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FINALS > Surgery > Flashcards

Surgery Flashcards

1
Q

What is the triad of anaesthesia

A

Hypnosis, muscle relaxation, analgesia

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2
Q

What are some complications of anaesthesia?

A

Respiratory depression

Nausea

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3
Q

What are some general complications of surgery?

A

Infection

Haemorrhage

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4
Q

What are some patient risk factors for surgery?

A

CAD
DM
Haemophilia

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5
Q

What are some criteria for Well’s scoring?

A 
Active cancer
Paralysis 
Major surgery within 2 weeks
Local tenderness
Entire leg swollen 
Calf swelling >3cm 
Pitting oedema 
Collateral superficial veins 
Previous DVT 
(Alternative diagnosis more likely = -2)
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6
Q

What Well’s score makes DVT unlikely?

A

Less than 1 - do D dimer

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7
Q

What are some causes of bilateral leg swelling?

A

Right heart failure
Renal or liver failure - decreased albumin
Venous insufficiency
Pregnancy

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8
Q

What are some complications of biliary surgery?

A

Cholangitis, pancreatitis

Bile duct stricture

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9
Q

Where are colostomies usually situated?

A

Left iliac fossa

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10
Q

What are the different types of colostomy?

A

Loop - temporary, protects distal anastomosis, 2 lumens

End - usually permanent

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11
Q

Where are ileostomies usually situated?

A

Right iliac fossa, spouted

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12
Q

Where are urostomies usually situated?

A

Right iliac fossa, 2 ureters attached to piece of small bowel

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13
Q

What are some stoma complications?

A 
Infection 
Not draining 
High output 
Hernia
Retraction 
Ischaemia
Bleeding
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14
Q

What are some causes of acute abdomen?

A 
Peritonitis 
Ruptured AAA 
Appendicitis 
Pancreatitis 
Diverticulitis 
Ruptured ulcer
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15
Q

What are the boundaries of the inguinal canal?

A

Muscle - internal oblique
Aponeurosis - external oblique
Ligament - inguinal
Tendon - transversals fascia

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16
Q

Where is the deep ring of the inguinal canal?

A

Halfway along the inguinal ligament

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17
Q

Where is the superficial ring of the inguinal canal?

A

Superior and medial to the pubic tubercle

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18
Q

What are the features of a direct inguinal hernia?

A

Passes through posterior wall of the inguinal canal

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19
Q

What are the features of HNPCC?

A

Autosomal dominant
Risk 80%
Biennial colonoscopy 25-75 years

20
Q

What are the features of FAP?

A 
Mutation in APC suppressor gene 
Multiple colorectal adenomas - malignant transformation
Risk 100% by age 50 
Sigmoidoscopy from 12 years
Prophylactic surgery by age 25
21
Q

What are the red flags for bowel cancer?

A

Positive faecal occult blood
Over 40 + abdo pain + weight loss
Over 50 + rectal bleeding
Over 60 + IDA or change in bowel habit

22
Q

Where does bowel cancer spread to?

A

Liver, lung, bone

23
Q

What type of surgery is done for caecal/ascending bowel tumours?

A

Right hemicolectomy

24
Q

What type of surgery is done for transverse/descending bowel tumours?

A

Left hemicolectomy

25
Q

What type of surgery is done for sigmoid bowel tumours?

A

Sigmoid colectomy

26
Q

What type of surgery is done for low rectal tumours?

A

AP resection

27
Q

What type of surgery is done for emergency/palliative bowel tumours?

A

Hartmann’s procedure

28
Q

When is bowel screening done?

A

60-75 years with faecal occult blood test

29
Q

What are the red flags for oesophageal cancer?

A

Dysphagia, weight loss, hoarseness, retrosternal chest pain

30
Q

What are the risk factors for gastric cancer?

A

Pernicious anaemia, h pylori, smoking

31
Q

What are the signs of chronic mesenteric ischaemia?

A

Severe colicky post-prandial pain
Weight loss
Upper abdominal bruit

32
Q

What are the criteria for obesity surgery?

A 
BMI over 40 
Failure of non-surgical options for 6 months 
Fit for surgery 
Intensive management 
Well motivated patient
33
Q

What are the treatment options for haemorrhoids?

A 
Increase fluid and fibre
Stool softener 
Rubber band ligation 
Diathermy
Excisional haemorrhoidectomy
34
Q

What are some complications of diverticular disease?

A 
Perforation 
Haemorrhage 
Fistulae 
Abscesses 
Post-infective strictures
35
Q

What are the symptoms of biliary colic?

A

RUQ -> back pain

36
Q

What are the symptoms of acute cholecystitis?

A

Continuous RUQ or epigastric pain
Vomiting, fever, local peritonism
Murphy’s sign

37
Q

What are the symptoms of cholangitis?

A

Charcot’s triad - RUQ pain, jaundice, rigors

38
Q

What are the causes of pancreatitis?

A 
Gallstones
Ethanol 
Trauma
Steroids 
Mumps
Autoimmune 
Scorpion 
Hyperlipidaemia 
ERCP
Drugs
39
Q

What are the symptoms and signs of pancreatitis?

A

Severe epigastric to back pain relieved by sitting forwards
Vomiting
Cullen’s - periumbilical bruising
Grey Turner’s - flank bruising

40
Q

What tests should be done for pancreatitis?

A

FBC, LFTs, UEs, blood sugar
Amylase, lipase, ABG
CT

41
Q

What are the symptoms and signs of kidney stones?

A

Spasms of loin to groin pain
Nausea and vomiting
Pelvic pain, dysuria, interrupted flow
Renal angle tenderness

42
Q

What investigations should be done for renal stones?

A

FBC, UE
Urine dip
Non-contrast CT

43
Q

What are the treatment options for renal stones?

A

Pass spontaneously
>5mm medical expulsive - nifedipine/tamsulosin
>48 hours extracorporeal shockwave lithotripsy

44
Q

What are some causes of urinary tract obstruction?

A

Stones, clot, tumour
Stricture, neuromuscular dysfunction
Abdominal/pelvic mass

45
Q

What are the symptoms and signs of acute lower urinary tract obstruction?

A

Severe suprapubic pain and acute confusion

Distended, palpable bladder

46
Q

What are some causes of haematuria?

A 
RCC
Glomerulonephritis 
HSP
UTI 
Menstrual 
Rifampicin 
Rhabdomyolysis

FINALS (19 decks)

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