Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FINALS: Passmed > Surgery > Flashcards

Surgery Flashcards

1
Q

occlusion of which artery can cause acute mescenteric ischemia?

A

superior mesenteruc artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

classical PMHx finding for Pt with acute mesenteric ischemia

A

Afib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

classical Px of mesenteric ischaemia

A

abdo pain severe and out of keeping with exam findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tx for mesenteric ischemia

A

immediate laparotmy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Px of anal fissures

A

painful bright red rectal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

where are 90% of anal fissures found? what should be considered if they’re found elsewhere?

A
  • on the posterior line
  • alternate cause like Crohn’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mx of acute anal fissure

A

soften stool (dietary advice), bulk-forming laxative like (lactulose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

fissures are distal to the __________

A

dentate line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tx options for haemorrhoids

A
  • conservative
  • rubber band ligation
  • haemorrhoidectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

diverticulitis Mx
- mild attacks
- severe/recurrent attacks
- perforations

A
  • mild attacks: increase dietary fibre intake, Mx with Abx
  • severe/recurrent attacks: segmental resection
  • perforations: resection + stoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

suspected abscess in diverticulitis - Ix of choice?

A

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

If diverticulitis doesn’t settle with orab abx for 72h?

A

admit for IV abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

______________ classification describes the extent of spread of colorectal cancer

A

Dukes’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

external/vs internal haemorrhoids:

A

external originate below dentate line
internal originate above dentate line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

xray finding for ischaemic colitis

A

thumbprinting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common cause of LBO + other causes

A

tumour
volvulus, diverticular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ix of choice for LBO?

A

Abdo XRAY - intra-peritoneal gas indicates colonic perforation
CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

most common type of hernia? where does it occur?

A

inguinal hernia
superior and medial to public tubercle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

extensive physical training or coughing (from lung diseases), obesity can cause which hernia

A

epigastric hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

which hernia in children needs immediate surgical repair? which resolves by itself in 4-5years?

A

immediate repair: congenital inguinal hernia
self resolving: infantile umbilical hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cryptorchidism Mx

A

orchidopexy at 6-18m of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

most bladder cancers are _____ cell carcinomas

A

transitional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

most sensitive test for hiatus hernia

A

barium swallow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

electrolyte imbalances caused by blood transfusion

A
  1. hypoC - FFP and platelets have citrate –> chelate calcium
  2. hyperK
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Leading cause of transfusion related deaths

A

Transfusion related lung injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Upper GI bleed - 2nd line if OGD fails?

A

pH and manometry studies with contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

cholecystitis - Ix and Tx

A

US
early laparoscopic cholecystectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

lab Ix for acute pancreatitis

A

hypocalcaemia
hyperglycaemia
hypoxia
neutrophilia
elevated LDH and AST
raised amylase, lipase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

acute pancreatitis causes

A

Gallstones
Ethanol
Trauma
Steroids
Mumps (other viruses include Coxsackie B)
Autoimmune (e.g. polyarteritis nodosa), Ascaris infection
Scorpion venom
Hypertriglyceridaemia, Hyperchylomicronaemia, Hypercalcaemia, Hypothermia
ERCP
Drugs (azathioprine, mesalazine*, didanosine, bendroflumethiazide, furosemide, pentamidine, steroids, sodium valproate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Boerjaave’s syndrome - Dx and Tx

A

subcutaneous emphysema on chest wall
diagnosis is CT contrast swallow
Thoracotomy and lavage (within 12h) or insertion of T tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Courvoisier sign

A

a palpable mass in the right upper quadrant (Cholangiocarcinoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

__________ can be used to measure exocrine pancreatic function in chronic pancreatitis

A

faecal elastase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

C/I to laparoscopic surgery

A

haemodynamic instability/shock
raised intracranial pressure
acute intestinal obstruction with dilated bowel loops (e.g. > 4 cm)
uncorrected coagulopathy

34
Q

jaundiced Pt with malignancy: Mx

A

a stent will need to be inserted

35
Q

digital rectal examination: tender, boggy prostate gland =

A

Acute bacterial prostatitis

36
Q

Acute bacterial prostatitis Tx

A
  • 14-day course of a quinolone (ciprofloxacin)
  • STI screen
37
Q

Ix for BPH

A
  • U&Es
  • PSA
    urinary frequency-volume chart
  • IPSS
38
Q

Mx for BPH

A
  • alpha-1 antagonist: tamsulosin
    decreases smooth muscle tone of the prostate and bladder
  • 5 alpha-reductase inhibitor: finasteride
    blocks conversion of testosterone to dihydrotestosterone [start if high risk of progression]
  • TURP
39
Q

[bladder cancer]
- RFs for transitional cell carcinomas
- RFs for squamous cell carrcinomas

A
  • RFs for transitional cell carcinomas: smoking, exposure to aniline dyes
  • RFs for squamous cell carrcinomas: schistomiasis
40
Q

what happens when catheterised after chronic urinary retention?

A

decompression haematuria

41
Q

It is important to exclude ____________prior to circumcision as the foreskin may be used in surgical repair

A

hypospadias

42
Q

suspected epididymo-orchitis: what must you exclude?

A

torsion

43
Q

Ix for erectile dysfunction

A
  1. 10 year cardiovascular risk, lipid, glucose
  2. free testosterone
44
Q

Mx of erectile dysfunction

A
  1. PDE-5 inhibitors: sildenafil (Viagra)
  2. Vacuum erection devices
45
Q

features of hydrocele. Ix?

A
  • soft, non-tender swelling aterior to and below the scrotum
  • you can get above the mass on examination
  • transilluminates

Dx clinically but can do US to exclude underlying cause.

In babies can resolve spontaneously by 1-2 years.

46
Q

Hydropnephrosis: causes of unilateral/bilateral

A

Unilateral: PACT
- Pelvic-ureteric obstruction (congenital or acquired)
- Aberrant renal vessels
- Calculi
- Tumours of renal pelvis

Bilateral: SUPER
- Stenosis of the urethra
- Urethral valve
- Prostatic enlargement
- Extensive bladder tumour
- Retro-peritoneal fibrosis

47
Q

Ix for hydronephrosis

A
  1. US
  2. CT scan to detect stones
48
Q

Mx of hydronephrosis

A
  1. remove obstruction, drain urine
  2. Acute obstruction: nephrostomy tube
  3. Chronic obstruction: ureteric stent/pyeloplasty
49
Q

how to differentiate between ischemic and non-ischemic priapasm

A

Cavernosal blood gas analysis

50
Q

1st line Ix for suspected prostate cancer

A

multiparametric MRI

51
Q

most common type of renal cell cancer

A

clear cell

52
Q

renal colic Mx

A
  1. Pain relief: NSAIDs, IV paracetamol if NSAID C/I
  2. for distal urteteric stones <10mm in size: alpha blockers

Imaging
- non-contrast KUB
- if pregnant woman/children: USS

If stone is <5mm and asymptomatic: watchful waiting
5-10 mm: shockwave lithotripsy
10mm - 20mm: shockwave lithiotripsy OR ureteroscopy
>20mm: percutaneous nephrolithotomy

Uretic stones:
- shcokwave lithiotripsy/alpha-blockers if <10mm
- 10-20mm: urteteroscoopy

53
Q

ureteric obstruction from stones + infection =

A

surgical emergency!! decompress (nephrostomy tube placement, insertion of ureteric catheters and ureteric stent placement)

54
Q

preventing renal stones

A

calcium: high fluids, low salt, potassium citrate, thiazide diuretics (increase distal tubular calcium resorption)

oxalate: cholesystramine

uric acid: allopurinol

55
Q

renal tubular acidosis is a RF for

A

renal stones

56
Q

_______ may be the presenting feature of testicular cancer
_______ may be the presenting feature of renal cancer

A

hydrocele
varicocele

57
Q

screening AAA

A

a single abdominal ultrasound for males aged 65

58
Q

AAA Mx
1. rescan every 3 months:
2. urgent 2 week referral to vascular surgery:

A
  1. rescan every 3 months: 4.5-5.4cm
  2. urgent 2 week referral to vascular surgery: >5.5cm
59
Q

other than >5.5cm, what else makes an AAA at high risk of rupture

A

enlarging >1cm/year

60
Q

Tx for AAA

A

elective endovascular repair (EVAR)

61
Q

___________________is suggestive of critical limb ischaemia.

A

An ankle-brachial pressure index (ABPI) of < 0.5

Patients often report hanging their legs out of bed at night to ease the pain.

62
Q

PAD Mx

A

Atorvastatin 80mg + clopidogrel + exercise training

Surgical: endovascular/surgical revascularization

63
Q

The following are all NICE criteria for referring a patient to secondary care for consideration of interventional treatment of varicose veins as laid out in the NICE CKS summary:

A

significant/troublesome lower limb symptoms e.g. pain, discomfort or swelling
previous bleeding from varicose veins
skin changes secondary to chronic venous insufficiency (e.g. pigmentation and eczema)
superficial thrombophlebitis
an active or healed venous leg ulcer

64
Q

how can you tell there is a subcutaneous emphysema on CXR?

A

You can see the striations of pec major lateral to the right lung field. Pec major is only visible if there is subcut emphysema.

65
Q

For a young patient who has always had difficulty achieving an erection –>

A

referral to urology is appropriate

66
Q

Scrotal swelling you can’t get above:

A

inguinal hernia

67
Q

An ________ may cause bubbly urine

A

enterovesical fistula

an enterovesical fistula is frequently a result of colorectal malignancy

68
Q

A sinusoidal ECG pattern is indicative of

A

severe hyperkalaemia

69
Q

what blood test abnormalities would TPN cause?

A

TPN is known to result in derangement of liver function tests

70
Q

strangulated primary unilateral inguinal hernias are usually repaired via ________ approach

A

an open

71
Q

what type of amnesia is an indication for a CT head scan?

A

Over 30 minutes retrograde amnesia is an indication for a CT scan following a head injury, not anterograde amnesia

72
Q

_______is a recognised complication of enteral feeding

A

Diarrhoea

73
Q

inguinal hernia Mx rules for children

A

< 6 weeks old = correct within 2 days
< 6 months = correct within 2 weeks
< 6 years = correct within 2 months

74
Q

pain during flexion and a palpable nodule at the base of her right ring finger are classic signs of

A

trigger finger

75
Q

A 19-year-old man is attacked outside a club and beaten with a baseball bat. He sustains a blow to the right side of his head. He is brought to the emergency department and a policy of observation is adopted. His Glasgow coma score (GCS) deteriorates and he becomes comatose. Which of the following haemodynamic parameters is most likely to be present?

A

Hypertension and bradycardia are seen prior to coning. The brain autoregulates its blood supply by controlling systemic blood pressure.

Fast and weak- there’s a leak. Slow and strong-something in the head wrong

76
Q

Pt becomes apnoeic after anesthesia - most likely cause? (esp if FHx)

A

suxomethonium apnoea

77
Q

SBO + tingling down medial left thigh + tender mass per rectum?

A

obturator hernia

78
Q

Pt needs twice as much propofol to be induced for surgery + becomes confused after and develops seizure

A

post-alcohol withdrawal, give IV lorazepam

79
Q

A painful, non-healing ulcer secondary to trauma in a woman with a past medical history of vascular disease (myocardial infarction) =

A

PAD

80
Q

Mx of acute limb ischemia
1. without motor dysfunction
2. with motor dysfunction

A
  1. without motor dysfunction: IV heparin
  2. with motor dysfunction: urgent embolectomy
81
Q

A 52-year-old female patient is brought to the emergency department with altered mental status and decreased responsiveness. She is at risk for airway obstruction due to her tongue falling back. Which airway adjunct is most appropriate for this patient?

A

oropharyngeal, used for Pts with decreased responsiveness

FINALS: Passmed (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions