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Ex3GI CM > Surgical Abdomen- Beloy > Flashcards

Surgical Abdomen- Beloy Flashcards

1
Q

______ have significantly reduced surgical intervention for gastric ulcers

A

Antacids

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2
Q

This type of ulcer has a strong association with H. pylori

A

Duodenal ulcer

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3
Q

This surgery involves resection of the vagus nerve for peptic ulcer dz so that pepsin is not produced

A

Vagotomy

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4
Q

This surgery is done so that gastrin decreases secretion

A

Antrectomy

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5
Q

This type of surgery is done for the purpose of restrictive/malabsorptive purposes

A

Gastric bypass

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6
Q

Removal of all or part of the stomach is called?

A

Gastrectomy

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7
Q

Post-op complication of gastric bypass, vagotomy or other stomach resection?

A

Dumping syndrome: Post prandial tachycardia, diaphoresis, abdominal pain, & diarrhea

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8
Q

What kind of diet is recommended s/p gastric surgery?

A

Post gastrectomy diet: Eat small frequent meals, high fiber, avoid simple sugars, do not drink fluids with meals, wait 30-60 mins after meals

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9
Q

What condition is this?

Partial paralysis of the stomach, is a disease in which the stomach cannot empty itself of food in a normal way. If you have this condition, damaged nerves and muscles don’t function with their normal strength and coordination — slowing the movement of contents through your digestive system.

A

Gastroparesis

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10
Q

How is gastroparesis treated?

A

NPO, IV fluids, may include total parental nutrition

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11
Q

T/F: enteric feeding is better than IV?

A

True

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12
Q

PEG vs NG tube?

A

PEG is placed in the stomach percutaneously (through the skin) and an NG tube is done through the nose to the stomach

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13
Q

Which vein in the liver is the detoxifying vein?

A

The portal vein

If it is blocked, can lead to death because doesn’t filter toxins

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14
Q

What is rim enhancing?

A

Any mass that is rim enhancing (has a line around it on CT) is an infection until proven otherwise

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15
Q

Is a hepatic hemangiomata a concerning finding?

A

No, just clusters of blood cells (benign vascular malformation)

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16
Q

What duct SHOULD we cut with gallbladder surgery

A

We should Cut the Cystic duct, not the common hepatic duct

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17
Q

What duct should we NOT cut in gallbladder surgery?

A

Common hepatic

CUT the Cystic

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18
Q

Murphy’s sign is pathomnemonic in what disease?

A

Seen in acute cholecystitis

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19
Q

Procedures for acute cholecystitis?

A

HIDA scan, MCRP, ECRP

20
Q

An infection that same from stomach to the gallbladder is what?

A

Ascending cholangitis and can cause inflammation of the bile duct

21
Q

How do you treat Ascending cholangitis?

A

IV fluid and broad-spectrum abx

22
Q

In a cholecystectomy, what should we cut?

A

CYSTIC DUCT

23
Q

When you hear porcelain gallbladder, think _____

A

cancer. This is calcification of the gallbladder that leads to higher risk of adenocarcinoma

24
Q

What is the only essentially “hail mary” way of buying patients time who have pancreatic cancer?

A

Pancreaticoduodenectomy “Whipple”

Resection of the head of the pancreas, gallbladder (including part of the common bile duct), a portion of the duodenum, sometimes the pyloric sphincter

25
Q

What organs are removed during a whipple?

A

Head of pancreas, gallbladder, common bile duct, portion of the duodenum and sometimes pyloric sphinchter

26
Q

Name three encapsulated organisms that need to be given in immunization to pt prior to splenectomy or before d/c?

A

-pneumococcal
-H. flu
-Meningococcal
“please help me” mnemonic

**all encapsulated because without spleen these can kill you since they are encapsulated

27
Q

What is a common finding if a patient has intussusception (teloscoping of the intestines)?

A

Jelly current stool

28
Q

We use _______ not stitches when repairing the bowels

A

staples (because holding the bowel is like holding wet spaghetti)

29
Q

Most common area of constipation?

A

Ileum

30
Q

What is the difference between ileus constipation and small bowel obstruction?

A

Ileus- prolonged constipation, Abdomen Distension

SBO- distension, diminished bowel sounds, not passing gas

31
Q

Appendicitis is commonly located where in abdominal quadrants?

A

RLQ

32
Q

McBurney’s pt is in what disease and what is it?

A

Pain around umbilicus (appendicitis)

33
Q

Rovsing’s, obturator and “psoas” signs can all test for what?

A

Appendicitis

34
Q

The stool in the ascending colon is very ______ whereas the stool in the descending colon is very ______

A

watery, solid

35
Q

Don’t forget to do a ______ on a large intestinal prob physical exam

A

DRE

36
Q

Also known as colonic pseudo- obstruction when the cecum is >10 cm and dysregulation within the ANS

A

Ogilvie’s Syndrome

37
Q

Tx for Ogilvie’s Syndrome?

A

Decompression and Neostigmine (anticholinergic so we can give the ANS a kick)

38
Q

What is a colostomy vs ileostomy?

A

Colostomy- bringing colon to surface when you can’t reconnect the colon

Ileostomy- bring part of the ileum so waste drains here

39
Q

Hemorrhoids are characterized by above and below the dentate line what does this mean?

A

Internal are above dentate line and external are below the dentate line

40
Q

Where is an epigastric hernia located?

A

Upper abdomen at midline

41
Q

Where is an inscisional hernia located?

A

At site of previous surgical inscision

42
Q

Where is a direct inguinal hernia located?

A

Near opening of the inguinal canal

43
Q

Where is an umbilical hernia located?

A

At the navel

44
Q

Where is a femoral hernia located?

A

Femoral canal

45
Q

Where is an indirect inguinal hernia located?

A

At opening of inguinal canal

46
Q

In trauma, use these imaging methods?

A

CT, FAST scan

Ex3GI CM (15 decks)

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