Surgery Mnemonics

SURGERY MNEMONICS

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 MANTRES: Migratory pain (1) Anorexia (1) Nausea (1) Tenderness (2) ebound tenderness (1) R ebound Elevated temperature (1) eucocytosis (2) Shift to left (1)  !core "#$ % no appendicitis& !core '# % doubtful& !core  or more % appendicitis is confirmed& Post operative order list c!ec"#$p %A&R : %luids aboratories Activity &ital signs ral allowances R x *medications+ C!ild#P$g! classification ,Pour Another (eer At Eleven,: PAlbumin (ilirubin Ascites Encephalopathy !coring (each is either 1. 2 or " points): - (greater than 12 sec&): 1#" or $# or 0& lbumin: 0"&' or 2&#"&' or less than 2& 3ilirubin: less than 2 or 2#" or 0"& scities: none or slight or moderate 4ncephalopathy: 4ncephalopathy: none or 1#2 (sub5ective) or "#$ (sub5ective)  6nterpretation: 7lass : '# points (candidate for surgical liver resection)& 7lass 3: #8 points (consider chemoemboli9ation or ;)& ;)&

7lass 7: 1<#1' points (consider options in 3 or no therapy)& Hernias of A)dominal *all -hin= of the abdomen as a buc=et. or PAI that contains the viscera& -hese are the four groups of hernias: Pelvic hernias: obturator. perineal. sciatic Anterior hernias: epigastric. incisional. !pigelian. supravesical. umbilical Inguinal hernias: indirect. direct. femoral umbar hernias: inferior lumbar triangle (etit). superior lumbar  triangle (>rynfelt) Hernias: a)dominal +all: pelvic -he end products of  metabolism that are released through the pelvis. are , Pee r Stool,: Perineal hernia  bturator hernia Sciatic hernia Hernias: a)dominal +all: l$m)ar triangles ,+it! eponymsPI.S: Petit a=a Inferior lumbar triangle .rynfelt a=a Superior lumbar triangle TPN indications ,MISIPPI ($rning/: Ma5or visceral in5ury I3? Sepsis Ileus Post#op Paralysis Intestinal fistula ($rns S$rgical disc!arge c!ec"list %A. C0P: ucid Ambulatory . letter sent CV! chec=ed (3. pulse  peration site @A  0rinating @A  Prescription Compartment syndrome: signs and symptoms  ' Bs: Pain Palor  Pulseless Paresethesia Pressure (increased) esop!ageal cancer ris" factors PC (ASTAR1S: Plummer#Vinson syndrome Coeliac disease (arrettBs

Alcohol Smo=ing Tylosis Achalasia R ussia (geographical distribution) 1iet Stricture A)dominal aortic ane$rysm: genetic component  (2 Bs) is sometimes due to a defect in the gene encoding for type III procollagen& 1isease description: organi3ation of ans+er ,In A SurgeonBs .own. Physicians May Ma=e Some Clinical Progress,: Incidence Age Sex .eography Predisposing factors Macroscopic appearance Microscopic appearance S pread Clinical features Prognosis Ing$inal mass: differential ,Hernias &ery Much i=e To Swell,: Hernias (inguinal. femoral) &ascular (femoral aneurysm. sapheno varyx) Muscle (psoas abscess) ymph nodes Testicle (ectopic. undescended) S permatic cord (lipoma. hydrocoele) Haematocele: etiology  "TBs and 2 HBs: Tumor  Torsion Trauma Hydrocele as a complication Haemophilia (blood diseases) A)domen: inspection ' !Bs: Si9e Shape Scars S=in lesions Stoma &aricose veins: symptoms AEI0: Aching Ec9ema

Itching edema 0lceration/ 0gly (C?!. haemosiderin. varicosities) S+ollen leg: $nilateral s+elling ca$ses T& (AI: Trauma &enous (varicose veins. ?V-. venous insufficiency) (a=erBs cyst Allergy Inflammation (cellulitis) ymphoedema 0lcers: edge types % P0RE: %lat (eg venous) Punched#out (eg trophic. arterial) 0ndetermined (eg pressure. -3) R olled (eg 377) Everted (eg !77) Post#operative fever ca$ses !ix DBs: *ind: pulmonary system is primary source of fever first $ hours. may have pneumonia *ound: infection at surgical site *ater: chec= 6V for phlebitis *al=: deep venous thrombosis. due to pelvic pooling or restricted mobility related to pain and fatigue *hi9: urinary tract infection if urinary catheteri9ation *onder drugs: drug#induced fever  Scrot$m: scrot$m s+elling differential THE THEATRES: Torsion Hernia E pididymytis. orchitis Trauma Hydrocoele. varicocele. hematoma Edema A ppendix testes (torsion. hemorrhage) Tumour  R ecurrent leu=emia E pididymal cyst Syphilis. -3 Post#operative complications ,immediate- ,Post#op PR(S,: Pain Primary haemorrhage R eactionary haemorrhage liguria (asal atelectasis Shoc=/ Sepsis

%ist$las: conditions preventing clos$re %ETI1: %oreign body E pitheliali9ation Tumor  Infection 1istal obstruction edema ca$ses: generalised /HIARI IS SA&E/ (Eilary): Heart failure Iatrogenic iver causes Aldosterone increased/ A?E increased R enal cause Inadequate protein in blood (hypoalbuminaemia)  7auses for the inadequate protein in blood are: Inta=e Inadequate (Awashior=or) Secretion fro pancreas decreased (pancreatitis) Synthesis decreased (liver failure) A bsorption decreased (7rohnBs disease) &omit (pyloric stenosis) Excretion increased (nephrotic) edema ca$ses: localised AI&E: Allergic (angio#oedema) ymphatic (elephantiasis) Inflammatory (infection. in5ury) &Enous (?V-. chronic venous insufficiency) .I )leeding: ca$ses A(C1E%.HI : Angiodysplasia (owel cancer  Colitis 1iverticulitis/ 1uodenal ulcer  E pitaxis/ Esophageal (cancer. esophagitis. varices) %istula (anal. aortaenteric) .astric (cancer. ulcer. gastritis) Hemorrhoids Infectious diarrhoea/ I3?/ Ischemic bowel Melanoma sites ,Mel SEA, (ronounced ,Fel 7, from the !pice >irls)  Melanoma sites. in order of frequency: S=in Eyes Anus %ist$las: conditions preventing clos$re %RIEN1: %oreign body R adiation Infection/ Inflammation (7rohn) E pitheliali9ation

Neoplasia 1istal obstruction Appendicectomy: complications *RAP I% HT: *ound infection R espiratory (atelectasis. pneumonia) A bscess (pelvic) Portal pyemia Ileus (paralytic) %ecal fistula Hernia (r& inguinal)  bstruction (intestinal due to adhesions) Thrombus (?V-)