Surgery

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  1. Bleeding in Hemoptysis occur from
    Bronchial artery
  2. External Haemorrhoids
    • Below Dentate line
    • Painful
  3. Internal Haemorrhoids
    • Above Dentate line
    • Painless
    • Treated with Sclerotherapy
  4. Marjolin Ulcer
    When Squamous Ulcer occur in Burn
  5. Rhabdomyosarcoma associated with poorer prognosis
    Extremity
  6. Primary Site of Rhabdomyosarcoma
    Orbit
  7. Mixed Tumor(Pleomorphic Adenoma)
    • Most Common Beningn Salivary tumor
    • Parotid MC site
    • Beningn and Slow Growing
  8. Tumor Occuring in residual breast/ overlying skin following wide local excision
    Angiosarcoma
  9. Reffered Pain in the inner side of thigh seen in
    • Inflammed Pelvic Appendix
    • Inflammed Ovaries
    • Stone in Pelvic Ureter
  10. Charcoat Triad
    • Pain
    • Fever
    • Jaundice
  11. Treatment of Choice for all cases of anal cell ca
    NIGRO REGIMEN Chemoradiotherapy
  12. Dacron Graft
    Synthetic Textile Graft
  13. Hemodialysis Access
    • Most common forearm of non dominant hand
    • Most common upper limb
    • Radiocephalic (Anastomosis between cephalic vein and radial artery)
  14. CEA Increased in
    Adeno Ca Colon, Pancreasm Lung, Breast, Ovary
  15. Preffered Incision for abdominal Exploration in Blunt Injury
    Always Midline incision
  16. Recommended Investigations in individual >40yrs ild who develop hematuria
    • Urine Cytology for malignant cell
    • Cystoscopy Imaging Of Urinary tect with IVP/CT Scan
  17. Most Specific Screening Protocol for Prostate Ca
    Digital Rectal Examination And Serum protein Specific Antigen
  18. Symptoms of Poor urinary Stream, Hesitancy, Incomplete Vodind in Diabetes are consistent with Diagnosis of
    • BPH (Increased Freq of Micturition)
    • Autonomic neuropathy (Decreased frequency of micturition)
  19. Penetrating Injury are those that
    ViolatesPlatysma
  20. Most COmmon histological subtype of thyroid Ca
    • Papillary
    • Near total thyroidectomy with modified neck dissection
  21. Non Absorbable Suture
    • Natural (Silk, Cotton, Linen)
    • Synthetic (Surgical steel, Nylon, Polypropylene)
  22. Absorbable suture
    • Natural (Catgut, Collagen(
    • Synthetic (Polydioxane, Vicryl)
  23. Anterior Medistinum
    Thymoma
  24. Middle Mediastinum
    Bronchogenic Cyst
  25. Posterior Mediastinum
    Neurogenic Cyst
  26. Abbe Flap
    Lip
  27. Flatulent Dyspepsis
    • GB Stone disease
    • Peptic ulcer disease
  28. MC site of colonic volvulus
    • Sigmod
    • MC in psychiatric patient
    • Lower GI endocopy is not contraindicated in volvulus
  29. Hepatocellular Carcinoma
    • Friction Rub/Bruit
    • Ascites may occur
    • Elevated ALP and AFP
    • JAUNDICE IS RARE
  30. AFP
    • Non seminomatous GCT (Yolk sac tumor/Endodermal Sinus tumor, Embryonal Carcinoma, Teratoma)
    • Hepatocellular Ca/Hepatoblastoma: Maxm raised
    • GI Carcinoma e.g: Ca. Colon
    • Ca lung
    • Non Neoplastic Condition (Cirrhosis, Hepatitis, Pregnancy)
  31. Zollinger Ellison Syndrome
    • Gastrin secreting endocrine tumor or Gastrinomas arising from non B cells or gastrin secreting G cells
    • Triad of ZES ( Non B ceell tumor, Gastric acid secretion, Peptic ulceration)
    • Recurrent ulceration refractory to medical therapy
    • Diarrhoea: MC manifestation
    • Gastrin Provocative test (Secretin stimulation, Calcium Infusion, Standard meal Test)
  32. Pseudo pancreatic Cyst
    • MC cause: Pancreatitis
    • Present as an abdominal mass
    • Serum amylase are raised
    • Cystojejunostomy treatment of choice
    • NOTE: PERCUTANEOUS ASPIRATION NOT INDICATED AS IT CAN RESULT IN FISTULA FORMATION AND INTRODUCE INFECTION
  33. Painless gross hematuria
    • Urinary Bladder Ca
    • Renal Cell Carcinoma
  34. Trosseau Sign
    • Migratpry thrombophlebitis with certain disseminated cancer (@PLS)
    • Pancreas, Lung Stomach
  35. Osteoblastic Ovaries
    • Ca. Prostrate/Seminoma
    • Ca. Breast, Ca Ovary/Uterus
    • Combined: Neurogenic Tumors
    • Carcinod Tumors
    • Osteosarcoma
  36. Osteolytic Secondaries
    Ca. Kidney lung breast thyroid
  37. Papillary Ca Thyroid
    • Most Common
    • Not associated with blood borne metastasis, hence prognosis better
    • Usually spread through lymphatics
    • Thyroid Ca. following accidental Irridation in childhood
  38. Follicular carcinoma
    • Spread through lymph nodes is less common
    • Long standing goiter can result in follicular Ca
  39. Basal Cell Carcinoma MC Site/mode of spread
    Face/ Spread by local invasion, Lymphatic spread is not seen
  40. Sliding Hernia/ Hernia En glissade
    • Hernia in which piece of extraperitoneal bowel may side into inguinal canal
    • Contents Lt(Sig. Colon and Mesentry) Right(Caecum)
    • Common in left side so sigmoid coln is common
  41. Distension of Abdomen proximal to bnstruction is mainly by
    Swallowed air
  42. In any trauma of kidney
    IVP should be done urgently to assess function of kidney
  43. Medullary Sponge Kidney
    • Cong. disorder characterized by cystic dilatation of inner medullary and papillary collect
    • Present with Kidney Stone, Rec. Hematuria, Infection(UTI)
    • B/l in most cases
  44. Fecal Continence depends on
    • Intergrity of sphincter mechanism
    • Nerve Supply
    • Maintainence of Anorectal angle
  45. Kehr Sign
    Pain referred to left shoulder seen in splenic rupture
  46. Dietel Crisis
    After an attackof acute renal pain, a swelling in the loin is found. Some hour later, following the passage of urine pain is relieved and swelling dissapears
  47. Saint's triad
    • is a medical condition of concurrence of the following:
    • Cholelithiasis (gallstones)
    • Hiatal hernia
    • Diverticular disease (diverticulosis of colon)
  48. Kocher criteria
    Tool useful in the differentiation of septic arthritis from transient synovitis in the child with a painful hip
  49. Order of Structure to be repaired in injury
    • @BEFAN VS
    • Bone
    • Extensor Tendon
    • Flexor Tendon
    • Artery
    • Nerve
    • Vein
    • Skin
  50. Epidymitis
    • Inflammation of epididymis
    • MC result from secondary urinary infection
    • Swelling, exquistely tender
    • Mimics torsion of testis
  51. Structure removed in Whipples Operation
    • Head of pancreas
    • Distal Common Bilde duct
    • Duodenum
    • Gall Bladder
  52. Whipple Triad
    • Seen in Insulinoma
    • S/S of Hypoglycemia
    • Serem level less than 2.5 mmol/l
    • Prompt relief of symptoms on administration of glucose
  53. Best substitute of oesophagous following oesophagectomy
    Stomach
  54. Meckels Diverticulum
    • Remnant of Vitello-Intestinal Duct situated in ANTImesentric border of small intestine
    • MC rembered as 2% of population, 2 feet (60 cm) from ileocaecal valve, 2 inches(3-5cm) in length
    • All 3 coats of intestinal wall and has its own blood supply
    • Symptoms in order of frequency (Haemorrhage, Intussusception, Diverticulosis, Intestinal Obstruction)
  55. Painful Ulcer
    • Aphthous Ulcer
    • Herpes ulcer
    • Tuberculosis Ulcr
    • Carcinomatous Ulcer: Single, painless
  56. Spontaneous Regression
    • Salmon Patch by 1 year of age
    • Strawberry Hemangioma: by 7-8yrs
  57. Ca Breast
    • MC: Lt side
    • MC site: Left upper quadrant
    • MC histological variant: Ductal Ca
    • Histological Variant with good prognosis even in the presence of axillary mets: Medullary Carcinoma, Intraductal: Good prognosis
  58. Prognostic factor for Ca Breast
    • LN mets: Axillary metastais is the MOST IMPORTANT prognostic factor
    • Tumor Size
    • Histological Subtype
    • Tumor Grade
    • Estrogen and Progesterone Receptor(Tumor estrogen and progesterone receptor positive good prognosis)
    • Proliferation rate
    • DNA Content: Aneuploidy (AbN. DNA) worse
    • Expression of oncogens: Her2/neu, c myc ras poorer prognosis
    • Angiogenesis
  59. Treatment of Ductal Papilloma of Breast
    Microdochectomy
  60. Warthin tumor/Adenolymphoma of Parotid Gland
    • Benign tumor of salivary gland
    • Slow growing at the lower pole of of parotid gland
    • MC salivary gland: Parotid gland
    • Often define as a tumor where diagnosis is established without biopsy by Tc 99 pertechnetate scan
    • All tumor produce a cold spot on Tc 99 pertechnetate scan except adenolymphoma which produce hot spot
    • Treatment: Partial(Superficial) Parotidectomy with conservation of facial nerve
  61. Parotid malignancy spread through Neural Sheath
    Adenoid Cystic Carcinoma
  62. T/t of CSF Rhinorrhoea
    • Early post traumatic Cases: Conservative treatment
    • Persistent Cases: Surgiclly by extracranial or intracranial approach
  63. LN metastasis is higher for
    • Synovial and Epitheloid Carcinoma
    • Clear cell carcinoma
    • ANGIOSARCOMA
    • Rhandomyosarcoma
  64. Malignant Melanoma
    • MC type: Superficial Spreading type
    • Least Common type: Lentingo Malinga type
    • Least malingnant type: Lentingo Malinga type
    • Most malgnant type: Nodular variety, ACRAL LENTIGINOUS TYPE(pooR PROGNOSIS)
    • MC site in male: Lower back
    • MC site in female: Lower leg
  65. Silent/Asymptomatic GB Stone
    Observation
  66. Ca Buccal Mucosa Spread through
    Submandibular LN
  67. All of the fllowingare required for visualisation of GB in an oral cholecystogram
    • Ability to absorb water
    • Functional Hepatocyte
    • Patency of Cystic Duct
  68. Exostrophy of Bladder/Ectopic Vesicae
    • Incomplete development of infraumbilical part of anterior abdominal wall associated with incomplete develpment of anterior wall of bladder owing to delayed rupture of cloacal membrane
    • Since ant.abdominal wall is absent, the posterior bladder wall through the defect
    • In male: Complete Epispiadiasis, B/L Inguinal hernia associated
    • In Female: Clitoris Bifid
  69. Bronchogenic Cyst
    • Usually Unilocular
    • Most frequently located just posterior to the carina or main stream bronchi
    • Cyst lned by respiratory epithelium
    • Frequently get Infected
  70. Peptic Ulcer
    • Solitary lesions usually 4 cm in diameter or less located in the following site in order of frequency
    • Duodenal 1st portion
    • Stomach Usually Antrum
    • Gastroesophageal Junction in setting of GERD
  71. Cushing Ulcer
    • Acute Ulcer of upper GIT associated with intracranial injury or an increase in ICT
    • Ulcers may involve Stomach, Proximal Duodenum, Esophagous
  72. Consquences of Repeated Vomiting
    • D/t process of Vomiting (Pressure rupture of oesophagous, Boerhaeve Syndrome, Linear tear in GE Junction(Mallory Weiss tear))
    • Metabolic (Dehydration, Loss of Gastric content (esp HCL, K) leading to hypocholemia hypokalemia metabolic alkalosis, HCO3 increased d/t compensation)
    • Nutritional: Malnutrition, Dental Caries
    • Aspiration Pneumonitis
  73. Least Irritant of peritoneal cavity
    Blood
  74. Most common/Least Type of Intussusception
    Ileocolic/ Retrograde
  75. Fibrocystic changes
    • Refers to the loose association of cyst formation, breast nodularity, stromal proliferation and epithelial hyperplasaia
    • Exaggerated response of breast stroma and epithelium to a variety of circulating and locally produced hormone
    • No consistent relation between fibrocystic disease and breast ca
    • Common in breast of elderly
  76. Meconium Ileus
    • Neonatal manifestation of cystic fibrosis
    • Fibrocystic disease of pancreas is also a manifestation of cystic fibrosis
    • Hence Meconium ileus is certainly associated with fibrocyctic disease of pancreas
  77. Splenectomy
    • MC organism: Streptococcus Pneumoniae, H. Influenza, N. Meningitidis
    • MC Complication: Pulmonary Complication (Lt. Basal Atelectasis)
    • MC serious Complication: Post splenectomy septicemia
  78. Spleen MC beningn tumor/ Neoplastic enlargement
    Hemangioma/ Lymphoma
  79. Hemobilia
    • Biliary Colic
    • Obstructive jaundice
    • Malena/Occult blood in stool
  80. Superior Mesentry Syndrome/ Wiklie Syndrome
    • Rare Condition characterised by compression od 3rd portion of duodenum by superior mesentry artery as it passes over this portion of duodenum
    • MC seen in Young Asthenic individual with women being more commonly involved
  81. Commonest cause of Lower GI bleeding over 55 yrs
    • Anorcectal Disease ( Haemorrhoids and Fissure)
    • Diverticulosis
    • Angiodysplasia
    • Polyp and Cancer
    • Enterocolitis
  82. Diverticulosis
    • MC site of colonic Diverticuli: Sigmoid Colon (Left Colon)
    • MC site of bleeding Diverticuli: Ascending Colon (Rt. Colon)
    • Ascending colon is supplied by superior mesentric artery. Massive Haemorrhage from colonic Diverticuli is caused by erosion of vessels by a fecolith within diverticular sac
  83. Postcibal Syndrome/Dumping Syndrome
    • Both type of cibial syndrome are treated by dietary measures including
    • Limiting of sugar containing liquid and solid
    • Eimination of liquid at bed time
    • Eating of frequent small meal
    • In severe cases, Symptoms may improve with somatostatin analoque Octreotide
    • NO ROLE OF SURGERY
  84. MC Form of Thyroiditis
    Hashimotos Throiditis
  85. Hypothyroid Condition
    • Riedel condition is usually associated with a constant hypothyroid conditon
    • Hashimotos Thyroiditis most often progress to hypothyroidism. Uncommonly, however it may cause acute destruction of thyroid gland and release store hormones causing feature of throtoxicosis
  86. Partial Thickness graft
    • Include whole of epidermis and part of dermis
    • Leave behind part of dermis in donor site including epidermal appendages such as hair and sweat gland
    • Thinner the graft more will be wound contraction. Hence these grafts are used where minimizing the contracture is not the priority
    • Used to resurface large area such as burn burn wounds
  87. Full thickness grafts
    • Include whole of epidermis and Dermis
    • Donot leave part of appendiges in donor site and must be closed
    • Used when minimizing contracture is the priority along with colore match and texture match
    • For this reason ideal resurfcing small areas like face
  88. Structure preserved in radical neck dissection
    • Carotid arteries
    • Cranial Nerves: VII, X, XII
    • Phrenic Nerve
  89. Structure removed in Radical Neck Dissection
    • Muscle: SCM/ Omohyoid
    • Vein: IJV
    • Nerve: Accessory nerve
    • Gland: Sub mandibular Gland
  90. Structure Preserved in Modified radical neck dissection
    • Carotid Artery
    • IJV
    • Stermomastoid muscle
    • Accessory Nerve
  91. Key features of Ca. oesophagous
    • Squamous Cell Carcinoma: MC, Loacted in upper 2/3rd of oesophagous usually at 1/3rd
    • Adenocarcinoma occur in lower third of oesophagous. Barrets oesophagous (Lower Oesophagous lined by columnar epithlium) predispose to adeno Ca
  92. Hypertrophic Pyloric Stenosis
    • 1st born Male child
    • 3rd and 6th week of life, almost never present at birth
    • MC symptoms: Vomting and occur for hypochloremic alkalosis
    • Metabolic Alkalosis With paradoxical Aciduria
    • Procedure of Choice: Halsted Operation/ Ramstedt operation
  93. Achlasia Cardia T/t modalitiesProcedure of Choice
    • Sublingual Nitroglycerine, Long Acting Nitrates and Calcium Channel Blocker
    • Botulinum Toxin ( High Recurrence)
    • Pneumostatic/ Hydrostatic Reduction
    • Heller Myotomy
  94. Duodenal Ulceration
    • Operation with maximum reduction in acid production: Truncal Vagotomy and Antrectomy
    • Operation with maximum reduction in mortality: Highly Selective Vagotomy
  95. Torsion testis and Epidymo Orchitis
    Elevation ot testis reduces pain in Epididymoorchitis, and makes worse in Torsion Testis
  96. Common tumor of Testis
    • Seminoma (MC): 35-45 yrs
    • Teratoma: 20-35 yrs
    • Combined Seminoma and teratoma
    • Lymphoma
    • Interstitial tumor
  97. MC cause of respiratory distrss following thyroid surgery
    Laryngeal edema 2 to tension hematoma
  98. AV fistula
    • Arterilisation of Vein
    • Enhanced venous return result in increased pulse rate and increased CO and increased CO
    • Increased Pulse pressure
    • Lt ventricular enlargement and cardiac failure may occur
    • Overgrowth of limb
    • Indolent ulcer
    • Pulstile swelling and thrill
    • Nicolandi and Braham Sign (Pressure on artery proxima to fistula cause swelling to diminish, thrill and bruit to ceasem Pulse rate to fallm Pulse pressure return to normal)
  99. Fibrolamellear Ca differs from typical HEepatocellular Ca in that
    • Tends to occur in young adults(Female)
    • Tends to occurs without underlying cirrhosis
    • Non capsulated and well circumscribed
    • Grows slowly and is associated with a longer survival of treatment
    • Prognosis is better
    • No AFP Elevation
  100. Meningocele
    • Present as a cystic swelling which is expansile, transucent, compressible and shows picture of fluctuation test
    • Common Site (Lumbosacral Region, Occipital Region, Roof of nose)
  101. Intestinal Pesudo Obstruction
    Air fluids are unusual
  102. Changes in intrathoracic pressure minimum in
    Mid Expiration (best phase for measurement of intravascular Pressure)
  103. De Querian Throidits
    • Viral in Origin
    • Follows an URTI
    • S.S: Asthenia, Malaise, Pain d/t stretching of capsule
    • High ESR
    • Depressed RAIU
  104. Thyroid Storm
    • Extreme form of thyrotoxicosis may occur with
    • Stressful Illness
    • Thuroid Surgery
    • Radioactive Iodine
    • NOTE: Thyroid storm occur in thyrotoxic patient who has been inadequately prepared for thyroidectomy. Thyroidits maynot be necessarily associated with thyroitoxicosis
  105. Medullary Ca thyroid
    • High Serum Calcitonin
    • Cervical LN discovered at time of presentation
    • Diarrhoea
    • Amyloid
    • MEN Setting
    • T/t: Total Thyroidectomt +resction of Involved LN by Radical/ Modified radical neck dissection
  106. Eythroplakia Va Leukoplakia
    Incidence of malignant changes in Erythroplakia is 17 times more than Leukoplakia
  107. Ideal Age for repair of Hypospadiasis
    6-10 month
  108. Gastric Ca
    • Early gastric Ca:Cancer limited to mucosa and submucosa with/without LN involvement
    • Late Gastric Ca: Involve the muscularis
  109. Risk factor for development of Stomach Ca
    • Long term Ingestion of high conc of Nitrates in dried smoke and Salt food
    • Loss of Gastric acidity (Atrophic gastritis, Partial GAstrectomy, Pernicious Anemia)
    • Infection with H. Pylori
    • Intestinal Metaplasia
    • Gastric Ulcer and Polyp (No ass. of Duodenal Ulcer and Gastric Ca)
    • Mentrier D.s: Ext. Hypertrophy of Gastric rugael folds
    • Blood Group A
    • Cigarrette Smoking
  110. Sentinel LN
    • 1st node to receive lymphatics from site of primary tumor
    • Breast Ca; Axillary LN
  111. Buerger Disease (Thromboangitis Obliterans)
    • Inflammatory reaction in arterial wall of small and medium sized arteries with involvement of neighbouring veins and nerves
    • Typically seen in Young Male Smokers
    • Arterial Involvement: Normal Brachial And Politeal Pulse but diminished or absent radial, ulnar and tibial pulse
    • Migratory Superficial Phlebitis indicating Involvement of adjacent Veins
    • H/O Claudication progressing to rest pain
    • Raynauds phenomenon
  112. Fistula In Ano
    • Interpshincteric:Commonest
    • Goodsalls Rule
  113. Micoradenoma of Anterior Pituitary
    Not dected by neither CT/MRI
  114. Breast Ca Etiology
    • Age
    • Breast Cancer and Syndrome (Li Fraumenni Synd, Cowden Disease, Ataxia Telengiectasia)
    • Chromosomal Abnormalities (Chr. 17, BRCA 1 and BRCA 2)
    • Diet
    • Endocrine (Related to Mestrating period, Lactation Period, OCP, Abortion HRT)
    • Female Sex
    • Geographical White Western Women
  115. Management of Burn Patient
    • First Aid
    • Careful history
    • Hospitalization and admission
    • Ass of depth of Burn: I, II, III (Based on Involved area, Pain, Adnexa, Appearence and Healing)
    • Assessment of Extent of burn interm of BSA: RULE OF NINE
    • ABC
    • Temp, Pulse, BP, RR
    • Urinary Catherization for I/O Charting
    • Ryles tube passes (Curling Ulcer)
    • Replacement of fluid Volumne (Muir and Barclay Formula, Parkland Formula, Modified Brookes Formula)
    • Broad Spectrum Antibiotics
    • Narcotic Analgesia
    • Treatment of Burn Wound (Clean with Antiseptic, Silver Sulfadiazine, 1% Silver Nitrate)

Card Set Information

Author:
drsubashb
ID:
336599
Filename:
Surgery
Updated:
2017-12-11 18:07:50
Tags:
Surgery
Folders:
Surgery
Description:
Surgery
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