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MRCS A > Abdominal > Flashcards

Abdominal Flashcards

1
Q

Earliest complication of ileostomy

A

Necrosis

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2
Q

Lienorenal ligament

A

Posterior to the spleen
Splenic artery+vein
Tail of the pancreas

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3
Q

Acute mesenteric embolus

A

Set an onset abdominal pain followed by profused diarrhoea
May be associated with vomiting
Rapid clinical deterioration and
Test high white cell count lactate amylase may all be abnormal particularly in established disease. These can be normal in the early phases

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4
Q

Acute in chronic mesenteric ischaemia

A

Usually longer prodromal history

Post prandial abnormal discomfort and weight loss

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5
Q

Low flow mesenteric infarction

A

This occurs in patients with multiple comorbidities in profusion significantly compromised by overuse of inotropes with background cardiovascular compromise
The end result is that the ball is not in adequately profused any forwards occur from the mucosa outwards

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6
Q

Which anatomical element will be least likely encountered when transverse incision is made 2/3 -umbilicus-symphysis

A

Posterior lamina of the recrus sheath

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7
Q

Accessory adrenal tissue frequent location

A

Mostly firmed only from vortex
Broad ligament or spermatic cord
However it can be found anywhere, even intracranial

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8
Q

Bilious vomiting in neonates

A

Think intestinal malrotation, volvulus

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9
Q

Necrotising entérocolites

A

Prematurity is the main risk
Early features abdominal distension and passage of bloody stools
X-ray pneumatics is intestinales and evidence of free air
Increased risk when empirical antibiotics are given to infants beyond 5 days
Treatment total gut rest and TPN
Laparotomy

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10
Q

Recommandation for ER thoracotomy

A

Penetrating thoracic trauma that is followed by cardiac arrest

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11
Q

Paget vs Eczema of the breast

A

Paget will affect the nipple first and then spread to the areolar area

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12
Q

The most important structure involved in supporting the uterus

A

Central perineal tendon

If this is injured->uterus prolapse

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13
Q

Lymphoedema primary

A

Congenital -milroy’s disease
1-35 years: meige’s disease
> 35 years Tarda

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14
Q

Malignant hyperthermia arterioles

A

Fibrinoid necrosis

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15
Q

Spigelian hernia

A

Arcuate line

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16
Q

Lumbar hernia

A

Crest of ilium inferiorly
External oblique laterally
Latissimus dorsi medially

17
Q

Obturator hernia

A

Herniation through the obturator canal
Commoner in females
Lies behind pectineus muscle
Will present with obstruction

18
Q

Richter hernia

A

Small bowel is strangulated within hernia
May present with obstruction
Where vomiting is prominent -paralytic ileus from peritonitis( these hernias can perforate)

19
Q

Littres hernia

A

Hernia containing Meckel’s diverticulum

20
Q

E colo symptoms

A

Enterohepathogenic
Enteroinvasive: dysentery, large bowel necrosis/ulcer
Enterotoxic:small intestine, travels diarrhoea
Enterohaemorrhagic:0157, cause a haemorrhagic colitis, haemolytic uraemic syndrome and thrombocytopaenic purpura

21
Q

Yesenia enterocolitica

A

Gram negative, coccobacili
Typically produces a protracted terminal ileitis that may mimic Crohns
DD appendicitis
May progress to septicaemia in susceptible individuals
Usually sensitive to quinolone or tetracyclines

22
Q

Exploration of CBD drain tube

A

Latex T tube- form fibrosis

23
Q

CNS drain

A

Low suction drain

/ free drainage- sub dural haematoma

24
Q

CVS drain

A

Underwater seal drain

25
Q

Most frequent abdominal emergency in children under 1

A

Intussuseption

26
Q

Carcinoid syndrome tests

A

5-HIAA -urine
Somatostatin receptor scintigraphy
CT scan
Chromogranin A

27
Q

Structures passing through the diaphragm

A

Aorta+ thoracic duct -aortic hiatus
Vagal trunks accompany the oesophagus- muscle part R
R Frenic+ iVC -caval opening
L frenic- anterior to central tendon on the left

28
Q

Spleen structure

A

Réticuloendothélial organ
Red pulp-venous sinuses
Réticuloendothélial cords-white pulp

29
Q

Hernia repair

A

Open/ laparoscopic
Open Lichtenstein repair
Shouldice - acceptable

30
Q

Dercums

A

Multiple lipomas

Adipose is dolorosa

31
Q

Segmental resection for pts with polyps

A 
Incomplete excision if malignant polyps
Malignant sessile polyps 
Malignant pedunculated polyp with submucosal invasion
Polyps with poorly diff. Carcinoma 
Familial polyposis
32
Q

Acute pseudo-obstruction medical treatment

A

If supportive treatment doesn’t work- neostigmine

33
Q

Treatment Barrett

A

Long term PPI
Consider ph and manometry studies
Regular endoscopic monitoring. Quadratic biopsies

34
Q

Total vs sub total gastrectomie

A

If <5 cm from from the OD- total

If 5-20 from the OF - subtotal

35
Q

Origin of most pancreatic carcinoma

A

Ductal

MRCS A (16 decks)

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