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Surgical conditions Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

What does SOCRATES stand for

A 
Site
Origin
Character
Radiation
Associated symptoms
Time
Exacerbation or releiving
Severity
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2
Q

What are the 3 types of pain someone can have?

A

Somatic
Visceral
Neuropathic

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3
Q

What is Somatic pain?

A

MSK or body surface

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4
Q

What is visceral pain?

A

Internal organs

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5
Q

What is neuropathic pain?

A

Spinal Cord and peripheral nerves

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6
Q

Where is the pancreas located?

A

Epigastric area

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7
Q

Where can pain radiate to if you have pancreas pain?

A

The back

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8
Q

What do you check if someone has Peritonitis?

A

Amylase

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9
Q

What kind of pain might someone have if they have toothache?

A

MSK pain

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10
Q

What kind of pain is post op pain likely?

A

Somatic +/- visceral

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11
Q

4 steps to manage pain?

A
  1. Oral/topical analgesic
  2. Local analgesia
  3. Regional analgesia (spinal/epidural)
  4. Patient controlled analgesia
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12
Q

What might you use for local analgesia around a wound?

A

Bupvicaine

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13
Q

What is the WHO pain ladder?

A

Step 1- mild pain- non-opiod +/- adjuvent analgesia
Step 2- mild-moderate pain- opiod for pain + non-opiod +/- adjuvent analgesia
Step 3- Severe pain- opiod for pain + non-opiod +/- adjuvent analgesia

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14
Q

What is a simple analgesia?

A

Paracetamol

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15
Q

What are examples for NSAIDS?

A

Aspirin, Ibuprofen, Biclofenac, Naproxen, Celocoxib

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16
Q

When should you be cautious with Biclofenac?

A

Cardiovascular disease

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17
Q

What is a mild opiate?

A

Codeine, co-codamol

18
Q

What is a moderate opiate?

A

Tramadol

19
Q

What is a strong opiate?

A

Morphine, Oxycodone, Pethadine

20
Q

Why is Pethadine not recommended post operatively?

A

It is metabolised by the renal system

21
Q

What are adjuvents to Analgesia?

A

Gabapentin, Carbamazipine, Amytriplyline

22
Q

What are some side effects of opiates?

A

N & V
Constipation
Toxicity
Respiratory depression

23
Q

NSAIDS cause various side effects, what are they?

A 
Renal impairment
Hepatic impairment
Avoided in pregnancy
Gi pathology- ulceration and GORD
Asthma symptoms may be worsened
Risk of Cv disease- MI
24
Q

What are signs of Opiod toxicity?

A 
Decreased consciousness
Pin point pupils
Seizures
Muscles spasm
Cyanosis
25
Q

What should you do if someone is suffering from opiod toxicity?

A

ABCDE approach

Naloxone 0.4-2mg at intervals of 2-3 mins.

26
Q

Electrolytes will be altered- explain what happens

A

Vomiting will depite the body of water and HCl- leading to hypochloremic alkalosis

27
Q

What are the K levels of someone with hypochloremic alkalosis?

A

<3.5mmol/L

28
Q

What is post op Pyrexia?

A

Fever

29
Q

Post op pyrexia day 1-2 cause?

A

Atelectasis (fluid)

30
Q

Post op pyrexia day 3-4 cause?

A

Pneumonia (after anasthetic in operation)

31
Q

Post op pyrexia day 4-5 cause?

A

Anatomostic leak

32
Q

Post op pyrexia day 7-8 cause?

A

Would infection

33
Q

Post op pyrexia 8+ cause?

A

DVT

34
Q

What is sepsis?

A 
SIRS is when 2 or more of: temp is <36/>38
HR>90
RR>20
WCC<4 >12
BG >7.7mmol/L
35
Q

What is sepsis shock?

A

Severe sepsis when BP is constantly low and failed response to fluid

36
Q

What is the Sepsis 6??

A
  1. Oxygen
  2. Take blood tests
  3. IV antibiotics
  4. Fluid challenge
  5. Measure lactate
  6. Measure urine output
37
Q

What is primary haemorrhage?

A

Continuous bleeding during surgery

38
Q

What is secondary haemorrhage?

A

1-2 weeks post op due to infection

39
Q

What is reactive bleeding?

A

Bleeding stable until high BP

40
Q

What are the signs of a class 3 haemorrhage?

A 
Blood loss: 1500-2000ml
%: 30-40
Pulse >120
BP: Decreased
RR: 30-40
Symptoms- confused
Urine output- 5-15ml
41
Q

What drug if someone had DVT?

A

Heparin

CMS (25 decks)

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