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ABSITE > Abdomen - General > Flashcards

Abdomen - General Flashcards

1
Q

Perf appy with >3cm abscess

A

Perc drainage and abx

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2
Q

<3cm abscess s/p appy

A

IV abx

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3
Q

Imaging for penetrating flank trauma

A

CT IV/oral/rectal contrast

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4
Q

HypoT on insufflation, next step

A

Go slow, convert to open if intolerant

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5
Q

Origin mucin-secreting omental growths

A

Appendix

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6
Q

Biochemical workup, adrenocortical Ca

A

Dex suppression test, plasma meta, aldo:renin ratio

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7
Q

Syndrome assoc Desmoid tumors

A

FAP and Gardner

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8
Q

Spindle shaped cells, abundant collagenous matrix

A

Desmoid tumor

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9
Q

Unresectable desmoid, tx

A

Tamoxifen and NSAIDs

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10
Q

Paracentesis milky, leuks with lymphatic predominence

A

Chylous ascites

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11
Q

Hemodynamics of pneumoperitoneum (MAP, SVR, CI, renal flow, splachnic flow)

A

Inc MAP, SVR. Decr CI, renal flow, splachnic flow

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12
Q

SBP organisms

A

E Coli, Klebsiella, pneumococci

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13
Q

Chylous ascites, tx

A

Medium chain fatty acids -> TPN and Octreotide

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14
Q

Ventral hernia and going for PD cath placement

A

Repair at the same time with extraperitoneal mesh

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15
Q

Mesenteric cyst, tx

A

Cyst excision

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16
Q

Indications for open drainage intraabdominal abscess

A

No perc or failed perc access, no source control, interloop or multiple abscesses, loculated, necrosis, unstable

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17
Q

Peritoneal dialysis catheter outflow dysfunction, common cause

A

Constipation

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18
Q

Painless, unilateral scrotal mass, next step

A

Scrotal US, Testicular cancer until proven otherwise

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19
Q

Pseudomyxoma peritonei, tx

A

Cytoreduction, debulking, HIPEC

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20
Q

Mesenteric ischemia, dx

A

CT angio abd/pelv

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21
Q

Salmon colored fluid from surgical wound, tx

A

OR for wound exploration (fascial dehiscence)

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22
Q

Abd pain, bowel wall thickness in setting of cocaine, hypovolemia or CHF

A

Mesenteric ischemia

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23
Q

Abd pain, bowel thickness in setting of PVD, arrhythmia, valvular dx

A

Arterial occlusion

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24
Q

Abd pain, bowel thickening in setting of portal HTN, rHF, hypercoagulable

A

Venous occlusion

25
Q

Abd pain, whirl sign

A

Mechanical strangulation

26
Q

Young healthy with bradycardia on insufflation, cause

A

Vasovagal stretch peritoneal membrane

27
Q

Chronic Mesenteric ischemia, dx

A

CT angio

28
Q

Anticoagulants, coughing, tender abdominal mass

A

Recurs sheath hematoma

29
Q

Difference in robotic vs lap chole

A

Cost

30
Q

Indications for diag lap

A

Gyn eval, onc staging, bx node, chronic abd pain

31
Q

Dense fibrosis, high cellularity, low mitotic index, dx and associations

A

Desmoid tumor, FAP and Gardner

32
Q

Indication for right hemi for appendiceal neoplasm

A

> 2cm, AdenoCa, involve base, 1-2cm with lymphovasc invasion, pos margin, high proliferation(grade 2 Ki-67), mixed histo(goblet cell, adenocarcinoid)

33
Q

Complicated appendicitis with fluid collection, tx

A

Perc drainage, colonoscopy 6wks

34
Q

Appendicitis in pregnancy; tx and how

A

Lap appy entering abdomen via Hasson technique, bump left lateral decubitus

35
Q

Biggest indication for interval appendectomy

A

Appendicolith

36
Q

Most common malignant tumor of the appendix

A

Carcinoid

37
Q

Absolute contraindications PEG

A

Poorly controlled ascites, uncorrectable coagulopahthy, peritonitis, inability to appose wall, gastric outlet obstruction, expected survival <4weeks

38
Q

Most common complication PEG

A

Infection at PEG site

39
Q

CT-proven symptomatic bleeding mass in small bowel; tx

A

Surgical exploration and resection

40
Q

Initial treatment for ischemic orchitis

A

NSAIDs

41
Q

Where to sew inferior aspect of mesh during IHR and what is at risk

A

Shelving edge of inguinal ligament, iliac vessels

42
Q

Hesselback triangle; boundaries and what type of hernia

A

Inguinal ligament, rectus and inferior epigastrics, direct IH

43
Q

Howship Romberg sign, pathognomonic for what

A

Increased hyperesthesia from the medial crease through medial thigh towards knee with extension, adduction and internal rotation, obturator hernia

44
Q

Ilioinguinal nerve location

A

Anterior to the spermatic cord

45
Q

Iliohypogastric nerve location

A

Between int/ext oblique superior to cord

46
Q

Genital br of genitofemoral, location and supply

A

posterior to cord in cremasterics, scrotal and medial thigh sensation

47
Q

Best way to reduce seroma formation s/p abd hernia repair

A

Drain placement

48
Q

Tx for seroma

A

Observe, pressure dressing, possibly aspirate

49
Q

At risk for injury during lateral tacking of mesh in IHR; deficit

A

Ant femoral cutaneous nerve, lateral thigh sensation

50
Q

Repair for both inguinal and femoral hernias; describe

A

McVay, Conjoint to Coopers

51
Q

Chronic inguinodynia resfractory to conservative management; tx

A

Local injection with bupivacaine, corticosteroids and hyaluronic acid

52
Q

Hernia with highest risk for strangulation

A

Femoral

53
Q

Diastasis recti; tx

A

Weight loss, core strengthening

54
Q

Best technique to repair parastomal hernia

A

Sugarbaker mesh repair

55
Q

Treatment for >4cm incisional hernia

A

Permanent or long acting mesh with 3-4cm overlap, PDS suture

56
Q

Rives-Stoppa-Wantz repair

A

Retrorectus repair

57
Q

Access to abdomen in patient with hx of sigmoidectomy

A

Veress at Palmer’s

58
Q

Lap IHR with mesh; where to avoid tacks

A

Inferior to the iliopubic tract and lateral to the gonadal vessels

59
Q

Adult with intussusception; tx

A

Ex lap with resection

ABSITE (34 decks)

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