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46 Cards in this Set
- Front
- Back
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What are some causes of bowel ileus?
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Abdominal operation
Takes SB out for 24 hrs, takes colonic and gastric motility out for 2-5 days Infection Electrolyte - hypo K, Na, Mg, and hyper Mg Hypothyroidism Spinal cord injury MI mesenteric ischaemia drugs - opiates, anticholinergics, CCBs, TCAs |
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What are the main causes of intussuception in adults?
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tumours
abdominal surgery |
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Which chromosomal abnormality is associated with hirschsprung's disease
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trisomy 21
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Are epididymal cysts usually separate or attached to the body of the testicle?
Posterior/anterior |
Separate
Usually found posterior |
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Management of infantile hydroceles?
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Generally repaired if they do not resolve spontaneously by the age of 1-2 years
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What is a varicocele?
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abnormal enlargement of testicular veins
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Management of varicocele?
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usually conservative
occasionally surgery is required if the patient is troubled by pain debate as to whether surgery improves infertility |
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What is first line management for chronic anal fissues?
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> 6 weeks
topical nitrates if not effective after 8 weeks - consider botulinum toxin |
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Which hernia is strangulation more common in?
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femoral
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How does an obturator hernia typically present?
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bowel obstruction
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Which peptic ulcer is improved pain with eating?
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Duodenal
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What are the storage symptoms of LUTS?
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frequency
urgency urge incontinence nocturia |
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What are the voiding symptoms of LUTS?
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weak stream
straining hesitancy terminal dribbling incomplete emptying |
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MOA of finasteride?
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blocks conversion of testosterone to DHT
can cause a reduction in prostate volume - hence may slow disease progression |
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Which meds are first line in treatment of BPH?
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alpha 1 antagonists
tamsulosin |
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What is mammary duct ectasia and how does it present?
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dilatation of the large breast ducts
most common around menopause tender lump around areola +/- a green nipple discharge if ruptures can cause local inflammation (plasma cell mastitis) |
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What are lumpy breasts called?
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fibroadenosis
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Which bacteria presidpose to the formation of staghorn calculi?
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ureaplasma urealyticum
proteus |
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Do 5 alpha reductase inhibitors affect the PSA level?
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yes
they may decrease it by 50% |
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What is the maxium safe volume dose of lidocaine 1% that can be used during minor surgery on an average sized adult?
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20ml of 1%
10ml of 2% |
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What is gosrelin?
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synthetic GnRH agonist (Zoladex)
Must cover initially with anti-androgen (cyproterone acetate) to prevent rise in testosterone |
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Management of intermittent claudication?
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Graduated walking program
Smoking cessation Station ACE I 1. Aspirin 2. clopidegral (not on PBS) |
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Which positions are haemorrhoids usually seen?
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3 7 11 O clock
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Which haemorrhoids are more prone to thrombosis?
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external
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When is surgery recommended for haemorrhoids?
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large symptomatic haemorrhoids that do not response to outpatient treatments
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How do you manage thrombosed haemorrhoids?
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I pt presents within 72 hours then referral should be considered for excision otherwise patients can usually be managed with stool softeners, ice packs, analgesia
Sx usually settle within 10 days |
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How long does finasteride take to work before results are seen in BPH?
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6 months
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Congenital inguianl hernias are more common on which side?
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right side
NB: 10% are bilateral |
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Describe the C in the CEAP classification of venous disease?
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0 - none
1 - telangiectasiae/reticular veins 2 - varicosities 3 - swelling 4 - lipodermatosclerosis 5 - healed ulceration 6 - chronic venous ulcer |
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What is the difference between venous and arterial claudication?
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Similar except venous takes longer to subside after rest and may not go away completely until leg is elevated
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What is superficial thrombophlebitis?
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clot forms in a varicose vein
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Are complression stockings used for venous problems stronger or weaker than those used for DVT prophylaxis?
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Stronger
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HOw do you manage veins in the C1,C2 category? I.e. telangeictasiea/reticular veins, varicosities? i.e. just localised varicosities with no incompetence or obstruction
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Sclerotherapy
+ compression with stockings/bandages |
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When is surgical intervention for venous disease warranted?
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C2-C6
Varicosities, swelling, lipodermatosclerosis, healed ulceration, chronic venosu ulcer Femorofemoral bypass for iliac obstruction venous valve reconstruction |
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What classified major surgery? How long do they need prophylaxis for?
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Major surgery = intra-abdominal surgery or surgery > 45 mins
Require 5-10 dayus prophylaxis |
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Which drugs are used for urge incontinence?
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anticholinergics - oxybutynin
antimuscarinics - darifenacin, solifenacin + bladder training Anti-muscarinic jsut as effective with less side effects BUT expensive not on pbs |
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What are the urodynamic findings seen in women with stress incontinence?
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urethral hypermobility - lack of support to bladder neck
intrinsic sphincter deficiency - inherent weakness in the actualy sphincter mm Usually a combination of both |
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What is detrusor sphincter dyssynergia?
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detrusor contracts against a closed distal sphincter mechanism
Predominantly seen in spinal cord injured patients high morbidity/mortality without approprate treatment |
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Is excess acid involed in GORD?
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NO
a whole lot of other factors are including competence of the lower oesophageal sphincter |
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What is reflux oesophagitis?
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consequence of reflux with presence of inflammation and ulceration of the lower oesophageal mucosa - precuror of peptic stricture and barrett's oesophagus
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What is a peptic stricture?
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Consequence of severe GORD
Fibrous stricture related to collagen deposition, which occurs in course of repaid or oesophagitis causes mechanical obstruction can treat with balloon dilatation |
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In endoscopy what do multiple rings, furrows, whitish exudates "tramtarcks" suggest?
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eosinophillic oesophagitis
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How do you manage eosinophilic oesophagitis?
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oral fluticasone
eliminiation diets montelukast careful dilataion |
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does coeliac's disease predispose to oesophageal cancer?
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yes
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Does achalasai predispose to oesophageal cancer?
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yes
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What is boerhaave's syndrome?
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Spontaneous oesophageal rupture
tyipcally with vomitting but can occur with any transient elevation of intra-abdominal pressure (e..g, lifting, straining) Pain, vomiting, SC emphysema, pneumothorax, penumomediastribnum, dysphagia |
