Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > Hernia + Miscellaneous > Flashcards

Hernia + Miscellaneous Flashcards

1
Q

What is an inguinal hernia

A

Bowel moved into inguinal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an indirect hernia

A

Bowel passes through weakness in the internal ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you know it is indirect

A

Press down on deep ring + reduce

Won’t refill on cough impulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a direct hernia

A

Bowel pushes through weakness in posterior wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you know it is direct

A 
Reduce the hernia
Occlude the deep ring 
Ask patient to cough or stand 
Will refill on cough if direct
Won't refill if indirect as blocked off 
Doesn't hang into scrotum

Can only truly determine at surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is the superficial (external) ring

A

Above and medial to pubic symphsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where is the femoral ring

A

Below and lateral to PS

This is where femoral hernia is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is deep ring of inguinal canal

A

Between ASIS and PS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the anatomy of inguinal canal

A

External oblique = infront
Inguinal ligament = floor
Rectus abdominas = medial
Transverse abdominas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

WHat are the contents

A

Vas deferens
Testicular artery and vein
Genitofemoral nerve
Ilioinguinal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the symptoms of inguinal hernia

A 
Bulge
Sensation of drag
Increases with cough
Reduces lying flat
May become irreducible and painful
May obstruct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a strangulated hernia

A

Blood supply cut of
Rare in inguinal
Common in femoral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms of strangulation

A 
Tender red stcotum so always ask for this 
Red
Sudden pain
Fever
Tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you examine a hernia

A

Stand and get to cough
Lie flat and cough while pressing
CHeck other side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the RF for hernia

A 
Male
Older as ring gets bigger
Obesity 
Weight lifting
Manual job
Chronic cough
Obstruction
Constipation
Past abdo surgery
Ascites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are women with hernia likely to have

A

Inguinal hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Who is most likely to have a femoral

A

Women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What imaging for hernia

A

USS

Differentiate fromLN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do you treat hernia

A

Weight loss
Stop smoking
If becomes irreducible = urgent surgery as risk of strangulation

20
Q

What are surgical options

A

MESH / open - reinforce posterior wall

Laparoscopic

21
Q

What are complications of surgery

A 
Recurrecne
Chronic pain
Mesh infection
Testicular damage
Bowel damage
22
Q

What are complications of hernia

A

Incarcerated - can’t reduce
Strangulation - necrosis
Obstruction

23
Q

WHat is SMA syndrome

A

Duodenum gets obstructed by aorta and SMA

24
Q

What are symptoms of weak sphincter

A

Diarrhoea
Incontinence
Key is formed stool still leads to incontience not just diarrhoea

25
Q

How do you investigate

A

DRE - tone
GI physiology to measure sphincter
USS

26
Q

How do you Rx

A

Sural nerve stimulation

27
Q

What do you do for loose stools

A

Send stool culture

If on Ax suspect C.diff

28
Q

If tired / weight loss / diarrhoea

A 
FBC 
Ferritin 
Thyroid 
Coaelic
qFIT
29
Q

If Hb low

A

Haematinic bloods

30
Q

How can you give contrast

A

Oral
IV
Rectal - not routine

Double = oral and IV

31
Q

Why is contrast useful

A

Time around body allows you to visualise
PA = 15s
Aterial = 90s
Portal venous = 3 miuntes

32
Q

When do you do USS

A 
Gall stone
Intra+extra hepatic dilatation
Portal vein
Liver texture
LIver mets
Pancreatic tumour
Exclude spleen / kidney / aorta pathology
33
Q

WHen do you do pancreatico-biliary EUS

A

Small pancreatic tumour + bile duct stone
Dx of duoedenal / pancreatic cancer
Allow FNA

34
Q

When is CT useful

A

STage malignancy

Acute pancreatitis + complication

35
Q

When is MRCP used

A

Hepatic + pancreatic duct if not fit for ERCP / no intervention
CBD stones and biliary
No contrast or invasion
Miss small stone / PSC/ stricture

36
Q

What does PTC allow

A

Visualisation of biliary tract
Percutaneous acess + stent
Use if ERCP fails as bigger risk

37
Q

What is calprotectin

A

Neutrophil in inflammation release protein

Higher lower down the bowel

38
Q

What is QFIT

A

Immunotherapy

FOB was detecting blood / Hb

39
Q

How do you investigate iron anaemia

A 
FBC
Ferritin (not in inflammation) - low 
Transferin- low 
TIBC - high 
Colonoscopy once confirmed
40
Q

What does TIBC show if iron is low

A

High if iron deficiency as want more binding receptors for iron to bind do
Low in haemachromatosis

41
Q

What causes iron deficiency anaemia

A

Blood loss
Malabsorption
Mentruation
Pregnancy

42
Q

How do you differentiate iron deficiency from anaemia of chronic disease

A

Anaemia chronic disease has low TIBC as don’t want iron available for pathogen

43
Q

What is a hernia

A

Protrusion of viscous or part through a defect of the walls of its containing cavity

44
Q

Irreducible

A

Cannot push back into place

Need to reduce to prevent obstruction, strangulation and necrosis

45
Q

Obstructed

A

Content cannot pass

eg. faeces can’t pass through bowel

46
Q

Strangulated

A

Non reducible and becomes so tight it cuts of blood supply
Significant pain and tenderness at site
Ischaemia occurs = urgent surgery

47
Q

Incacerated

A

Contents of sac stuck inside by adhesions

GI (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions