Surgery Halo-halo 4 Flashcards

1
Q

congestive hepatopathy characterized by obstruction to venous outflow

A

BUDD-CHIARI SYNDROME

  • primary: endoluminal hepatic venous thromboses
  • secondary: veins compressed / invaded by a neighboring lesion
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2
Q

Factor V Leiden

A

AD
point mutation in Factor V
m/c inheritic thromboPHILIC condition among caucasians

normally, activated protein C inhibits Va
in FVL, factor Va is RESISTANT to inhibition by activated protein C
=THROMBOSIS

“Activated Protein C Resistance”

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3
Q

Diagnostics in budd chiar syndrome

A

initial: abdominal US
definitive: HEPATIC VENOGRAPHY

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4
Q

tx of budd-chiari syndrome

A

systemic anticoagulation

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5
Q

noormal portal venous pressure

A

5-10 mmHg

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6
Q

Banti’s syndrome

A

massive splenomegaly

-prehepatic portal hpn

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7
Q

schistosomiasis is what type of portal hypertension

A

INTRAhepatic, PREsinusoidal obstruction

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8
Q

gold standard for diagnosis of achalasia

A

manometry

  • identifies EARLY diseaes before esophageal dilatation and food retion
  • MOST SENSITIVE DIAGNOSTIC TEST
  • endoscopy - to rule out malignancy
  • bird’s beak esophagus - seen in esophagogram
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9
Q

remarks on achalasia

A

“Second only to reflux disease, ACHALASIA is the most common functional disorder of the esophagus to require surgical intervention.”

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10
Q

treatment of nutcracker esophagus

A

aimed at treatment of GERD

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11
Q

Most common surgical tx for achalasia

A

[laparoscopic] HELLER MYOTOMY + partial fundoplication
-goood to excellent results in 62-100%

  • pneumatic dilation
  • most effective non-surgical (endoscopic)
  • reported efficacy of 32-98%
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12
Q

Leading cause of intestinal obstruction in the young child

A

intussusception

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13
Q

idiopathic intussusception occurs in children between the ages of

A

6 and 24 months of age

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14
Q

Dance’s sign

A

elongated mass in the RUQ or epigastrium with absence of bowel in the right lower quadrant

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15
Q

management of intussusception

A

in the absence of peritonitis, the child should undergo radiographic reduction
AIR ENEMA: preferred method of DX and TX

(+) PERITONITIS / appears systemically ILL —> urgent LAPAROTOMY

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16
Q

unless booth of what signs are observed, it cannot be assumed that the intussusception is reduced

A

free reflux of air into multiple loops of small bowel

symptomatic improvement

17
Q

of note, recurrent intussusception occurs in _____, independent of wheter the bowel is reduced radiographically or surgically

A

5-10%

18
Q

the ______ is a diagnostic black box

A

abdomen

19
Q

the presence of ________ is an undisputed indication for prompt surgical exploration

A

abdominal rigidity and hemodynamic compromise

20
Q

abdominal penetrating wounds that doesn’t require immediate surgery

A

RUQ or tangential GSW
do CT scan first

SW

  • if anterior abd, do local wound exploration, then serial exam/lab
  • if RUQ/back —> CT
21
Q

blunt abdominal trauma is now evaluated initially by

A

FAST
(Focused Assessment with Sonography for Trauma)
-sensitiv for detecting intraperitoneal fluid of >250 mL

23
Q

FAST is used to identify free intraperitoneal fluid in

A

Morrison’s pouch
-hepatorenal recess
LUQ
pelvis

24
Q

Diagnostic peritoneal aspiration is considered positive if ____ of blood is aspirated

A

> 10 mL

29
Q

if (+) FAST, what is the next step?

A

if stable, no evidence of peritonitis, unreliable PE
-CT to quantify injuries

if unstable
-LAPAROTOMY