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General Surgery > PassMed > Flashcards

PassMed Flashcards

1
Q

most likely explanation for ongoing pain + jaundice after cholecystectomy?

A

Gallstones in the common bile duct

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2
Q

Most common type of colorectal cancer?

A

adenocarcinoma

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3
Q

Caecol volvulus is associated with…
Toxic megacolon is associated with…

A

1) previous surgery, Crohn’s
2) UC

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4
Q

T or F, amylase level correlates with severity of pancreatitis?

A

False

though calcium does!

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5
Q

Compare an end vs loop stoma?

A

Loop can be reversed

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6
Q

What type of bowel surgery is indicated if there is a malignancy in the ascending colon?

A

Loop ileostomy

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7
Q

What bowel resection in a splenic fixture or descending colon cancer?

A

Left hemicolectomy

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8
Q

hyper vs hypo kalemia on ECG

A

hyper –> peaked T waves, wide QRS
hypo –> prominent U waves

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9
Q

Airway management in followin scenarios:
1) long-term weaning in ICU
2) inguinal repair, day case
3) laparotomy SBO

A

1) tracheostomy
2) laryngeal mask (don’t need muscle paralysis for this surgery, quick recovery)
3) endotracheal (due to high risk of regurg/vomit)

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10
Q

Diabetic preparing for surgery, well-controlled with sulphonylurea (gliclizide). What to do re: diabetic control for surgery?

A

Withhold morning dose.

If they had poorly controlled diabetes/long as fuck fasting periods, would withhold and change to a variable rate insulin infusion

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11
Q

HER-2 positive biologic treatment

A

Trastuzumab/Herceptin

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12
Q

Biologic in peri-anal Crohn’s disease w/ multiple fistalue?

A

Infliximab

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13
Q

T or F Crohn’s patients are susceptiable to haemorrhoids?

A

No, susceptible to fissures!!!

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14
Q

Steatorrhoea in chronic pancreatitis medical management

A

Pancreatic enzyme supplement to aid with digestion

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15
Q

What tumour location –> right hemicolectomy?

A

Cacum, ascending or hepatic flexure

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16
Q

What surgery for tumour in sigmoid colon?

A

High anterior resection

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17
Q

What are the two types of hitaus hernia?

A

Sliding (95%), the esophagus-stomach junction literally moves up above the diaphragm into thorax

Rolling - a diff part of the stomach goes up

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18
Q

What does time out mean in the WHO checklist?

A

when the patient is anaesthetised before first skin incision, where the team talks about cool secret information

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19
Q

What 7 things need to be checked before preceding with operation on the WHO safety checklist?

A

1) Patient confirms identity, site, procedure and consent
2) Site marked
3) Anaesthesia safety check
4) Pulse oximeter on patient and functioning
5) Known allergies
6) Difficult airway/aspiration risk?
7) Risk of blood loss?

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20
Q

Jaundice but normal liver + cholestatic results…

A

Do a FBC! Could be haemolysis or Giberts syndrome (liver doesn’t process bilirubin)

21
Q

Gold standard for confirming SBO?

A

CT abdomen

XRAY usually first line - shows dilatation and perforation

22
Q

What is rosvings sign?

A

pain felt R) when push on L), indicative of appendicitis

23
Q

Script: severe epigastric pain worse leaning forward, vomiting,

A

pancreatitis

24
Q

T or F: amylase is specific to pancreatitis

A

False, can rise in small bowel obstruction

25
Q

Treatment for low grade gastric MALT lymphoma

A

Eradicate H Pylori

26
Q

How do we eradicate H pylori?

A

Omeprazole, amoxicillin and clarithromycin

27
Q

Critieria for 2 week referral for ?CRC

A

> 40 with weight loss + abdo pain
50 with bleed
60 Fe+ anaemia or change bowel habit

All occult blood tests.

CONSIDER it in other circumstances (e.g. <50 bleed and weight loss)

FIT test if symptoms and don’t reach the criteria

28
Q

Blood features post-splenectomy?

A

Howell-Jolly bodies

inclusions of DNA remants in RBCs usually removed by spleen as ‘quality control’. tiny little dots inside cells.

Not pathological

29
Q

How to treat local anaesthetic toxicity? e.g. accidentally put lignocaine in a vessel

A

20% lipid emulsion

30
Q

How to treat benzo overdose?

A

Flumazenil

competitive antagonist

31
Q

TAC overdose?

A

sodium bicarbonate

32
Q

What is a Hartmann’s procedure, why is it preferred over a hemicolectomy in an emergency?

A

Hartmann’s involves removing bad bowel and forming a stoma, stitch the rectum shut totally. Can be reversed later by stitching them back together.

Better in an emergency due to not needing an anastomosis

33
Q

Where are diverticula most common?

A

Sigmoid colon

34
Q

How does diverticular disease present?

A

change in bowel habit, rectal bleeding, abdo pain.

mimics malignancy! –> colonoscopy

35
Q

What common medication can cause slower fracture healing?

A

NSAIDs

36
Q

Risk factors for pigment gallstones?

A

Cirrhosis, haemolysis (e.g. sickle cell anaemia), biliary stasis

37
Q

What medication must be given before an appendicectomy?

A

Prophylactic antibiotics

38
Q

What does diverticulitis look like on a CT?

A

mural thickening of the colon and presence of pericolon fat stranding

e.g. bleed, low grade fever, pain

39
Q

lifestyle - How to treat diverticular disease?

A

Increase fruit + vege (fibre)!

40
Q

Where does UC begin?

A

the rectum

41
Q

Where is Crohn’s most commonly found?

A

terminal ileum

42
Q

Chronic pancreatitis is associated with ____ and should be monitored _______

A

diabetes!

annual Hba1c

43
Q

What is the general advice around COCP for surgery?

A

Stop taking 4 weeks in advance due to thromboembolism risk

44
Q

Are the following safe for surgery:
1) beta blockers
2) amlodipine
3) levothyroxine

A

Yes all are safe to take on the day of surgery.

45
Q

What is the difference between a strangulated and incarcerated hernia?

A

Incarcerated = cant reduce, but not painful
Strangulated = cant reduce + very painful

46
Q

How to differentiate between acute cholecystitis and ascending cholangitis?

A

Very similar presentation - both have RUQ pain, fever, raised inflammatory markers. HOWEVER, ascending cholangitis more likely to have ABNORMAL LIVER TESTS. - think about the anatomy :)

47
Q

Abdominal pain, bloating and vomiting following bowel surgery?

A

Post op ileus

+ presents with electrolytes

48
Q
A

General Surgery (7 decks)

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