Term
| difference between mid inguinal point and midpoint of inguinal ligament |
|
Definition
mid inguinal point is between ASIS and pubic symphysis: where femoral artery crosses into lower limb
midpoint of the inguinal ligament is between ASIS and pubic tubercle where the deep ring of the inguinal hernia is found |
|
|
Term
| contents of inguinal canal in males and females? |
|
Definition
males: spermatic cord and illioinguinal nerve
females: round ligament and illioinguinal nerve |
|
|
Term
| femoral artery is found at which point? |
|
Definition
| mid inguinal pint between ASIS and PS |
|
|
Term
deep ring is found where?
superficial ring found where? |
|
Definition
deep ring at midpoint of inguinal ligament between PT and ASIS
superficial ring: superior and medial to PT |
|
|
Term
| what kind of hernia can result from failure of the closure of processes vaginals? |
|
Definition
|
|
Term
| which type of hernia can be controlled by applying pressure over the deep inguinal ring? |
|
Definition
|
|
Term
which hernia occurs below and lateral to pubic tubercle?
which hernia occurs above and medial to pubic tubercle? |
|
Definition
femoral: below and lateral to PT
inguinal: above and medial to PT |
|
|
Term
| where would you find a psoas absess in relation to the femoral artery? |
|
Definition
| lateral to the femoral artery |
|
|
Term
| there is a hard swelling lateral to the femoral artery and panful when pressed. it is not a psoas absess, what are you thinking? |
|
Definition
|
|
Term
| at mid inguinal point you will find the femoral artery which canal does it come out of? obturator canal |
|
Definition
|
|
Term
| causes of chronic liver disease? |
|
Definition
alcohol
NFALD
viral hepatitis
AI hepatitis
metabolic: heamachormatosis |
|
|
Term
| in cirrhosis the liver is not often palpable because it shrink. what is a common finding? |
|
Definition
|
|
Term
| long term management of liver disease? |
|
Definition
treat the cause if possible
nutrition and avoid alcohol
6 month afp
USS for thrombus, reversed portal flow
endoscopy for varices
rx/prevent complication
varices: banding/propanalol
ascites: spirinolactone, low salt, fluid
encephalopathy: lactulose
coagulopathy: vitamin K |
|
|
Term
|
Definition
Bloods: FBC, UE, LFTs, coagulation for liver synthetic fx
USS liver
ascitic tap if ascites is present
CXR: pleural effusion |
|
|
Term
| complications of liver disease |
|
Definition
decompensated liver failure
hepatorenal disease: AKI that isn't responsive to fluids
SPB |
|
|
Term
|
Definition
malignancy: primary or secondary
hepatic congestion: RHF
heamatological
infection: hepaitis |
|
|
Term
|
Definition
infiltration: leukaemia, lymphoma, myeloproliferative
increased function: extravascular hemolysis, extra medullary heamopoiesis, response to infection
vascular congestion: cirrhosis, splenic vein and hepatic vein obstruction |
|
|
Term
| causes of massive splenomegaly? |
|
Definition
|
|
Term
| causes of hepatosplenomegaly? |
|
Definition
chronic liver disease with portal HTN
heamatomlogical: lymohoma, leukimia, myeloproliferative
infections: EBV/CMV, malaria, viral hepatitis
infiltration: amyloidosis, sarcoidosis |
|
|
Term
| causes for renal transplant? |
|
Definition
|
|
Term
| what to look for in renal transplant patient? |
|
Definition
flank masses (PCKD)
hearing aid (Alports)
collapsed nasal bridge (Wegeners)
previous RRT
AV fistula
immunosupression side effects e.g. tremor from calcineurin inhibitor |
|
|
Term
| 2 I 2 Bs 2 Cs of hepatomegaly |
|
Definition
infection: viral hepatitis, EBV, malaria
infiltration: sarcoid amyloid, fatty liver
blood related: lymphoma, leukaemia, myeloproliferative disorders
biliary: PBC, PSC
cancer: primary or mets
congestion: RHF, tricuspid regurg |
|
|
Term
| causes of hepatosplenomegaly |
|
Definition
lymphoma
leukimia
heamolytic anemias
malaria
EBV
viral hepatitis |
|
|
Term
|
Definition
cancer
active infection
hepatic disease
cardiac or pulmonary insufficiency |
|
|
Term
liver edge characteristics
smooth
knobbly
pulsatile |
|
Definition
smooth: congestion, fatty infiltrartion
knobbly: cancer
pulsatile: tricuspid regurg
bruit: TIPPS
AV malformation |
|
|
Term
| what to do with renal vein an artery in renal transplant? |
|
Definition
renal vein to external iliac vein
renal artery to external iliac artery |
|
|
Term
| what post op immunosuppression would someone with renal transplant be on? |
|
Definition
steroids
azathioprine
ciclosporin
more suseptible to infection from cmv and also SCC of skin |
|
|
Term
| the most common type of fistula in renal replacement is Cimino fistula. this is made from which vein and artery? |
|
Definition
| radio-cephalic anastamoses |
|
|
Term
| in a fistula you may palpate a thrill, what is this due to? when might it be absent? |
|
Definition
due to turbulent blood flow
absent in thromboses fistulas |
|
|
Term
| complications of renal transplant? |
|
Definition
acute rejection3-6 months
and chronic rejection > 6 months
immunosuppressive complications: CMV, SCC, EBV mediated lymphoproliferative disorder
UTI, kidney disorders |
|
|
Term
| prognosis of kidney transplant |
|
Definition
affected by
cold donor time
type of donor
donor age |
|
|
Term
| stoma inspection: ask pt to cough, why? |
|
Definition
|
|
Term
|
Definition
AP resection of low rectal tumours
Hartmans procedure |
|
|
Term
| what is a proctosigmoidectomy AKA? |
|
Definition
|
|
Term
| Loop colostomy, when are they usually reversed? |
|
Definition
In 6 weeks
done to protect anastamoses of a distal segment of bowel |
|
|
Term
| when are end iliostomys used? |
|
Definition
|
|
Term
| when would urostomy be used? |
|
Definition
cystectomy for bladder cancer
ileal conduit: short segment of ilium removed to act as bladder |
|
|
Term
complications of stoma
FOUL SHITS |
|
Definition
fistula
odour
ulcers of skin
leak
stenosis
hernia
ischemia
terminal ileum loss
sexual problems |
|
|
Term
|
Definition
lots of fluid
small fibre
avoid nuts: cause blockage
avoid: brocoli beans fizzy drinks, flatulence |
|
|
