General Surgery - Hernias, Bariatric Surgery + Stomas

Question 1

what is a hernia?

Answer 1

abnormal protrusion of an organ/fatty tissue through a weakness in its containing wall

Question 2

what 3 bad things can happen to hernias?

Answer 2

incarcerated
obstructed
strangulated

Question 3

difference between direct and indirect inguinal hernias?

Answer 3

direct - medial to inferior epigastric artery

indirect - lateral to inferior epigastric artery

Question 4

where are inguinal hernias related to the pubic tubercle?

Answer 4

superior and medial

Question 5

which type of hernia is at higher risk of strangulation? why?

Answer 5

indirect

narrow neck

Question 6

where are femoral hernias in relation to the pubic tubercle? femoral pulse?

Answer 6

inferior and lateral

medial to femoral pulse

Question 7

what are femoral hernias at high risk of? why?

Answer 7

strangulation

bony structures nearby

Question 8

what types of ventral hernias exist? what are these?

Answer 8

umbilical
paraumbilical
epigastric

bulge through muscles of the abdomen

Question 9

what types of congenital hernias exits?

Answer 9

inguinal due to persistant process vaginalis

umbilical

Question 10

features of an incarcerated hernia?

Answer 10

irreducible

Question 11

features of an obstructed hernia?

Answer 11

distended
constipated
colicky

Question 12

features of a strangulated hernia?

Answer 12

tense
tender
irreducible

Question 13

how can examination help distinguish hernia type?

Answer 13

femoral - upper thigh

occlusion of internal ring controls indirect

Question 14

Tx for an inguinal hernia?

Answer 14

patient choice

mesh repair

Question 15

Tx for a femoral hernia?

Answer 15

always repair

Question 16

Tx for ventral hernias?

Answer 16

only if symptomatic or high risk of strangulation

Question 17

hernia repair complications?

Answer 17

infection
reoccurance
bleeding
chronic groin pain

Question 18

what is the criteria for bariatric surgery?

Answer 18

BMI >35 with co morbidities that would improve with weight loss
trying to lose for >6months

Question 19

what gastric surgery is slower with less weight loss?

Answer 19

gastric band

Question 20

what gastric surgery is better with more weight loss?

Answer 20

roux en Y

Question 21

what happens in a roux en Y bypass?

Answer 21

jejunum attached to stomach pouch
contents bypass straight through this
duodenum attaches to jejunum

Question 22

complications of a gastric band?

Answer 22

pouch enlargement
erosion
band slip
vomiting

Question 23

complications of a roux en Y?

Answer 23

vitamin deficiencies
hernias
dumping syndrome 
stricture
cholelithiasis

Question 24

what is dumping syndrome?

Answer 24

fainting and sweating after eating food with high osmotic potential

Question 25

what type of stoma is commonly on the RHS?

Answer 25

ileostomy

Question 26

what type of stoma is commonly on the LHS?

Answer 26

colostomy

Question 27

what are ileostomies and colostomies made form?

Answer 27

ileo - mid to distal small bowel

colostomy - large. bowel

Question 28

what are jejunostomies often used for?

Answer 28

feeding

have tube access

Question 29

what are urostomies made from?

Answer 29

ileum with the ureters within

Question 30

what is ileostomy output like?

Answer 30

thick green/brown porridge

Question 31

what is colostomy output like?

Answer 31

similar to faeces

Question 32

how does stoma output vary?

Answer 32

more proximal the more liquid output