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INTERNSHIP > Surgery/Operations/Procedures > Flashcards

Surgery/Operations/Procedures Flashcards

1
Q

What is a laparoscope?

A

A thin tube with a video camera and light attached at the end used in surgeries.

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2
Q

What does ‘bridging’ refer to in the context of surgery?

A

Bridging in therapy refers to using enoxaparin while warfarin is being held to maintain anticoagulation closer to surgery.

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3
Q

On average, how long after holding warfarin does it take for a patient with a stable INR to fall to an INR of 2?

A

Two days

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4
Q

How long after holding warfarin should a patient start enoxaparin for bridging?

A

On day 3

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5
Q

What is a cystoscopy?

A

A urinary tract scope procedure.

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6
Q

What is an implication of COVID-19 vaccines in surgery?

A

COVID-19 vaccines should be spaced by at least 7 days from any procedure.

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7
Q

Why are ACE inhibitors/angiotensin-II receptor blockers usually held on the morning of surgery?

A

As they can lead to prolonged hypotension.

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8
Q

What are 2 examples of reasons we would not hold an ACE inhibitor or angiotensin-II receptor blocker on the morning of surgery?

A
  1. Uncontrolled hypertension
  2. Heart failure
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9
Q

How should escitalopram be used around surgery?

A

Escitalopram can be continued through surgery

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10
Q

How should oxybutynin be used around surgery?

A

Oxybutynin can be continued through surgery

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11
Q

How should phentermine be used around surgery?

A

Phentermine should be held for 5 days prior to surgery.

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12
Q

Ideally, how long should aspirin be held for before surgery?

A

7 days

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13
Q

Laparascopy

A

TBC

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14
Q

What is a laparoscopic appendicectomy?

A

A minimally invasive surgery to remove the appendix using several small incisions.

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15
Q

Cholecystectomy

A

TBC

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16
Q

Septoplasty

A

TBC

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17
Q

What is a polyp?

A

Abnormal tissue growth on a mucous membrane.

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18
Q

Describe the expected follow-up for all surgical patients at Flinders Medical Centre.

A

All patients should have follow-up either with their surgeon and/or general practitioner.

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19
Q

What percentage of opioid naïve patients continue using opioids for more than 90 days post surgery?

A

4 to 10%

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20
Q

Describe the role of opioids in post-surgical pain relief

A

We always want to use multimodal pain relief rather than relying solely on opioids

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21
Q

Can opioid-induced pruritis be treated with antihistamines? Why/why not?

A

Opioid-induced pruritis is not histamine-mediated and thus will not respond to antihistamines

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22
Q

What is the best resource to use to determine morphine equivalence for dose of opioids greater than 100 mg morphine equivalent?

A

The ANZCA calculator

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23
Q

When is active recreational drug use relevant in surgery?

A

Active recreational drug use is always relevant in surgery.

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24
Q

Describe the role of parecoxib

A

Parecoxib is often used intra-operatively

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25
Q

How should parecoxib be used in relation to other NSAIDs?

A

No other NSAIDs should be used 12 hours either said of parecoxib.

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26
Q

What is the opioid of choice in surgery?

A

Morphine

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27
Q

Why is morphine the opioid of choice for surgery?

A

As it has the best retention in the cerebrospinal fluid.

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28
Q

What is the time limit on the use of epidurals?

A

Epidural use is limited to 5 days.

29
Q

Why is the use of epidurals limited to 5 days?

A

Due to the infection risk.

30
Q

Describe the size of intrathecal and epidural doses.

A

Intrathecal and epidural doses are always very small.

31
Q

Describe the use of antihypertensives around surgery.

A

Antihypertensives are usually held around surgery to reduce the risk of hypotension.

32
Q

Describe the use of IV opioids on the wards.

A

IV opioids are not used on the wards.

33
Q

How is clonidine used in surgery?

A

Clonidine may be used to manage anxiety (for example about pain) in the recovery room.

34
Q

Describe the recommendation about benzodiazepines post-operatively.

A

Benzodiazepines are not recommended post-operatively except for in pre-existing chronic use.

35
Q

In which patient cohort is ketamine particularly useful?

A

Opioid-tolerant patients.

36
Q

Describe the relationship between regional anaesthetics and postoperative opioid use.

A

Use of regional anaesthetics tend to be associated with lower post-operative opioid use.

37
Q

How can pregabalin and amiTRIPTYLine be used in surgery?

A

Pregabalin and amiTRIPTYLine are both options post limb amputation.

38
Q

Which is preferred post limb amputation: pregabalin or amiTRIPTYLine?

A

Pregabalin

39
Q

As a rule of thumb, how is postoperative pain managed by Flinders Medical Centre?

A

We manage acute postoperative pain, chronic pain is the role of the community general practitioner.

40
Q

Trapeziectomy

A

TBC

41
Q

Arthrotomy

A

TBC

42
Q

Sternal debridement

A

TBC

43
Q

Mastectomy

A

TBC

44
Q

What is a Sapling Oopherectomy?

A

Surgery to remove the ovaries and fallopian tubes

45
Q

What is a colostomy?

A

A colostomy is an operation that creates an opening for the colon through the abdomen.

46
Q

What is Type 3 Diabetes?

A

Diabetes induced by the removal/injury of the pancreas.

47
Q

Which antihyperglycaemics can be given to patients with a full pancreatectomy?

A

Patients with a full pancreatectomy must be given insulin as their pancreas has no function and thus oral agents will be ineffective.

48
Q

What is the major implication of a splenectomy?

A

Patients who have had their spleen removed will have a compromised immune system.

49
Q

How is the immunosuppression caused by spleen removal treated?

A

Patients typically require lifelong antibiotic prophylaxis with amoxicillin 250 mg once daily (roxithromycin is used in penicillin allergy).

50
Q

Colonoscopy

A

TBC

51
Q

Describe the use of immunosuppressants around surgery.

A

Immunosuppressants are often held around surgery as they inhibit wound healing and increase the risk of infection.

52
Q

What may a patient be prescribed if they are refusing a colonoscopy and why?

A

They may be prescribed pantoprazole 40 mg twice daily in case there is a bleed.

53
Q

What is an anastomosis?

A

A surgical connection of two structures in the body which are not normally connected (such as blood vessels).

54
Q

What are surgical adhesions?

A

Bands of scar tissue that bind two parts of tissue or organs together in the body.

55
Q

What is a seroma?

A

A build up of bodily fluids in a tissue or organ after a surgery, usually at the site of the surgery. The skin appears as a swollen lump.

56
Q

What is a cystectomy?

A

Surgical removal of the urinary bladder

57
Q

What is an endarectomy?

A

Surgical procedure to remove the plaque in arteries that obstructs blood flow, causing heart disease.

58
Q

What is a laminectomy?

A

A surgical operation to remove the back of one or more vertebrae

59
Q

What is the most common purpose of a laminectomy?

A

Usually to give access to the spinal cord or to relieve pressure on nerves.

60
Q

What is an oopherectomy?

A

The removal of the ovaries

61
Q

What is a total knee arthroplasty also called?

A

A total knee replacement

62
Q

What is a total knee replacement (total knee arthroplasty)?

A

A surgery that removes a diseased knee joint and replaces it with an artificial joint (prosthesis)

63
Q

What is Posterior Lumbar Interbody Fusion (PLIF) Surgery?

A

A surgery to fuse painful vertebral segments in order to stop the painful motion.

64
Q

What is anterior cervical discectomy and fusion (ACDF) surgery?

A

A type of neck surgery that involves removing a damaged disc to relieve spinal cord or nerve root pressure.

65
Q

What is open reduction and internal fixation (ORIF) surgery?

A

A type of surgery used to stabilise and heal a broken bone.

66
Q

What is a total shoulder replacement?

A

Shoulder replacement removes damaged areas of bone and replaces them with parts made of metal and plastic (implants)

67
Q

What is a craniotomy?

A

The surgical removal of part of the bone from the skull to expose the brain

68
Q

What is a mini craniotomy?

A

Mini-craniotomy is defined as an opening in the skull of diameter of the bone flap limited to 3 to 4 cm

69
Q

What is a lumbar disectomy?

A

A surgery to remove a degenerative or herniated disc in the lower spine.

INTERNSHIP (189 decks)

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