Surgery Flashcards
What is pseudocholinesterase deficiency ?
A rare genetic abnormality in the production of plasma cholinesterases
What does pseudocholinesterase deficiency lead to in anaesthesia?
Increased duration of muscle relaxants, it leads to respiratory arrest - patient must be mechanically ventilated
What question is asked in pre-anaesthetic assessment to try and stop complications occurring?
Family history as pseudocholinesterase deficiency is hereditary
What drug can cause pseudocholinesterase deficiency?
Suxamethonium - this is a muscle relaxant
What are the uses of muscle relaxant suxamethonium?
Short term muscle relaxants in surgery or mechanical ventilation or facilitate rapid sequence intubation
Describe fibroadenoma lump
Mobile, firm, smooth, clearly defined edges (discrete), rubbery
What is a fibroadneoma?
Overgrowth of one breast lobule - epithelial and fibrous component
What age are fibroadenomas most common?
Under 30
Diagnosis of fibroadenoma?
Ultrasound followed by core biopsy
Ultrasound fibroadenoma
Single round solid mass, well circumscirbed and lobulated
Core biopsy fibroadenoma
Epithelial and stromal elements
Surgical excision for fibroadenoma?
> 3cm, for cosmosis or symptomatic
Cyproterone acetate in prostate cancer?
-Anti androgen works by blocking androgen receptors
-It also acts on pituitary gland reducing secretion of LH which is responsible for stimulating testosterone production in testes
What is a common consequence of subarachnoid haemorrhage?
syndrome of inappropriate antidiuretic hormone secretion (SIADH)
What electrolyte abnormality does SIADH lead to ?
Hyponatremia due to dilutional effects of excessive water retention
Goserelin in prostate cancer?
Androgen deprivation therapy - GnRH agonist - reduces the levels of testosterone and other androgens in the body which stimulate growth of prostate cancer cells
What is the flare effect with goserelin?
It acts on the pituitary gland stimulating the release of LH and FSH initially this inital stimulation can cause temporary surge in testosterone - continued use causes desensitisation
Symptoms of tumour flare with GnRH agonists?
Bone pain, bladder obstrucion
What medication can be given alongside GnRH agonsits such as goserelin?
Anti androgens such as cyproterone acetate
Describe volvulus
Twisting of a loop of intestine around itself and the mesentery - this can lead to obstruction, ischemia and necrosis
What is the most common volvulus?
Sigmoid volvulus
Describe sigmoid volvulus
Large bowel obstruction caused by the sigmoid colon twisting on the sigmoid mesocolon
Caecael volvulus
Ceaceal volvulus twists around mesentry
what si the mesentry?what is
