Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Internal Medicine > Abdomen > Flashcards

Abdomen Flashcards

1
Q

Define ascities

A

An abnormal accumulation of fluid in the peritoneal cavity, causing abdominal swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Grades of ascities

A

Grade 1: mild, only detectable on ultrasound
Grade 2: moderate, symmetrical distension of abdomen
Grade 3: severe, gross/large ascities with marked abdominal distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Differential for abdominal distension

A

Fat
Faeces
Fluid
Fetus
Fatal mass
Flatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What would you want analysed on peritocentesis fluid?

A

Appearance and colour
Cells count and diff
Albumin, total protein (SAAG)
LDH
Cytology
Microscopy
Culture and gram stain
Sensitivity
ADA
Acid fast bacilli smear
Amylase
Glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes of low SAAG

A

<11.1

HIM
Hypoalbuminaemia (nephrotic syndrome, protein losing enteropathy, malnutrition)
Inflammatory (TB, infective peritonitis, pancreatitis)
Malignancy (pancreas, ovarian, mets)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes for high SAAG

A

> 11,1
HOLM

Heart disease (HF, constrictive pericarditis)
Obstruction of hepatic veins (Budd Chiari syndrome)
Liver disease (portal vein thrombosis, cirrhosis, fatty liver)
Massive metastasis to liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is liver cirrhosis

A

The irreversible diffuse fibrosis of the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of hepatosplenomegaly

A

Chronic liver disease with portal HPT
Haematological (myeloproliferative, lymphoma, leukaemia, sickle cell, pernicious anaemia)
Infection (acute hepatitis, CMV, nfective mononucleosis)
Infiltrative (sarcoid, amyloid)
Connective tissue (SLE)
Acromegaly
Thyrotoxicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Complication of ascities and how do you diagnose and treat it

A

Spontaneous bacterial peritonitis
Diagnose: polymorph >250, protein <10 (of the ascitic fluid)
Treatment: cefotaxime 2g IVI TDS, 5-7days, albumin 1g/kg IVI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define cirrhosis

A

Liver damage characterised by loss of basic architecture of the liver with fibrosis and formation of regenerative nodules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Complications of liver cirrhosis

A

VARICES

Varices
Ascities/anaemia
Renal failure
Infection
Coagulopathy
Encephalopathy
Sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Define non-alcoholic fatty liver disease

A

Spectrum of disorders characterised by macrovesicular hepatic steatosis sometimes with inflammation and/or fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Define acute liver failure

A

An increase in transaminases, hepatic encephalopathy and impaired synthesis function with an INR >1.5 in a patient with no liver cirrhosis or pre-existing liver disease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of acute liver failure

A

Autoimmune
Budd chiari
Cryptococcal, CMV
Drugs and toxins
EBV
Fatty infiltration
Genetic eg Wilson’s
Hepatitis A-E, HELLP syndrome, Hypoperfusion
Infiltration (tumor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Complications of acute liver failure

A

Cerebral oedema
Secondary Infections (pneumonia, sepsis, unbalanced infections)
Metabolic (hypoglycaemia, hypokalaemia, hyponatraemia, hypophosphataemia)
Multi-organ failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of cerebral oedema secondary to acute liver failure

A

Lactulose 10ml tds = decrease ammonia levels
Terminate seizures = midazolam
Raised ICP = mannitol 0,5-1g/kg, monitoring for fluid overload and serum osmolality (keep <320)
Grade 3-4 encephalopathy = 30% hypertonic saline at 5-20ml/hr, maintain sodium 145-155 to reduce risk increased ICP

17
Q

Management of coagulopathy in acute liver failure

A

Vit K IV 10mg bolus slowly
FFP’s if bleeding, preop or Intraop = 15ml/kg or 4 units
Platelets <50 and bleeding/intraop/preop = infuse platelets 10ml/kg or 6 units (check levels at 1hr and 24hrs) - survive 3-5days

18
Q

Management of toxin ingestion causing Acute liver failure

A

Paracetamol = N-acetylcysteine
Mushroom = N-acetylcysteine and penicillin G
DILI = N-acetylcysteine
Suspected Herpes or varicella = acyclovir 5-10mg/kg every 8hrs IV

PLUS prophylactic H2 antagonists or PPI’s

19
Q

Causes of splenomegaly

A

Congestive
Haematological
Infectious
Neoplasm
Autoimmune

20
Q

Ring around eyes in Wilson’s disease

A

Kayser fleischer rings

21
Q

Commonest causes of pancreatitis

A

Alcohol
Cholodocholithiasis
Idiopathic

22
Q

Causes of MASSIVE splenomegaly

A

Chronic malaria
Chronic Schistosomiasis
Chronic TB
Primary splenic lymphoma
Myelofibrosis
Chronic myeloid leukaemia
Thalassaemia
Sarcoidosis

Internal Medicine (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions