General Surgery — Flashcards

Flashcard 141: Treatment for quinsy?

Answer: IV antibiotics + surgical drainage; tonsillectomy may be considered in 6 weeks

Flashcard 142: How should a patient on warfarin with an INR of 5.0–9.0 and no significant bleeding be managed?

Answer: Omit 1–2 doses of warfarin, monitor INR, and reduce the maintenance dose.

Extra: ACCP Guidelines for Warfarin Reversal: 1. INR < 4.5 (No bleed): Reduce dose or omit one dose. 2. INR 4.5–10 (No bleed): Routine use of Vitamin K is NOT recommended. 3. INR > 10 (No bleed): Give Oral Vitamin K (2.5–5 mg). 4. Major Bleeding (Any INR): Give IV Vitamin K (5–10 mg) and 4-factor Prothrombin Complex Concentrate (PCC).

Flashcard 143: Why is mastoiditis a medical emergency?

Answer: Potential risk of meningitis

Flashcard 144: What do Auricular haematomas warrant?

Answer: Same-day ENT assessment and prompt incision & drainage (I&D) to prevent 'cauliflower ear' deformity.

Flashcard 145: In the management of breast cancer, the FEC-D regimen is used to:

Answer: • Downstage a primary tumor before surgery (neoadjuvant treatment) • Treat systemic microscopic disease if axillary nodes are positive after surgery (adjuvant treatment)

Extra: FEC-D is a chemotherapy regimen commonly used for Breast Cancer. FEC = Fluorouracil, Epirubicin, Cyclophosphamide. D = Docetaxel.

Flashcard 146: Otitis externa with signs of spreading infection may be managed with _____ in combination with topical treatment

Answer: systemic antibiotics (e.g. flucloxacillin)

Flashcard 147: Malignant otitis externa is most commonly caused by _____

Answer: pseudomonas

Flashcard 148: In penicillin-allergic patient, what is a suitable alternative to phenoxymethylpenicillin for a bacterial sore throat?

Answer: • Clarithromycin

Flashcard 149: Following grommet insertion for otitis media with effusion, a _____ must be performed 6 weeks later

Answer: hearing test

Flashcard 150: Examination of the ear in malignant otitis externa may reveal _____

Answer: granulation tissue