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Surgery passmed points Flashcards

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1
Q

what type of cancer is assoc with barretts oesophagus

A

adenocarcinoma

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2
Q

what is the MOA of anastrozole

A

aromatase inhibitor
- same as letrozole
- give to post menop women with breast cancer

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3
Q

how to treat local anaesthetic toxicity?

A

IV 20% lipid emulsion

  • occurs if too much LA gets into venous system
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4
Q

signs and symptoms of ductal ectasia?

A

benign
symmetrical slit like contraction of nipple
cheese like discharge

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5
Q

best treatment for stones caused by high calcium?

A

thiazide like diuretics

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6
Q

management plan for women with breast cancer but no palpable axillary lymphadenopathy?

A

pre-op axillary US before primary surgery and if negative = sentinel LN biopsy to assess nodal burden

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7
Q

management plan for women with breast cancer and palpable axillary lymphadenopathy?

A

axillary LN clearance is indicated at primary surgery

can cause arm lymphoedmea and functional arm impairment

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8
Q

complication of patients on long term mechanical ventilation?

A

Tracheosophageal fistula
-> due to increased pressure of tracheosomy or prolonged intubation

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9
Q

complications of a TOF in pts with long term mechanical ventilation

A

aspiration pneumonia
air leak
cough

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10
Q

what type of cancer is comedo necrosis associated with?

A

breast -> ductal carcinoma in situ

this has high rate of progression to invasive

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11
Q

how long to stop COCP before a surgery

A

4 weeks before

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12
Q

indications for open revascularisation/bypass surgery in PAD?

A

diffuse disease
or stenosis >10cm

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13
Q

what is fibroadenosis?

A

fibrocystic disease, benign mammary dysplasia

Most common in middle-aged women

‘Lumpy’ breasts which may be painful.

Symptoms may worsen prior to menstruation

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14
Q

MC cause of discitis

A

staph aureus

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15
Q

TPN should be administered via

A

central vein -> PICC into subclavian vein

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16
Q

diclofenac nt working for renal stones -> next pain relief is?

A

iv paracetamol

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17
Q

when is time out performed

A

before first skin incision

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18
Q

when is a sign in done

A

before induction of anaesthesia

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19
Q

when is a sign out done

A

before pt leaves operation room

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20
Q

electrolyte abn assoc with SAH

A

hyponatriema

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21
Q

pt has UTI/prostatits, when can i do PSA test

A

after 6 weeks

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22
Q

inheritance pattern of susceptibility of malignant hyperrthermia

A

auto dominant

so if mum has it, you have 50% chance

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23
Q

pt with intracranial bleed that becomes unresponsive, what do you do>

A

CT head -> ?hydrocephalus

if its a rebleed will see that on ct head then can due ateriogram to see where it is but if do that first could miss hydrocephalus

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24
Q

how can a pt clean wounds post surgery

A

up to 48 hours = sterile saline
after 48 hours = shower

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24
isolated fever in post op pt 24 hours after surgery?
physiological systemic inflam reaction
25
factors that point towards organic cause of Ed
Gradual onset of symptoms Lack of tumescence Normal libido
26
critical limb ischaemia vs acute limb threatening
critical limb developes over 2 weeks
27
medications for peripheral AD
clopidogrel and atorvastatin
28
initial mx of acute limb ischaemia
analgesia IV heparin vascular review
29
what is the prognostic test for pancreatitis
blood glucose >10
30
how to investigate bladder wall repair after partial cystectomy
cystogram
31
blockage of which duct does not cause jaundice?
cystic duct as bile still able to flow through cbd to sphincter of oddi
32
thumbprinting on AXR indicates?
ischaemic colitis due to mucosal oedema/haemorrhage
33
irregular testicular lump with normal HCG and AFP?
seminoma teratoma and yolk sac usually have raised levels of these teratomas for troops 20-30 seminomas for sergeants 30-40 sergeants dont leave a mess = normal markers
34
when should a variable rate insulin infusion be set up for surgery
pts on insulin having majory surgery -> more than 1 meal missed poorly controlled DM
35
when is lignocaine not mixed with adrenaline
in minor ops on finger toes penis as no collateral blood flow so necrosis
36
tx for kidney stone <2cm
lithotripsy +/- alpha blocker first if impacted in upper ureter or 10mm-20mm = ureteroscopy (stent left for 4 weeks after procedure)
37
tx for kidney stone >2cm
percutaneous nephrolithotomy
38
indications for thoractomy
>1.5L blood lose initally >200ml lost per hourfor >2hours
39
A pelvic fracture and highly displaced prostate?
membranouse urethral rupture
40
when is femoral A bypass surgery indicated over endovasc revasc
with long segment >10cm
41
imaging to check anastomosis
gastrograffin enema
42
gnrh side effects
causes tumour flare bone pain bladder obstruction
43
side effect of etomidate used for rapid sequence induction
adrenal suppression
44
which stones are ardio-lucent on xray
urate and xanthine
45
how can you tell if there is free air in abdomen from AXR
rigglers sign - double wall sign
46
which anal fissure is a red flag
lateral 3 oclock position
47
strongest rf for anal cancer
HPV infection
48
hydrocephalus px in a child
increased head circumference bulging fontanelle sunsetting of eyes -> impaired upward gaze caused by pressure on tectal plate dilated scalp veins bradycardia seizure coma
49
tx for prostatitis
14 days of ciprofloxacin
50
what nerve is at risk for a carotid endartectomy
hypoglossal
51
when is best to use oropharyngeal airway
bridge until more definitive airway
52
when is a laryngeal mask good and bad to use
good: easy to use, no paralysis needed, day surgery bad: poor control of gastric reflux, cant use for high pressure ventilation
53
when is a tracheostomy usefu;
used in slow weaning in ITU
54
when is endotracheal tube useful
optimal control of airway paralysis needed capnogaphy to check if oesophageal intubation
55
classic finding o/e of patient with pulseless peripheries
takayasus arteritis young asian females mx with steroids
56
subclavian steal syndrome presents as
caused by prox stenosis causing retrograde flow through vertebral or internal thoracic A synocopal duplex scan
57
examination findings in co arc of aorta
rib notching systolic murmur difference in BP between arms and legs
58
prevention medication for calcium stones
potassium citrate
59
what bmi should be considered for immediate referral for bariatric surgery
>50
60
if a pt is symptomatic with RCC what is the most likely stage
stage 4
61
62
what nerve is involved in cremasteric reflex
afferent/sensory = femoral branch of genitofem efferent/motor = genital branch of GF nevre
63
which anaesthetic agent is hepatotoxic
halothane
64
which form of testicular cancer has a better prognosis? seminoma vs teratoma
seminoma
65
in a pt with superficial thrombophelbitis, who requires an urgent scan
if it affects the proximal long saphenous vein >5cm of STB have greater risk of DVT
66
complications of total parenteral nutrition
sepsis thrombophlebitis hepatic dysfunction -> derranged LFT that would suggest obstructive jaundice this is due to paraenteral feeding not causing CCK to be released so you get stasis of gallbladder
67
signs of subcutaneous emphysema on cxr
will be able to see pec major striations
68
acute anal fissure treatment <1 week
soften stool fibre topical lidocaine topical diltiazem or GTN is only started if it persists for 1 week+
69
consequences of SAH
HD tv? Remember VHS tapes Hydrocephalus Death Re-bleed -> within 12 hours Vasospasm -> 7-14 days hyponatriema -> SIADH seziures
70
partial vs radical nephrectomy in RCC
T1<7cm can be considered for partial
71
serum lipase vs serum amylase in diagnosis of acute appendicitis
lipase is more specific and sensitive to amylase lipase is more expensive test
72
types of enteral feeding
NG tibe peg/RIG -> long term >4 weeks jejunosotomy

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