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Year 3 EMQ revision > Abdomen and Surgery > Flashcards

Abdomen and Surgery Flashcards

1
Q

UC patient presents with jaundice, pruritus and abdo pain

Raised ALP

Negative anti-mitochondrial antibodies

Association with HLA-B8 and HLA-DR3

A

Primary sclerosing cholangitis

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1
Q

Abdominal film of an elderly constipated woman shows an ‘inverted U’ loop of bowel

A

Volvulus

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2
Q

Abdominal pain, vomiting and jaundice

Tender hepatomegaly and ascites

History of recurrent miscarriages

A

Budd-Chiari syndrome

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2
Q

Signs on examination

Leuconychia

A

Hypoalbuminaemia

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2
Q

Chronic liver disease associated with:

Early onset emphysema

A

α1-antitrypsin deficiency

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3
Q

Signs on examination

Angular stomatitis

A

Iron deficiency anaemia

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4
Q

Constipation and bright-red blood coating her stools

Two bluish tender spongy masses are found protruding from the anus

They prolapse through the rectum on defecation but spontaneously reduce

A

Second-degree haemorrhoids

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5
Q

65-year-old woman presents with constipation and colicky left-sided abdominal pain relieved by defecation

A

Diverticular disease

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5
Q

Hereditary nephritis, sensorineural deafness, ocular abnormalities

A

Alport’s

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6
Q

Early oliguria followed by recovery of renal function with an increase in renal output

A

Acute tubular necrosis

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7
Q

Signs on examination

Asterixis (liver flap)

A

Hepatic encephalopathy

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8
Q

21-year-old man presents with a history of constipation and rectal bleeding

On examination there are numerous dark freckles on the palm, lips and oral mucosa

A

Peutz-Jeghers syndrome

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9
Q

62-year-old man presents with rectal bleeding and a year’s history of left iliac fossa pain and change in bowel habit

There is no weight loss

A

Diverticular disease

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9
Q

Pruritis, jaundice, pigmentation, AMA positive, middle-aged woman

Associated with: RA, Sjorgen’s syndrome, thyroid disease, renal tubular acidosis

A

Primary biliary cirrhosis

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10
Q

Testicular swelling that has increased in size over the last couple of months

The swelling is fluctuant and the underlying testis impalpable

A

Hydrocoele

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11
Q

Lump behind the anterior border of sternocleidomastoid on the upper left side of the neck

A

Branchial cyst

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11
Q

Treatment of GI conditions

IBS patient complains of colicky pain and bloating

A

Mebeverine

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12
Q

Worsening eczema-like rash overlying the areola and nipple

Palpable mass can be felt under the rash

A

Paget’s disease of the breast

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13
Q

Chronic liver disease associated with:

Dysarthria, dyskinesia, dementia, Kayser-Fleishcer ring

A

Wilson’s disease

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14
Q

Vitamin D, folate and nicotinic acid (Vit B3) are absorbed in the…

A

jejunum

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15
Q

Treatment of GI conditions

Severe oesophagitis confirmed on endoscopy

A

High-dose PPI

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15
Q

Classical presentation

Severe epigastric pain radiating to back associated with vomiting

A

Acute pancreatitis

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16
Q

Signs on examination

Glossitis

A

Vitamin B12 deficiency

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17
Q

Caused by occlusion of the hepatic veins that drain the liver

Classical triad of abdominal pain, ascites and liver enlargement

A

Budd-Chiari syndrome

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18
Q

Glomerulonephritis, pulmonary damage, anti-GBM antibody

A

Goodpasture’s

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20
Q

Splenomegaly

Neutropenia

Rheumatoid arthritis

A

Felty’s syndrome

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21
Q

Soft lump in left groin

Expansile cough impulse

Fluid thrill felt when percussing lower down the legs

A

Saphena varix

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21
Q

Tanned man with an ulcer on nose with rolled edge, due to necrosis of centre

A

Basal cell carcinoma

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22
Q

Crohn’s patient complains of watery discharge from a puckered area 2cm from the anal canal

A

Anal fistula

22
Q

Fever and bloody diarrhoea

Tachycardic and Hb of 10g/dL

Abdominal film shows loss of haustral pattern and a colonic dilatation of 8cm

A

Toxic megacolon - presentation of severe UC

22
Q

A 35-year-old woman is worried about an abdominal mass that has grown over the last six months and a similar length history of very heavy menstrual bleeding with no intermenstrual bleeding

On examination a knobbly mass can be felt in the middle lower quadrant that is dull to percussion

The lower edge is not palpable

A

Fibroids

22
Q

Most common cause of glomerulonephritis

A

IgA nephropathy / Berger’s disease

24
Q

Week history of fever and sore throat

Macular rash after ampicillin

Enlarged posterior cervical nodes

Palatal petechiae

Splenomegaly

A

Infectious mononucleosis (glandular fever)

Results from primary infection with EBV

25
Q

Signs on examination

Buccal pigmentation

A

Peutz-Jeghers syndrome

Addison’s disease

25
Q

Signs on examination

Expansile pulsatile mass

A

Aneurysm

27
Q

Treatment of GI conditions

Cirrhosis, with haematemesis

A

Upper GI endoscopy (suspected oesophageal varices)

28
Q

Classical presentation

Jaundice and constant right upper quadrant pain

A

Biliary colic

29
Q

Hepatosplenomegaly

Anaemia

Bone involvement

Increased pigmentation on forehead and hands

A

Gaucher’s disease

32
Q

Patient treated with broad-spectrum antibiotics presents a few days later with bloody diarrhoea

A

Pseudomembranous colitis

34
Q

Thirst, tiredness, depression, bone pain, constipation

A

Hypercalcaemia

36
Q

19-year-old man complains of severe pain and swelling of sudden onset in his right scrotum

Testes and epididymis are very tender

Has had unprotected sex recently

A

Acute epididymo-orchitis

37
Q

Man presenting with scrotal swelling is worried that he is growing a third testicle

On examination there is a smooth fluctuant swelling within the scrotum

Both left and right testes are palpable

A

Epididymal cyst

37
Q

Constipation and bright-red blood coating her stools

Two bluish tender spongy masses are found protruding from the anus

These do not reduce spontaneously and require digital reduction

A

Third-degree haemorrhoids

38
Q

Chronic liver disease associated with:

Pigmentation, diabetes

A

Haemochromatosis

40
Q

Woman who has recently given birth complains of excruciating pain on defecation, which persists for hours afterwards

Examination reveals a defect posterior to the anal canal

A

Anal fissure

42
Q

Vitamins B12 and C are absorbed in the…

A

terminal ileum

43
Q

Transmural, non-caseating granulomatous inflammation, skip lesions

A

Crohn’s

45
Q

Treatment of GI conditions

Perforated gastric ulcer

A

Laparotomy

46
Q

GET SMASHED

causes of pancreatitis

A
  • *G**all stones
  • *E**thanol
  • *T**rauma
  • *S**teroids
  • *M**umps
  • *A**utoimmune
  • *S**corpion stings/spider bites
  • *H**yperlipidaemia/hypercalcaemia (metabolic)
  • *E**RCP
  • *D**rugs
47
Q

Classical presentation

Iliac fossa pain, positive pregnancy test

A

Ectopic pregnancy

48
Q

Feeling of a lump in throat that causes discomfort on swallowing, but examination and imaging of the pharynx and oesophagus reveal no abnormality

A

Globus hystericus

49
Q

Signs on examination

Craggy hepatomegaly

A

Liver malignancy

51
Q

Irreducible lump in the left groin that is positioned below and lateral to the pubic tubercle

A

Femoral hernia

52
Q

Signs on examination

Koilonychia

A

Iron deficiency anaemia

53
Q

4-year-old presents with large swelling at the posterior triangle

Swelling is soft and fluctuant and transilluminates brilliantly

A

Cystic hygroma

54
Q

Constipation and bright-red blood coating her stools

Two bluish tender spongy masses are found in the rectum

A

First-degree haemorrhoids

55
Q

Signs on examination

Aphthous ulceration

A

IBD

Coeliac disease

56
Q

55-year-old woman presents with abdominal pain, weight loss and fatty stools

She also complains of extremely uncomfortable itchy blisters on her knees and elbows

Particularly strong association with HLA-DR3 and -DQ2

A

Coeliac disease

57
Q

6-year-old boy presents with a 2-week history of non-blanching rash over the buttocks and macroscopic haematuria

Complains of pain in both knees

A

Henoch-Schönlein purpura

58
Q

Anaemia + mild jaundice

Reticulocytosis

Elevated serum unconjugated bilirubin

Reduced plasma haptoglobin

Raised LDH

Increased urinary urobilinogen

A

Haemolytic anaemia

60
Q

Bleeding ulcer on upper region of left cheek

Everted edge

Palpable cervical lymph nodes

A

Squamous cell carcinoma

61
Q

Calcium and iron are absorbed in the…

A

duodenum

63
Q

Classical presentation

Colicky pain radiating to the groin

A

Ureteric colic

64
Q

Crypt abscesses, goblet cell depletion, mucosal ulcers, continous

A

Ulcerative colitis

65
Q

Barrett’s oesophagus is metaplasia from…

A

squamous to columnar

66
Q

Presence of red cell casts in urine are strongly suggestive of…

A

glomerular pathology

67
Q

Treatment of H. pylori

A

Triple therapy (PPI + 2 Abx)

  • Abx:* amoxicillin + clarithromycin
  • (for penicllin allergic):* clarithomycin + metronidazole
68
Q

Pruritis, jaundice, abdominal pain, elevated ALP, AMA negative

Associated with IBD

A

Primary sclerosing cholangitis

69
Q

At what plasma bilirubin level is jaundice usually visible at?

A

>35µmol/L

70
Q

Double stranded DNA virus with the cytoplasm of hepatocytes

A

Hepatitis B

71
Q

RNA virus in a patient with signs of hepatic inflammation

A

Hepatitis C

Year 3 EMQ revision (8 decks)

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