Surgery Flashcards
First 24-48 hours of life with abdominal distension and bilious vomiting, more common in cystic fibrosis
Meconium ileus
Initial investigation for patients presenting with symptoms that may be indicative of colorectal cancer, such as an abdominal mass, altered bowel habits, or iron-deficiency anaemia
FIT
Wide local excision for breast cancer, sentinel node negative, next step:
Whole breast radiotherapy
Acute epididymo-orchitis in sexually active younger adults is most commonly caused by:
Chlamydia trachomatis
Small breast cyst in young women:
Aspirate, small increase in cancer risk in young
Adjuvant hormonal therapy for ER +ve breast cancer in pre/post-menopausal women
Tamoxifen/anastrozole
Treatment for biliary cholic:
Elective laparoscopic cholecystectomy
Suspected epididymo-orchitis: If unknown organism:
ceftriaxone 500mg intramuscularly single dose, plus oral doxycycline 100mg twice daily for 10-14 days
Abdominal aortic aneurysm (AAA) screening 4.9 cm, no symptoms, next step
3-monthly ultrasound assessment.
< 3 cm No further action
3 - 4.4 cm Small aneurysm Rescan every 12 months
4.5 - 5.4 cm Medium aneurysm Rescan every 3 months
≥ 5.5cm Large aneurysm Refer within 2 weeks to vascular surgery
Distal colectomy because of cancer, bowel will be defunctioned, what stoma would be the appropriate to reverse in the future?
Loop ileostomy
Treatment for hiatus hernias:
Lifestyle advice and omeprazole
Post operatively receives a total of 6 litres of 0.9% sodium chloride solution, complication:
Hyperchloraemic acidosis
Old age, alcoholism and anticoagulation, fluctuating confusion:
Subdural haematoma
Suspected long saphenous vein superficial thrombophlebitis, Wells DVT score 1, next step:
Ultrasound scan to exclude an underlying DVT
First-line management for BPH with bothersome lower urinary tract symptoms
Alpha-1-antagonist like tamsulosin or alfuzosin
Most common location for peptic ulcers, pain relieved by eating:
Duodenal ulcers
Screening programme for colorectal cancer:
Faecal immunochemical test (FIT) test kits are sent every 2 years to all patients aged 60-74 years in England, 50-74 years in Scotland
Schistosoma haematombium increases risk for which cancer:
Squamous cell carcinoma of the bladder
Changes to once-daily insulin (Lantus, Levemir) on and before day of surgery:
Reduce 20%
Changes to twice-daily insulin (Novomix, Humulin) on and before day of surgery:
No changes day before, halve morning dose of the surgery day
First-line investigation in suspected prostate cancer, after PSA
Multiparametric MRI
Treatment for arterial ulcers without signs of infection, necrosis or osteomyelitis:
Hydrocolloid dressings
Most common cause of newborn intestinal obstruction?
Hirschprung’s disease.
Meconium ileus is a differential but is rarer
Treatment for acute pancreatitis:
Fluids and analgesia. Abx only if evidence of infection.
