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Surgery (Y4) > General Surgery > Flashcards

General Surgery Flashcards

(63 cards)

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1
Q

What is meant by Class I shock?

A

Completely compensated for

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2
Q

What is meant by Class II shock?

A

Tachycardia only

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3
Q

What is meant by Class III shock?

A

Tachy, hypotension but conscious

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4
Q

What is meant by Hartmann’s procedure?

A

Removal of a section of the bowel with a colostomy/ileostomy (rather than anastamoses)

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5
Q

Hernia below and lateral to the pubic tubercle is…

A

Femoral hernia

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6
Q

What are the causes of pancreatitis?

A

GET SMASHED - Gallstones, Ethanol, Trauma, Steroids, Mumps, Autoimmune, Scorpion bite, Hypertriglyceride/Hypercalcaemia/Hypothermia, ERCP, Drugs

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7
Q

Bruising of the flanks in acute pancreatitis is called…

A

Grey-Turner’s sign

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8
Q

Pain/catch of breath elicited on palpation of the right hypochondrium during inspiration is called…

A

Murphy’s sign

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9
Q

Rigler’s sign (double wall sign) suggests…

A

Free air in the abdomen

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10
Q

Low rectal cancer is usually treated with…

A

Low anterior resection

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11
Q

How should congenital inguinal hernias be treated?

A

Refer to surgery (due to high complication rate)

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12
Q

Reddening and thickening of nipple and areola suggests…

A

Paget’s disease of the nipple

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13
Q

Which antibiotics should be used in severe diverticulitis?

A

IV Ceftriaxone and Metronidazole

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14
Q

What is the first-line investigation for bowel perforation?

A

Erect CXR

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15
Q

What is the best first-line investigation in suspected acute critical limb ischaemia?

A

Handheld arterial doppler

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16
Q

Give red flag symptoms of bowel cancer.

A

Change in bowel habit, weight loss, fatigue, blood in stool

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17
Q

Which patients with a change in bowel habit should be referred on the urgent cancer pathway?

A

> 60 or > 50 with another red flag

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18
Q

What is the gold-standard investigation for diagnosing colorectal cancer?

A

Colonoscopy

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19
Q

What is the tumour marker for cholangiocarcinoma?

A

CA 19-9

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20
Q

Give 3 causes of LUQ pain.

A

Gastric ulcer, lower lobe pneumonia, pyelonephritis

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21
Q

Give 4 causes of epigastric pain.

A

Peptic ulcer, cholecystitis, pancreatitis, MI

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22
Q

Give causes of RUQ pain.

A

Cholecystitis, Hepatitis, Pyelonephritis

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23
Q

Which investigations are particularly important in upper abdo pain?

A

ECG (rule out MI) and erect CXR (exclude perforation)

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24
Q

Give 3 causes of RLQ pain.

A

Appendicitis, gynae pathology (ectopic pregnancy), IBD, ureteric colic

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25
Give 3 causes of LLQ pain.
Diverticulitis, IBD, Gynae
26
How can you assess for peritonism?
ask them to cough and see if pain on percussion or light palpation
27
What is the first-line investigation for gallstones?
USS
28
Give causes of LBO.
Tumour, strictures, volvulus (sigmoid or caecal)
29
Give causes of SBO.
Adhesions, Hernia, Strictures, Intussusception, Gallstone ileus, Bazoar
30
Which method may be used for incomplete bowel obstruction?
‘drip and suck’ method - IV fluids & aspirate NG tube
31
Give causes of abdo pain with shock.
Ruptured AAA Upper GI bleed eg. varices, gastric ulcer etc Rupture ectopic pregnancy
32
What is the most common cause of upper GI bleed?
Peptic ulcer
33
Vomiting, abdominal or chest pain, and subcutaneous emphysema suggests...
Boerhaave’s syndrome
34
What is the definitive investigation for upper GI bleed?
OGD
35
What is the Glasgow-Blatchford score used for?
Assesses risk pre-endoscopy in upper GI bleed
36
What is the Rockall score used for?
Assess risk of re-bleeding and death in upper GI bleed post-endoscopy
37
What are the conservative management options for anal fissures?
laxatives, lubricants, and topical GTN
38
What is the best investigation for chronic pancreatitis?
CT abdomen
39
Give causes of fresh red blood in stool.
Haemorrhoids, anal fissure, IBD, Diverticulitis, Colorectal polyps/cancer
40
Which patients with rectal bleeding should be referred for urgent colonoscopy?
Unexplained rectal bleeding in > 50s
41
Emphysematous cholecystitis usually occurs in...
Diabetics
42
What are the risk factors for gallstones?
4F's: - Female - Forty - Fat - Fertile
43
How is cholecystitis managed?
Antibiotics, can use ERCP to remove stones, usually cholecystectomy
44
What are the two main causes of ascending cholangitis?
secondary to gallstone obstruction or post-ERCP
45
What are the most common organisms in ascending cholangitis?
E Coli, Klebsiella, Enterococcus
46
RUQ pain, fever and jaundice =
Ascending cholangitis
47
How does PSC typically present?
Progressive, obstructive jaundice
48
Which condition is highly associated with PSC?
UC
49
PSC increases the risk of...
cirrhosis and cholangiocarcinoma (10-20%)
50
‘beaded’ or ‘onion-skin’ appearance on MRCP suggests...
PSC
51
Which auto-antibody is associated with PSC?
ANCA
52
How does PBC typically present?
Fatigue and itch
53
PBC is associated with which other conditions?
Sjogren's, SLE, RA
54
Which auto-antibody is associated with PBC?
AMA
55
What are the main risk factors for cholangiocarcinoma?
PSC and liver flukes (parasitic infection)
56
How does cholangiocarcinoma usually present?
Obstructive jaundice
57
What does Courvoisieur’s law state?
if jaundice + palpable gallbladder, unlikely to be gallstones → most likely cholangiocarcinoma or pancreatic cancer
58
What is the tumour marker for cholangiocarcinoma?
CA19-9
59
How is cholangiocarcinoma usually managed?
Curative surgery not usually possible (only early cases)
60
Which procedure is undertaken to defunction the bowel following anastamosis?
Loop ileostomy
61
What is the initial investigation to check for free fluid in trauma?
FAST scan
62
Are ilestomies typically spouted or flush to the skin?
Spouted
63
Are colostomies typically spouted or flush to the skin?
Flush to the skin

Surgery (Y4) (8 decks)

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