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Junior Posting > Week 5 > Flashcards

Week 5 Flashcards

1
Q

VATER (VACTERL) is an acronym that stands for the affected parts of the body including the ________,_______,________,___________,______,_________,_________

A

vertebrae, anus, cardiac(heart) , trachea, esophagus, kidney and limbs

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2
Q

Fever is associated with ______ and _______

A

Chills and rigor

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3
Q

Is VATER syndrome a hereditary condition?

A

No

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4
Q

Rigor is a sudden feeling of _____ with ______ accompanied by a ___ in temperature, often with copious _______, especially at the onset or height of a ________.

A

cold; shivering

rise; sweating

fever

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5
Q

Full meaning?
P
O
T
T
E
R

A

Pulmonary hypoplasia
Oligohydraminos
Twisted skin
Twisted face
Extremities defect
Renal agenesis

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6
Q

Hydrocalycosis is defined as ________ of a ________ with a demonstrable connection to the renal ______ and an epithelial lining of the cyst wall.

A

cystic dilatation

major calyx

pelvis

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7
Q

A urinoma is a mass formed by ________________________ .

A

encapsulated extravasated urine

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8
Q

urinary ascites typically result from spontaneous _________ with ________ of urine into the _________ compartment

A

bladder rupture; leakage

intraperitoneal

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9
Q

Boundaries of femoral triangle

The borders of the femoral triangle are the ________ superiorly, the _____________ medially, and the __________ laterally.

A

inguinal ligament

adductor longus muscle

sartorius muscle

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10
Q

Contents of the femoral triangle???

A

Nerve
Artery
Vein
Empty space
Lymphatics

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11
Q

mastopexy operation to _____________

orchidopexy ,an operation to ________________ and fix it there

gastropexy, surgical _______________________

A

lift and fix the breast

move an undescended testicle into the scrotum

attachment of the stomach to the intestinal wall.

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12
Q

Due to Bladder outlet obstruction, the bladder gets ________, then ________ leading to __________ muscles which can lead to __________; while the resulting __________ can become a _________

A

Dilated
Distended
Disarrayed
Traberculation
Sacculation
Diverticuli

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13
Q

A thyroglossal cyst is a congenital _____ filled sac, commonly presenting in (younger or older?) patients (typically ______yrs) and have _______ incidence between men and women.

A

fluid; younger

<20

equal

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14
Q

Embryology of Thyroglossal Cysts

During embryonic development, the thyroid gland originates from the ______________ ( ____________ ), migrating down to its final position in the neck and connecting back to the tongue via the _____________.

In normal development, this duct will obliterate, however thyroglossal cysts occur when portions of this duct remain patent, creating cavities that may fill with _______ and being prone to infection.

A

base of the tongue

foramen caecum; thyroglossal duct

fluid

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15
Q

Thyroglossal cysts present as a (palpable or non-palpable ?) (painful or painless?) midline mass that move up with ________ and __________.

When infected, they can _________ and become _______.

A

Palpable; painless

swallowing and protrusion of the tongue

increase in size ; painful

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16
Q

Standard treatment of a thyroglossal cyst is _____________, with the modified ____________ being the most widely used.

A

surgical intervention

Sistrunk procedure

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17
Q

Sistrunk Procedure

The central body of the ___________ is removed to allow complete removal of the entire _________. There is a high chance of recurrence if the _____________________ is not removed.

A

hyoid bone ; thyroglossal tract

medial portion of the hyoid bone

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18
Q

Hyoid bone

____-shaped bone in the neck which _______________.

A

U

supports the tongue.

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19
Q

It is essential that patients with thyroglossal cyst have _________ scan of the neck to identify the thyroid gland pre-operatively, as the only functioning thyroid tissue may be attached to the cyst and risks getting excised during the procedure.

A

an ultrasound

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20
Q

Branchial cysts are congenital masses which arise in the ______ aspect of the ________, typically anterior to the __________

A

lateral; neck

sternocleidomastoid (SCM

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21
Q

A ranula is a _________ or _________, that forms in the ———- under the ________.

It is filled with _________ that has leaked out of a ____________________

A

fluid collection, or cyst

mouth; tongue

saliva (spit)

damaged salivary gland.

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22
Q

Von Hippel-Lindau syndrome (VHL) is a hereditary condition associated with _________________. VHL-related tumors include hemangioblastomas, which are blood vessel tumors of the brain, spinal cord, and retina.

A

tumors arising in multiple organs

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23
Q

Brodie’s abscess is defined as a ____________ of the bone. It is an uncommon condition, usually mistaken for being a ______________ , and has been frequently observed to involve the _________ of bones (especially _____)

A

subacute osteomyelitis

bone tumor

metaphysis; tibia

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24
Q

Complications of undescended testes??

A

Fertility(lack of)
Atrophy
Inflammation
Testicular torsion, trauma and tumor
Hernias

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25
Q

Contraindication of hypospadias is??

A

Circumcision

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26
Q

Hydrocele

A _____-filled sac around a ________, often first noticed as ________________.

A

fluid

testicle

swelling of the scrotum.

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27
Q

A colostomy is surgery to _______________________ . The opening creates a passage from the ___________ to the ___________.

This is so that ___________ and ________ can leave the body through the ________ instead of passing through the _________.

A

create an opening called a stoma

large intestine ;outside of your body.

solid stool ; gas

stoma ; rectum.

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28
Q

Bedsores — also called _________ and _________ — are injuries to skin and underlying tissue resulting from ___________________

A

pressure ulcers ; decubitus ulcers

prolonged pressure on the skin.

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29
Q

Bedsores most often develop on skin that _______________, such as the heels, ankles, hips and tailbone.

A

covers bony areas of the body

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30
Q

People most at risk of bedsores have medical conditions that _______________________ or cause them to _____________________________

A

limit their ability to change positions

spend most of their time in a bed or chair.

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31
Q

Bedsores can develop over ______ or _________ .

Most sores heal with treatment, but some never heal completely.

A

hours or days

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32
Q

Warning signs of bedsores or pressure ulcers are:

Unusual changes in _______ or ______
__________
_______ draining
An area of skin that feels _________________ to the touch than other areas
__________ areas

A

skin color or texture

Swelling; Pus-like

cooler or warmer

Tender

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33
Q

Clinically, the Systemic Inflammatory Response Syndrome (SIRS) is identified by two or more symptoms including ____________,_________,_______, and _________

A

fever or hypothermia, tachycardia, tachypnoea and change in blood leucocyte count

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34
Q

SIRS

Temp:
HR:
RR:
WBC:

A

Less than 36 or greater than 38
Greater than 90bpm
Greater than 20 breaths per min
Less than 4k or greater than 11k

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35
Q

_____________________________ (LODS)

________________________________(SOFA)

A

Logistic Organ Dysfunction System

Sequential Organ Failure Assessment

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36
Q

Criterias in SOFÀ scoring?

A

Respiratory PO2
Playtelets
GCS
Mean arterial pressure
Liver bilirubin
Renal creatinine

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37
Q

IV Cannula Sizes

14
16
18
20
22
24
26

A

Orange
Medium gray
Deep green
Pink
Deep blue
Yellow
Violet

38
Q

The preferred sites for IV cannulation?

Mention 6

A

Hand
Wrist
Cubital fossa
Foot
Leg
Scalp

39
Q

Potential complications of IV cannulation include:

Mention 5

A

phlebitis
cellulitis
sepsis
tissue necrosis
air embolus (incorrect priming).

40
Q

ACCESS SITE — Centrally inserted central venous catheters are primarily placed via the __________ vein, _________ vein, or ________ vein.

A

internal jugular

subclavian

femoral

41
Q

Angles for injection

IM- ?
Subcutaneous-??
IV-??
Intradermal-??

A

90 degrees
45 degrees
Less than 30 degrees
10-15 degrees

42
Q

A thrill or buzz is like a _______ caused by ___________ through the fistula and can be felt by placing your fingers just above your incision line.

A ‘bruit’ is a ______ sound.

A

vibration

blood flowing

whooshing

43
Q

Which testes drops first?

Right of left

A

Left

44
Q

Hernia is a _______ of a__________ through a defect in the __________________________

A

protrusion

viscus/part of a viscous

wall of its containing cavity

45
Q

Desmoid tumors are (cancerous or noncancerous?) growths that occur in the ___________.

Desmoid tumors most often occur in the _______,_______, and ________.

A

noncancerous

connective tissue

abdomen, arms and legs

46
Q

Another term for desmoid tumors is ________________.

A

aggressive fibromatosis

47
Q

Inguinal hernia repairs are of the following three general types:

Herniotomy: ????

Herniorrhaphy : __________________

Hernioplasty :???

A

removal of the hernial sac only

herniotomy plus repair of the posterior wall of the inguinal canal

herniotomy plus reinforcement of the posterior wall of the inguinal canal with a synthetic mesh

48
Q

In hernioplasty, instead of ________________ , as is done in herniorrhaphy , the surgeon covers it with a ____,_________ _______, usually made of flexible plastics, such as __________ or _________

A

stitching the muscle opening shut

flat, sterile mesh

polypropylene, or animal tissue.

49
Q

Hernioplasty is better-known as __________ hernia repair.

A

tension-free

50
Q

Cholelithiasis

Characteristically, this pain is (mild or severe?) and located in the ________ and/or the ___________ quadrant. The pain may radiate to the ________ or the __________ in 60% of the cases and might be associated with nausea or vomiting, usually occurring in the _______ or _________, in 80% of the cases

A

severe; epigastrium

right upper; upper back

right scapula

late evening or at night

51
Q

The classic clinical symptoms associated with ___________________________ are known as Charcot’s triad and consist of ___________,___________, and __________

A

acute obstructive cholangitis

intermittent abdominal pain, fever, and jaundice

52
Q

Charcot’s cholangitis triad is the combination of_________; _______ , usually with _______ ; and _______________________.

When the presentation also includes __________ and ________ changes, it is known as Reynolds’ pentad.

A

jaundice; fever ; rigors

right upper quadrant abdominal pain

low blood pressure; mental status

53
Q

Murphy’s sign is elicited in patients with _____________ by asking the patient to _______________________ while palpating the _______________

A

acute cholecystitis

take in and hold a deep breath

right subcostal area

54
Q

Nail clubbing, also known as digital clubbing or clubbing, is a deformity of the finger or toe nails associated with a number of diseases, mostly of the ______ and ________.

When it occurs together with joint _______, joint _______, and abnormal _______ and _________ it is known as _____________________________

A

heart; lungs

effusions; pains

skin and bone growth

hypertrophic osteoarthropathy

55
Q

Stages of clubbing?

A

No visible
Mild
Moderate
Gross
Hypertrophic osteoarthropathy

56
Q

5Rs of Fracture management

A

Rescuscitation
Radiology and other investigations
Reduce
Retain reduction
Repair and Rehabilitation

57
Q

Descent of the Testes
The testes develop from the __________ in the (anterior or posterior?) abdominal wall (medial or lateral?) to the developing kidneys.

As the ________ end grows, the ________ end atrophies, resulting in progressive shifting ___wards of the testes.

By the third month the gubernaculum testis, a __________ __________ structure, appears and extends from the ________ end of the testis through the __________ which forms around it, and protrudes through the external ring to pass into the __________.

At the same time a pouch of peritoneum, the __________ , attached to the ________ end of the gubernaculum
(above or below?) the testis herniates and follows the course of the gubernaculum through the inguinal canal into the scrotum.

A

genital ridge; posterior ;medial

caudal ; cranial ; down

cylindrical ligamentous ;caudal

inguinal canal ;scrotum

processus vaginalis ; upper ;
below

58
Q

Descent of the testes

From the third to the seventh month, the testis lies in the _______ near the _______ ring.
In the seventh month, it begins its descent to the scrotum (anterior or posterior?) to and projecting into the ___________.

By the _______ month, it has traversed the inguinal canal and is at the _______ ring, and in the _______ month it descends into the scrotum.

A

iliac fossa ; internal ring.

posterior ;processus vaginalis

eighth month ; external ring

ninth month

59
Q

The _______ testis usually descends later than the _______ , so accounting for a higher incidence of abnormalities on the ________.

A

right

left

right.

60
Q

The testes grows when they are (inside or outside?) of the _______ ring.

A

Outside

external

61
Q

The part of the processus vaginalis in the inguinal canal normally becomes obliterated _______ _______ and the part in the ________ remains patent as the _________.

Obliteration ceases at age ______ .

A

at or soon after birth

Scrotum; tunica vaginalis

2

62
Q

Failure of obliteration of the processus vaginalis may lead to any of the following abnormalities

Mention 4

A

I. Indirect inguinal hernia
2. Encysted hydrocele of the cord
3. Infantile hydrocele.
4. Congenital hydrocele.

63
Q

Indirect inguinal hernia.

The (proximal or distal?) part is patent.

If the entire processus is patent, then a __________ may occur in infancy.

A

Proximal

complete hernia

64
Q

Encysted hydrocele of the cord.

The __________ parts are obliterated but the _________ is patent and filled with ———- .

The corresponding anomaly in the female is ____________

A

proximal and distal

mid-portion; fluid

cyst of the canal of Nuck

65
Q

Infantilehydrocele.

The processus is obliterated near the ___________ but is otherwise patent and continuous with the ___________

A

internal ring

tunica vaginalis

66
Q

Congenital hydrocele.

The _________ processus is patent, but the neck is ________. It contains fluid

A

entire ; narrow

67
Q

The testis

It may, however, pass through the external inguinal ring but be prevented from entering the scrotum by a ______ at the _____________ .

It then assumes an _______ position usually superficial to the _____________ in the groin, but occasionally in the ________,_________, or the ___________

A

fibrous band

neck of the scrotum

ectopic; external oblique aponeurosis

perineum, femoral triangle or the pubic area.

68
Q

The inguinal canal is an _________ passage directed _____wards , (medially or laterally?) and forwards in the lower part of the AAW, above the _______ through which pass the _________ with the testicular vessels , _________ nerve and the ____________________________ nerve in the male and the __________ in the female

A

oblique; down; medially

groin; spermatic cord ; ilioinguinal

genital branch of the genito-femoral

round ligament

69
Q

Inguinal canal:

______ long in adult

Internal Inguinal ring is _____ shaped and found in the _____________

External ring is ______ shaped and is an opening in the ______________

A

4cm
U ; transversalis fascia

Triangular ; external oblique aponeurosis

70
Q

The anterior wail of the inguinal canal is formed by the ________________ and additionally in the lateral part by the muscular fibres of the ______________

The posterior wall is formed by the ___________, reinforced superficially by aponeurotic fibres from the ___________ and buttressed in the medial half by the __________

A

external oblique aponeurosis

internal obljque

transversalis fascia

transversus abdominus; conjoint tendon

71
Q

Conjoint tendon is the fused common insertion of the __________ and _________ muscles

A

transversus abdominis

internal oblique

72
Q

Intussusception is a medical condition in which ______________________

It typically involves the ________ and less commonly the ___________

A

a part of the intestine folds into the section immediately ahead of it.

small bowel ; large bowel.

73
Q

Symptoms of intussusception include ————— which may come and go, __________, abdominal _______, and ___________

A

abdominal pain; vomiting

bloating

bloody stool

74
Q

intussusception often results in a small bowel ____________ .

Other complications may include _________ or bowel __________.

A

obstruction

peritonitis; perforation

75
Q

Risk factors of intussusception in children include certain infections, diseases like __________, and ____________.

Risk factors in adults include __________,_________, and __________

A

cystic fibrosis; intestinal polyps

endometriosis, bowel adhesions, and intestinal tumors

76
Q

Treatment of intussusception in children is typically by an ________ with _______ used if this is not successful.

____________ may decrease the risk of another episode.

A

enema; surgery

Dexamethasone

77
Q

Intussusception

Treatment: In adults, ________________________ is more often required.

A

surgical removal of part of the bowel

78
Q

Intussusception occurs more commonly in __________ than __________.

A

children

adults.

79
Q

Intussusception

In children, ________ are more often affected than ________.

The usual age of occurrence is ________ to ________ old.

A

males ; females

3months ; 3years old

80
Q

In the most frequent type of intussusception, the ________ enters the ________. However, other types occur, such as when a part of the ________ or ________ prolapses into itself.

A

ileum ; cecum.

ileum ; jejunum

81
Q

intussusception

The part that prolapses into the other is called the ________, and the part that receives it is called the ___________ .

A

intussusceptum

intussuscipiens

82
Q

Almost all intussusceptions occur with the intussusceptum having been located (proximally or distally?) to the intussuscipiens. This is because _________ of the intestine pulls the ______ segment into the _______ segment.

A

proximally

peristaltic action

proximal; distal

83
Q

Intussusception

The trapped section of bowel may have ___________________ , which causes _________.
The ________ is very sensitive to this, and responds by _____________.

This creates the classically described “___________” stool, which is a mixture of ________,______,________ .

A

its blood supply cut off

ischemia

Mucosa; sloughing off into the gut

red currant jelly

sloughed mucosa, blood, and mucus

84
Q

An intussusception is often suspected based on history and physical exam, including observation of ________ sign. A _________ examination is particularly helpful in children, as part of the intussusceptum may be felt by the finger.

A definite diagnosis often requires confirmation by diagnostic imaging modalities. _______ is the imaging modality of choice for diagnosis and exclusion of intussusception, due to its high accuracy and lack of radiation. The appearance of _______ sign (also called “ ________ sign” on a sonograph, usually around 3 cm in diameter, confirms the diagnosis.

A

Dance’s; digital rectal

Ultrasound; target

doughnut

85
Q

An intussusception has two main differential diagnoses: ___________ and ___________

A

acute gastroenteritis

rectal prolapse

86
Q

intussusception VS acute gastroenteritis

Abdominal pain, vomiting, and stool with mucus and blood are present in acute gastroenteritis, but _________ is the leading symptom.

A

diarrhea

87
Q

intussusception VS Rectal prolapse

Rectal prolapse can be differentiated by projecting mucosa that can be felt in _________________, whereas in intussusception the finger may ________________

A

continuity with the perianal skin

pass indefinitely into the depth of the sulcus.

88
Q

intussusception

Early symptoms can include periodic __________ , nausea, _______ (sometimes _______ in color from _____), pulling _______ to _________ , and intermittent moderate to severe cramping abdominal pain.

A

abdominal pain; vomiting

green; bile

legs to the chest area

89
Q

Intussusception

Pain is intermittent—not because _________________ , but because the intussuscepted bowel segment ____________.

Later signs include ________, often with “ ___________ “ stool , and lethargy.

Physical examination may reveal a “ _________-shaped” mass, felt upon palpating the abdomen

A

the intussusception temporarily resolves

transiently stops contracting

rectal bleeding; red currant jelly

sausage

90
Q

Classification of intussusception?

A

Location

Direction

Etiology

91
Q

What are the risks of thyroidectomy?

_______ changes, such as _______

______throat

Bleeding and blood clots

__________ or _________ that require another surgery

Injury to the ________ or _______

______________

A

Voice; hoarseness

Sore; Adhesions or scar tissue

esophagus or trachea

Hypoparathyroidism

Junior Posting (35 decks)

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