Surgical Conditions Flashcards by

Symptoms of small bowel obstruction. Causes?

Vomiting, abdominal pain.

Adhesion from previous abdominal surgery, hernia, cancerous lesion (normally at cecum).

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What are the 3 types of pain?

somatic: body surface or musculoskeletal.
visceral: internal organs.
neuropathic: spinal cord and peripheral nerves.

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Rutherford Morrison incision?

Renal transplant
Colonic resection

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What are the investigations for renal colic?

CT KUB (Kidneys, ureters, bladder).

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WHat are 4 investigations that must be done is suspected appendicitis?

FBC (raised leukocytes + neutrophils).
UE (urea and electrolytes) to assess HYDRATION.
USS (ultra sound scan - if young). CT scan (particularly unwell or over 40).
Pregnancy test if female

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What are 2 types of regional anesthesia?

epidural , spinal.

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What is pseudo obstruction?

Clinical syndrome (intestines not working as well as they normally do - has signs and symptoms of an intestinal obstruction) yet no actual physical causes found.

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How is renal colic treated?

Stone may pass dependent on size.
Surgical intervention if not (open surgery or stent in ureter).

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Lanz incision

open appendectomy

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What is an acute abdomen?

the rapid onset of severe symptoms that may indicate potentially life-threatening intra-abdominal pathology that requires urgent surgical intervention.

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What are the investigations for acute pancreatitis?

Bloods will show ELEVATED SERUM AMYLASE and MORE SENSITIVE LIPASE.
USS in first instance and CT scan if suspected necrosis.

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Symptoms of small bowel obstruction. Causes?

Abdominal distention, absolute constipation.

Malignancy.

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When are antibiotics given for acute appendicitis?

On blood results.
Pyrexial or showing signs of sepsis.

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What are the symptoms of renal colic (6)? Why does it occur?

Renal stone partially/ fully blocks the outflow of urine from the kidney.
FLANK PAIN (loin to groin - from flank to lower abdomen), rigors, haematouria, reduced urine output, tachycardia, pyrexia.

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What is appendicitis? What is a common cause?

Inflammation of the apendix commonly caused by an obstruction of the appendix.

FAECOLITH.

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Midline incision?

Laparotomy.
Repair of abdominal wall hernia.

What investigations can be undertaken for acute cholecystitis?

Deranged liver function tests.
USS (check for gallstones) and MRI.

What are 7 symptoms of appendicitis?

Right iliac fossa pain.
Tachycardia.
Pyrexia.
Nausea and vomiting.
Anorexia.
Constipation or diarrhea.
ROVSING’S POSITIVE.

How will patients with acute pancreatitis present?

Epigastric pain which radiated to the back. Patient profoundly unwell.

Kocher incision?

Open cholecystectomy
Access to biliary tree/ liver.

Name the 9 regions of the abdomen

see pic online

Pfannestiel incision?

Caesarian section
Abdominal hysterectomy

What is the management for acute appendicitis?

NBM (nothing by mouth/ fasted), hydration, analgesia, antibiotics.

APPENDICECTOMY

What should be checked in patients presenting with bowel obstruction?

Electrolytes + bloods: electrolyte deficiencies can slow down bowel.

What types of pain is dental pain?

Musculoskeletal pain thus SOMATIC.

3 treatment methods for acute cholecystitis?

- **conservative treatment**: with (sepsis) or without antibiotics - **cholecystectomy**: removal of gallbladder within 3 month period - inflammation must resolve. - **ERCP**: endoscopic retrograde cholangiopancreatography - enedoscopy procedure used to remove stones from gallbladder (ex. when gallstones in bile duct).

In what patients may an acute abdomen present pain free?

older people, children, immunocompromised, last trimester of pregnancy.

What are 5 complications of pancreatitis?

Fluid collections, pseudocyst formation, necrosis, abscess, haemorrhage.

What is Rovsing's positive and what does it indicate?

- palpating left iliac region causes pain in the right iliac region - SIGN OF APPENDICITIS.

Where does pain from appendicitis commonly present? Who is commonly affected?

- Umbilical region which spread to right ileac fossa. - Women, age less than 40 years (10-30).

What are the two most common causes of pancreatitis in the UK?

- Alcohol. - Gallstones. - ERCP (endoscopic retrograde cholangiopancreatography).

What is murphy's positive? What does it suggest?

- Place hand at the COSTAL MARGIN and the RUQ and asking patient to take a deep breath - INFLAMED GALLBLADDER CAUSES PAIN AND PATIENT CATCHES THEIR BREATH.

What is acute cholecystitis? Common cause? Symptoms (4)?

- Inflammation of the gallbladder (commonly due to GALLSTONES). - RUQ pain, tachycardia, fever, murphy's positive.