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eMRCS questions > Abdomen > Flashcards

Abdomen Flashcards

1
Q

Most likely conditions to cause Cullens

A

Pancreatitis
Ruptured ectopic

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2
Q

Imaging if pregnant lady has abdominal signs

A

CT

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3
Q

What appendicitis can cause negative rovsig sign

A

Retroceacal

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4
Q

Painless massive GI bleed in paeds 1-2 years

A

Merckels Diverticulum

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5
Q

Mesenteric ischaemia vs ischaemic colitis

A

MI- out of proportion to exam findings, bowel emptying (vomiting and diarrhea), and a potential embolic source

IC- bloody bowel movements, abdominal pain, and leukocytosis

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6
Q

Stoma that is swollen and presenting with obstructive symptoms

A

Incisional hernia

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7
Q

What part of GI tract should not show fluid filled level

A

Descending colon

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8
Q

IBS symptoms

A

Improvement with defecation.
Onset associated with a change in the frequency of stool.
Onset associated with a change in the form of the stool.

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9
Q

Blood test for IBD

A

Faecal calprotectin

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10
Q

Ix if blood stained discharge and abdo tenderness

A

Abdo and pelvic USS and pregnancy test

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11
Q

Spigelian hernia

A

hernia lateral to the rectus muscle at the level of the arcuate line

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12
Q

Richters hernia

A

part of the wall of the small bowel (usually the anti mesenteric border) is strangulated within a hernia (of any type)

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13
Q

Bochdalek hernia

A

Of the posterolateral diaphragm

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14
Q

Morgagni Hernia

A

Herniation through foramen of Morgagni- anterior
Usually located on the right and tend to be less symptomatic

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15
Q

Littres hernia

A

Hernia containing Meckels diverticulum

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16
Q

Intusseption sx

A

Screaming
Drawing legs up
The child may pass bloody mucus stool, which is a late sign. Examination of the abdomen is often normal as the sausage mass in the right upper quadrant is difficult to feel.

17
Q

Most commons smooth abdo lump in children

A

Mesenteric cyst

18
Q

commonest cause of acute abdominal pain in acute unselected surgical ‘take’

A

Non specific abdo pain

19
Q

Femoral canal borders

A

Laterally- Femoral vein
Medially - Lacunar ligament
Anteriorly- Inguinal ligament
Posteriorly- Pectineal ligament

20
Q

Pale opalescent liquid from chest drain

A

Damage to the lymphatic duct may occur during this procedure

Occurs in Ivor - Lewis oesophagogastrectomy

21
Q

A 5 year old boy develops a persistent fever following an open appendicectomy for gangrenous appendicitis. On examination, he has erythema of the wound and some abdominal distension. What is the most appropriate course of action?

A

USS

22
Q

Lining of meckel diverticulum

A

Most asymptomatic Meckels diverticulum will be lined by ileal mucosa. Those which present with bleeding are more likely to contain gastric type mucosa.

23
Q

Causes of intusseption

A

CF
Merkels diverticulum
Polyps and inflammation of Peyers patches

24
Q

After surgery, swinging fever and ileus investigation

A

CT with contrast

25
Q

Causes of intrabdominal compartment syndrome and how it presents

A

Obese patients with ileus following major abdominal surgery are at increased risk of intra abdominal compartment syndrome
use of prosthetic meshes

Nasogastric aspirates increase, urine output falls and metabolic acidosis.

26
Q

Blood supply of meckel diverticulum

A

Vitelline

27
Q

Location of meckels diverticulum and epidemeology

A

60cm proximal to ileocaecal valve

2% population and 2 inches long, 2x as common in men

28
Q

Pulsatile lump in groin in Hep C patent

A

False aneurysm
Associated with IVDU

29
Q

Embryonic derivative of meckels diverticulum

A

vitello-intestinal duct.

30
Q

After cholecystectomy drain starts draining 200ml of bile per day- cause and ix?

A

Most likely clip has come loose in big duct
ERCP and allows stent placement

31
Q

Intusseption tx

A

Resuscitation first - fluid and abx

Then fluoroscopic reduction if ileocolic

Ileo-ileal intussusception require laparotomy

32
Q

Why is a chest tube inserted after oesophagestomy

A

As lung is collapsed to access oesophagus

33
Q

Splenic vein thrombosis ix and tx

A

CT angio
Causes gastric varies as shunts to them

Splenectomy

34
Q

Child with facial oedema, abdo pain and fever

A

SBP - after nephrotic syndrome

35
Q

What structure lies under deep inguinal ring

A

Inferior epigastric

36
Q

Embryological origin of diaphragm

A

Septum transversum - Central tendon
Pleuroperitoneal membranes - Parietal membranes surrounding viscera
Cervical somites C3 to C5 - Muscular component of the diaphragm

37
Q
A

eMRCS questions (45 decks)

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