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Final Year > E > Flashcards

E Flashcards

1
Q

Contents of the inguinal canal ‘rule of

3’s’

A 
• 3 arteries: testicular, cremasteric and
vas deferns
• 3 nerves: genitofemoral,
sympathetics, ilio inguinal nerve (only
structure outside the spermatic cord
and commonly damaged during
repair)
• 3 other: lymphatics, vas deferens,
pampiniform plexus
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2
Q

Borders of the inguinal canal MALT:

A 
• Roof = Muscle, internal oblique
• Anterior wall = Aponeurosis external
oblique (internal oblique lateral third)
• Floor = Ligament, inguinal ligament
• Posterior wall = Tendon, transversalis
fascia and conjoint tendon
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3
Q

Femoral vs Inguinal Hernia

A

Fem - Lat and inf to pubic tubercule

Ing - Med and sup to pubic tubercule

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4
Q

Hernia?

A

Definition: protrusion of a viscus out of its cavity into an

abnormal position through a defect in the wall of the cavity.

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5
Q

What are the classical signs of bowel ischaemia?

A
  1. Acute severe abdominal pain
  2. Hypovolaemic shock
  3. Absence of abdominal signs
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6
Q

AKI STage 1

A

rise in cr >1.5x baseline
or by 26.5 in 48hrs
UO <0.5ml/kh/h for 6 hrs

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7
Q

AKI STage 2

A

Rise in Cr >2-2.9 x baseline

UO <0.5ml/kg/h for 12 hours

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8
Q

AKI STage 3

A

Rise in Cr >3 x baseline

UO <0.3ml/kg/h for 24 hr or anuric for 12hr

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9
Q

CKD needing dialysis

A 
A - acidosis pH <7.2
Electrolytes - hyperK
Intoxication - SLIME
Overload fluid
Uraemia
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10
Q

Horner’s syndrome

A 
Features
miosis (small pupil)
ptosis
enophthalmos* (sunken eye)
anhidrosis (loss of sweating one side)
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11
Q

3rd N Palsy

A

ptosis
dilated pupil
down and out

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12
Q

Ottawa Knee - perform x ray if any one of these presents

A
  • over 55
  • cant flex to 90 degrees
  • tender on palpation of fibula head
  • discomfort confined to patella on palpation
  • inability to weight bear - immediately and in ED
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13
Q

Ottawa Ankle

A

ankle xray

  • any pain in malleolar zone and any of these
  • bone tenderness at posterior edge/ tip lateral mallelous
  • bone tendernes at posterior edge/ tip of medial malleolus
  • inability to bear weight immediately and in ED
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14
Q

Ottawa Foot

A

pain in midfoot

  • bony tenderness at base of 5th metatarsal
  • bony tenderness at navicular
  • inability to bear weight both immediately and in ED
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15
Q

LLOAF

A

Lateral 2 lumbricles
Opponens pollicis
abductor pollicis
flexor pollicis brevis

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16
Q

Rockall Score

A 
Pre-Endo
- age
- shock: BP, pulse
- comorbidities
Post Endo
source of bleeding
- active bleeding
- diagnosis
initial >3 or final >6 = surg!
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17
Q

Child-Pugh Grading of Cirrhosis

A
  • Albumin
  • Bilirubin
  • Clotting
  • Distenstion - Ascites
  • Encephalopathy

3 categories for each and up to 3 points for each.
>8 = significant risk bleeding

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18
Q

Exudate

A

due to inflammation causing increased capillary permeability

pneumonia, cancer, ai

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19
Q

transudate

A

due to increased hydrostatic pressure/ low plasma oncotic pressure
ccf, cirrhosis, nephrotic syndrome

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20
Q

TLS

A

high urate
high phosphate
high potassium

low calcium

renal failure

hydrate!!
high risk WBC>50 = rasburicase
mod risk WBC 10-50 = allopurinol

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21
Q

Indirect Hernia

A

Through deep ring

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22
Q

direct hernia

A

through the wall - hesselbachs triangle

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23
Q

R Hemicolectomy

A

tumour in

  • caecum
  • ascending colon
  • prox transverse
24
Q

L Hemicolectomy

A

tumour in

  • distal transverse
  • descending colon
25
Q

sigmoid tumour

A
  • sigmoidectomy

- anterior resection

26
Q

transverse colon

A

extended R hemicolectomy

27
Q

Monteggia

A

Ulnar fracture with dislocation of radial head

proximAl

28
Q

Galeazzi

A

Radius fracture with dislocation of distal radioulnar joint

diZtal

29
Q

The closure of which valve causes the first heart sound?

A

Mitral

30
Q

The closure of which valve causes the 2nd heart sound?

A

Aortic

31
Q

Examination of the neck reveals Cannon waves. What is the likely diagnosis

A

complete heart block

32
Q

. Examination reveals reduced expansion on the left side with dullness to percussion and increased tactile vocal resonance (when he says “99”).

A

Pneumonia

33
Q

. Examination reveals reduced expansion on the left side with dullness to percussion and reduced tactile vocal resonance (when he says “99”)

A

Pleural effusion

34
Q

MEN A

A

Pit tumour
Parathyroid adenoma
Pancreatic Tumour

35
Q

Men 2a

A

Parathyroid hyperplasia
medullary cancer
phaeo

36
Q

Men 2B

A

mucosal neuroma
marfanoid
medullary
phaeo

37
Q

Neurofibromatosis 2

A

bilateral vestibular schwannomas

meningiomas

38
Q

Neurofibromatosis 1 - Von Recklinghausens

A

CAFE NOIR

cafe-au-lait spots
axillary freckling
fibromas
eye - lisch nodules = slit lamp

neoplasia: meningioma, phaeo
ortho - kyphoscolisis
iq decreased
Renal - RAS

39
Q

RA XRAY

A

Loss of joint space
Erosions
Soft tissue swelling
Soft bones - osteopenia

40
Q

hyperthyroid

A

TSH receptors

TPO

41
Q

hypothyroid

A

anti-TPO

anti-TSH

42
Q

diabetes drug - weight loss

A

SGLT2 inhibitor Empoglaflozin - end in ozin

DDP-4 - neutral - gliptins

43
Q

diabetes drug - may cause weight gain

A

sulphonylurea

44
Q

diabetes drug - hypoglycaemia risk

A

sulphonylurea

45
Q

dont want insulin - BMI >30

A

GLP-1

46
Q

legionella

A

clarithromycin

47
Q

klebsiella

A

cefotaxime

48
Q

post triangle neck

A

post margin SCM
ant margin trap
mid 1/3 clavicle

49
Q

webers - what side, sensorineural

A

louder in the UNAFFECTED EAR

50
Q

webers - what side, conductive

A

louder in the AFFECTED EAR

51
Q

B12 or folic acid first?

A

B12!! (prevent SACD)

52
Q

Anterior MI

A

LAD

53
Q

Lateral MI

A

Circumflex

54
Q

Inferior MI

A

RCA

55
Q

Some Lovers Try Positions That They Cannot Handle

A 
scaphoid
lunate
triquetrum
pisiform
trapezium
trapeziod
capate
hamate

Final Year (1 decks)

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