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4th Year General Surgery > Classic Presentations > Flashcards

Classic Presentations Flashcards

1
Q

A patient presents with a tongue that is red, smooth (loss of lingual papillae) and sore

A

Glossitis (caused by B12 deficiency)

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2
Q

An obese patient presents with heartburn aggravated by lying down, a nocturnal cough, regurgitation of food and acid and excessive salivation

A

GORD

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3
Q

A patient experiences intermittent dysphagia for both solids and liquids, regurgitation (particularly at night) and chest pains (spasms). A barium swallow shows a bird-beak appearance

A

Achalasia

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4
Q

A patient reports feelings of early fullness, bloating, N&V, weight loss and abdominal pain

A

Gastroparesis

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5
Q

A patient presents with burning upper abdominal pain that improves with eating

A

Duodenal ulcer

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6
Q

A patient presents with burning upper abdominal pain that is exacerbated with eating

A

Gastric ulcer

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7
Q

A patient vomits coffee-ground vomit

A

Upper GI bleed caused by peptic ulcer disease

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8
Q

A female patient complains of abdominal pain, weight loss, diarrhoea and steatorrhoea. On examination the patient has mouth ulcers and angular stomatitis

A

Coeliac disease

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9
Q

A patient has severe abdominal colicky pain, abdominal distension and tenderness and reduced bowel sounds

A

Small bowel obstruction (gallstone ileus, Chron’s, strangulated hernia etc)

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10
Q

A patient has epigastric pain that moves into the RIF (McBurney’s point). They also have N&V and a low grade fever. They have rebound tenderness and Roving’s pain (pain in RIF when LIF palpated)

A

Appendicitis

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11
Q

A child develops viral diarrhoea. The most common cause is…

A

Rotavirus

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12
Q

A patient presents with food poisoning. The most common cause is…

A

Campylobacter

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13
Q

Which of the following require a stool culture, stool toxin or stool PCR:

  • Salmonella
  • C.diff
  • Norovirus
  • Campylobacter
  • Shigella
  • E.coli
A
  • Salmonella, campylobacter & shigella = stool culture
  • C.diff & E.coli = stool toxin
  • Norovirus = Stool PCR
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14
Q

A young patient reports abdominal cramps, diarrhoea, weight loss and painful ulcers in mouth and rectum

A

Crohn’s disease

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15
Q

A 30 year old patient experiences diarrhoea + bleeding + mucus, increased bowel frequency, night rising, lower abdominal pain, weight loss, urgency, tenesmus and incontinence

A

Ulcerative colitis

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16
Q

A 60 year old patient presents with left sided abdominal pain, altered bowel habit and nausea

A

Diverticular disease

17
Q

A patient presents with bloody diarrhoea and cramping abdominal pain

A 
Infective colitis (C. difficile, Campylobacter, Shigella, E. coli 0157)
OR
Ischaemic colitis (obstruction, atherosclerosis of mesenteric vessels)
18
Q

A young woman on the pill presents with fatigue, discomfort, myalgia and loss of appetite. On examination she is found to have jaundice. Blood tests show ↑AST ↑ALT, ↑CRP, ANA +ve, SMA +ve, anti-LKM +ve, ↑IgG

A

Autoimmune hepatitis

19
Q

A patient presents with jaundice, N&V, steatorrhoea, ascites, hepatosplenomegaly, spider naevi and caput medusa. LFTs show ↑AST, ↑GGT

A

Alcoholic liver disease

20
Q

An obese patient begins to show signs of liver disease

A

Late stage NAFLD

21
Q

A middle aged woman presents with fatigue and an itch without a rash. On examination you see xanthelasma, jaundice and hepatosplenomegaly. LFTs show a cholestatic pattern

A

Primary biliary cirrhosis

22
Q

A female patient presets with signs of liver disease and joint pain. Examination shows hepatomegaly and a slate grey appearance. TFTs show hypothyroidism and LFTs show↑AST ↑ALT, ↑IgG

A

Haemochromatosis

23
Q

A patient presents with signs of liver disease. On examination, Kayser-fleisher rings can be seen in the eyes

A

Wilson’s disease

24
Q

A 40 year old, obese female patient presents with RUQ colicky pain (± radiation to shoulder) and N&V

A

Biliary colic

25
Q

A 40 year old, obese female patient presents with constant RUQ pain (± radiation to shoulder), fever, vomiting, tenderness, guarding and +ve Murphy’s sign

A

Acute cholecystitis

26
Q

A patient presents with Charcoat’s triad (jaundice, fever, RUQ pain), pale stool, dark urine and puritis. LFTs show obstructive jaundice

A

Ascending cholangitis

27
Q

A male patient with ulcerative colitis presents with, fatigue, fever, RUQ pain, pruritis and weight loss. Blood tests show cholestatic LFTs

A

Primary sclerosing cholangitis

28
Q

A patient presents with severe epigastric pain that radiates to the back, fever, nausea, vomiting, loss of appetite, Grey Turner’s sign (flank bruising) and Cullen’s sign (periumbilical bruising

A

Acute pancreatitis

29
Q

A patient with a history of alcohol abuse presents with chronic abdominal pain and steatorrhoea

A

Chronic pancreatitis

30
Q

A patient presents with abdominal and back pain, weight loss, jaundice, pale stool and dark urine

A

Pancreatic cancer

31
Q

A patient presents with a groin lump that you cannot get above and is non-pulsatile

A

Femoral hernia

32
Q

A patient presents with a groin lump that you cannot get above and is pulsatile

A

Femoral artery aneurysm

33
Q

A patient with a history of IVDU presents with a groin lump, fever, back pain and a limp

A

Psoas abscess

34
Q

A patient presents with a leg that is pale, painful and cold. They report parasthaesia and paralysis in the limb and on examination no pulses can be found

A

Acute limb ischemia

35
Q

A patient presents with a leg with the ‘6Ps’ of limb ischemia. They have a PMH of claudication

A

Acute on chronic limb ischemia

36
Q

A patient has a relatively normal looking leg but is complaining of extreme pain. There is pain on passive stretch, parasthaeisa and paralysis. Peripheral pulses are present

A

Compartment syndrome

37
Q

A patient experiences claudication after short distances. They also report rest pain for >2 weeks that is worse at night and relieved by swinging the foot over the edge of the bed. They also have a non-healing ulcer

A

Critical limb ischemia

38
Q

A patient presents with diffuse, constant abdominal pain and N&V. Abdominal exam is unremarkable. They have a PMH of AF. Blood gases show acidosis and lactate is elevated

A

Mesenteric ischaemia

4th Year General Surgery (1 decks)

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