Surgery Part 2 (156-201) Flashcards
Lateral deviation of head because of hypertrophy of unilateral SCM
Torticollis
Torticollis can be caused by congenital, neoplasms, infection, trauma, disease, of drug tox… but it’s especially caused by…
D2 blockers esp phenothiazines
Tx for torticollis
Muscle relaxants and/or surgical repair
Midline congenital cyst that EVELVATES on swallowing
thyroglossal duct cyst
Lateral congenital cysts that don’t present until adulthood when they get inflammed. Don’t elevate on swallowing
Branchial cleft cyst
Aspirate of cyst contains cholesterol crystals
Branchial cleft cyst
Neck mass that is caused by occluded lymphatics, usually present in the first 2 years of life. Lateral OR midline. Transluscent, benign mass painless and soft.
Cystic hygroma
What diseases are cystic hygromas associated with?
Fetal hydrops, Turner’s syndrom or Noonan’s syndrome
Lateral or midline solid mass composed of overgrowth of epithelium. No elevation with swallowing
Dermoid cyst
Palpable mass at the bifurcation of the common carotid artery originating from neural crest cells. Located in teh carotid body within the carotid sheath.
Tumor causes bradycardia, dizziness. Can move horizontally but not vertically
Paraganglioma (carotid body tumor)
Unilateral cervical lymphadenitis is usually bc what etiololgy?
Bacterial, usually Staph aureus
Scrofula is caused by what etiology?
Tuberculosis
Enlargement of the thyroid gland, usually secondary to decreased iodine intake or inflammation.
Goiter
What is the differential for RUQ abdominal pain? (7)
- Biliary colic
- Cholecystitis
- Choledocholithiasis
- Pneumonia
- Fitz-Hugh-Curtis syndrome
- Cholangitis
- Hepatitis
Constant RUQ to epigastric pain. Ultrasound shows no gallbladder wall thickening or pericholecystic fluid
Biliary colic
fever RUQ pain, inspiratory arrest upon deep palpation of RUQ
Labs: moderate to severe leukocytosis, increased LFTs and increased bilirubing
Cholecystitis
What does the ultrasound of a pt with cholecystitis show?
gallstones (maybe), pericholecystic fluid, thickened gall bladder wall.
RUQ pain worse with fatty meals, jaundice. Ultrasound shows CBD dilation.
Labs: increased LFTs and bilirubin
Choledocolithiasis
pleuritic chest pain and fever. CXR shows infiltrate, and labs show leukocytosis
pneumonia
Syndrome of perihepatitis caused by ascending chlamydia or N. gonorrhea salpingitis
Fitz-Hugh Curtis syndrome
What does a pt’s gallbladder and biliary tree look like in pt with fitz hugh curtis syndrome?
Normal gallbladder and biliary tree
Pt shows Charcot’s triad and later develops into Raynold’s pentad… What are the sx and dx?
Charcot’s triad: fever, jaundice and RUQ pain
Reynold’s pentad: hypotension and mental status change
Dx: cholangitis
What are the labs for cholangitis? WBC? blood culture? LFTs? Bilirubin?
leukocytosis
culture shows enteric organisms
increased LFTs
increased bilirubin
What does the US for cholangitis look like?
biliary duct dilation from obstructing gallstones