Surgery

Front 1

When do you perform surgery for Diverticulitis?

Back 1

IHOP: Intractable pain, Hemorrhage, Obstruction, Perfusion

Front 2

Difference between Diveritculitis & Diveritculosis

Back 2

Diverticulosis is pressence of diverticulu; Diverticulitis is an inflamed bowel d/t Diverticuli

Front 3

Name true diverticulums

Back 3

Zenker Diverticulum & Merkels Diverticulum

Front 4

Medical Tx of Diverticulosis

Back 4

High fiber diet, exercise, lots of fluids

Front 5

Ogilvie's Syndrome S/Sx

Back 5

Dilation of cecum & R colon, ileus, constipation

Front 6

Ogilvie's Tx

Back 6

Electrolytes/NG/NPO... then neostygmine... then Colonoscopy

Front 7

Cholecystectomy risks

Back 7

Common bile duct damage, post-op adhesions, post-op infections

Front 8

Describe Postcholecystectomy Syndrome

Back 8

RUQ pain, GI distress, a/w post-op adhesions or bile leak

Front 9

Acute Toxic Cholangitis S/Sx

Back 9

Charcots triad, hypotension, AMS

Front 10

Charcots triad

Back 10

RUQ pain, jaundice, fever

Front 11

Reynolds Pentad

Back 11

Charcots triad + hypotension + AMS [seen in Acute Toxic Cholangitis]

Front 12

Acute Toxic Cholangitis Tx

Back 12

ERCP, Lap CBD decompression, PCT (percutaneous transhepatic cholangiography, done by IR)

Front 13

Define Cholelithiasis

Back 13

Biliary stones in the Gallbladder

Front 14

Define Choledolithiasis

Back 14

Biliary stones in the Common Bile Duct

Front 15

Describe ESWL for biliary stones

Back 15

High failure rate, used as an adjunct Tx with ERCP or PCT

Front 16

Describe Calot's Triangle

Back 16

Common Hepatic duct, cystic duct, top liver edge

Front 17

Calot's Triable clinical significance

Back 17

Cystic Artery runs on inferior of triangle or through triangle, thus avoid this artery during cholecystectomy

Front 18

Describe ducts of Lushka

Back 18

Accessory Common Bile Ducts, often injured during cholecystectomy

Front 19

Valves of Heister

Back 19

Mucosal folds in Common Bile Duct that act as false valves

Front 20

Kocher Maneuver

Back 20

Cut left peritoneum under duodenum, move duodenum to right to look under duodenum

Front 21

Cholecystitis Complications

Back 21

Gallbladder perforation, fistula formation, grangrenous gallbladder

Front 22

Describe choledochotomy

Back 22

Incision of Common Bile Duct for removing stones a/o placing T-Tube

Front 23

Describe T-Tube cholangiography

Back 23

Tube placed in common bile duct during cholecystectomy, used for imaging later to detect choledolithiasis

Front 24

Tx of Cholecystitis in pts unsuitable for Sx

Back 24

Cholecystotomy (drainage performed percutaneously) or medications (Ursodiol)

Front 25

What is enterohepatic circulation?

Back 25

Secretion of bile salts into duodenum, reabsorption, and return to liver

Front 26

Classically, where can jaundice first be detected

Back 26

Under the tongue

Front 27

What is a "positive HIDA" scan?

Back 27

1) radionucleotide can't enter Gallbladder (Obstruction), 2) EF < 35%, 3) Pain with CCK-HIDA

Front 28

What ABX is a/w cholestatic jaundice & gallbladder sludge?

Back 28

ceftriaxone

Front 29

Caroli Dz

Back 29

Caroli, Congenital, Choledochal cyst, Cholangitis

Front 30

Etiology of Clear or White Bile

Back 30

Stagnant bile, seen in Mucocele/Hydrops Gallbladder, mostly gallbladder lining secretions [w/o proportionate bile pigments]

Front 31

Most Common Gallbladder Ca

Back 31

AdenoCa

Front 32

Hesselbach's triangle boundaries

Back 32

Inferior Epigastric Vessels, Rectus Abdominus, Inguinal Ligmanet

Front 33

Hepatic Adenoma Management

Back 33

< 5cm asymptomatic Observation & D/C steroids, OCP; >5cm or symptomatic or wants to get pregnant, resection

Front 34

Describe Carpal Tunnel Syn

Back 34

Release adhesions of the median nerve and divide the transverse carpal ligament.

Front 35

Length of Hartmann's Pouch required to re-anastomose

Back 35

5cm