Surgery Flashcards
When do we use tamoxifen?
Tamoxifen is used in the management of oestrogen receptor-positive breast cancer in pre or peri-menopausal women
A 42 yr old F presents worried due to a FH of breast ca and ovarian ca. What is the management?
Referral to secondary care
How do we treat oestrogen positive breast cancer?
Oestrogen positive means it has hormone receptor and that’s when you use anastrozole or letrozole in post-menopausal women, or tamoxifen in pre- or peri-menopausal women.
How do we treat HER receptor positive cancer?
Her2 positive is positive for human epifermal growth receptor 2 (HER2) and indicates treatment with herceptin
What is the most common type of breast cancer?
Invasive ductal carcinoma (no special type)
How does an epidydimal cyst present?
These are common in middle-aged men and feature a swelling posterior and separate from the body of the testicle. They are benign, and the diagnosis can be confirmed by ultrasound. Management is generally conservative.
How do germ-cell tumours present?
Germ-cell tumour presents as a firm and typically painless lump on the testicle. They are the most common malignancy in younger males, but the incidence then decreases with age. Other risk factors include infertility, cryptorchidism, mumps orchitis, and Klinefelter syndrome. There may be associated hydrocele and gynaecomastia due to an increased oestrogen to androgen ratio.
What is varicocele?
Varicocele is an abnormal enlargement of the testicular veins that is classically felt as a ‘bag of worms’ within the scrotum. It is more common on the left side and can be associated with subfertility.
How do we diagnose varicocele?
Diagnosis can be confirmed on ultrasound with Doppler studies.
How do we manage varicocele?
Management is generally conservative unless the patient is having issues with pain or subfertility.
How do we manage chronic anal fissures?
Topical glyceryl trinitrate
When should you stop the COCP prior to surgery?
1/12
When do we perform a low anterior resection surgery?
Low anterior resection is the operation of choice for this patient and patients whose malignancy lies in the upper two thirds of their rectum. This surgery involves resection of the area of malignancy, followed by anastomosis.
When do we perform abdominoperineal resections?
abdominoperineal resections, which involve the removal of the anus, rectum and section of sigmoid colon, are used for tumours located in the distal one third of the rectum.
How do we manage obstructive urinary caliculi?
Patients with obstructive urinary calculi and signs of infection require urgent renal decompression and IV antibiotics due to the risk of sepsis
