Medical Mnemonics- Surgery

Theme: Surgery
 
Causes of acute pancreatitis
 
I GET SMASHED:
Idiopathitic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune (PAN)
Scorpion stings
Hyperlipidemia/ Hypercalcemia
ERCP
Drugs (including azathioprine and diuretics)
· Note: 'Get Smashed' is slang in some countries for drinking, and ethanol is an important pancreatitis cause.
· Note: Shortest answer is gallstones for women, and ethanol for men. And scorpian stings for people from Trinidad.
 

Modified Glasgow criteria for predicting severity of pancreatitis
 
PANCREAS:
PaO2 below 8
Age >55
Neutrophils: WCC >15
Calcium below 2
Renal: Urea >16
Enzymes: LDH >600; AST >200
Albumin below 32
Sugar: Glucose >10 (unless diabetic patient
 
Treatment for Pancreatitis:
 
MACHINES:
Monitor vital signs
Analgesia/ Antibiotics
Calcium gluconate (if deemed necessary)
H2 receptor antagonist
IV access/ IV fluids
Nil by mouth
Empty gastric contents
Surgery if required/ Senior review


Features of Cholangitis


CHOLANGITIS:
Charcot's triad/ Conjugated bilirubin increase
Hepatic abscesses/ Hepatic (intra/extra) bile ducts/ HLA B8, DR3
Obstruction
Leukocytosis
Alkaline phosphatase increase
Neoplasms
Gallstones
Inflammatory bowel disease (ulcerative colitis)
Transaminase increase
Infection
Sclerosing
 
Appendicitis: Alvarado's scoring system for diagnosis
 
MANTRELS:
Migratory pain (1)
Anorexia (1)
Nausea (1)
Tenderness (2)
Rebound tenderness (1)
Elevated temperature (1)
Leucocytosis (2)
Shift to left (1)


* score 3-4 = no appendicitis. Score 5-6 = doubtful. Score 7 or more = appendicitis is confirmed.


Indication for TPN


"MISIPPI Burning":
Major visceral injury
IBD
Sepsis
Ileus
Post-op
Paralysis
Intestinal fistula
Burns
 
Type of ulcers (by looking at the edge)
 
F PURE:
Flat (eg venous)
Punched-out (eg trophic, arterial)
Undetermined (eg pressure, TB)
Rolled (eg BCC)
Everted (eg SCC
 
Causes of post- operative fever 
 
Six W's:
Wind: pulmonary system is primary source of fever first 48 hours, may have pneumonia
Wound: infection at surgical site
Water: check IV for phlebitis
Walk: deep venous thrombosis, due to pelvic pooling or restricted mobility related to pain and fatigue
Whiz: urinary tract infection if urinary catheterization
Wonder drugs: drug-induced fever
 
Ulcerative Colitis: Definition of a severe attack
 
A STATE:
Anemia less than 10g/dl
Stool frequency greater than 6 stools/day with blood
Temperature greater than 37.5
Albumin less than 30g/L
Tachycardia greater than 90bpm
ESR greater than 30mm/hr


Complications of Ulcerative Colitis
 
"PAST Colitis":
Pyoderma gangrenosum
Ankylosing spondylitis
Sclerosing pericholangitis
Toxic megacolon
Colon carcinom
 
Crohn's disease: Morphology, symptoms
 
CHRISTMAS:
Cobblestones
High temperature
Reduced lumen
Intestinal fistulae
Skip lesions
Transmural (all layers, may ulcerate)
Malabsorption
Abdominal pain
Submucosal fibrosis


Source: http://www.medicalmnemonics.com/