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Doctor, Patient and Disease Lectures > Amir sam 4 > Flashcards

Amir sam 4 Flashcards

1
Q

What should you look for in the hands in a patient presenting with an abdominal complaint. (6)

A 
Asterixis (liver flap). 
Bruising. 
Clubbing. 
Dupuytren's contracture. 
Erythema (palmar). 
Leuconychia.
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2
Q

What should you look at in the forearms of a patient presenting with an abdominal complaint.

A

AV fistulae (current or previous renal replacement therapy).

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3
Q

What should you look for in the head and neck of a patient presenting with an abdominal complaint. (6)

A 
Anaemia.
Jaundice. 
Excoriation marks. 
Spider naevi. 
Oral examination: pigmentation, gum hypertrophy.
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4
Q

Right subcostal incision.

A

Kocher’s incision for biliary surgery.

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5
Q

Mercedes-Benz incision.

A

Liver transplant.

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6
Q

Midline laparotomy incision.

A

GI or any major abdominal surgery.

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7
Q

McBurney’s incision.

A

Appendicectomy.

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8
Q

J-shaped/ hockey stick incision.

A

Renal transplant.

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9
Q

Low transverse incision.

A

Gynaecological procedures.

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10
Q

Inguinal incision. (2)

A

Hernia repair.

Vascular access.

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11
Q

Loin incision.

A

Nephrectomy.

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12
Q

What are the causes of hepatomegaly. (5)

A 
Cancer (primary or secondary deposits). 
Cirrhosis (early, usually alcoholic). 
Congestive cardiac failure. 
Constrictive pericarditis. 
Infiltration: fatty infiltration, haemochromatosis, amyloidosis, sarcoidosis, lymphoproliferative diseases.
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13
Q

What are the main causes of liver disease. (5)

A 
Alcohol. 
Autoimmune. 
Drugs. 
Viral. 
Biliary disease.
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14
Q

What are the causes of splenomegaly. (4)

A

Portal hypertension.
Haematological.
Infection.
Inflammation.

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15
Q

What are some causes of epigastric pain. (9)

A 
Peptic ulcer disease. 
GORD. 
Gastritis. 
Malignancy. 
Acute pancreatitis. 
MI. 
Ruptured AAA. 
Cholecystitis. 
Hepatitis.
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16
Q

What are the main features of acute pancreatitis. (2)

A

Pain.

High amylase.

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17
Q

What are the main features of chronic pancreatitis. (5)

A 
Pain. 
Weight loss. 
Loss of exocrine and endocrine function of the pancreas. 
Normal amylase. 
Faecal elastase.
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18
Q

What are some causes for RUQ pain. (10)

A 
Cholecystitis. 
Cholangitis. 
Gallstones. 
Hepatitis. 
Liver abscess. 
Basal pneumonia. 
Appendicitis. 
Peptic ulcer disease. 
Pancreatitis. 
Pyelonephritis.
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19
Q

What are some causes for RIF pain. (8)

A 
Appendicitis. 
Mesenteric adenitis. 
Colitis (IBD). 
Malignancy. 
Ovarian cyst rupture. 
Ovarian torsion.
Ovarian bleed.
Ectopic pregnancy.
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20
Q

What are some causes of suprapubic pain. (2)

A

Cystitis.

Urinary retention.

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21
Q

What are some causes of LIF pain. (7)

A 
Diverticulitis. 
Colitis (IBD). 
Malignancy. 
Ovarian cyst rupture. 
Ovarian torsion. 
Ovarian bleed.
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22
Q

What are some causes of generalized abdominal pain. (10)

A 
Obstruction. 
Peritonitis. 
Gastroenteritis. 
IBD. 
Mesenteric ischaemia. 
DKA. 
Addison's disease. 
Hypercalcaemia. 
Porphyria. 
Lead poisoning.
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23
Q

What structures does the celiac artery supply. (5)

A 
Stomach. 
Spleen. 
Liver. 
Gallbladder. 
Duodenum.
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24
Q

What strutures does the SMA supply. (2)

A

Small intestine.

Right colon.

25
Q

What structures does the IMA supply.

A

Left colon.

26
Q

What structure does the ileomesenteric arcade supply.

A

Rectum.

27
Q

What are the causes of abdominal distention. (5)

A 
Fluid. 
Flatus. 
Fat. 
Faeces. 
Fetus.
28
Q

What are the clinical features of bowel obstruction. (6)

A 
Nausea and vomiting. 
Not opened bowels. 
High pitched tinkling bowel sounds. 
Previous surgery (adhesions?). 
Tender irreducible femoral hernia in the groin?
29
Q

What is the most common cause of bowel obstruction post surgery.

A

Adhesions.

30
Q

What are the two subsets of ascites. (2)

A

Trasudate.

Exudate.

31
Q

What are the causes of ascites caused by transudate. (3)

A

Cirrhosis.
Cardiac failure.
Nephrotic syndrome.

32
Q

What are the causes of ascites caused by exudate. (3)

A

Malignancy (abdominal, pelvic, peritoneal mesothelioma).
Infection (TB, pyogenic).
Budd-Chiari syndrome (hepatic vein thrombosis, portal vein thrombosis).

33
Q

What are the causes of jaundice. (3)

A

Pre-hepatic.
Hepatic.
Post hepatic.

34
Q

What are some pre-hepatic causes of jaundice. (2)

A 
Haemolysis. 
Defective conjugation (eg Gilber's syndrome).
35
Q

What is a hepatic cause of jaundice.

A

Hepatitis (alcohol, autoimmune, drugs, viruses).

36
Q

What is a post hepatic cause of jaundice.

A

Common bile duct obstruction (eg gallstones).
Strictures.
Cancer of the head of the pancreas.

37
Q

What happens to the urine in hepatic and post-hepatic jaundice.

A

It is dark.

38
Q

What occurs the the stools in post-hepatic jaundice.

A

They are pale.

39
Q

What the organisms responsible for infective colitis. (5)

A 
Camplylobacter. 
haemorrhagic E coli. 
Entamoeba histolytica. 
Salmonella. 
Shigella.
40
Q

Who tends to get inflammatory colitis.

A

The young.

41
Q

Who tends to get ischaemic colitis.

A

The elderly.

42
Q

How do you manage an acute GI bleed. (6)

A 
ABC. 
IV access. 
Fluids. 
Group and save, cross match blood. 
OGD. 
Variceal bleed: terlipressin, antibiotics.
43
Q

What investigations should be carried out in an acute abdomen. (9)

A 
FBC. 
UandEs. 
LFTs. 
CRP. 
Clotting screen. 
Group and save. 
Cross match blood. 
Erect CXR. 
CT.
44
Q

How should you manage an acute abdomen. (6)

A 
NMB. 
Fluids. 
Analgesic. 
Anti-emetics. 
Antibodies. 
Monitor vitals and urine output.
45
Q

How should you investigate a patient with jaundice. (2)

A

Bloods: FBC, LFTs, CRP.

Abdominal ultrasound: after a fast (gallstones better visualised in a distended, bile-filled gallbladder).

46
Q

How should you investigate a patient with dysphagia and weight loss.

A

OGD and biopsy.

47
Q

How should you investigate a patient with PR bleeding and weight loss.

A

Colonoscopy.

48
Q

How is ascites treated. (5)

A

Diuretics (spirinolactone and furosemide).
Dietary sodium restriction.
Fluid restriction in patients with hyponataemia.
Monitor weight daily.
Therapeutic paracentesis (with IV human albumin).

49
Q

How is encephalopathy treated. (4)

A 
Lactulose. 
Phosphate enemas. 
Avoid sedation. 
Treat underlying infections. 
(Exclude GI bleed).
50
Q

What are the features of a wound infection following abdominal surgery. (2)

A

Erythematosus.

Discharge.

51
Q

What are the features of an anastomotic leak following abdominal surgery. (5)

A 
Diffuse abdominal tenderness. 
Guarding. 
Rigidity. 
Hypotensive. 
Tahcycardic.
52
Q

What are the features of a pelvic abscess following abdominal surgery (eg appendectomy). (4)

A

Pain.
Fever.
Sweats.
Mucus diarrhoea.

53
Q

What is the presentation of a perianal abcess. (2)

A

Tender, red swelling.

54
Q

How are perianal abscesses treated.

A

Incision and drainage.

55
Q

What are the features of an anal fissure. (2)

A

Rectal pain on defaecation.

Stools coated in blood.

56
Q

What is the treatment for anal fissures. (2)

A

Advice re: diet (fluids and fibre).

GTN cream.

57
Q

What is the typical presentation of IBS. (8)

A

Recurrent abdominal pain.
Bloating.
Pain improves with defecation.
Change in the frequency/form of the stool.
No PR bleeding, anaemia, weight loss or nocturnal symptoms.

58
Q

What must be excluded in a patient presenting with symptoms of IBS.

A

Coeliac.

59
Q

What is the treatment for IBS. (4)

A

Diet and lifestyle modification.
Abdominal pain: antispasmodics.
Laxatives for constipation.
Anti-diarrhoeals.

Doctor, Patient and Disease Lectures (36 decks)

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