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YEAR 3 CORRECTIONS > Surgery > Flashcards

Surgery Flashcards

1
Q

What gene is mutated in breast/ ovarian cancer?

A

BRCA

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2
Q

What artery is stenosed if the patient has pain in their butt, thigh and calf?

A

Aorta

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3
Q

What artery is stenosed if the patient has intermittent claudication pain in their butt?

A

Common iliac artery

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4
Q

What artery is stenosed if the patient has intermittent claudication pain in their calf?

A

Superficial femoral artery

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5
Q

What artery is stenosed if the patient has intermittent claudication pain in their thigh?

A

Common femoral artery

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6
Q

If the heart rate is raised with a normal BP, in upper GI bleed what does this suggest and hence what is the most appropriate treatment?

A

Haemodynamic instability, so resuscitate with IV crystalloid.

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7
Q

What is the most common and second most common breast cancer types?

A
  1. Invasive ductal carcinoma
  2. invasive lobular carcinoma
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8
Q

Is lobular carcinoma in situ benign or malignant?

A

benign

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9
Q

What is the most appropriate analgesia for old patients after surgery?

A

Fascia ilia block

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10
Q

What is the most common and second most common type of testicular cancer?

A
  1. seminoma
  2. non seminomatous
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11
Q

What are the types of non-seminoma testicular cancers?

A

Teratoma
Embryonal carcinoma
Yolk sac tumour
Choriocarcinoma

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12
Q

In which testicular cancer (s) is b-HCG raised more in?

A

Non-seminomatous (raised in 80-85%)

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13
Q

A patient is in severe pain, with a low BP and their abdo is guarded with rebound tenderness. What is the first imaging?

A

Erect CXR for perforation

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14
Q

Post surgery, a patient has hallucinations, fluctuating consciousness and vital signs. What does this suggest?

A

Delirium

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15
Q

What sign is seen on CXR vs abo X-ray with a perforated peptic ulcer?

A

Dome sign - CXR
Rigler sign- abdo X-ray

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16
Q

A swelling on testes transilluminates and you can palpate above it. What does this suggest?

A

Epididymal cyst

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17
Q

At what haemoglobin level do you transfuse blood in a bleeding patient?

A

Hb <7

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18
Q

What is the management for more than 1 lump and a tumour >4cm on one breast?

A

Mastectomy then radiotherapy.

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19
Q

What is the first investigation for colorectal cancer before any bloods?

A

Abdominal examination

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20
Q

What is torsion of the Hydatid of Morgani and what is seen on examination?

A

Torsion of the testicular appendage. Gradually improved pain with a blue dot seen.

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21
Q

What kind of ulcer weeps serous fluids with swelling around it?

A

Venous ulcer

22
Q

What is the stepwise management of an acute limb?

A

ABCDE
1. IV opioids
2. IV heparin -> surgery / intra-arterial thrombolysis

23
Q

What are three risk factors for developing breast cancer?

A
  1. not having children
  2. early menarche
  3. late menopause
24
Q

What is the triad for Leriche syndrome?

A

Aortoiliac occlusive disease
Erectile dysfunction
Reduced distal pulses

25
Q

What is the name of the classification system used for pressure sores?

A

EPUAP

26
Q

What are the four stages in the EPUAP for pressure sores and the treatments indicates?

A
  1. intact skin
  2. partial thickness loss of epi and dermis
    1&2: hydrocolloid patches
  3. full thickness, necrosis, subcutaneous tissue
  4. muscle, bone seen
    3&4: surgery
27
Q

When is breast screening offered to women and how often?

A

Aged 50-70 every 3 years

28
Q

What is a false femoral artery aneurysm a complication of and what investigation and treatment is first line?

A

Complication of angiography
urgent USS and compression

29
Q

How can chronic limb ischaemia be classified?

A

Fontaine classification

30
Q

In which stage of Fontaine classification is ulcers and gangrene seen?

A

D

31
Q

When is a femoral-femoral crossover surgery done?

A

Unilateral iliac occlusion

32
Q

When is an aortobifemoral bypass done?

A

Bilateral iliac occlusion -> Leriche syndrome

33
Q

In a bed bound patient with an unsalvagable lower limb what surgery is done?

A

Above the knee amputation

34
Q

What investigation can be used for compartment syndrome?

A

Compartment needle manometry

35
Q

What imaging is used to diagnose an unruptured AAA ?

A

CT aortogram

36
Q

How can you treat a DVT in a patient with recurrent severe bleeding where anticoagulation is CI?

A

IVC filter to catch the embolus

37
Q

If testicle is salvageable in testicular torsion what procedure is done?

A

Unilateral orchidopexy and contralateral fixation.

38
Q

What is the next step after a hydrocele is found?

A

USS as could be caused by malignancy

39
Q

What needs to be done before bandaging venous ulcers?

A

ABPI

40
Q

When is embolectomy preferred over IV heparin when treating acute limb ischaemia?

A

If there are sensory and motor deficits

41
Q

What grade haemorrhoids cannot be reduced manually and what surgery is indicated?

A

Grade 4
Surgical haemorrhoidectomy

42
Q

What treatment is indicated fro grade 2 and 3 haemorrhoids?

A

Rubber band ligation
Sclerotherapy

43
Q

What surgery treats rectal prolapse?

A

Rectopexy

44
Q

What can be used to treat vaginal prolapse?

A

Ring pessary

45
Q

When is a tonsillectomy indicated?

A

> 7 episodes in one year
5 episodes in 2 years
3 episodes in 3 years
2 peritonsillar abscesses at any point in life

46
Q

When is a variable rate insulin fusion indicated before surgery?

A

Poor blood glucose control pre-op
Major surgery where more than 2 meals will be missed post surgery

47
Q

What grade haemorrhoids needs manual reduction and can be reduced?

A

Grade 3

48
Q

When is fine needle aspiration considered in fibrocystic disease?

A

When it is large and causing discomfort

49
Q

After a major abdominal surgery what analgesia is preferred?

A

Epidural anaesthesis
avoid opioids-> constipation

50
Q

In a diabetic going for morning surgery that is done by lunch, what should be done with their glicazide and metformin?

A

Omit glicazide and continue metformin

51
Q

What advice should you give to a young person with backpain for a short duration?

A

Advise to continue usual activity

YEAR 3 CORRECTIONS (16 decks)

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