Pancreas DSA Flashcards

1
Q

What kind of cancer is pancreatic head cancer

A

Normally adenocarcinoma and they can invade the bile duct=jaundice

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2
Q

Pancreatic head cancers cause pain how

A

They invade the nerves

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3
Q

What is the best treatment of pancreatic head cancer

A

Whipple procedure, removing head of pancreas, duodenum, and intra-pancreatic bile duct

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4
Q

Whipple procedure is most positive when?

A

When the whole cancer can be excised(ie it hasn’t spread to arteries or lymph nodes

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5
Q

Survival rates

A

With lymph spread-10% at 5 yrs

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6
Q

Inguinal hernias

A

Happen more in males and if the processus vaginalis doesn’t obliterate in development there will be a patent hernia

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7
Q

What forms the inguinal ligament

A

The external oblique as it passes under the superficial inguinal canal

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8
Q

What forms the cremaster muscle

A

The internal oblique

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9
Q

Transversalis fascia forms what

A

The back of the inguinal canal and internal deep ring

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10
Q

Hesselbachs triangle

A

Formed by the lateral rectus sheath, inf epigastric vessels, inguinal ligament
This is where direct hernias go through

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11
Q

Indirect hernias

A

Lateral to the epigastric vessels and follows through the internal and superficial inguinal ring in the the spermatic cord

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12
Q

Hernia repair must be careful of what nerves

A

Iliohypogastric, ilioinguinal, genitofemoral nerves

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13
Q

What is a hernia that is stuck and will not go back even on exam

A

Incarcerated hernia- may lose blood supply die and perforate

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14
Q

What is a hernia with ischemic/necrotic bowel

A

Strangulated hernia- makes it an emergency

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15
Q

Upper gastro bleeds present how and are where

A

Either hematemesis bright red blood, or coffee grounds emesis/stool
Must be proximal to the ligament of treitz ie duodenum

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16
Q

What are causes of upper gastro bleeds

A

Gastric/duodenal ulcers
Esoph/gastr/duodenitis
Portal hypertension(causing esophageal varicies)

17
Q

PUD

A

Pain in the RUQ or epigastric region
H pylori and NSAIDs
Dx via upper endoscopy

18
Q

Treatment of PUD

A

Proton pump inhibitors and H pylori treatment

Or stop NSAIDs

19
Q

Complications of PUD

A

Either perforations on the anterior duodenum

Or erosion into the the gastroduodenal artery causing UGI hemorrhage

20
Q

Portal HTN

A

Can present with Caput Medusae, hemorrhoids or esophageal varicies

21
Q

Porto-systemic collateralization

A

4 areas
Esoph-azygous
Periumbilical and superficial epigastric (caput medusae)
Mid and inferior rectal veins
Bare area of liver or post veins in retro-peritoneal viscera