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
Q

also known as the femoral canal

A

femoral ring

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26
Q

medial component of the femoral sheath

A

femoral ring

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27
Q

hernias are often small, usually occur in females

A

Femoral hernias

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28
Q

particularly liable to produce bowel obstruction

A

Femoral hernias

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29
Q

hernias require urgent surgery

A

Obstructed and strangulated

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30
Q

The risk of strangulation is greatest with

A

Femoral hernias

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31
Q

include a testicular tumour, epididymo-orchitis, and torsion of testes

A

Solid lumps scrotum

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32
Q

include hydroceles,epididymal cysts and spermatoceles

A

Cystic lumps scrotum

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33
Q

If it is not possible to get above the lump

A

inguinal hernia

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34
Q

collection of clear fluid in the tunica vaginalis

A

Hydrocele

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35
Q

is helpful in assessing hydrocele

A

Ultrasound

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36
Q

symptomless or cause dragging discomfort in scrotum

A

Hydrocele

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37
Q

managed conservatively with reassurance and scrotal support

A

Hydrocele

38
Q

aspiration can prevent fluid accumulation

A

Hydrocele

39
Q

Surgery is generally considered a second-line procedure

A

Hydrocele

40
Q

These are common, often multiple

A

Epididymal cysts

41
Q

found in middle-aged/elderly men

A

Epididymal cysts

42
Q

the size of a pea and contain a clear colourless fluid

A

Epididymal cysts

43
Q

Extratesticular, fluctuant, cystic swellings

A

Epididymal cysts

44
Q

transilluminate and are readily palpable

A

Epididymal cysts

45
Q

Fertility may be impaired in bilateral cyst excision.

A

Epididymal cysts

46
Q

Aspiration and injection of sclerosant agents

A

Epididymal cysts

47
Q

varicosity of the veins of the pampiniform plexus

A

Varicoceles

48
Q

It is seen in 8–10% of normal males

A

Varicoceles

49
Q

occurs on the left side in 98% of affected patients

A

Varicoceles

50
Q

due to mechanical problem in drainage of left kidney vein

A

Varicoceles

51
Q

relationship with infertility has been observed

A

Varicoceles

52
Q

are asymptomatic and incidental findings

A

Varicoceles

53
Q

can cause a dragging discomfort in the scrotum

A

Varicoceles

54
Q

ultrasound is useful where the diagnosis is doubtful

A

Varicoceles

55
Q

a neoplasm is suspected

A

ultrasound

56
Q

Treatment is indicated if it is symptomatic or for infertility

A

Varicoceles

57
Q

Firm-fitting underpants may relieve discomfort

A

Varicoceles

58
Q

Surgical treatment is by venous ligation

A

Varicoceles

59
Q

are anterior to the testis

A

Haematoceles

60
Q

not transilluminable

A

Haematoceles

61
Q

A mass that is part of the testis, and solid, likely a cancer

A

Testicular tumours

62
Q

They mainly affect fit young men

A

Testicular tumours

63
Q

represent the commonest cancer in men aged 15–40 years in Australia

A

Testicular tumours

64
Q

Some 90–95% of testicular tumours arise from the

A

germ cells

65
Q

seminomas

A

40%

66
Q

non-seminoma germ cell tumours (NSGCT)

A

60%

67
Q

All solid scrotal lumps are malignant until proved otherwise

A

must be surgically explored.

68
Q

Testicular tumours spread by direct infiltration via

A

the lymphatics & bloodstream

69
Q

Metastases typically occur in the

A

para-aortic nodes

70
Q

best detected by

A

a CT scan of the abdomen and chest.

71
Q

also occur in the neck, brain, liver, chest and bones.

A

Metastases

72
Q

Investigations Testicular tumours

A

ultrasound, tumour markers ,lactic dehydrogenase

73
Q

tumour markers

A

α-fetoprotein and β-hCG

74
Q

ultrasound of the testis

A

precision

75
Q

Investigations for staging include:

A

chest X-ray , CT scanning of abdomen, pelvis and chest

76
Q

CT scanning of abdomen, pelvis and chest

A

for node involvement

77
Q

Spread is usually direct to the

A

para-aortic nodes

78
Q

lactate dehydrogenase

A

monitors secondary spread

79
Q

indicates tumour mass

A

lactate dehydrogenase

80
Q

Note: Avoid scrotal needling biopsy because

A

risk of tumour implantation in the scrotal wall

81
Q

All solid scrotal lumps are

A

malignant until proved otherwise

82
Q

Beware of hydroceles in

A

young adults

83
Q

Tumours can mimic

A

acute epididymo-orchitis

84
Q

The initial treatment is orchidectomy

A

Testicular tumours

85
Q

Early seminomas are given radiation

A

ipsilateral lymph nodes

86
Q

or a single dose of chemotherapy

A

Early seminomas

87
Q

Early NSGCTs undergo active surveillance

A

(tumour markers, CXR, CT scans)

88
Q

can be temporarily or permanently reduced following
radiotherapy and chemotherapy.

A

sperm production

89
Q

one that fails to reach the bottom of the scrotum by 3 months

A

Undescended testes (cryptorchidism)

90
Q

If the testis is not palpable at birth, review in 3 months

A

Undescended testes (cryptorchidism)

91
Q

The optimal time for orchidopexy is

A

6–12 months of age

92
Q
A