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Mrcs > Abdomen > Flashcards

Abdomen Flashcards

1
Q

Cells and enzymes in pancreas

A

Beta- insulin
Alpha - glucagon
Delta- somatostatin
F - pancreatic peptide

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2
Q

Calots triangle

A

Locate cystic artery (branch rt hepatic)
Cystic duct
Common hepatic duct
Liver

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3
Q

Pringles manoeuvre

A

Control bleeding cholecystectomy

Hepatic artery
Portal vein
Lesser omentum

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4
Q

Absorbed in ileum

A

B12
Water
Vitamin C
Bile salts

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5
Q

Cells in small bowel

A

D- somatostatin (inhibits gastrin)
S- secretin (inhibits gastrin)
N cells
Enterochromaffin

Duodenum - brunners (reduce acidity)

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6
Q

Gastrin

A

Inhibited by:

  • somatostatin
  • secretin
  • CCK & GIP (released with fatty food)
  • ph 2-3

Stimulates peptin from parietal cells

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7
Q

Bile

A

Breakdown of heam in spleen, transported to liver by albumin. Conjugated in liver to form bile salts - converted to urobillinogin in bowel ( reabsorbed) remainder converted to stercobilin/urobilin

CCK causes GB to relax

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8
Q

Porta hepatis

A

Common hepatic duct (anterior)
Hepatic artery
Hepatic portal vein

In hepatoduodenal ligament

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9
Q

Anterior structure to kidney Hilum

A

VEIN

artery
Ureter

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10
Q

Ureteric areas of narrowing

A

Pelvicureteric junction
Pelvic brim
Entry of bladder

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11
Q

Male urethra important structures

A

Abdominal
Crosses common illiacs and genitofemoral nerve

Pelvic
Cross vas deferens (vagina )
Obturstor, common and internal illiacs

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12
Q

Gerotas fascia

A

Continuation of transversalsis on kidneys and adrenals

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13
Q

Renal calculus

A

Calcium oxalate- hypercalaemia
Cysteine - inherited
Uric acid- low PH, may be secondary to malignancy , radiolucent
Sturvate- alkaline, proteus infection, staghorns
Calcium phosphate- high PH, RTA 1&3

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14
Q

Renal cell carcinoma

A

ASBESTOS/ LEAD

T1 partial nephrectomy
T2 total

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15
Q

TCC bladder

A

2-naphthylamine - hydrocarbon = rubber

T1 TRANSURETHRAL RESCECTION OF BLADDER TUMOUR TURBT

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16
Q

Bosniak grading

A

Ct Scan of cysts

IV = cancer

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17
Q

Cave of retzius

A

Retro pubic space

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18
Q

Denonvilliers

A

Fascia separating prostate and rectum only in men

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19
Q

Prostate cancer surveillance

A 
T1c
Gleason 3+3
Psa <15
Cancer less than 50% biopsies 
<10mm of any core

All should have 10 biopsies and one re-biopsy

1st year psa 3-4mths, yearly mri/ dre
2-4y. Psa 6monthlh and dre yearly

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20
Q

Batsons veins

A

Venous drainage from prostate - pelvis and lumbar spine spread of cancer

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21
Q

Waldeyers fascia

A

Pre sacral

Rectal cancers spread

Hypogastric vessels

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22
Q

Internal illiac branches

A

Posterior
Superior glut
Illiolumbar
Lateral sacral

Anterior
Middle/inf rectal
Sup/inf vestical
Uterine/vas
Umbilical
Inferior glut 
Obturator
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23
Q

External illiac branches

A

Femoral

Inferior epigastric

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24
Q

Richters hernia

A

Partial enterocele only one side of mesentry enters and strangulates

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25
Q

Littres

A

Hernia sac containing meckels

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26
Q

Pantaloon

A

Hernia sacs bikateral side to inferior epigastric separated by inguinal canal. Direct and indirect hernia

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27
Q

Inguinal canal

A

FLOOR - inguinal and lacunae ligament
POSTERIOR - transversalis and conjoint tendons
ROOF - internal oblique and trans versus abdominis
MEDIALLY - deep ring
LATERALLY - internal ring, transversailis fascia
ANTERIOr - external oblique aponeurosis

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28
Q

Hesselbachs triangle

A

Direct hernias
Lateral = inf epigastrics
Medical = rectus abdomins
Roof = inguinal

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29
Q

Poor prognosis of liver cancer

A

Bilobar
Large
Venous invasion
Extrahepatic disease

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30
Q

Hydatid cyst

A

Echinoccus granulosus

Dogs/ sheep

Pain, jaundice, malaise

Uss- septa, daughter cysts, hyatid sands

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31
Q

Amoebic abscess

A

Amoebiasis

Pain and fevers

Uss- poorly defined borders

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32
Q

Liver cystadenoma

A

Anaechoic and irregular margins

Malignant potential

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33
Q

Gardner’s

A

FAP & Desmoid rumours and mandible osteoma, extra teeth

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34
Q

Turcots

A

Polyps and CNS tumours

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35
Q

Lynch

A

HNPCC

Endometrial, CNS, renal

Mucinous polyps

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36
Q

Cowdens

A

PTEN

Breast cancer
Harmatoumous

37
Q

Pudendal canal

A

Passage thought obturator fascia from lesser sciatic notch to posterior edge of perineal membrane

Internal pudendal A&V
Pudendal nerve
Nerve to obturator internus

38
Q

EBv

A

Burkitts
Hodgkins
Post transplant lymphoma
Nasopharyngeal tumour

39
Q

HPV 16/18

A 
Anal cancer 
Cervical
Penile
Vulva
Oropharngeal
40
Q

HPV 8

A

Kaposi

41
Q

Splenic trauma

A 
1 - <1cm
2 1-3cm
3 >3cm/> 50%
4 major vessels
5 shattered
42
Q

Abdominal dehiscence

A 
Malnutrition 
Feacal peritonitis 
Jaundice 
Steroids 
Poor technique 
Vitamin deficiency

Treat
Analgesia, abx, fluids, saline impreganated gauze on ward
Bogotá bag then plan for theatre

43
Q

Scrot innervation

A

Anterior - illioinguinal

Posterior - pudendal

44
Q

Hyatid of morgagni

A

Appendix if epididymis

45
Q

Renal imaging

A

Dmsa cortical detects and ectopic sure
DTPA- filtration
MAG3- already impaired renal function
MCUG - bladder reflux

46
Q

Management of renal stone

A

Ureter
< 5mm watch
10-20mm - lipoth
20mm - nephroscopty

Renal 
5mm watch
10mm lipo 
10-20 liopth or nephroscopsry 
20 - percutaneous nephrolithotomy
47
Q

Vipomas

A

Severe watery diarrhoea, low potassium and achlorhydria

48
Q

Glucagonoma

A

Diabetes, anaemia, necrolytic migratory erythema

49
Q

Somatostatin

A

Diabetes, stones, steatorrhoea

50
Q

Diaphragm disease

A

Lumen if small bowel is divided into short compartments by circular membranes of submucosa. From prolonged NSAIDS. Results in smal bowel obstruction

51
Q

Common bile duct blood supply

A

Hepatic artery

52
Q

Cremaster reflex

A

L1 fem branch and illioinguinal

53
Q

Phrens sign

A

Relief in epididymitis

54
Q

Lesser sac

A 
Anterior = Posterior wall of stomach 
Posterior = left kidney/adrenal + pancreas
Inferior = transverse colon 
Left - spleen/gastrosplenic ligament
Right = epiploic foramen + quadrate love
55
Q

Epilopic foramen

A

Post - ivc
Anterior lesser omentum
Inf duodenum
Superior caudate lobe

56
Q

Renal nutcracker syndrome

A

Left renal vein between aa and sma

57
Q

Rectal arteries

A

Superior ima
Middle internal illiac
Inferior pudendal

58
Q

Ureter

A

Renal artery
Gonadal
Superior vescical

59
Q

Oesophagus lengths

A

40cm to stomach
27cm to left bronchus
22cm arch

60
Q

Pancreatic pseudocysts

A

Lesser sac- left subheptatic space

61
Q

Sister Mary joesph

A

Ligamentum teres - intraabdominal cancer

62
Q

Ligament trietz

A

Suspensory ligament of 3rd part duodenum lies close to infrarenal aortic aneurysm

63
Q

S4

A

Legatos ani and external sphincter

64
Q

Epispadia

A

Dorsum of penis

65
Q

Penile hypospadia

A

Shaft of penis

66
Q

Peroneal hypospadiaw

A

Scrotum

67
Q

Coronal hypospadia

A

Below glans on underside

68
Q

Glandular hypospadia

A

Most common under side of glans

69
Q

Polyp and Gb stones

A

? Cancer

70
Q

GB cancer > T1b

A

Cholecystectomy

Resection 4b/5 + LN

71
Q

Right side liver

A

5, 6, 7 , 8

72
Q

Left side liver

A

2,3,4

73
Q

Hepatoduodenal ligament

A

Ports hepatitis

74
Q

Riglers triangle

A

Gallstone ileus
Pneumobilia
Sbo
Ectopic gallstone

75
Q

Portal hypertension

A

> 6

76
Q

Gastroplenic ligament

A

Short gastric

Often cause of bleed post splenectomy was

77
Q

Splenic renal ligament

A

Splenic artery

78
Q 
Howell jolly 
Papinhame 
Target 
Heinz 
Spur
A 
Nuclear remanents 
Iron
Increased surf ace membrane 
Denatured hb
Deformed membrane
79
Q

Spherocytosis

A

Anaemia
Splenamegaly
> 6yo for surgery
Increase change of gallstone so prophylactic cholecystectomy

80
Q

Splenic pseudocyst

A

Common following trauma

Leave alone unless >5cm or symptoms

81
Q

Splenic aneurysms

A

Often women
Pain then stabilises due to collection less sac then pain again and decrease bp
Common if pregnant

If >2cm then ligation

82
Q

Acute vs late dumping syndrome

A

Acute due to hyperosmolar state

Late due to surg insulin and hypoglycaemia

83
Q

Lymph nodes lesser curve

A

1-6

84
Q

Resections stomach

A

R0 - microscopy clear
R1- negative macro
2 positive both

85
Q

Stomach

A

Neoadjuvant

If LN then chemoradiation post

86
Q

MALT

A

Expansion of margins
Lymphoid cells

Treat h. Pylori

87
Q

Li- faumeni

A

Breast
Ovary
Sarcoma
Astrocytoma

88
Q

Renal pelvis squamous cell cancer

A

From chronic infections or stones

Mrcs (11 decks)

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