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AMEDEX MIX > HERNIAS > Flashcards

HERNIAS Flashcards

1
Q

Diagnosis by barium swallow.

A

Hiatus hernia

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2
Q

GO junction slides into chest. Acid reflux common

A

Hiatus hernia

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3
Q

Weight loss, Consider PPIs.

A

Hiatus hernia

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4
Q

Surgery for repair of rolling hernia

A

Hiatus hernia

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5
Q

birth–6 weeks: surgery within 2 days

A

Reducible herniae

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6
Q

6 weeks–6 months: surgery within 2 weeks

A

Reducible herniae

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7
Q

over 6 months: surgery within 2 months

A

Reducible herniae

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8
Q

Soft, round, skin-coloured lump in umbilicus

A

Umbilical hernia

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9
Q

occurring in around 15% of infants

A

Umbilical hernia

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10
Q

Surgery is not usually required for

A

Umbilical hernia

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11
Q

most close naturally by 12
months of age

A

Umbilical hernia

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12
Q

This is due to a defect in the Linea alba

A

Para-umbilical hernia

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13
Q

Leave to age 4

A

Umbilical hernia

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14
Q

commonest swellings in the groin or inguinal area are

A

enlarged lymph nodes and hernias

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15
Q

commonest types of hernias in the groin are

A

inguinal, femoral

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16
Q

hernia emerging through deep inguinal ring

A

indirect inguinal hernia

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17
Q

originating lateral to the inferior epigastric vessels

A

indirect inguinal hernia

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18
Q

following the path of the spermatic cord

A

indirect inguinal hernia

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19
Q

also pass through the superficial inguinal ring

A

indirect inguinal hernia

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20
Q

such hernias are often irreducible and can lead to strangulation

A

indirect inguinal hernia

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21
Q

hernia originates medial to the inferior epigastric vessels

A

direct inguinal hernia

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22
Q

protrudes through posterior wall of the inguinal canal

A

direct inguinal hernia

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23
Q

It is almost always seen in men

A

direct inguinal hernia

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24
Q

hernia herniates through the femoral ring

A

femoral hernia

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25
also known as the femoral canal
femoral ring
26
medial component of the femoral sheath
femoral ring
27
hernias are often small, usually occur in females
Femoral hernias
28
particularly liable to produce bowel obstruction
Femoral hernias
29
hernias require urgent surgery
Obstructed and strangulated
30
The risk of strangulation is greatest with
Femoral hernias
31
include a testicular tumour, epididymo-orchitis, and torsion of testes
Solid lumps scrotum
32
include hydroceles,epididymal cysts and spermatoceles
Cystic lumps scrotum
33
If it is not possible to get above the lump
inguinal hernia
34
collection of clear fluid in the tunica vaginalis
Hydrocele
35
is helpful in assessing hydrocele
Ultrasound
36
symptomless or cause dragging discomfort in scrotum
Hydrocele
37
managed conservatively with reassurance and scrotal support
Hydrocele
38
aspiration can prevent fluid accumulation
Hydrocele
39
Surgery is generally considered a second-line procedure
Hydrocele
40
These are common, often multiple
Epididymal cysts
41
found in middle-aged/elderly men
Epididymal cysts
42
the size of a pea and contain a clear colourless fluid
Epididymal cysts
43
Extratesticular, fluctuant, cystic swellings
Epididymal cysts
44
transilluminate and are readily palpable
Epididymal cysts
45
Fertility may be impaired in bilateral cyst excision.
Epididymal cysts
46
Aspiration and injection of sclerosant agents
Epididymal cysts
47
varicosity of the veins of the pampiniform plexus
Varicoceles
48
It is seen in 8–10% of normal males
Varicoceles
49
occurs on the left side in 98% of affected patients
Varicoceles
50
due to mechanical problem in drainage of left kidney vein
Varicoceles
51
relationship with infertility has been observed
Varicoceles
52
are asymptomatic and incidental findings
Varicoceles
53
can cause a dragging discomfort in the scrotum
Varicoceles
54
ultrasound is useful where the diagnosis is doubtful
Varicoceles
55
a neoplasm is suspected
ultrasound
56
Treatment is indicated if it is symptomatic or for infertility
Varicoceles
57
Firm-fitting underpants may relieve discomfort
Varicoceles
58
Surgical treatment is by venous ligation
Varicoceles
59
are anterior to the testis
Haematoceles
60
not transilluminable
Haematoceles
61
A mass that is part of the testis, and solid, likely a cancer
Testicular tumours
62
They mainly affect fit young men
Testicular tumours
63
represent the commonest cancer in men aged 15–40 years in Australia
Testicular tumours
64
Some 90–95% of testicular tumours arise from the
germ cells
65
seminomas
40%
66
non-seminoma germ cell tumours (NSGCT)
60%
67
All solid scrotal lumps are malignant until proved otherwise
must be surgically explored.
68
Testicular tumours spread by direct infiltration via
the lymphatics & bloodstream
69
Metastases typically occur in the
para-aortic nodes
70
best detected by
a CT scan of the abdomen and chest.
71
also occur in the neck, brain, liver, chest and bones.
Metastases
72
Investigations Testicular tumours
ultrasound, tumour markers ,lactic dehydrogenase
73
tumour markers
α-fetoprotein and β-hCG
74
ultrasound of the testis
precision
75
Investigations for staging include:
chest X-ray , CT scanning of abdomen, pelvis and chest
76
CT scanning of abdomen, pelvis and chest
for node involvement
77
Spread is usually direct to the
para-aortic nodes
78
lactate dehydrogenase
monitors secondary spread
79
indicates tumour mass
lactate dehydrogenase
80
Note: Avoid scrotal needling biopsy because
risk of tumour implantation in the scrotal wall
81
All solid scrotal lumps are
malignant until proved otherwise
82
Beware of hydroceles in
young adults
83
Tumours can mimic
acute epididymo-orchitis
84
The initial treatment is orchidectomy
Testicular tumours
85
Early seminomas are given radiation
ipsilateral lymph nodes
86
or a single dose of chemotherapy
Early seminomas
87
Early NSGCTs undergo active surveillance
(tumour markers, CXR, CT scans)
88
can be temporarily or permanently reduced following radiotherapy and chemotherapy.
sperm production
89
one that fails to reach the bottom of the scrotum by 3 months
Undescended testes (cryptorchidism)
90
If the testis is not palpable at birth, review in 3 months
Undescended testes (cryptorchidism)
91
The optimal time for orchidopexy is
6–12 months of age
92

AMEDEX MIX (7 decks)

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