Surgery Flashcards
What is an end colostomy?
Performed when a section of large bowel has been removed. Proximal end brought to the skin. Distal part sutured and left inside. Can be reversed later but can also be permanent.
What is an end ileostomy?
Stoma from the end of the ileum when the whole large bowel has been removed. Permanent
What is a loop colostomy?
Bowel is partially opened and a loop of bowel is taken outside the skin and opened - leaving 2 openings. Proximal end is turned into a spout. Temporary and will be reversed 6 - 8 weeks later
ASA1
Normal healthy patient
ASA2
Patient with mild systemic disease
ASA 3
Substansive functional limitations/severe systemic disease eg renal disease on dialysis
ASA4
Severe systemic disease that is a constant threat to life
ASA5
Moribound patient who is not expected to survive without the operation eg ruptured AAA
ASA6
Brain dead patient - organ harvesting
What surgery is required for colorectal cancer on the anal verge?
Abdomino perineal excision of rectum
What surgery is required for colorectal cancer in the low rectum?
Anterior resection
What surgery is required for colorectal cancer in the upper rectum?
Anterior resection
What surgery is required for colorectal cancer in the sigmoid colon?
High anterior resection
What surgery is required for colorectal cancer in the distal transverse descending colon?
Left hemicolectomy
What surgery is required for colorectal cancer in the caecal, ascending or proximal transverse colon
Right hemicolectomy
How long should the COCP be stopped before surgery
4 weeks
Hernia which is inferolateral to the pubic tubercle. Cough impulse is often absent . typically non reducible
Femoral
Management of femoral hernia
Surgical repair - high risk of strangulation
When does an AAA need to be referred to vascular surgery
Over 5.5cm
AAA of 3 - 4.4cm
Rescan every 12 months
AAA of 4.5 - 5.4cm
Rescan every 3 months
soft, non-tender swelling of the hemi-scrotum. Usually anterior to and below the testicle
the swelling is confined to the scrotum, you can get ‘above’ the mass on examination
transilluminates with a pen torch
Hydrocele
Testicular tumour. Elevated AFP and Beta HCG
Non seminoma
Managment of anal fissure not improved by topical GTN
Sphincterotomy or botox
First line investigation into priapism
Cavernosal blood gas to differentiate between ischaemic and non ischemia
Management of priapism
If longer than 4 hours aspiration of blood from the cavernosa with an injection of saline flush.
If this fails intracavernosal injection of phenylephrine
If both fail then surgery
Investigation for suspected renal stone
Non contrast CTKUB
Ulcer that is relieved by eating
Duodenal ulcer
Ulcer that is exacerbated by eating
Gastric ulcer
