Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Bryn Lepley - Surgery Clerkship Review > Acute Care Surgery > Flashcards

Acute Care Surgery Flashcards

1
Q

Mnuemonic for remembering most common causes of groin masses:

A

MINT: malformations, nfections, neoplasms, or trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Groin mass that is tender, mobile, and <1 cm

diagnosis?

A

‘shotty’ lymph nodes, reactive with follicular hyperplasia (2/2 minor infections, scrapes, or cuts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

a patient who has ‘shotty’ reactive lymph nodes in their groin area s/p a small cut to the skin above it. What type of mass is it?

A

Groin mass that is tender, mobile, firm, and <1 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Groin mass that is tender, large (>1 cm), and limited to the inguinal region

possible diagnosis?

A

syphilis, chancroid, or lymphogranuloma venerum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what types of groin mass do you expect to see with syphilis, chancroid, or lymphogranuloma venerum?

A

tender, large (>1 cm) and limited to the inguinal region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Groin mass that is non-tender and associated with diffuse lymphadenopathy?

diagnosis?

A

systemic process of some kind (infectious, malignant, or autoimmune) (not very specific)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

non-tender groin mass that is limited to the inguinal region.

possible diagnosis?

A

metastatic cancer from local source such as melanoma, anal, genital OR from lymphoma / lipoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what cancer originating in the groin region does NOT metastasize to the inguinal region? (i.e. cause a non-tender mass that is limited to the inguinal region)

where does this cancer mets to?

A

testicular cancer.

this metastasizes to the retroperitoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

pathophysiology (explain why these occur):

  1. direct inguinal hernia
  2. indirect inguinal hernia
  3. femoral hernia
A
  1. acquired weakness in abdominal floor or chronic strining
  2. congenital
  3. multiple pregnancies dilated femoral veins and widens the femoral canal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hernia sac lining for the following hernias:

  1. direct inguinal hernia
  2. indirect inguinal hernia
  3. femoral hernia
A
  1. peritoneum
  2. patent processus vaginalis
  3. peritoneum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q
  1. most likely hernia to strangulate?
  2. most common hernia in Men? women? children?
  3. what populaton are femoral hernias most common in?
A
  1. femoral hernia
  2. all = indirecti inguinal hernia
  3. females
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which hernia ONLY goes through the superficial ring?

A

Direct inguinal hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What ring(s) in the inguinal canal does

  1. the direct hernia pass through?
  2. the indirect hernia pass through?
A
  1. direct only goes through superficial ring
  2. indirect goes through both the deep AND superficial ring
    * *Reminder: External ring = superficial ring, and internal ring = deep ring.*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pt with femoral hernia has absentbowel sounds and localized pain over the region.

diagnosis?

A

ischemic bowel (if just SBO would see hyperactive BS 2/2 to hyperperistalsis to try to push past the obstruction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
  1. Direct inguinal hernia occurs _____ to the inferior epigastric arteries
  2. Indirect inguinal hernia occurs ______ to the inferior epigastric arteries
A
  1. direct = medial
  2. indirect = lateral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a richter’s hernia? why is it important to not miss?

A

circumference of bowel trapped in the hernia sac

important to catch because high likelihood of strangulation and causing ischemia

17
Q

when the entire cirumference of bowel is trapped within a hernia sac, this is called a ______ hernia

A

Richter’s Hernia

18
Q
  1. What is a sliding hernia?
  2. what population do they most occur in?
  3. do they occur most often on the left or right side of the body?
A
  1. an indirect hernia where a retroperitoneal organ (eg colon or bladder) herniates within a sac and makes up the posterior wall of the sac
  2. males > females
  3. Left > right
19
Q

when do you want to repair umbilical hernia in children?

A

you only want to repair if:

  1. it persists for >4 yo
  2. the defect is >2 cm
  3. if there is progressive enlargement s/p age 2
20
Q

What nerves can be injured in a hernia repair and what would the subsequent deficit be? (x4 nerves)

A
  1. genital branch of genitofemoral nerve = loss of cremaster reflex + loss of sensation to anterior scrotum / labia majora
  2. ilioinguinal nerve: loss of sensation at base of penis, mons pubis, and inner thigh
  3. iliohypogastric nerve = loss of sensation in suprapubic region
  4. lateral femoral cutaneous nerve = loss of sensation in lateral side of thigh, down to knee (more common in laparoscopic repair)
21
Q

A patient had a laparoscopic repair of a right sided inguinal hernia. Now they have been having a burning sensation to their lateral right thigh, and on physical exam you notice loss of sensation to the lateral side of the thigh, down to the level of the knee.

  1. what is this disease process called?
  2. what was injured?
A
  1. ‘meralgia paresthetica’ (the burning pain)
  2. lateral femoral cutaneous nerve
22
Q

indirect hernias travel with the _________ so they need to be separted for fear of injuring the ________ or _______

A

spermatic cord

testicular vessels; vas deferens

23
Q

what is the leading cause of testicular ischemia?

A

attempting to excise an indirect hernia that was extended and adhered to the scrotum, should’ve been left in situ!

24
Q

is hernia recurrence s/p repair more common in laparoscopic or open?

A

laparoscopic

25
Q

cramping abdominal pain, nausea, bilious vomiting, abdominal distension, hypoactive BS

  1. diagnosis?
  2. what part of hx would make you more concerned that this is the diagnosis?
A
  1. small bowel obstruction
  2. prior abdominal surgery, indicating likely adhesions
26
Q

cramping abdominal pain, fevers, nausea, vomiting, diarrhea, and hyperactive BS

diagnosis?

A

gastroenteritis

27
Q

diffuse abdominal pain, hypoactive BS, stool in rectum but pt notes intermittent diarrhea since her appendectomy 5 days ago

A

paralytic ileus (or post-op ileus)

28
Q

gradually increasing abdominal pain that is intermittent but with increasing intervals between pain, distension, feculent vomiting in 80 yo female

diagnosis?

A

large bowel obstruction

29
Q

debilitated, hospitalized male who is passing flatus and has large amount of abdominal distension.

diagnosis?

A

colonic pseudo-obstruction

Reminder: this is normally idiopathic

30
Q

A patient comes in with LUQ abdominal pain; she has not had an appetite or felt like eating. She notes bloody diarrhea for the past x1 day. Physical exam shows chandalier sign to the LUQ.

diagnosis?

A

mesenteric ischemia

31
Q
  1. what surgeries in the US are most likely to cause adhesions that in turn may cause a SBO?
  2. most common cause of SBOs worldwide
A
  1. Appendectomy, colorectal resection, gyn procedure
  2. hernias
32
Q
A

Bryn Lepley - Surgery Clerkship Review (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions