Day To Day Knowledge Flashcards
26/9/23
What is valvulae conniventes?
What is haustra?
What is the 3/6/9 rule?
What is the common cause of small bowel obstruction?
What are the common causes (4) of large bowel obstruction?
-The lining on the small intestine that is obviously seen when there is dilatation of the small bowel due to Intestinal obstruction.
- Same thing as above but seen on large intestine
- Small intestine diameter: 3cm
- Large intestine diameter: 6cm
- Caecum diameter: 9cm
- Post- operative adhesions
- Cancer (colorectal)
- Diverticulitis related strictures
Less common: - Volvulus
- Hernias
26/9/23
What are the 4 cardinal symptoms of intestinal obstruction?
1) Abdominal pain
2) Vomiting
3) Constipation & Obstipation
4) abdominal distension
26/9/23
What is a Bezoar?
-foreign particles (food)
- from accumulation of indigestible material
- rare cause of mechanical intestinal obstruction
26/9/23
1) What is ALVARADO SCORE?
2) Describe MANTRELS mnemonic for ALVARADO score.
3) All features have 1 point except which two? (2)
4) What is the percentage likelihood of someone having appendicitis based on the following score?
1-4:
5-6:
7-10:
5) What is the treatment based on the scoring above?
1) The ALVARADO score predicts the likelihood of appendicitis
2)
- Migration of pain
- Anorexia
- Nausea
- Tenderness in RLQ
- Rebound pain
- Elevated temperature (37.3)
- Leucocytosis
- Shift of WBC to the left
3) Tenderness in RLQ & Leucocytosis have 2 points each
4)
1-4: 30%
5-6: 66%
7-10: 93%
5)
1-4: Discharge
5-6: Observation/admission
7-10: Surgery
27/9/23
Organs found in RUQ/ R. Hypochondriac region? (8)
- Ascending colon
- Liver
- Gall bladder
- Small intestine (duodenum)
- Transverse colon
- Diaphragm
- Lower lobe of R. Lung
- Porta hepatis
27/9/23
Suspected diagnosis of RUQ pain/ R. Hypochondriac pain? (10)
Hepatitis
Hepatic abscess
Cholecystitis
Cholangitis (Charcot’s triad)
Cholelithiasis
Gallbladder empyema
Referred pain:
- MI
- Lower lobe pneumonia
- Acute pancreatitis
- Appendicitis (pain can be in any quadrant)
27/9/23
What is ileus? (3)
Ileus typically caused by? (5)
What is gallstone ileus?
How does gallstone ileus happen?
Is gallstone ileus a misnomer?
-Intolerance of oral intake
- due to inhibition of gastrointestinal peristalsis
- W/o signs of mechanical obstruction
-surgery
- Medications
- Trauma
- Peritonitis
- Severe illness
- mechanical intestinal obstruction due to impaction of one or more gallstones within the gastrointestinal tract
- adhesions form due to inflammation of gallbladder and adjacent GI tract –> causing pressure necrosis from gallbladder impact –>inflammation and necrosis –> Cholecystenteric fistula forms
- yes, because ileus means neurogenic cause of intestinal paralysis but in gallstone ileus it is due to impaction of gallstone in the GIT that causes mechanical obstruction
29/9/23 Prof Aishah BT#2
Cases:
1) Breast abscess
2) Breast ca.
What is Augmentin?
What is clavulanic acid?
How does clavulanic acid work? (2)
What are the indications of incision and drainage of breast abscess? (2)
What is the treatment of chronic granulomatous mastitis?
How is CGM diagnosed?
How long does it take for CGM to resolve?
How does peri-ductal mastitis present?
What are the risk factors of peri ductal mastitis?
Ddx for breast abscess? (4)
• Augmentin is used for community acquired infection
• Contains Amoxicillin and clavulanic acid
• Clavulanic acid is a Beta Lactamase inhibitor
• Beta Lactamase deactivate beta lactam antibiotics like amoxicillin
• Beta lactam inhibitors inactivate beta lactamases produced by bacteria and potentiates the effect of amoxicillin
• Thick pus (unable to aspirate to clear it)
• Extensive necrosis
• Steroid - prednisolone + Antibiotics
• CGM diagnosed via biopsy of breast tissue
• at least 1 year
• Painful,swollen, erythematous with nipple inversion at peri areola region
• smoking, passive smoker
• Old age
- TB breast
- Chronic Granulomatous mastitis
- Breast ca (infective)
- Lactational breast abscess
