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Thread: surgery mnemonics-1

  1. #1
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    Cool surgery mnemonics-1

    Post-operative fever causes
    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
    Scrotum: scrotum swelling differential
    THE THEATRES:
    Torsion
    Hernia
    Epididymytis, orchitis
    Trauma
    Hydrocoele, varicocele, hematoma
    Edema
    Appendix testes (torsion, hemorrhage)
    Tumour
    Recurrent leukemia
    Epididymal cyst
    Syphilis, TB
    Post-operative complications (immediate)
    "Post-op PROBS":
    Pain
    Primary haemorrhage
    Reactionary haemorrhage
    Oliguria
    Basal atelectasis
    Shock/ Sepsis
    Fistulas: conditions preventing closure
    FETID:
    Foreign body
    Epithelialization
    Tumor
    Infection
    Distal obstruction
    Oedema causes: generalised
    "HILARI IS SAVE" (Hilary):
    Heart failure
    Iatrogenic
    Liver causes
    Aldosterone increased/ ADH increased
    Renal cause
    Inadequate protein in blood (hypoalbuminaemia)
    · Causes for the inadequate protein in blood are:
    Intake Inadequate (Kwashiorkor)
    Secretion fro pancreas decreased (pancreatitis)
    Synthesis decreased (liver failure)
    Absorption decreased (Crohn's disease)
    Vomit (pyloric stenosis)
    Excretion increased (nephrotic)
    Oedema causes: localised
    ALIVE:
    Allergic (angio-oedema)
    Lymphatic (elephantiasis)
    Inflammatory (infection, injury)
    VEnous (DVT, chronic venous insufficiency)
    GI bleeding: causes
    ABCDEFGHI:
    Angiodysplasia
    Bowel cancer
    Colitis
    Diverticulitis/ Duodenal ulcer
    Epitaxis/ Esophageal (cancer, esophagitis, varices)
    Fistula (anal, aortaenteric)
    Gastric (cancer, ulcer, gastritis)
    Hemorrhoids
    Infectious diarrhoea/ IBD/ Ischemic bowel
    Melanoma sites
    "Mel SEA" (Pronounced "Mel C" from the Spice Girls)
    · Melanoma sites, in order of frequency:
    Skin
    Eyes
    Anus
    Fistulas: conditions preventing closure
    FRIEND:
    Foreign body
    Radiation
    Infection/ Inflammation (Crohn)
    Epithelialization
    Neoplasia
    Distal obstruction

    Appendicectomy: complications
    WRAP IF HOT:
    Wound infection
    Respiratory (atelectasis, pneumonia)
    Abscess (pelvic)
    Portal pyemia
    Ileus (paralytic)
    Fecal fistula
    Hernia (r. inguinal)
    Obstruction (intestinal due to adhesions)
    Thrombus (DVT)

    Oesophageal cancer risk factors
    PC BASTARDS:
    Plummer-Vinson syndrome
    Coeliac disease
    Barrett's
    Alcohol
    Smoking
    Tylosis
    Achalasia
    Russia (geographical distribution)
    Diet
    Stricture

    Disease description: organization of answer
    "In A Surgeon's Gown, Physicians May Make Some Clinical Progress":
    Incidence
    Age
    Sex
    Geography
    Predisposing factors
    Macroscopic appearance
    Microscopic appearance
    Spread
    Clinical features
    Prognosis
    Abdomen: inspection
    5 S's:
    Size
    Shape
    Scars
    Skin lesions
    Stoma
    Swollen leg: unilateral swelling causes
    TV BAIL:
    Trauma
    Venous (varicose veins, DVT, venous insufficiency)
    Baker's cyst
    Allergy
    Inflammation (cellulitis)
    Lymphoedema
    Ulcers: edge types
    F PURE:
    Flat (eg venous)
    Punched-out (eg trophic, arterial)
    Undetermined (eg pressure, TB)
    Rolled (eg BCC)
    Everted (eg SCC)
    Pancreatitis: treatment
    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

    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
    .


    Child-Pugh classification
    "Pour Another Beer At Eleven":
    PT
    Albumin
    Bilirubin
    Ascites
    Encephalopathy
    ·Scoring (each is either 1, 2 or 3 points):
    PT (greater than 12 sec.): 1-3 or 4-6 or >6.
    Albumin: >3.5 or 2.8-3.5 or less than 2.8
    Bilirubin: less than 2 or 2-3 or >3.
    Ascities: none or slight or moderate
    Encephalopathy: none or 1-2 (subjective) or 3-4 (subjective)
    · Interpretation:
    Class A: 5-6 points (candidate for surgical liver resection).
    Class B: 7-9 points (consider chemoembolization or RFA).
    Class C: 10-15 points (consider options in B or no therapy).

    TPN indications
    "MISIPPI Burning":
    Major visceral injury
    IBD
    Sepsis
    Ileus
    Post-op
    Paralysis
    Intestinal fistula
    Burns
    Surgical discharge checklist
    FLAG COUP:
    Lucid
    Ambulatory
    GP letter sent
    CVS checked (BP, pulse
    Operation site OK
    Urinating OK
    Prescription
    Alap Christy
    life is an empty bowl

  2. #2
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    nice list alap. just to add to:

    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
    The timing of fever relative to the postoperative day (POD) will indicate the most likely cause. The five W's of postoperative fever - Wind, Water, Walking, Wound and Wonder drugs - as a useful memory tool could help a physician when he is following patients after surgery.[15],[16]

    POD 1-2: Wind: Atelectasis (without air) often cause fever. Reasons include being on a ventilator, inadequate sighs during surgery and (in the general surgery patient) incisional pain on deep breathing. This is treated with incentive spirometry because there is evidence that deep inspiration prevents atelectasis better than just coughing .

    POD 3-5: Water: Urinary tract infections (UTIs) are common here. Foley catheters are sometimes still in place.

    POD 4-6: Walking: Deep venous thrombosis can occur. This is more of a problem in patients undergoing pelvic orthopedic or general surgery than in head and neck surgery. Subcutaneous low dose heparin and venous compression devices reduce the incidence of thromboembolization . Walking the patient on POD1 is the best way to prevent this complication.

    POD 5-7: Wound : Most wound infections occur during this period. Preoperative antibiotics are important to prevent or reduce the risk of infection in head and neck surgery that crosses mucosal linings.

    POD 7+: Wonder drugs : Drugs can cause fevers.(Note that in obstetrics and gynaecology, this W is "womb" and it precedes "Wonder drugs").

  3. #3
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    thanks a lot

  4. #4
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    thanks for document

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