20/02 Flashcards
What are the indications for splenectomy?
Uncontrollable splenic bleeding
Hilar Vascular injuries
Devascularised spleen
What are signs of mammary duct ectasia?
Common around menopause
Tender lump around areolar
Can have green nipple discharge
What is ASA classification 1?
Healthy normal patient
Non smoker
Minimal alcohol use
What is ASA classification 2?
Patient with mild systemic disease
E.g. current smoker, pregnant, obesity BMI 30-40, well controlled diabetes and HTN
What is ASA classification 3?
Patient with severe systemic disease Examples -BMI >40 -COPD -poorly controlled HTN or DM - regular dialysis -alcohol abuse - pacemaker
What is ASA classification 4?
Patient with severe systemic disease that is a threat to life
- recent MI (<3 months ago)
- sepsis
- cerebrovascular events
- reduced ejection fraction
- DIC
What is ASA classification 5?
A moribound patient who is not expected to survive without the operation
- ruptured AAA
- intracranial bleed
- massive trauma
What is ASA classification 6?
Declared brain dead patient whose organs are being removed for donation
What is the triad of cholangitis?
Fever
Jaundice
Right upper quadrant pain
What are causes of acute pancreatitis?
Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion bite Hyperlipidaemia, hypercalcaemia and hypothermia ERCP Drugs- furosemide, azathioprine, sodium valproate
What is Murphy’s sign?
Pain or catching of breath during palpation of upper right quadrant in cholecystitis
What is an XR finding of air in the abdomen?
Double wall sign
What is the indicator of pancreatitis severity?
PaO2 <7.9 Age >55 Neutrophils- WCC >15 Calcium <2 Renal function- urea >16 Enzymes LDH >600 Albumin <32 Sugar >10
What needs to be monitored in a patient with post operative ileus?
U&Es
