Surgical Emergencies Flashcards
PS Biliary colic
RUQ pain
No fever + inflamm markers normal
What is biliary colic
Gallstone lodged in bile duct
What is acute cholecystitis
Inflammation of GD due to gall stones
PS acute cholecystitis
RUQ pain
Murphys sign +ve
Fever + inflamm markers incr
What is ascending cholangitis
Bacterial infection of biliary tree
+ Charcot’s triad
What is Charcot’s triad
RUQ pain
Fever
Jaundice
PS pancreatitis
Severe pain in epigasstrium which radiates to back
PS appendicitis
pain - central –> RIF
Anorexia
Fever + bradyC
Rovsings sign
What is Rovsing’s sign
Incr pain in RIF when pressing LIF
In appendicitis
PS acute diverticulitis
Colicky pain LIF
Diarrhoea
Fever
Incr inflamm markers + WCC
What is AAA due to?
Failure of elastic proteins within the ECM
Norm diameter abdo aorta 50 y/o F
1.5cm
Norm diametic abdominal aorta 50 y/o M
1.7cm
What cm abdo aorta is considered aneurysmal
3cm
RF AAA (5)
Smoking HTN Syphillis Ehlers -Danlos Marfans
Mx low risk AAA
USS surveillance
RF optimised
def low risk AAA
Asymp
Diameter <5.5cm
def high risk AAA
> 5.5cm
symp
Mx high risk AAA
EVAR - elective endovascular repair
DDx - ocular discomfort (4)
Conjunctivitis
Thyroid eye disease
Dry eye
Blephritis
DDx - eye pain on movement
optic neuritis
DDx - pain around eye (2)
Temporal arteritis
Orbital cellulitis
Severe eye pain SSx (4)
Anterior uveitis
Bacterial keratitis
AACG
Scleritis
Features of anterior uveitis
Photophobia
Blurred vision
Red eye
Synechiae
Features of bacterial keraitis
Blurred vision
Hypopyon
Features of AACG
Red eye Blurred vision Photophobia Headache Nausea
Features of scleritis
Red eye
Intense pain
Blurred vision
Mx ant uveitis
steroids
mydriatics
Abx
Mx bacterial keratitis
Topical Abx
Mx AACG
IV acetazolamide
TO pilocarpine ev 5mins
Mx scleritis
Systemic steroids
Sudden painful LOV DDx (4)
AACG
Uveitis
Optic neuritis
Giant cell/temporal arteritis
Sudden painless LOV DDx (4)
Retinal aa/vv occlusion
Retinal detachment
Vitreous haemorrhage
ARMD
Mx corneal foreign body
TO anaesthetic to eye
Fluorescein stain for abrasions
If embedded in cornea - seek help
