SURGERY 2 Flashcards
what commonly causes persisting pain and jaundice post lap cholecystectomy?
gallstones in the common bile duct
investigation for suspected gallstones in the bile duct?
Magnetic resonance cholangiography or intraoperative imaging
what can cause renal vein thrombosis?
nephrotic syndrome (as induces a hyper coagulable state)
others:
any hypercoaguable state e.g. pregnancy, OCP, SLE, factor V Leiden deficiency
RCC
kidney transplant
APS
Behcet syndrome
how does renal vein thrombosis present?
rapid deterioration of renal function
flank pain
haematuria
n&V
fever
what is a FAST scan?
a Focussed Assessment with Sonography for Trauma scan
a point of care USS to identify intraperitoneal free fluid
which ethnicity has the highest incidence and mortality of prostate cancer?
black afrocaribean men
interpretation of ABPI: >1.2
what usually causes this?
calcified stiff arteries
advanced age, diabetes
what can you do instead of an ABP in diabetic to avoid the calcified vessels and detect PAD?
toe brachial index
what ABPI would you expect with intermittent claudication?
0.95-0.5
what ABPI would you expect with rest pain?
0.5-03
what ABPI would you expect with gangrene and ulceration?
<0.2
what ABPI is compression bandaging consider acceptable?
> =0.8
what is the difference between a sliding and rolling hiatus hernia?
sliding - 95% of cases, gastroesophageal junction moves about the diaphragm
rolling - gastroesophageal junction remains below the diaphragm but a separate part of the stomach herniates through the oesophageal hiatus
features of hiatus hernia
heartburn
dysphagia
regurgitation
chest pain
risk factors for hiatus hernia?
obesity
increased abdominal pressure e.g. ascites or multiparty
