Current treatments for axillary hyperhidrosis
Regarding primary hyperhidrosis:
• It affects approximately 1% of the population TRUE
• The isolated palmar variant is commoner than isolated axillary hyperhidrosis FALSE
• Over-production of sweat occurs at the apocrine sweat glands in the axillae FALSE
• Acetylcholine is the principal terminal neurotransmitter TRUE
• Excessive parasympathetic stimulation is the cause FALSE
Regarding the treatment of primary hyperhidrosis:
• Systemic anticholinergics are effective and cause few side effects FALSE
• Topical aluminium chloride is effective in the majority of cases of axillary hyperhidrosis TRUE
• Treatment with intradermal botulinum toxin offers a permanent solution FALSE
• Intradermal botulinum toxin is as effective as sympathectomy for axillary hyperhidrosis TRUE
• Surgical sympathectomy remains the gold standard in palmar hyperhidrosis TRUE
How much do healthcare professionals know about informed consent? A Bristol experience
A “Gillick-competent” child aged 12:
• is defined as a child who has sufficient intelligence to understand the potential complications of a treatment FALSE
• cannot have their consent to treatment overidden by a parent TRUE
• can have elective surgery against their own will if the parents want it TRUE
• should only be operated on in an emergency situation with parental consent FALSE
• cannot be operated on without a signed consent form FALSE
Regarding the law on Jehovah’s Witnesses and blood transfusion:
• If the relative of an unconscious adult produces evidence of a patient’s belief and wish not to receive blood, then it must not be given by law TRUE
• A surgeon may not give a transfusion to a child of Jehovah’s Witnesses in an emergency if the parents do not consent FALSE
• If a Jehovah’s Witness adult makes an informed decision not to receive blood, this must be adhered to TRUE
• If an adult who is not a Jehovah’s Witness makes an informed decision to refuse a blood transfusion, then this does not have to be acted upon FALSE
• An adult Jehovah’s Witness may make an advanced statement stating their intent not to receive blood in an emergency in the event that they are unable to communicate. This statement must be honoured TRUE
Daflon for haemorrhoids: A prospective multi-centre observational study
Daflon:
• Is a flavonoid vasoprotector and phlebotrophic agent TRUE
• Cannot be used safely during pregnancy FALSE
• Interacts with anticoagulants such as warfarin FALSE
• Alleviates most haemorrhoidal symptoms TRUE
Treatment options for haemorrhoids include:
• Injection sclerotherapy with adrenaline FALSE
• Rubber band ligation TRUE
• Daflon TRUE
• Stapled haemorrhoidectomy TRUE
A simple technique to control iatrogenic solid organ injury haemorrhage
Which of the following statements are true regarding iatrogenic splenic injury:
• The only mechanism of injury is traction FALSE
• Rarely occurs other than with left colon surgery FALSE
• Always needs a splenectomy FALSE
• Splenic preservation is possible in most of the cases TRUE
• Splenic auto-transplantation is recommended in all cases FALSE
Which of the following statements are false regarding splenic injury haemostasis:
• High intensity focused ultrasound (HIFU) has been used to control splenic injury bleeding TRUE
• Topical application of fibrin glue can be used to achieve haemostsis TRUE
• Splenic wrapping with polyglactin mesh can be used to repair and control splenic injury haemorrhage TRUE
• Simple diathermy is adequate most of the time to control minor bleeding TRUE
• Haemostatic agents to control splenic injury haemorrhage are difficult to use and devoid of any complications FALSE