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FLASH FINALS > General surgery > Flashcards

General surgery Flashcards

1
Q

Rovsing’s sign

A

Appendicitis

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2
Q

Boas sign (hyperalgesia below right scapula)

A

Cholecystitis

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3
Q

Murphy’s sign

A

Cholecystitis

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4
Q

Inguinal hernias in relation to pubic tubercle

A

Above and medial to pubic tubercle

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5
Q

Femoral hernia in relation to pubic tubercle

A

Below and lateral

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6
Q

Spigelian hernia

A

Lateral ventral hernia - older pts.

hernia through Spigelian fascia between rectus abdominus and semiluinar line

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7
Q

Richter’s hernia

A

Can present w/ symptoms of strangulation without bowel obstruction

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8
Q

Congenital inguinal hernia:

should these be repaired:

A

Yes as soon after diagnosis due to risk of incarceration

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9
Q

Infantile umbilical hernia
Most common in:
should these be repaired:

A

Afro-caribbean infants

Most resolve before the age of 4-5 years

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10
Q

Wound dehiscence mx.

A

Coverage of wound with saline impregnated gauze
IV broad-spectrum antibiotics
Analgesia
IV fluids

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11
Q

Major pre-disposing factor for liver abscess

A

Biliary sepsis

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12
Q

Most common extra-intestinal manifestation of Amoebiasis

A

Liver abscess

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13
Q

Hydatid cysts are seen with which infection:

A

Echinococcus (tape worm)

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14
Q

Cryptorchidism
Complications:
tx.

A

Infertility, testicular cancer, testicular torsion, cosmetic appearance
Orchidopexy at 6-18 months of age

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15
Q

Spondylolithesis classical appearance on X-ray

A

Scotty dog.

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16
Q

ECG findings Hyperkalaemia:

A 
Peaked, tall-tented T waves
Loss of P waves
Broad QRS 
Ventricular fibrillation 
Sinusoidal wave pattern
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17
Q

Complications of enteral feeding:

A

Diarrhoea, aspiration, metabolic (hyperglycaemia, refeeding syndrome)

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18
Q

Diagnostic investigation for femoral hernia

Mx.

A

Usually clinical although ultrasound is used

Surgical repair is essential due to the risk of incarceration

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19
Q

High out-put fistula may be managed with which endocrine drug:

A

Octreotide - reduces pancreatic secretions

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20
Q

When is most fluid lost after burning:

A

24 hours after

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21
Q

Parkland formula

A

4 ml X (total burn surface area) X body mass (KG)

Fluids given:
50 % in the first 8 hours
50 % in the next 16 hours

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22
Q

In burns what blood components should be monitored:

A

Packed red cells, plasma sodium, base excess and lactate

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23
Q

In-direct inguinal hernia

Anatomy:

A

Protrudes down through inguinal ring passes lateral to the inferior epigastric artery

24
Q

Direct inguinal hernia

Anatomy:

A

Protrudes through Hesselback triangle passes medial to the epigastric artery.

25
Q

Hiatus hernia mx.:

A

All pts. benefit from wt. loss
Medical - PPI
Surgical - only has a role in para-oesophageal hernias

26
Q

Hiatus hernia most sensitive test:

A

Barium swallow although many have endoscopy and HH is found incidentally

27
Q

First-line imaging hydatid cysts:

A

Ultra-sound used 1st line

CT used to differentiate between hydatid and amoebic cysts

28
Q

Normal small bowel diameter on XR

A

35mm

29
Q

Normal large bowel diameter on XR

A

55 mm

5.5 cm

30
Q

Hepatocellular carcinoma diagnostic investigations

A

CT/ MRI (or both)
serial AFP

No place for biopsy

31
Q

What should also be examined in cases of increased AFP

A

Testes

32
Q

Main risk factor for cholangiocarcinoma

A

PSC

33
Q

Cholangiocarcinoma - markers elevated:

A

CA-19-9 CEA CA125

34
Q

Indications for surgery in a lower GI bleed:

A

Pts. > 60 years
Continued bleeding despite endoscopic intervention
Recurrent bleeding
Known cardio disease

35
Q

Lower GI bleeding - unstable pt. ix.

A

CT Angiogram

36
Q

Stable pt. lower GI bleeding ix.

A

Colonoscopy

37
Q

Lower GI bleed believed to be haemorrhoidal ix.

A

Proctosigmoidoscopy

38
Q

Massive haemeorrhage - Transfusion electrolyte disturbances

A

Hypothermia (transfused blood is cold)
Hypocalcaemia (FFP and platelets contain calcium chelating compounds)
Hyperkalaemia (plasma RBCs stored for 4-5 weeks have more potassium)

39
Q

Massive haemorrhage definition

A

Whole blood volume in 24 hours or 50% of circulating blood in 3 hours

loss of 150 ml/minute -

40
Q

Axillary node clearance - potential nerve injuries:

A

Long thoracic, thoracodorsal nerve and intercostobrachial nerve

41
Q

Carotid endarterectomy potential nerve injury

A

hypoglossal

42
Q

Posterior triangle biopsy potential nerve injury

A

(spinal) Accessory nerve (CNXI)

43
Q

Anterior resection of rectum: potential nerve injury

A

Hypogastric autonomic nerves

44
Q

posterior approach hip potential nerve injury

A

Sciatic nerve

45
Q

Which transplants are greatest risk of rejection

A

Renal

46
Q

Pneumoperitoneum ix. of choice:

A

CXR

47
Q

What type of injury will deteriorate with vigorous ventilation attempts:

A

Tension pneumothoraces

48
Q

What are cardiac contusions?

How to manage?

A

Essentially bruising of the myocardium - often overlying sternal fracture

Px. as cardiac arrhythmias - Perform echocardiography to exclude pericardial effusions and tamponade

49
Q

What does blood at the urethral meatus indicate:

A

Urethral tear

50
Q

What does high riding prostate on PR exam indicate:

A

Urethral disruption

51
Q

Diaphragm disruptions are more common on which side?

A

Left

52
Q

Long term TPN infusions should be administered through what type of vein:

A

A central vein - preferably via PICC line

53
Q

Xenograft:

A

Transplantation of tissue from another species

54
Q

Commonest cause of organic erectile dysfunction:

A

Vascular causes

55
Q

Tamsulosin MoA

A

a-1 antagonist

56
Q

Commonest cause of large bowel obstruction:

A

Colorectal carcinoma

FLASH FINALS (34 decks)

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