Hernia & General Flashcards

1
Q

What technique should be used for femoral hernia repair

A

McVay/Cooper because it closes the femoral canal defect without incorporating mesh

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2
Q

Management of dialysis-related peritonitis

A

Give empiric intraperitoneal antibiotics; if sepsis, give IV (catheter removal only indicated if no response after 5d or relapsing peritonitis)

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3
Q

Patient with PD catheter presenting with dialysate retention and watery diarrhea

A

Bowel wall erosion

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4
Q

Operative repair of rectus diastasis

A

Plicate the broad midline aponeurosis

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5
Q

Absolute contraindications to laparoscopic hernia repair

A

Active infection, strangulated hernia, and inability to tolerate pnemoperitoneum

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6
Q

Most common trimester for appendicitis in pregnancy

A

2nd trimester

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7
Q

Risk of fetal loss with appendicitis in pregnancy

A

Non-perforated: 2%
Complicated: 6%

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8
Q

Most common hernia in males and females

A

Indirect Inguinal hernia

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9
Q

Richter hernia

A

Contains antimesenteric border of bowel (usually distal ileum)

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10
Q

Littre hernia

A

Contains meckels diverticulum

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11
Q

Cause of direct Inguinal hernia

A

Weakness in floor of Inguinal canal (transversalis fascia)

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12
Q

Most commonly injured nerves in laparoscopic Inguinal hernia repair

A

Genitofemoral and lateral femoral cutaneous

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13
Q

Borders of triangle of doom

A

Vas deferens, spermatic vessels

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14
Q

Borders of hernia triangle of pain

A

Spermatic vessels, iliopubic tract, and peritoneal fold

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15
Q

Symptoms and physical exam in obturator hernia

A

Pain from Inguinal crease to anterimedial aspect of thigh, exacerbated by medial rotation of thigh
Loss of adductor reflex, positive patellar reflex

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16
Q

Region for spigelian hernia

A

At the level of the arcuate line, between semilunar line and lateral border of rectus abdominis

17
Q

Grynfeltt hernia

A

Superior lumbar hernia: between latissmus Dorsi, serratus posterior, and posterior border of internal oblique

18
Q

Hernia of petit

A

Inferior lumbar hernia: latismuss dorsi, iliac crest, and posterior border of external oblique

19
Q

Management of parastomal hernia

A

Transabdominal repair with mesh underlay (primary repair has high recurrence rates)

20
Q

Most common etiology of a mesenteric cystic mass

A

Cystic lymphangioma

21
Q

Management of Chylothorax

A

If low output (<1L/d) conservative management
If >1L/d or refractory: thoracic duct ligation or embolization

22
Q

Most common cause of chylous ascites in West

A

Lymphoma (TB in developing countries)

23
Q

SAAG for portal hypertension

A

> 1.1
(Serum albumin-ascites albumin)

24
Q

Desmoid tumor genetic syndromes

A

FAP and Gardner syndrome

25
Management of desmoid tumor
If >7cm and symptomatic: wide local excision with frozen section
26
Effect of pneumoperitoneum on urine output
Decreased due to decreased renal perfusion and increase in ADH
27
Effect of pneumoperitoneum on brain
Increased cerebral blood flow and MAP
28
Effect of pneumoperitoneum on lungs
Decreased pulmonary compliance
29
How to assess celiac lymph node basin intraop
Place US probe on left lobe of liver or on hepatoduodenal ligament
30
Types of rectus sheath hematomas
1: small, does not cross midline or dissect fascia planes 2: confined to rectus but crosses midline/fascial planes 3: below actuate line, large, blood in prevesical space