20 cards Flashcards
(18 cards)
Most common causes of acute scrotal pain in adults
Acute epididymitis
Testicular torsion
What does a positive cough impulse on scrotal exam suggest
Inguinal hernia
What does a positive Phren’s sign indicate
Epididymitis
Epididymo-orchitis
What lie does testicular torsion commonly present with?
Horizontal lie
Treatment for epididymo-orchitis if STI origin
Ceftriaxone and azithromycin
Test for epididymitis/ epididymo-orchitis
First pass urine MCS
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Small bowel obstruction
Dilated loops of small bowel
Air fluid levels
Paucity of air in colon
Which parameter do you measure to monitor complications of SBO
Complication you are monitoring for is ischemia, necrosis, perforation
Montior with lactate
Management of small bowel obstruction
Fluid resus
Correction of metabolic abnormalities
Symptom relief - analgesia, antiemetics
If uncomplicated, trial NGT
Advanced age, bloody nipple d/c, immobile, irregular lump, nipple inversion
Breast carcinoma - 75% ductal carcinoma, 15% lobular carcinoma
Bloody nipple d/c, small mass, age 30-50 yo
Intra-ductal papilloma
Assessment/ dx of breast lumps
Triple assessment - clincal examination, imaging- mammography, U/S or both, needle biopsy.
- mammogram - then US used in conjunction for diagnosis
- biopsy required in any clinically suspicious mass irregardless of imaging results
Why might a core biopsy be preferred over fine needle biopsy?
Core biopsy provides sufficient tissue differentiation between invasive and non invasice cancers and sufficient tissue for hormone receptor analysis
Which additional feature of a neck lump that is a ‘thyroid nodule’ would suggest likely malignnayc
Cervical lymphadenopathy
Common physical examination findings of appendicitis
Pain on percussion
Rebound tenderness
Guarding over McBurney’s point - right side abdomen one-third distance from anterior superior iliac spine to the umbilicus
Rovsing’s sign - RLQ pain with palpation of the LLQ
Obturator sign - RLQ pain with internal and external rotation of the flexed right hip
Psoas sign - RLQ pain with extension of the right hip or with flexion of the right hip against resistance
Murphy’s sign
Acute cholecystits
Absoluite contraindications to laparascopy
hemodynamic instability
acute bowel obstruction
increased intracranial pressure
ClinF/ presentation of bladder carcinoma
Painless gross hematuria
Smoking
occupational chemical exposure
