Mnemonics

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Surgeons like systems and rules and frameworks for learning and remembering things. We love to categorise and define and make big concepts simple. Also, KBW has a Big Exam approaching that marks the end of my training so I will be adding to this page extensively for the next 6 months, or longer if i have to resit..

Pancreatitis Glasgow scoring system

PO2<8, A age>55, neutrophils>15, C calcium <2, R renal urea>16, Enzymes LDH>600, AST>200, Albumin <32, Sugar Glucose >10

score 1 for each, severe if greater than or equal to 3

Complications (I am obsessed with complications as you may know) these monsters that haunt my dreams can be classified and thus controlled:

They can be immediate, early or late, they can be local or systemic.  Let’s apply this rule to complications of a right hemicolectomy:

Immediate local: haemorrhage, damage to the right ureter

Immediate systemic: Hypotension causing myocardial ischaemia, anaphylaxis to antibiotics

Early local: anastomotic leak, post-operative haemorrhage, wound infection, ileus

Early systemic: post-operative pneumonia, acute retention of urine, septicaemia

Late local: adhesive obstruction, fistula

Late systemic: recurrence of tumour

Causes of everything can be remembered with the use of a surgical sieve:

There are loads of these to choose from, I like this one.

VITAMIN CDEF

Vascular

Infection and Inflammation

Traumatic and Iatrogenic

Autoimmune

Metabolic

Idiopathic and Iatrogenic

Neoplastic

Congenital

Degenerative

Endocrine and Environmental

Functional

Causes of pancreatitis

GET SMASHED

Gallstones, ethanol, trauma, Steroids, Mumps, Autoimmune, Scorpio bites, Hypothermia/Hyperlipidaemia/Hypercalcaemia, ERCP, Drugs (Azathioprine etc)

Diaphragm: where structures cross
“I ate ten eggs at 12”
I8 10E A12
IVC crosses at T8, oEsophagus T10, Aorta T12.

Umbilical herniae in infants:

3% of Live births have one, only 3 in 1000 need surgery, operate on them aged 3, they recur in the 3rd trimester.

Enterocutaneous Fistula Management

SNAP

Sepsis, nutrition, anatomy, proceed (or prolonged stay- ho ho)

Things that shift the oxygen haemoglobin dissociation curve to the right. “Cadet face right”

C high CO2
A high acid (low pH) and altitude
D high 2,3 DPG
E exercise
T high temperature

Contraindications to renal transplant
CHUMP
CJD
HIV
Untreated infection
Metastatic malignancy
PMHx of high risk malignancy

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