Surgery GI

Question 1

proctitis

Answer 1

nocturnal diarrhoea
incontinence and brigh red blood

Question 2

anal cancers are?

Answer 2

squamous cell

Question 3

large bowel obstruction
most common cause?

Answer 3

colon cancer

Question 4

most common cause of small bowel obstruction?

Answer 4

adhesions from previous surgery

Question 5

Large bowel obstruction

1st line ix?

Answer 5

absence of flatus / stool
abdo pain
distension

abdominal XR

CT scan

Question 6

Mx of Large bowel obstruction?

Answer 6

NBM
IV fluids
nasogastric tube with free drainage

surgery

Question 7

causes of large bowel obstruction

Answer 7

malignancy - tumour
volvulus
Diverticular disease

Question 8

what is a loop ileostomy and why would you create one?

Answer 8

faecal matter goes from small bowel >

diverts / the colon

if you have an anterior resection of the colon you would connect 2 parts of colon whilst removing the diseased part

= anastomosis

but high risk of leak

so creat an anterior resection with loop ileostomy

Question 9

end ilestomy?

Answer 9

complete excision of colon

Question 10

loop colostomy

Answer 10

distal segment of colon

Question 11

Sigmoid volvulus with peritonitis

Answer 11

skip flexible sigmoidoscopy

treat urgent midline laparotomy

Question 12

mx of acute mesenteric ischaemia?

Answer 12

immediate laparotomy

Question 13

A spouted stoma with a double opening in the right iliac fossa

Answer 13

loop ileostomy.

Question 14

haemorrhoid management

Answer 14

dietary fibre
soften stool

local anaesthetic

rubben band ligation

> injection sclerotherpay

Question 15

colorectal cancer marker?

Answer 15

CEA

Question 16

FIT

Answer 16

home based
60-74

if abnormal > colonoscopy

Question 17

diverticula are most likely found?

Answer 17

sigmoid colon

Question 18

small bowel obstruction presents?

Answer 18

early vomiting
absolute constipation is a late sign

tinkling bowel sounds

Question 19

Mx of SBO?

Answer 19

abdo xray > dilated loops

IV fluid - drip
NG tube: suck

erect cxr

> surgical if no improvement

Question 20

Inguinal hernia location?

Answer 20

superior and medial to pubic tubercle

Question 21

strangulated hernia signs?

Answer 21

pain
fever
size increase
peritonitic features
bowel obstruction

Question 22

all pts with suspected perforation should be?

Answer 22

Erect CXR

blood gas > leukocytosis
raised lactate

Question 23

appendicectomy

Answer 23

open / laproscopic

IV abx prophylaxis

Question 24

Dx appendicitis

Answer 24

urine analysis
> exclude pregnancy
>Hx

USS (female)

Ct scans most sensitive but we don’t use it

Question 25

psoas sign

Answer 25

pain on hip extension
retrocaecal appendix

Question 26

Rovsigns sign

Answer 26

palpation in the LIF

causes pain in RIF

Question 27

definative diagnostic investigation for SBO?

Answer 27

CT abdomen

Question 28

SBO imaging?

Answer 28

Abdominal XR
CT

Question 29

distributive shock?

Answer 29

warm peripheries

due to vasodilatation

interruption of the autonomic nervous system
> spinal cord transection

Question 30

what is paralytic ileus?

Answer 30

seen after surgery
> loss of peristaltic movements

food/drink not passing

Question 31

managing femoral hernias?

Answer 31

need repair
due to risk of strangulation

Question 32

what is a femoral hernia?

Answer 32

femoral ring

Question 33

flail chest?

Answer 33

multiple rib fractures

Question 34

ascending cholangitis

Answer 34

RUQ pain

fever
Jaundice

Question 35

thoracotomy

Answer 35

theatre