surgical emergencies

Question 1

4 cardinal signs of bowel obstruction

Answer 1

absolute constipation, colicky pain, distention, vomiting

Question 2

Main cause of large bowel obstruction

Answer 2

cancer

Question 3

Signs of large bowel obstruction

Answer 3

Periphery
Haustra dont go across bowel
Dilation (>6cm) + >9cm caecum

Question 4

Main cause of small bowel obstruction

Answer 4

adhesion

Question 5

signs of small bowel obstruction

Answer 5

centre
Valcular conniventes frequent and completely across
Dilation >3cm

Question 6

Treatment of bowel obstruction

Answer 6

Nill by mouth
Drip + suck = IV fluids + NG tube
Analgesia
catheter - urine output if dehydrated
surgery

Question 7

volvulus sign

Answer 7

coffee bean sign

Question 8

treatment of volvulus

Answer 8

stable = sigmoidoscopy + flatus tube
unstable = colectomy (surgery)

Question 9

ischaemic bowel (mesenteric ischaemia) Rx

Answer 9

Atrial fibrillation

Question 10

ischaemic bowel (mesenteric ischaemia) signs

Answer 10

severe abdo pain +- PR bleeding
rapid hypovolaemia causing shock
minimal abdo signs
AF

Question 11

treatment of ischaemic bowel (mesenteric ischaemia)

Answer 11

Nill by mouth
supportive: oxygen, fluids, analgesia
IV antibiotics
correct arrhythmia
remove clot: embelectomy, bypass, bowel resection

Question 12

Appendicitis Rx

Answer 12

anorexic

Question 13

Peritonitis (impending) signs

Answer 13

rebound tenderness
guarding
no bowel sounds