General Surgery UK Medical PG Flashcards - Medical Study Cards
Master General Surgery with OnCourse flashcards. These spaced repetition flashcards are designed for medical students preparing for NEET PG, USMLE Step 1, USMLE Step 2, MBBS exams, and other medical licensing examinations.
General Surgery Flashcard Deck - 10 Cards
Flashcard 411: The reversal agent of low molecular weight heparin is _____
Answer: IV protamine sulfate
Extra: Note: Protamine sulfate completely neutralizes Unfractionated Heparin (UFH) but only partially neutralizes (approx. 60-80%) the anti-Xa activity of Low Molecular Weight Heparin (LMWH).
Flashcard 412: If aspirin must be stopped for surgery, it should be stopped _____ prior
Answer: 7 days
Flashcard 413: Clopidogrel works by inhibiting _____ which stops platelet activation and aggregation
Answer: ADP binding to P2Y12 receptor
Flashcard 414: Patients taking DOACs undergoing surgery with a high-risk of bleeding should stop taking the DOAC _____ prior to surgery.
Answer: 48 hours
Extra: For DOACs (Apixaban, Rivaroxaban, Edoxaban, Dabigatran):
- Low bleed risk surgery: Stop 24 hours before.
- High bleed risk surgery: Stop 48 hours before.
- Note: Dabigatran may require longer cessation (up to 96 hours) if CrCl < 50 mL/min.
- Warfarin usually requires 5 days cessation. DOACs have much shorter half-lives.
Flashcard 415: Prasugrel works by _____ which stops platelet activation and aggregation
Answer: irreversibly blocking the P2Y12 ADP receptor
Flashcard 416: Unfractionated heparin should be stopped _____ prior to surgery
Answer: 6 hours
Flashcard 417:
DOACs can be restarted _____ after surgery
Answer: 12-24 hours
Extra: For procedures with low bleeding risk, DOACs are typically restarted 24 hours post-operatively. For high bleeding risk procedures, consider delaying 48-72 hours.
Flashcard 418: If ticagrelor must be stopped for surgery, it should be stopped _____ prior
Answer: 5 days
Flashcard 419: Antiplatelet medication (e.g., Aspirin) should be continued through surgery if there is a high _____ risk (e.g., recent coronary stent).
Contrastingly, anticoagulants (e.g., Warfarin) are the medications typically temporarily replaced by heparin bridging.
Answer: thrombosis
Extra: In surgical patients, Aspirin is often continued if the risk of a major adverse cardiac event (MACE) outweighs the risk of surgical bleeding. True 'bridging' with heparin is indicated for patients on long-term anticoagulation (Warfarin) with a high risk of thromboembolism (e.g., mechanical heart valves, high-risk AF).
Flashcard 420: Ticagrelor works by _____ which stops platelet activation and aggregation
Answer: reversibly blocking the P2Y12 ADP receptor
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