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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
Littres
Hernia sac containing meckels
26
Pantaloon
Hernia sacs bikateral side to inferior epigastric separated by inguinal canal. Direct and indirect hernia
27
Inguinal canal
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
28
Hesselbachs triangle
Direct hernias Lateral = inf epigastrics Medical = rectus abdomins Roof = inguinal
29
Poor prognosis of liver cancer
Bilobar Large Venous invasion Extrahepatic disease
30
Hydatid cyst
Echinoccus granulosus Dogs/ sheep Pain, jaundice, malaise Uss- septa, daughter cysts, hyatid sands
31
Amoebic abscess
Amoebiasis Pain and fevers Uss- poorly defined borders
32
Liver cystadenoma
Anaechoic and irregular margins | Malignant potential
33
Gardner’s
FAP & Desmoid rumours and mandible osteoma, extra teeth
34
Turcots
Polyps and CNS tumours
35
Lynch
HNPCC Endometrial, CNS, renal Mucinous polyps
36
Cowdens
PTEN Breast cancer Harmatoumous
37
Pudendal canal
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
EBv
Burkitts Hodgkins Post transplant lymphoma Nasopharyngeal tumour
39
HPV 16/18
``` Anal cancer Cervical Penile Vulva Oropharngeal ```
40
HPV 8
Kaposi
41
Splenic trauma
``` 1 - <1cm 2 1-3cm 3 >3cm/> 50% 4 major vessels 5 shattered ```
42
Abdominal dehiscence
``` 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
Scrot innervation
Anterior - illioinguinal | Posterior - pudendal
44
Hyatid of morgagni
Appendix if epididymis
45
Renal imaging
Dmsa cortical detects and ectopic sure DTPA- filtration MAG3- already impaired renal function MCUG - bladder reflux
46
Management of renal stone
Ureter < 5mm watch 10-20mm - lipoth 20mm - nephroscopty ``` Renal 5mm watch 10mm lipo 10-20 liopth or nephroscopsry 20 - percutaneous nephrolithotomy ```
47
Vipomas
Severe watery diarrhoea, low potassium and achlorhydria
48
Glucagonoma
Diabetes, anaemia, necrolytic migratory erythema
49
Somatostatin
Diabetes, stones, steatorrhoea
50
Diaphragm disease
Lumen if small bowel is divided into short compartments by circular membranes of submucosa. From prolonged NSAIDS. Results in smal bowel obstruction
51
Common bile duct blood supply
Hepatic artery
52
Cremaster reflex
L1 fem branch and illioinguinal
53
Phrens sign
Relief in epididymitis
54
Lesser sac
``` Anterior = Posterior wall of stomach Posterior = left kidney/adrenal + pancreas Inferior = transverse colon Left - spleen/gastrosplenic ligament Right = epiploic foramen + quadrate love ```
55
Epilopic foramen
Post - ivc Anterior lesser omentum Inf duodenum Superior caudate lobe
56
Renal nutcracker syndrome
Left renal vein between aa and sma
57
Rectal arteries
Superior ima Middle internal illiac Inferior pudendal
58
Ureter
Renal artery Gonadal Superior vescical
59
Oesophagus lengths
40cm to stomach 27cm to left bronchus 22cm arch
60
Pancreatic pseudocysts
Lesser sac- left subheptatic space
61
Sister Mary joesph
Ligamentum teres - intraabdominal cancer
62
Ligament trietz
Suspensory ligament of 3rd part duodenum lies close to infrarenal aortic aneurysm
63
S4
Legatos ani and external sphincter
64
Epispadia
Dorsum of penis
65
Penile hypospadia
Shaft of penis
66
Peroneal hypospadiaw
Scrotum
67
Coronal hypospadia
Below glans on underside
68
Glandular hypospadia
Most common under side of glans
69
Polyp and Gb stones
? Cancer
70
GB cancer > T1b
Cholecystectomy | Resection 4b/5 + LN
71
Right side liver
5, 6, 7 , 8
72
Left side liver
2,3,4
73
Hepatoduodenal ligament
Ports hepatitis
74
Riglers triangle
Gallstone ileus Pneumobilia Sbo Ectopic gallstone
75
Portal hypertension
>6
76
Gastroplenic ligament
Short gastric Often cause of bleed post splenectomy was
77
Splenic renal ligament
Splenic artery
78
``` Howell jolly Papinhame Target Heinz Spur ```
``` Nuclear remanents Iron Increased surf ace membrane Denatured hb Deformed membrane ```
79
Spherocytosis
Anaemia Splenamegaly > 6yo for surgery Increase change of gallstone so prophylactic cholecystectomy
80
Splenic pseudocyst
Common following trauma | Leave alone unless >5cm or symptoms
81
Splenic aneurysms
Often women Pain then stabilises due to collection less sac then pain again and decrease bp Common if pregnant If >2cm then ligation
82
Acute vs late dumping syndrome
Acute due to hyperosmolar state | Late due to surg insulin and hypoglycaemia
83
Lymph nodes lesser curve
1-6
84
Resections stomach
R0 - microscopy clear R1- negative macro 2 positive both
85
Stomach
Neoadjuvant If LN then chemoradiation post
86
MALT
Expansion of margins Lymphoid cells Treat h. Pylori
87
Li- faumeni
Breast Ovary Sarcoma Astrocytoma
88
Renal pelvis squamous cell cancer
From chronic infections or stones

Mrcs (11 decks)

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