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Finals > Surgery > Flashcards

Surgery Flashcards

1
Q

Causes of generalised abdo pain

A
  • Peritonitis
  • Ruptured AAA
  • Bowel obstruction
  • Ischaemic colitis
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2
Q

Causes of right upper quadrant pain

A
  • Biliary colic
  • Acute cholecystitis
  • Acute cholangitis
  • Right lower lobe pneumonia
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3
Q

Causes of epigastric pain

A
  • Acute gastritis
  • Peptic ulcer disease
  • Pancreatitis
  • Ruptured AAA
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4
Q

Causes of central abdo pain

A
  • Ruptured AAA
  • Bowel obstruction
  • Ischaemic colitis
  • Early appendicitis
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5
Q

Causes of right iliac fossa pain

A
  • Acute appendicitis
  • Ectopic pregnancy
  • Ruptured ovarian cyst
  • Ovarian torsion
  • Meckel’s diverticulitis
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6
Q

Causes of left iliac fossa pain

A
  • Diverticulitis
  • Ectopic pregnancy
  • Ruptured ovarian cyst
  • Ovarian torsion
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7
Q

Causes of suprapubic pain

A
  • LUT infection
  • Acute urinary retention
  • Pelvic inflammatory disease (PID)
  • Prostatitis
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8
Q

Loin to groin pain causes?

A
  • Renal colic/kidney stones
  • Ruptured AAA
  • Pyelonephritis
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9
Q

Causes of testicular pain

A
  • Tensticular torsion
  • Epididymo-orchitis
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10
Q

Signs of peritonitis

A
  • Guarding- involuntary tensing of abdo muscles when palpated
  • Rigidity- involuntary tensing of abdo muscles
  • Rebound tenderness- rapidly releasing pressure causes more pain than the pressure
  • Coughing test- pain worse when coughing
  • Percussion tenderness- pain when percussing abdomen
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11
Q

What is the name of the anatomical point specific to Acute appendicitis

And where is this point?

A

McBurney’s point.

One third of the distance from the anterior inferior iliac spine to the umbilicus

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12
Q

What is Rovsings sign, when is it positive

A

Palpation in the left iliac fossa causes pain in RIF
Indicative of acute appendicitis

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13
Q

Acute abdomen differentials?

A

Ectopic pregnancy
Acute appendicitis
Ovarian cysts, torsion or rupture?
Meckels diverticulum
Mesenteric adenitis

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14
Q

Features of critical limb ischaemia?

A

6 P’s
Pain, Pallor, Pulseless, Paralysis, Paraesthesia, perishingly cold

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15
Q

What is intermittent claudication?

A

Peripheral artery disease presents with it.
Pain occurs when walking. Goes when stopping. Often in calfs, can be thighs and buttocks

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16
Q

What is Leriche syndrome?

A

Occlusion of the distal aorta or proximal common iliac artery
Triad of:
Thigh/buttock claudication
Absent femoral pulses
Male impotence

17
Q

What test is used to test for peripheral artery disease?

A

Beurger’s test
1st part. Lie patient on back, hold leg at 45* for 2mins. Pallor suggests poor arterial supply. Beurgers angle is the angle where the leg goes pale.

2nd part. Sitting up w legs over side, blood should flow back in. Healthy- should go pink
In PAD- blue initially as ischaemic tissue deoxygenates blood, then dark red due to vasodilation responding to anaerobic resp

18
Q

Differentiating between arterial and venous ulcers?

A

Arterial- more painful, smaller but deeper, ‘punched out’ lesion
Veinous- often after injury, larger but superficial, irregular, often mid calf to ankle

19
Q

Management of critical limb ischaemia?

A

Endovascular angioplasty and stenting
Endartectomy- open artery and remove plaque
Bypass surgery
Amputation

20
Q

What vein is often used for a CABG?

A

Saphenous vein from medial calf

21
Q

Whats the gaiter area?

A

The area between the mid calf and ankle that’s most prone to getting venous ulcers

22
Q

What test is used to diagnose peripheral arterial disease?

A

Beurger’s test

23
Q

What is used to assess the severity of peripheral artery disease?

A

Ankle brachial pressure index (ABPI)

24
Q

What medications are used for secondary prevention in peripheral arterial disease?

A

Atorvatatin 80mg
Clopidogrel 75mg

25
Q

What’s the difference between endovascular thrombolysis and endovascular thrombectomy?

A

Both involve inserting a catheter through arterial system.
Thrombolysis then uses it to apply medication directly into thrombus to dissolve it
Thrombectomy is removing the thrombus by aspiration or with a mechanical device

26
Q

Quartet of bowel obstruction

A

Abdo pain
Abdo distension

Vomiting
Constipation

27
Q

Distension is pronounced and early in which area of bowel obstruction?

A

Large bowel

28
Q

Risk factors for primary sclerosing cholangitis?

A

Male
30-40yo
Family hx
! Hx of ULCERATIVE COLITIS

29
Q

Presentation of primary sclerosing cholangitis?

A

Jaundice
Chronic RUQ pain
Pruritis
Fatigue
Hepatomegaly

30
Q

Peptic ulcers eroding through stomach, what is the most likely blood vessel they’ll hit?

A

Gastroduodenal artery

31
Q

What is the term given when a vertabrae slips forwards?

A

Spondylolithesis

32
Q

What’s the difference between spondylolysis and spondylolithesis?

A

Spondylolysis is a stress fracture in the pars interarticularis of the lumbar spin (usually L5)
Spondylolithesis is the slipping forward of the vertebra as a result of the fracture

33
Q

What nodes are closest/most likely to have metastases from breast cancer?

A

Sentinel lymph nodes

Finals (13 decks)

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