Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals Revision > General Surgery > Flashcards

General Surgery Flashcards

1
Q

What is the water distribution in the body?

A

2/3rds ICF
1/3rd ECF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the water distribution in the extracellular space?

A

Intravascular - 20%
Interstitial space - 80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the third space

A

Areas that can collect fluid but shouldn’t. - e.g peritoneal cavity or joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is hypovolaemia?

A

Low amount of ECF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are signs of hypovolaemia?

A

Hypotension
Tachycardia
CRT >2
Cold peripheries
Raised RR
Dry mucous membranes
Reduced skin turgor
Reduced urine output
Sunken eyes
Reduced body weight from baseline
Feeling thirsty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the indications for IV fluids?

A

Resuscitation
Replacement
Maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the guidance for resuscitation fluids?

A

Initial 500ml fluid bolus over 15 mins (‘stat’)
Repeat boluses of 250ml-500ml if required each time followed by a reassessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The rate of potassium infusion should not exceed what?

A

10mmol/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the recommendations for maintenance fluid amounts?

A

25-30ml/kg/day water
1mmol/kg/day of sodium, potassium and chloride
50-100g/day of glucose, to prevent ketosis

Weight is IBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is diverticulitis associated with?

A

Increased age
Low fibre diets
Obesity
NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What type of laxatives should be avoided in diverticular disease?

A

Stimulant laxatives (e.g. Senna)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the management of acute uncomplicated diverticulitis?

A

Oral co-amoxiclav
Analgesia (avoiding NSAIDs and opiates)
Only taking clear liquids, avoiding solid food until symptoms improve
Follow up within 2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the complications of acute diverticulitis?

A

Perforation
Peritonitis
Peridiverticular abscess
Large haemorrhage
Fistula
Ileus/obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the three main branches of the abdominal aorta that supply the abdominal organs?

A

Coeliac artery
Superior mesenteric artery
Inferior mesenteric artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the foregut?

A

Stomach, part of the duodenum, biliary system, liver, pancreas and spleen. Supplied by the coeliac artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the midgut?

A

Distal duodenum to the first half of the transverse colon. Supplied by the superior mesenteric artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the hindgut?

A

Second half of the transverse colon to the rectum. Supplied by the inferior mesenteric artery

18
Q

What is the classic triad of chronic mesenteric ischaemia?

A

Central colicky abdo pain after eating (starting around 30 mins after eating and lasting 1-2 hrs)
Weight loss
Abdo bruits

19
Q

What is the cause of chronic mesenteric ischaemia?

A

Atherosclerosis

20
Q

What is the management of chronic mesenteric ischaemia?

A

Reducing modifiable risk factors
Secondary prevention of CVS disease
Revascularisation to improve blood flow - percutaneous mesenteric artery stenting or open surgery.

21
Q

What causes acute mesenteric ischaemia?

A

Thrombus - key risk factor is atrial fibrillation

22
Q

How does acute mesenteric ischaemia present?

A

Acute, non-specific abdominal pain, disproportionate to examination findings
Shock, peritonitis, sepsis
Necrosis and perforation

23
Q

How is acute mesenteric ischaemia diagnosed?

A

Contrast CT
Metabolic acidosis and raised lactate

24
Q

What is the management for acute mesenteric ischaemia?

A

Surgery to:
Remove necrotic bowel
Remove or bypass the thrombus in the blood vessel

Very high mortality still

25
Q

What type of cancer are most pancreatic cancers?

A

Adenocarcinoma, usually in the head

26
Q

How do pancreatic cancers present?

A

Painless obstructive jaundice

Also:
Non-specific upper abdo or back pain
Unintentional weight loss
Palpable mass in the epigastric region
Change in bowel habit
Nausea or vomiting
New-onset diabetes or worsening of T2DM

27
Q

What are the guidelines on suspected pancreatic cancer for GPs?

A

Direct access CT abdo if patient has weight loss and any of:
Diarrhoea
Back pain
Abdominal pain
Nausea
Vomiting
Constipation
New-onset diabetes

28
Q

What is Courvoisier’s law?

A

Palpable gallbladder along with jaundice is unlikely to be gallstones - usually cholangiocarcinoma or pancreatic cancer

29
Q

What is Trousseau’s sign of malignancy?

A

Migratory thrombophlebitis (blood vessels become inflames with an associated blood clot reoccurring in different locations over time)
Sign of pancreatic adenocarcinoma

30
Q

What is a tumour marker for pancreatic cancer?

A

CA 19-9
CT TAP
MRCP
ERCP

31
Q

What is the Whipple Procedure?

A

Remove a tumour in the head of pancreas that has not spread. Huge op.
Removes: head of pancreas, pylorus of stomach, duodenum, gallbladder, bile duct, relevant lymph nodes

32
Q

What are the three main causes of pancreatitis?

A

Gallstones
Alcohol
Post-ERCP

33
Q

What does IGETSMASHED stand for?

A

The long list of causes of pancreatitis:
Idiopathic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hyperlipidaemia
ERCP
Drugs (furosemide, thiazide diuretics and azathioprine)

34
Q

How does acute pancreatitis typically present?

A

Acute onset of:
Severe epigastric pain
Radiating through to back
Vomiting
Associated tenderness
Systemically unwell

35
Q

What are the investigations for acute pancreatitis?

A

FBC
U&E
LFT
Calcium
ABG
Amylase (raised x3)
Lipase (sensitive and specific)
CRP
USS
CT abdo

36
Q

What does the Glasgow score assess?

A

The severity of pancreatitis
0 or 1 - mild
2 - moderate
3 or more - severe

37
Q

What are the criteria for the Glasgow score?

A

PANCREAS
PaO2 <8KPa
Age >55
Neutrophils (WBC >15)
Calcium <2
uRea >16
Enzymes (LDH >600 or AST/ALT >200)
Albumin <32
Sugar (Glucose >10)

38
Q

Management of acute pancreatitis?

A

ICU or HDU
Initial resuscitation
IV fluids
Nil by mouth
Analgesia
Careful monitoring
Treatment of gallstones
Antibiotics if infection
Treatment of complications

39
Q

What are complications of acute pancreatitis?

A

Necrosis of the pancreas
Infection in a necrotic area
Abscess formation
Acute peripancreatic fluid collections
Pseudocysts (can develop 4 weeks after)
Chronic pancreatitis

40
Q

What is the most common cause of chronic pancreatitis?

A

Alcohol

41
Q

What are the complications of chronic pancreatitis?

A

Chronic epigastric pain
Loss of exocrine and endocrine function
Damage and strictures to the duct system, obstructing excretion of pancreatic juice and bile
Formation of pseudocysts or abscesses

42
Q

What is the management of chronic pancreatitis?

A

No alcohol or smoking
Analgesia
Replacement pancreatic enzymes (Creon)
Subcutaneous insulin regimes
ERCP with stenting
Surgery

Finals Revision (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions