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Year 6 > Surgery > Flashcards

Surgery Flashcards

1
Q

What is the most common cause of painful PR bleed?

A

Fissure

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2
Q

Where are anal fissures located?

A

midline and 12oclock position
distal to the dentate line

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3
Q

What usually precedes an anal fissure?

A

ano-rectal abscess

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4
Q

How does bladder cancer typically present?

A

macroscopic painless haematuria

can also have incidental finding of microscopic haematuria

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5
Q

What should all >60YO + haematuria + raised white cell count +- ex smoker be referred to?

A

2WW urology

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6
Q

Where are inguinal hernias located?

A

superior and medial to the pubic tubercle

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7
Q

What is the most common type of hernia?

A

Inguinal
really common in men

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8
Q

Typical features of inguinal hernias

A

location
reduces when patient lies down
reduces when pressure is applied

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9
Q

How can subdural haematomas be classified?

A

Acute - symptoms within 48 hours of injury
Subacute - symptoms gradually develop days to weeks after injury
Chronic - weeks to months later, common in elderly

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10
Q

What are conservative management of varicose veins?

A

weight loss
leg elevation
exercise
compression stockings

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11
Q

What are the criteria for a CT scan within 1 hour after head injury?

A

GCS<13
GCS<15 after 2 hours of injury
retrograde amnesia of more than 30 mins before
suspected skull fracture
>1 episode of vomiting
focal neurological deficit
seizure
signs of basal skull fracture

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12
Q

When should FIT test be suggested?

A

palpable abdominal mass
40YO+weight loss + abdo pain
IDA
change in bowel habits
<50YO with rectal bleed + weight loss/ abdo pain
>60YO and anaemia ( not IDA)

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13
Q

Screening programme for bowel cancer

A

60 to 74 YO Male and females
FIT every 2 years

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14
Q

What does incarcerated hernia mean?

A

hernia cannot be reduced

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15
Q

Symptoms of a strangulated hernia

A

pain
fever
erythema around the skin of the hernia
nausea
vomiting
blood in stools
guarding
tenderness

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16
Q

What is flail chest injury?

A

chest wall disconnects from thoracic cage

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17
Q

How many lymph nodes need to be positive in sentile biopsy to get removed?

A

3/5

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18
Q

Common cause of small bowel obstruction in adults

A

previous surgery causing adhesions
crohns
incarceration of hernias

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19
Q

What hormonal treatment is used in HER+ and post menopausal women?

A

aromatase inhibitors

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20
Q

How to pick up small bowel obstruction on XRAY?

A

Valvulae conniventes extend all the way across

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21
Q

What should all patients with peripheral arterial disease be prescribed?

A

Atorvastatin 80 mg
Clopidogrel

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22
Q

When should a LP be done when suspecting a SAH?

A

12 hours post onset of headache

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23
Q

What is the most frequent colorectal cancer?

A

adenocarcinoma

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24
Q

What are patients with chronic pancreatitis at risk of developing and how should they be managed?

A

Diabetes
annual HbA1c

25
Q

What vessel is most likely ruptured in an extradural haemorrhage?

A

middle meningeal

26
Q

How to treat local anaesthetic toxicity?

A

IV 20% lipid emulsion

27
Q

What are complications of transurethral resection?

A

TURP syndrome
Urethral stricture/UTI
Retrograde ejaculation
Perforation of prostate

28
Q

What are the features of TURP syndrome?

A

HypoNa
fluid overload
glycin toxicity

29
Q

Surgical management of Distal transverse or descending colon cancer?

A

left hemicolectomy

30
Q

1st line pain relief for renal colic pain

A

NSAIDs

31
Q

What should be used as investigation for children and pregnant women in suspected kidney stones?

A

US

32
Q

Management for renal stones

A

watchful waiting if < 5mm and asymptomatic
5-10mm shockwave lithotripsy
10-20 mm shockwave lithotripsy OR ureteroscopy
> 20 mm percutaneous nephrolithotomy

33
Q

Management for ureteric stones

A

shockwave lithotripsy +/- alpha blockers
< 10mm shockwave lithotripsy +/- alpha blockers
10-20 mm ureteroscopy

34
Q

Symptoms of epididymo-orchitis

A

unilateral testicular swelling
pain (gradually worsening)
present cremasteric reflex
erythema

35
Q

Treatment for epididymo-orchitis with unknown organism

A

IM Ceftriaxone
oral doxy 10-14days

36
Q

Most common organism that causes cholangitis

A

E.Coli

37
Q

Where are femoral hernias located?

A

below and lateral of the pubic tubercle

38
Q

What is paralytic ileus?

A

common complication after bowel surgery

39
Q

What are non seminal testicular tumours associated with marker wise?

A

high HCG and AFP

40
Q

What is described as eczema like changes of the breast?

A

Pagets disease of the nipple

41
Q

What is first line management for small bowel obstruction?

A

IV fluids and NG tube insertion

42
Q

Management of cholecystitis

A

IV antibiotics and analgesia
laparoscopic cholecystectomy within 1 week

43
Q

Management of cholangitis

A

IV antibiotics and analgesia
ERCP within 24-48 hours

44
Q

When should a right hemicolectomy be performed?

A

Caecal, ascending or proximal transverse

45
Q

What is a sigmoid volvulus?

A

large bowel obstruction due to sigmoid torsion

46
Q

What is seen in an XRAY with sigmoid volvulus?

A

coffee bean

47
Q

When does an anastomosis leak usually present?

A

5-7 days post surgery

48
Q

Signs of an anastomosis leak

A

new onset AF

49
Q

What are complications of acute pancreatitis?

A

Peripancreatic fluid collections
pseudocyst
ARDs
abscess

50
Q

How are asymptomatic renal stones <5mm managed?

A

watch and weight
image again after 4 weeks Wh

51
Q

What needs to be excluded prior to circumcision?

A

diagnosis of hypospasdiasis

52
Q

What initial investigations should be performed with males with ED?

A

Glucose
lipids
free testosterone

53
Q

painless lump in scrotum + gynaecomastia

A

testicular cancer

54
Q

What pain relief is used for acute renal colic?

A

IM diclofenac

55
Q

What is first line investigation for prostate cancer?

A

multiparametric MRI

56
Q

What is a hartmans procedure?

A

resect area of bowel that is not functioning
form ileostomy/colostomy temporarily
colorectal anastomosis formation to reform continous bowel

57
Q

Treatment for superficial thrombophlebitis

A

NSAIDs
Compression stockings

58
Q

What medication is used in chronic anal fissure?

A

Topical glyceryl trinitrate

59
Q

What drug is administered to patients post SAH to prevent spasm?

A

Nimodipine ( CCB)

Year 6 (19 decks)

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