Surgery Flashcards
(33 cards)
Causes of generalised abdo pain
- Peritonitis
- Ruptured AAA
- Bowel obstruction
- Ischaemic colitis
Causes of right upper quadrant pain
- Biliary colic
- Acute cholecystitis
- Acute cholangitis
- Right lower lobe pneumonia
Causes of epigastric pain
- Acute gastritis
- Peptic ulcer disease
- Pancreatitis
- Ruptured AAA
Causes of central abdo pain
- Ruptured AAA
- Bowel obstruction
- Ischaemic colitis
- Early appendicitis
Causes of right iliac fossa pain
- Acute appendicitis
- Ectopic pregnancy
- Ruptured ovarian cyst
- Ovarian torsion
- Meckel’s diverticulitis
Causes of left iliac fossa pain
- Diverticulitis
- Ectopic pregnancy
- Ruptured ovarian cyst
- Ovarian torsion
Causes of suprapubic pain
- LUT infection
- Acute urinary retention
- Pelvic inflammatory disease (PID)
- Prostatitis
Loin to groin pain causes?
- Renal colic/kidney stones
- Ruptured AAA
- Pyelonephritis
Causes of testicular pain
- Tensticular torsion
- Epididymo-orchitis
Signs of peritonitis
- Guarding- involuntary tensing of abdo muscles when palpated
- Rigidity- involuntary tensing of abdo muscles
- Rebound tenderness- rapidly releasing pressure causes more pain than the pressure
- Coughing test- pain worse when coughing
- Percussion tenderness- pain when percussing abdomen
What is the name of the anatomical point specific to Acute appendicitis
And where is this point?
McBurney’s point.
One third of the distance from the anterior inferior iliac spine to the umbilicus
What is Rovsings sign, when is it positive
Palpation in the left iliac fossa causes pain in RIF
Indicative of acute appendicitis
Acute abdomen differentials?
Ectopic pregnancy
Acute appendicitis
Ovarian cysts, torsion or rupture?
Meckels diverticulum
Mesenteric adenitis
Features of critical limb ischaemia?
6 P’s
Pain, Pallor, Pulseless, Paralysis, Paraesthesia, perishingly cold
What is intermittent claudication?
Peripheral artery disease presents with it.
Pain occurs when walking. Goes when stopping. Often in calfs, can be thighs and buttocks
What is Leriche syndrome?
Occlusion of the distal aorta or proximal common iliac artery
Triad of:
Thigh/buttock claudication
Absent femoral pulses
Male impotence
What test is used to test for peripheral artery disease?
Beurger’s test
1st part. Lie patient on back, hold leg at 45* for 2mins. Pallor suggests poor arterial supply. Beurgers angle is the angle where the leg goes pale.
2nd part. Sitting up w legs over side, blood should flow back in. Healthy- should go pink
In PAD- blue initially as ischaemic tissue deoxygenates blood, then dark red due to vasodilation responding to anaerobic resp
Differentiating between arterial and venous ulcers?
Arterial- more painful, smaller but deeper, ‘punched out’ lesion
Veinous- often after injury, larger but superficial, irregular, often mid calf to ankle
Management of critical limb ischaemia?
Endovascular angioplasty and stenting
Endartectomy- open artery and remove plaque
Bypass surgery
Amputation
What vein is often used for a CABG?
Saphenous vein from medial calf
Whats the gaiter area?
The area between the mid calf and ankle that’s most prone to getting venous ulcers
What test is used to diagnose peripheral arterial disease?
Beurger’s test
What is used to assess the severity of peripheral artery disease?
Ankle brachial pressure index (ABPI)
What medications are used for secondary prevention in peripheral arterial disease?
Atorvatatin 80mg
Clopidogrel 75mg
