blackboard Flashcards
1
Q
Gastric tumors, unusual findings
A
dysphagia
acnathosis nigarans
black velvety rash
2
Q
RFs for gastric cancer
A
pernicious anaemia
H pylori
consumption of N nitroso compounds
3
Q
Ranson’s criteria or modified Glasgow coma scale
A
prognostic criteria for pancreatitis
4
Q
perianal pain
A
abcess–> usually pain so bad that DRE is impossible
CT or MRI may be needed to get full diagnosis
5
Q
RFs for abcess
A
Chron’s and anal fistulae
Complication of abcess is fistula
6
Q
puritis ani
A
abcess
hameorrhoids
7
Q
Tx of abcess
A
involves drainage of abcess +/- adjunct Abx
8
Q
Hemorrhoids
A
Grade 1 is limited to within the anal canal.
Grade 2 protrudes but spontaneously reduces when the patient stops straining.
Grade 3 protrudes and reduces fully on manual pressure.
Grade 4 is irreducible.
9
Q
Tx for hemorrhoids and fissures:
A
-Hemorrhoids: fibre, ligation, photocoagulation, sclerotherapy or surgical haemorrhoidectomy
-Fissure: topical GTN or diltiazem
reccurrent fissures –> botulinum toxin
10
Q
Fissure risk factors
A
opiates and third trimester of pregnancy
11
Q
Tenesmus
A
Tenesmus is the constant feeling of needing to pass stools, even if there is nothing to pass. It may also be a symptom of rectal carcinoma, and is caused by a SOL.
12
Q
Pancreatic cancer procedure
A
Whipples
13
Q
Hepatitis spread by IVDU
A
Hep B and C
14
Q
70 year old woman has seen her GP for depression on several occasions. She now complains of abdominal pain, constipation & thirst –> what is the cause?
A
Hypercalcaemia
Causes hyperparathyroidism or malignancy. The serum PTH level is elevated in primary hyperparathyroidism whereas it may be very low in malignancy due to negative feedback.
15
Q
HIV and diarrhea
A
Cryptosporidium –> diagnosis is made in the lab by detection of oocysts or antigens in stool.
16
Q
When vomiting is the main presenting symptom
A
Staphylococcus aureus, bacillus cereus or norovirus
17
Q
Complications of chronic pancreatitis
A
pseudo cysts
calcification
DM
malabsorption
18
Q
secrete large amounts of mucus and result in hypokalaemia
A
villous adenomas
villous adenoma, which is a type of polyp in the GIT with a malignant potential. Most colorectal cancers arise from an adenoma and polypectomy reduces the incidence of colorectal cancer. The non-neoplastic polyps include hyperplastic ones, hamartomas, inflammatory and lymphoid polyps
19
Q
Yersinia enterocolitis
A
Yersinia enterocolitis can mimic Crohn’s RLQ pain
20
Q
Osler-Weber-Rendu syndrome
A
aka hereditary haemorrhagic telangiectasia
This causes abnormal blod vessels pretty much everywhere which are prone to bleed. It is an autosomal dominant condition so a positive FH can often be found.
21
Q
pancreatic psuedocyst
A
most common finding is pain followed by a palpable mass
complication of pancreatitis
22
Q
fever and CT of abdo shows a ring-enhancing fluid collection with gas
A
pancreatic abcess –> drainage and Abx
23
Q
EBV
A
infectious mononulceous
causes splenomegaly
meaning more prone to rupture
24
Q
viral gastroenteritis
A
N&V more so than diarrhoea
25
condition that is associated with Budd-Chiari syndrome
polycythemia vera --> Around 30% will go on to develop myelofibrosis.
26
Coombs’ test is positive
CLL --> warm type AIHA accounting for her pallor and fatigue
27
info
Retrosternal pressure experienced can be precipitated by drinking liquids but is eased by continuing to drink, and the pain may be relieved by cold water. This may wake the individual from sleep.
28
myasthenia gravis is associated with what?
associated with thymic hyperplasia in 70% or thymoma in 10%
29
elevated serum AChR receptor antibody titres or MuSK antibodies
myasthenia gravis
30
PBC is also associated with
srojens, rhA
31
Positive heterophile antibody test and serological testing
EBV
EBV and characterised by fever, pharyngitis and lymphadenopathy with atypical lymphocytosis.
IM is commonly named the ‘kissing’ disease as EBV is most commonly transmitted by saliva. Penetrative sex and general promiscuity in young women also increases the risk.
32
Leucoerythroblastosis and splenomegaly
myelofibrosis
Strong risk factors include exposure to radiation and industrial solvents. BM biopsy is essential for diagnosis. Extramedullary haematopoiesis leads to dacrocytes in the peripheral blood smear. Those without symptoms can be managed with folate and pyridoxine supplements. Otherwise options such as a BM transplant and hydroxycarbamide can be considered.
33
myalgia may indicate what infectious disease
influenza or typhoid
34
non-caseating granulomas
sarcoidosis
35
jaundice in malaria suggests what
| and thrombocytopenia and mild anaemia
falciparum infection
36
pain in lymph nodes after alcohol consumption
Hodgkins lymphoma
37
Typhoid / enteric fever
- fever increases incrementally until a persistent fever with temperature 39-41 is established.
- flu like symptoms after onset of fever and cough. -characteristic findings such as bradycardia and rose spots
- Rose spots are blanching red lesions reported in 5-30% of cases usually occuring on the chest or abdomen.
38
Brudzinski’s sign .
meningitis
39
and a petechial/purpuric rash, typically associated with ...
meningococcal meningitis
40
Dengue fever Px
- headache
- retrobulbar pain worsening with eye movement
- rash
- leukopenia and thrombocytopenia are common.
41
Two weeks after a holiday in the Far East, a 30 year old lady presented with anorexia, fever and joint pains. Jaundice appeared a week later and on examination her liver and spleen were both enlarged and very tender
5) This is likely hepatitis A which is primarily transmitted via the faecal-oral route. After the virus is consumed and absorbed, it replicates in the liver and is excreted in the bile (to be re-transmitted). Transmission usually precedes symptoms by about 2 weeks and patients are non-infectious one week after onset of jaundice. The history can reveal risk factors such as living in an endemic area, contact with an infected person, homosexual sex or a known food-borne outbreak. This is classically, in EMQs, associated with shellfish which is harvested from sewage contaminated water.
The clinical course of HAV consists of a pre-icteric phase, lasting 5-7 days, consisting characteristically of N&V, abdominal pain, fever, malaise and headache. Rarer symptoms may be present such as arthralgias and even severe thrombocytopenia and signs that may be found include splenomegaly, RUQ tenderness and tender hepatomegaly as well as bradycardia. The icteric phase is characterised by dark urine, pale stools, jaundice and pruritis. When jaundice comes on, the pre-icteric phase symptoms usually diminish, and jaundice typically peaks at 2 weeks. However, a fulminant course runs in <1% of patients with worsenining jaundice and encephalopathy. Serum transaminases may reach in excess of 10,000 units, although there is little correlation between the level and disease severity. ALT is typically higher than AST.
42
characteristics of EBV
fever
pharyngitis
lymphadenopathy
EBV causes a maculopapular pattern after ampicillin
43
Unexplained diarrhoea of >1 month duration with no pathogen diagnosed
HIV
| The oral candidiasis is also indicative of HIV and is an opportunitistic infection in an immunocompromised host.
44
you get rheumatic fever following infection with what?
group A streptococci
nb rheumatic fever is an autoimmune process
--> carditis, polyarthritis, chorea, erythema marginatum and SC nodules
45
painless white plaque found along the lateral tongue borders
oral hairy leukoplakia
46
Dengue fever Ix
Viral antigen or nucleic acid detection and serology are confirmatory tests to perform
47
CMV disease in AIDS
retinitis
However do remember that virtually any organ can be affected by CMV and it can cause a range of conditions from encephalitis to pneumonitis. In CMV retinitis, fundoscopy will reveal areas of infarction, haemorrhage, perivascular sheathing and retinal opacification. These findings here are of chorioretinitis.
48
friable cervix
chlamydia
49
green pigment = pyoverdine
Pseudomonas
50
gram negative bacilli causing hospital acquired pneumonia and UTI.
Pseudomonas
| green pigment = pyoverdine
51
organisms with the disease:
| Mycobacterium tuberculosis
Pott’s disease
52
organisms with the disease:
| Plasmodium falciparum
Blackwater fever
Blackwater fever is a complication of malaria infection caused by haemolysis, which releases haemoglobin into the bloodstream. This passes into the urine and it is the presence of haemoglobinuria which defines this condition (seen with dark red or black urine, hence the name). It can often lead to renal failure.
53
organisms with the disease:
| Clostridium difficile
Pseudomembranous colitis --> tissue culture assay
54
organisms with the disease:
| Borrelia bugdorferi
Lyme disease
55
organisms with the disease:
| Salmonella enterica
Enteric fever / typhoid
56
gram staining:
| Gram positive cocci:
Streptococcus, Staphylococcus, Enterococcus
57
gram staining
| •Gram positive bacilli:
Clostridium, Listeria
58
gram staining
| •Gram negative cocci:
Neisseria, Haemophilus
59
gram staining
| •Gram negative bacilli:
Most EMQ bacteria not already mentioned (Salmonella, Shigella, Pseudomonas, Legionella, Vibrio, ESBL, Proteus...)
60
organism causing scarlet fever or Kaywaskai
Streptococcus pyogenes
61
VRE stands for vancomycin resistent enterococci
Enterococcus faecium not facecialis
62
brown freckles (GI syndrome)
Peutz Jeghers
63
Abdominal pain:
constant -?
colicky-?
```
constant = inflammation
colicky = obstruction
```
64
Hepatomegaly causes
```
Cancer
Cirrhosis
Cardiac:
-congestive cardiac failure
-constrictive pericarditis
Infiltration:
-amyloidosis, sarcoidosis, lymphoproliferative disease
```
65
Splenomegaly causes
Portal HTN
Haemiatological: lymphomas, leukeamia
Infection: malaria, schistomasis, TB, glandular fever
Inflammation
66
fecal elastase
| fecal calprotectin
fecal elastase - chronic pancreatitis
| fecal calprotectin - IBD
67
suprapubic pain Dx
cystitis
| urinary retention
68
Mesenteric adenitis -- where is the pain?
RLQ
inflammation of lymph nodes in the abdomen, caused by the bacteriym Yersinia enterolitica, Occures in the RLQ and can be mistaken for appendicitis.
69
Diverticulitis - pain, where?
LIF
70
Medical causes of generalized abdominal pain
DKA, porphyria, addisons, hypercalacemia, ledpoisontin, phaeo.
71
Post hepatic causes of jaundice
| Px: dark urine, pale stool
Gallstones
Stricture
Ca of head of pancreas
72
Hepatic cause of jaundice
| Px: JUST DARK URiNE
```
Hepatits
AI
Alcohol
Drugs
Viruses
```
73
Thumb printing in abdo X ray
UC
74
Lead piping
UC
75
Serum albumin-ascities albumin cut off
```
>11g = cirrhosis and cardiac failure
<11g = TB, cancer, nephrotic syndrome
```
76
Ascities Tx
- Diuretics (spiro +/- frusemide)
- Dietary sodium restriction
- Fluid restriction in pts with hyponatemia
- Daily wts
- Theraputic paracentesis with IV human albumin
77
Encephalopathy Tx
```
Lactulose
Phosphate enemas
Avoid sedation
Tx infections
Exclude a GI bleed
```
78
Alcoholics usually have a urea of approx 1, if an alcoholic has a urea of 7/8 suggests a protein mean, which means what?
GI bleed
79
J waves on an ECG
Characteristically seen in hypothermia (typically T<30C), but they are not pathognomonic.
J waves may be seen in a number of other conditions:
Normal variant
Hypercalcaemia
Medications
Neurological insults such as intracranial hypertension, severe head injury and subarachnoid haemorrhage
Le syndrome d’Haïssaguerre (idiopathic VF)
80
Vesicular rash patterns are seen in ,
VZV, HSV and enteroviruses
81
maculopapular pattern
EBV causes a after ampicillin,
82
Lyme disease skin change
erythema migrans
83
erythema nodosum
TB
84
Porphyria Px
abdominal pain, peripheral motor neuropathy, mental symptoms like confusion
...trigger by the use of certain drugs which are known to provoke AIP attacks. In reality, the list of drugs is pretty vast and include most CYP450 inducers, but in EMQs, alcohol and the OCP are common
85
inflammed bulging tympanic membrane with decreased mobility. The membrane may be pink, red, yellow or white.
otitis media
Complications can include the facial weakness CNVII palsy, and perforation of the eardrum, mastoiditis and sigmoid sinus thrombosis.
86
Ramsay Hunt syndrome
reactivation of VZV in geniculate gaglion --> CNVII palsy due to herpes zoster
87
ear pain and an erythematous vesicular rash in the ear canal and on the hard palate
VZV causing Ramsy Hunt Syndrome
88
Conditions which predispose to aneurysm formation and SAH include
adult PKD, Marfan’s, NF1 and Ehlers-Danlos
Cerebral angiography can confirm the presence of aneurysms. The patient should be stabilised and this followed by surgical clipping or endovascular coil embolisation, the choice is subject to much current controversy sparked by relatively recent research. Complications can commonly occur and include rebleeding, hydrocephalus and vasospasm.
89
Trigeminal neuralgia is common in what?
| What is its treatment?
Common in MS
| antiepileptics such as carbamazepine
90
Acute glaucoma px
change in vision with other severe acute symptoms such as eye pain, headache and N&V
Ix: large optic disc cup
91
Seizures Ix
EEG
92
Hypos in unconcious pts
- IV dextrose
| - only do IM glucagon if IV access cannot be established
93
maculopapular rash and the parotitis
mumps
children not vaccinated against mumps and measles are at risk of mumps or measles encephalitis, and there is also a risk of subacute sclerosing panencephalitis from measles.
94
* Unilateral field loss (blindness due to trauma to eye, bloody supply or optic nerve)
* Central scotoma (macular degeneration, vascular lesion, bilateral -toxins
* Bitemporal hemianopia (damage to centre of optic chiasm - pituitary tumour, craniopharyngioma, suprasellar meningioma)
* Binasal hemianopia (rare)
* Homonymous hemianopia (stroke, macular sparing - optic radiation lesion, no macular sparing optic tract lesion)
* Homonymous quadrantanopia (upper - temporal lobe lesion, lower- parietal lobe lesion)
* Tunnel vision (glaucoma, retinal damage, papilloedema)
xxx
95
• Unilateral field loss
(blindness due to trauma to eye, bloody supply or optic nerve)
96
• Bitemporal hemianopia
(damage to centre of optic chiasm - pituitary tumour, craniopharyngioma, suprasellar meningioma)
97
• Homonymous hemianopia
(stroke, macular sparing - optic radiation lesion, no macular sparing optic tract lesion)
98
• Homonymous hemianopia
stroke
macular sparing - optic radiation lesion
no macular sparing optic tract lesion)
99
•Tunnel vision
(glaucoma, retinal damage, papilloedema)
100
Antistreptolysin O Titer
The ASO test is primarily used to help determine whether a recent strep infection with group A Streptococcus:
•Is the cause of a person's or glomerulonephritis, a form of kidney disease
•Caused rheumatic fever in a person with signs and symptoms
101
Complication of mumps parotitis
epidydimo orchitis
Mumps can also cause an aseptic meningitis, oophoritis in women and uncommonly, mastitis, encephalitis and SN deafness.
102
RFs for testicular cancer
cryptorchidism and FH
103
Beta-hCG is raised in
seminomas and teratomas
104
AFP is raised in
teratomas only (more common in 20-30s wherease seminomas are more common 30 plus)
105
cannot be differentiated from the testicle
hydrocele -The mass can also increase in size with increased intra-abdominal pressure (such as coughing, crying or raising the arms) which causes peritoneal fluid to move into the scrotal sac. This causes the mass to vary in size during the day (smaller after lying down).
106
A history of undescended testes is a major risk factor as is the bell clapper deformit
RF for torsion
107
- Painless swelling of testes
- Differentiated from testicle
- transilluminates
Epididymal cyst
108
Urinalysis: pigmented, muddy brown granular casts
ATN - urinalysis centrifuge is diagnostic
109
Gleason score
Prostate cancer grading
110
Testicular mass which varies in size over the day (smaller after lying down)
Hydrocele--> Surgery is only performed if the hydrocele is problematic
111
Abx in UTIs
co-trimoxazole or nitrofurantoin. If there is resistance, a quinolone can be considered such as ciprofloxacin.
112
Blood at end of the stream
bladder calculus
113
Bladder calculus Px
- pain on standing and difficulty urinating --> calculus blocks the bladder outflow.
- Blood at the end of the stream
- suprapubic pain, haematuria and obstructive symptoms.
- Ix urinalysis. A non-contrast CT abdomen is also indicated to look for the stone.
114
large painless bladder and overflow incontinence at night and a raised creatinine level
hydronephrosis (due to bph )
115
-blood at the start of voiding and then the urine became clearer as continue to void.
-hypertensive.
DRE: reveals a smooth enlarged prostate gland.
Prostatic varices
| A varix is an abnormally dilated vein which is prone to rupture and haemorrhage.
116
Causes of urinary retention
- renal failure
- UTI
- mets, spinal chord compression
- obstruction
- constipation
117
Hormonal Tx for Prostate cancer
1. anti androgens (start with this to block peripheral receptors)
2. LHRH agonist
118
Causes of hypothyroidism
1. Iodine deficiency
2. Hashimotos
3. secondary or tertiary hypothyroidism
4. viral
119
Wound refusing to heal
high cortisol
120
small cell lung cancer on cortisol and ACTH
increased ACTH
| increased cortisol
121
steroids on ACTH and cortisol
steroids supress ACTH and hence also decrease cortisol
122
peripheral neuropathy pain management
pregabalin and gabapentin
123
Non DM causes of hypoglycaemia include
insulinomas, alcohol, liver failure and Addison’s disease
124
carpal tunnel symptoms
Symptoms include numbness/tingling of the thumb and radial fingers, an aching wrist and clumsiness (especially with fine motor tasks). The symptoms are of gradual onset and often wake the patient up at night, and is relieved by shaking the wrist.
125
carpal tunnel Ix
EMG
126
carpal tunnel tests
Tinel's test
| phalen's test
127
carpal tunnel causes
inflammation, arthriris, tensonsynovtis, old fractures
128
Zenker’s diverticulum
pharengeal pouch
A pharyngeal pouch can cause symptoms of dysphagia and the sensation of a lump in the neck. There may also be regurgitation of food, cough, halitosis and gurgling noises and the condition is associated with webs. Additionally, it may be asymptomatic. A barium swallow will confirm the dagnosis. Surgical intervetion may be necessary.
129
parotitis and epidymo-orchitis togeather
mumps
130
dexamethasone suppression test
Cushings
131
Cushings Test
Dexamethasone suppression test
132
```
Addisons - levels of:
Aldosterone
ACTH
NA
K
```
```
Addisons - levels of:
Aldosterone - low
ACTH - high
NA - low
K - high
```
133
Addisons Test
ACTH stimulation test (synacthen test)
serum cortisol remains low despite the administration of synthetic ACTH. In an emergency, treatment should not be delayed by diagnostic testing.
134
Amiodarone can cause both hyperthyroidism (Jod-Basedow effect) and hypothyroidism (Wolff-Chaikoff effect). Amiodarone is 37.3% iodine by weight and is structurally similar to thyroxine.
xx
135
TrOusseau’s sign
| ChvOstek’s sign
hypOcalcaemia
136
Orphan Annie’ eyes and psammoma bodies.
Papillary thyroid cancer
137
Pernicious Anaemia Tests
Serum B12 levels are useful and APC (anti-parietal cell antibody) can determine whether pernicious anaemia is the cause (but note APC can also be elevated in atrophic gastritis). IF antibody is highly specific for PA but lacks sensitivity compared to APC. Treatment involves supplementation.
-Dont forget Schillings Test
138
fever, pharyngitis and lymphadenopathy.
EBV, infectious mononucleosis --> Kissing disease
139
heterophile antibodies using the Paul Bunnell monospot.
| atypical lymphocytes
infectious mononucleosis
140
pituitary adenoma secreting ACTH (i.e. Cushing’s disease) first line Tx
Surgery
141
Nephrogenic diabetes insipidus
fluids, salt restriction and thaizide diuretics (paradoxically).
142
RF for nephrogenic diabetes insipidus
FH
lithium use
CKD
chronic hypercalcaemia or hypokalaemia.
143
green nipple discharge
duct ectasia
144
fast growing fibroepithelial mass in the breast
Phylloids Tumor
145
gynaecomastia inducing drugs
- reduce testosterone synthesis (GnRH agonists, cancer drugs, ketoconazole, metronidazole, spironolactone),
- impair the action of testosterone (spironolactone again, finasteride, H2 blockers, PPIs)
- act via oestrogen (digoxin, PHT, anabolic steroids).
146
cold abscess with skin changes
TB
147
activated charcoal does not adsorb what
lithium
148
aspirin overdose Tx
The mainstay of treatment is alkaline diuresis induced by an infusion of sodium bicarbonate. In cases of severe poisoning, it is still started as a bridge to haemodialysis.
149
Vitamin B12 deficency not corrected by intrinsic factor
Coeliac
150
JAK2V617 mutation
polycythemia rubera vera
There is a clear link between Budd-Chiari syndrome and subsequent PRV. Treatment is with venesection. Around 30% will go on to develop myelofibrosis.
151
monoclonal plasma cells in the bone marrow
myeloma
152
Acute myeloid leukaemia
Auer rods
153
‘owl’s eye’
| orphan annie eyes
Hodgkin’s lymphoma
| Papillary thyroid cancer
154
warm-type AIHA and there is peripheral blood lymphocytosis.
CLL
155
Leukaemia associated with Downs
ALL
156
he most common cause of a hypovolaemic hyponatraemia.
thiazide diuretics these are NOT potassium sparing
157
potassium sparing diuretics
aldosterone antagonists
158
beta blocker's effect on potassium
cause hyperkalaemia
159
new onset osteopenia
hypercalacemia
160
- skull deformities, resulting from increased bone resorption, formation and remodelling which characterise this chronic disorder
- most patients are asymptomatic but features such as deafness can occur due to skull remodelling. This affects CNVIII, and can be accompanied by facial pain.
- The patient here also has high-output heart failure, due to the high blood flow to metabolically active bone sites.
Paget's disease
161
Low calcium, Low phosphate, High PTH, High ALP
Osteomalacia
162
High calcium, Low phosphate, Normal PTH, High ALP
primary hyper PTH
163
Normal calcium, Normal phosphate, High PTH, Very high ALP
pagets disease
164
High calcium, Normal phosphate, Slightly low PTH , High ALP
hypercalcaemia of malignancy
165
Normal calcium, Normal phosphate, Normal PTH, Normal ALP
osteoporosis
166
What confirms diagnosis is Paget's disease?
Bone biopsy (but this is rarely done)
167
blue colour of the sclera
type I osteogenesis imperfecta which is characterised by the blue colour of the sclera which is due to the choroidal veins showing through as the sclera is thinner than normal. The cause of this is defective type I collagen formation. The bones fracture easily without any major trauma. It is a genetic disorder which is classically autosomal dominant and warrants referral to a geneticist as a result.
168
seronegative HLA-B27
ankylosing spondlytis
psoriatic arthritis
enteropathic arthritis
reactive arthritis
169
erythromycin side effect
Nausea and vomiting
170
Tricyclic antidepressants e.g amitriptyline, imipramine side effect
constipation and dry mouth
171
Criteria for CHF
Diagnosis of CHF requires the simultaneous presence of at least 2 major criteria or 1 major criterion in conjunction with 2 minor criteria.
Major criteria:
· Paroxysmal nocturnal dyspnea
· Neck vein distention
· Rales
· Radiographic cardiomegaly (increasing heart size on chest radiography)
· Acute pulmonary edema
· S3 gallop
· Increased central venous pressure (>16 cm H2O at right atrium)
· Hepatojugular reflux
· Weight loss >4.5 kg in 5 days in response to treatment
Minor criteria:
· Bilateral ankle edema
· Nocturnal cough
· Dyspnea on ordinary exertion
· Hepatomegaly
· Pleural effusion
· Decrease in vital capacity by one third from maximum recorded
· Tachycardia (heart rate>120 beats/min.)
Minor criteria are acceptable only if they can not be attributed to another medical condition (such as pulmonary hypertension, chronic lung disease, cirrhosis, ascites, or the nephrotic syndrome).
The Framingham Heart Study criteria are 100% sensitive and 78% specific for identifying persons with definite congestive heart failure.
172
SAH immediate management
CCB nimodipine, reduces spasm of cerebral artery
173
thumb printing in barium enema
ischemic colitis
174
CREST symptoms in scleroderma
```
calcinosis
raynauds
oesophageal dismotility
sclerodactyly
telangactasia
```
175
Common cause of bowel obstruction:
- small bowel
- large bowel
- small bowel: adhesions and hernias --> pain is more colicky in nature
- large bowel: hernias, fecal impaction and tumors
- paralytic ileum usually occurs after surgery
176
Nelsons syndrome
A rare disorder and occurs in patients who have had both adrenal glands removed owing to Cushing's disease.[1] During the disorder the patient develops macroadenomas that secrete adrenocoticotropic hormone (ACTH).[2]
177
pleomorphic adenoma
benign tutor of salivary glands
178
cafe un lait spots
| autosomal dominant
neuroofibroma
179
cough impulse on examination of hernias
reducible
180
incarenated hernia
not reducible
181
hernia more commonly to be strangulated
femoral
182
Multiple ulcers in different sites
gastrinoma
| zollinger ellison syndrome
183
villous adenomas can cause
diarrhoea and hypokalaemia (muscle weakness, myalgia and arrhythmia)
184
Boerhave syndrome triad
subcutaenous emphysema
lower thoracic pain
vomiting
185
trimethoprim
UTIs ABx
186
Abdominal Aorta Aneurysm
- diagnosis limit
- follow up every 3 months
- elective intervention
- diagnosis limit = >3cm
- follow up every 3 months = 4-5.5cm
- elective intervention = >5.5cm
