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Flashcards in General Surgery Deck (28)
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1

List potential complications of laparotomy

Wound breakdown
Wound dehiscence
Infection
Haematoma
Smoking leads to poor healing

2

List potential complications of biliary surgery

Fistula
Cholangitis
Bleeding
Jaundice
Peritonitis

3

List potential complications of arterial surgery

Bleeding
Thrombosis
Embolism
Graft infection
Fistula
Ischaemia

4

List potential complications of colon surgery

Sepsis
Ileus
Fistula
Anastomotic leak
Haemorrhage

5

List potential complications of small bowel surgery

Short gut syndrome (less than 250 cm)
Malabsorption (ADEK, B12, bile salts)

6

List potential complications of total parenteral nutrition

Sepsis (Staph, Candida, Pseudomonas)
Thrombosis
Metabolic disturbance
Refeeding syndrome (hypophosphatemia)

7

List conditions typically presenting as an acute abdomen in the RUQ

Ruptured spleen/colon
Gastric ulcer
AAA
Pyelonephritis

8

List conditions typically presenting as an acute abdomen in the epigastrum

Pancreatitis
Peptic ulcer perforation

9

List conditions typically presenting as an acute abdomen in the LUQ

Cholecystitis
Duodenal ulcer perforation
Hepatitis
Pyelonephritis

10

List conditions typically presenting as an acute abdomen in the RLQ

Appendicitis
Salpingitis
Ruptured ectopic pregnancy
Strangulated hernia
Psoas abscess

11

List conditions typically presenting as an acute abdomen in the LLQ

Divericulitis
Abscess
Ruptured ectopic pregnancy
Strangulated hernia
Perforated colon
IBD
Renal stones

12

What investigations would you generally do for an acute abdomen?

FBC, U+E, amylase, LFT, CRP, ABG
Urinalysis
Erect CXR, AXR
Laparoscopy
USS

13

Outline general management of an acute abdomen

Treat shock
Crossmatch/G+S blood
Antibiotics (amox met gent)
Pain relief
IV fluids

14

List clinical features of colorectal carcinoma

Can depend on site
Left: PR bleed, altered bowels, obstructive symptoms, tenesmus, PR mass
Right: weight loss, low Hb, abdo pain

15

What investigations would you do for colorectal carcinoma?

FBC
FOB test screening every 2 years
Sigmoidoscopy/colonoscopy
CEA monitoring

16

Outline management of colorectal carcinoma

Hemicolectomy
Anterior resection if low sigmoid/high rectal
AP resection if low rectal
Hartmann's procedure in emergency
Radio/chemotherapy adjuvant

17

What is a hydrocele?

Fluid in tunica vaginalisis surrounding testes, usually due to patent processus vaginalis

18

Visceral pain from foregut organs is usually perceived where?

Epigastrium

19

Visceral pain from midgut organs is usually perceived where?

Periumbilical region/centre of abdomen

20

Visceral pain from hindgut organs is usually perceived where?

Suprapubic region

21

What are the two main types of hiatus hernia?

Sliding
Paraoesophageal/rolling

22

What is a sliding hiatus hernia?

Gastro-oesophageal junction slides upwards into chest

23

List aetiology/risk factors for sliding hiatus hernia

Obesity
Ageing
Ineffective lower oes sphincter

24

List clinical features of sliding hiatus hernia

Heartburn
Waterbrash
Regurgitation
Worst at night
Reflux

25

What investigations would you do for hiatus hernia?

Barium swallow
Endoscopy + biopsy to query Barrett's
Oesophageal function tests (manometry, pH)
CXR

26

Outline management of hiatus hernia

Antacids, PPI
Lifestyle - stop smoking, reduce alcohol
Surgery to strengthen sphincter/repair hiatus defect

27

What is a paraoesophageal hiatus hernia?

All or part of stomach herniates through oesophageal hiatus
Gastro-oesophageal junction remains in position

28

List clinical features of paraoesophageal hiatus hernia

Asymptomatic
Obstructive symptoms
Distention