Surgical Cases Flashcards
List screening Qs for someone with GIT problems?
General = FLAWS, N&V, abdo pain, PR bleed Specific = pain, fever, jaundice, dark urine, pale stool
List screening Qs for someone with urological problems?
Infective = frequency, urgency, nocturia Obstructive = hesitancy, intermittent, poor stream, incomplete voiding
List screening Qs for someone with vascular problems?
Non modifiable = age, sex, PMH or FH of CVA/MI
Modifiable = HTN, DM, high cholesterol, smoking
What is a Kocher scar from?
Gall bladder surgery
What is Murphys sign?
Palpate R subcostal on inspiration. Pain = cholecystitis
What is Rovsing’s sign?
Pressing LIF causes pain in RIF = appendicitis
What is Psoas sign?
Extension of hip when lying flat = retrocaecal appendicitis
What is obturator sign?
Flex hip and knee to 90 and rotate around . Pain = appendicitis.
What is Grey Turner sign?
Bruising around umbilicus
What is Cullen’s sign?
Bruising around flank
What is the approach you take to analysing a CXR?
ABCDE Adequacy - 6 ribs anteriorly Breathing - lobes / zones Cardiac Diaphragm Everything else inc bones
List immediate management for all surgical patients?
TED stocking
LMWH
NMB pending review
List 4 types of management for any medical problem
Conservative
Medical
Interventional
Surgical
Female, fat, forty, fertile, fair.
Intermittent pain triggered by fatty food.
Dx?
Biliary colic
What is ascending cholangitis?
Stone blocking tube
What is the management of sepsis?
SEPSIS 6
Give O2, fluids, Abx
Take urine output, blood cultures and serum lactase levels
How do you calculate pancreatitis severity?
PANCREAS PaO2 < 8 Age > 55 Neutrophils > 15 Calcium <2 Raised urea > 16 Elevated enzymes eg LDH >600 Albumin <32 Sugar >10
What is atelectasis?
Common post op presentation of difficulty breathing with a temperature.
List 7 causes of post op pyrexia
7 Cs Chest Catheter Central line Cannula Cut Collection Calves (DVT)
What is a post op pyrexia <24hrs?
Systemic response to trauma
Pre existing infection
What is a post op pyrexia 24-72hrs?
Pulmonary atelectasis
Chest infection
What is a post op pyrexia 3 - 10 days?
UTI DVT PE Wound Collection Anastomotic leak