Clinical Flashcards
PAEDIATRIC
What are the causes of bilious vomiting in neonates?
- Duodenal atresia (higher in Down’s)
- Malrotation + volvulus ( 3-7d after birth)
- Jejunal/ileal atresia
- Meconium ileus (CF)
- Necrotising enterocolitis (premature)
GENERAL
What is ‘diaphragm disease’?
Associated with prolonged NSAID use - lumen of small bowel divided into short compartments
GENERAL
What are the gynaecological causes of abdominal pain?
- Mittelschmerz - mid-cycle pain, sharp onset, little systemic disturbance
- Endometriosis - 25% asymptomatic, 25% associated with other pelvic organ pathology, 50% menstrual irregularity, infertility, pain and deep dyspareurnia.
- Ovarian torsion - sudden onset deep seated colicky abdominal pain.
- Ectopic pregnancy - symptoms of pregnancy, sudden collapse. Shoulder tip pain
- PID - bilateral lower abdominal pain associated with vaginal discharge. Associated peri-hepatic inflammation secondary to chlamydia = Fitz-Hugh-Curtis syndrome
COLORECTAL
What are Desmond tumours?
Fibrous neoplasms arising from musculoaponeurotic structures. Occur in 15% of patients with familial adenomatous polyposis coli.
Commonly occur in women in erectus sheath
UROLOGY
What is the difference between bulbar and membranous urethral rupture?
Bulbar rupture: straddle injury, triad of signs (urinary retention, perineal haematoma, blood at meatus)
Membranous rupture: pelvic fracture, penile/perineal oedema, on PR the prostate is displaced upward
VASCULAR
What are the primary and secondary causes of lymphoedema?
Primary:
- Congenital <1year - sporadic, Milroy’s
- 1-35 years - sporadic, Meige’s disease
- 35+ years - Tarda disease
Secondary:
- Infection (e.g. filariasis, TB)
- Lymphatic malignancy
- Radiotherapy to lymph nodes
- Surgical resection to lymph nodes
- DVT
- Thrombophlebitis
UPPER GI
When is surgery contraindicated in oesophageal cancer?
Single distant metastasis (e.g. liver)
Upper oesophagus SCC may be amenable to chemotherapy
