrent diverticulitis or perforation?

A

May involve Hartmann’s procedure.

76
Q

What are the referral indications for breast disease?

A
  • Discrete breast mass
  • Nipple changes or discharge
  • Persistent asymmetry or breast pain
  • Strong family history of breast cancer
77
Q

What is the triple assessment for breast disease?

A
  • Clinical Assessment: Medical history and physical exam
  • Radiology: Ultrasound, mammography (if > 35), MRI (high risk)
  • Pathology: Fine needle aspiration (FNA) cytology
78
Q

What are the risk factors for breast cancer?

A
  • Female gender
  • Early menarche
  • Increasing age
  • Late first child
  • Previous breast cancer
  • Delayed menopause
  • Smoking
  • Prolonged OCP/HRT use
  • Strong family history
79
Q

What are the characteristics of lumps in breast disease?

A

Common in upper outer quadrant; may be hard or firm.

80
Q

What is the most common type of breast cancer?

A

Invasive Ductal Carcinoma (80%).

81
Q

What is the treatment for DCIS?

A

Treated with lumpectomy or mastectomy.

82
Q

What is the screening recommendation for breast cancer?

A

Mammography for women > 30; screening every 2 years from 45-69.

83
Q

What is the immediate action for palpable breast lumps?

A

Immediate FNA biopsy.

84
Q

What is the prevalence of malignant breast disease?

A

Affects 1 in 11 women; mortality rate of 30%.

85
Q

What are the treatment options for malignant breast disease?

A
  • Breast conservation surgery
  • Mastectomy
  • Chemotherapy
  • Radiotherapy
86
Q

What is a fibroadenoma?

A

Common benign tumour, 60% of breast lumps in young women.

OSCE Examinations (3 decks)

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