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Surgery > Surgical MOSLER > Flashcards

Surgical MOSLER Flashcards

1
Q

Causes of diffusely swollen thyroid?

A 
Graves' Disease
Hashimoto's Thyroiditis
Multinodular colloid goitre
Iodine deficiency
Puberty
Pregnancy
de Quervain's thyroiditis (rare)
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2
Q

Causes of multiple nodules in thyroid?

A

Multinodular colloid goitre
Multiple thyroid cysts
Multiple adenomas

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3
Q

Causes of single nodule in thyroid?

A

Cyst
Tumour (benign/malignant)
Dominant single nodule in multinodular colloid goitre

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4
Q

How to describe a lump? [ANY LUMP]

A

She Cuts The Fish PERfectly

Site
Size
Surface
Colour
Contour
Consistency
Tenderness
Temperature
Transillumination
Fluctuance
Fixity
Fields
Pulsatile
Expansile
Reducible
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5
Q

Differentials for midline neck lump?

A 
Thyroid:
Physiological goitre
Multinodular goitre
Graves' disease
Hashimoto's Thyroiditis
Thyroglossal cyst
Thyroid cyst
Adenoma
Carcinoma
de Quervain's thyroiditis (rare)
Non-thyroid:
Lipoma
Dermoid cyst
Epidermal cyst
Abcess
Lymphoma (rare)
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6
Q

Differentials for lateral neck lump?

A

By structure:
Artery - Carotid aneurysm, subclavian aneurysm, carotid body tumour (chemodectoma)
Nerve - Neurofibroma, schwannoma
Lymphatic vessels - Lymphangioma (simple, cystic hygroma)
Lymph nodes - Infective, neoplastic (1ry, mets), granuloma
Salivary glands - Infective, autoimmune, neoplastic
Larynx - Laryngocele
Pharynx - Pharyngeal pouch
Branchial arch remnant - Branchial cyst/sinus/fistula
Superficial/skin - Lipoma, epidermal cyst, abcess, dermoid cyst (atypical)

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7
Q

First line investigation in thyroid lump?

A

Fine needle aspiration

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8
Q

Main primary thyroid tumours?

A

Benign (90%):
Adenoma - functioning or non-functioning
Malignant (10%):
Papillary carcinoma - 70%, younger patients, multifocal, better prognosis, thyroidectomy + radioiodine
Follicular carcinoma - 25%, younger patients, prognosis worse in older patients, thyroidectomy + radioiodine
Medullary cell carcinoma - 5%, part of MEN I, Ca of calcitonin-producing C cells thus ^ calcitonin, thyroidectomy, does not take up radioiodine
Anaplastic carcinoma - Rare, rapidly growing and invasive tumour in older patients, usually incurable, treatment palliative (may need tracheostomy and radiotherapy)
Lymphoma - Both Hodgkin’s and non-Hodgkin’s, treatment chemo

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9
Q

Complications of thyroid surgery?

A 
Immediate:
Bleeding
Infection
Damage to recurrent laryngeal nerve
Parathyroid resection/damage
Hypothyroidism

Early:
Bleeding - DANGEROUS

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10
Q

Symptoms of hyperparathyroidism

A 
Hypercalcaemia:
"Bones, stones, psychic moans and abdominal groans"
Joint pain
Kidney stones
Depression + cognitive impairment
Abdominal pain
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11
Q

Causes of acute epigastric pain?

A 
MI/ACS
Pericarditis
PUD
Pancreatitis
Cholecystitis
Gastritis
Perforated ulcer
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12
Q

Causes of acute LUQ pain?

A

PUD
Splenic rupture/infarct
Pancreatitis

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13
Q

Causes of acute RUQ pain?

A 
Hepatitis
Cholecystitis
Cholangitis
Pneumonia (RLL)
PUD
Biliary colic
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14
Q

Causes of acute central abdominal pain?

A 
Pancreatitis
PUD
Appendicitis (early)
Ischaemic bowel
Mesenteric adenitis
Small bowel obstruction
Abdominal aortic aneurysm
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15
Q

Causes of acute RIF pain in a male?

A 
Appendicitis (later)
Crohn's disease
Mesenteric adenitis
Meckel's diverticulum
Urolithiasis
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16
Q

Causes of acute RIF pain in a female?

A 
Appendicitis
Crohn's disease
Mesenteric adenitis
Meckel's diverticulum
Urolithiasis
Ectopic pregnancy
Pelvic inflammatory disease
Ovarian cyst rupture
17
Q

Causes of suprapubic pain in a male?

A

Urinary retention
UTI
Testicular torsion

18
Q

Causes of suprapubic pain in a female?

A 
Urinary retention
UTI
PID
Ectopic pregnancy
Endometriosis
Mittelschmerz
Salpingitis
Ovarian cyst rupture
Ovarian torsion
19
Q

Causes of acute LIF pain in a male?

A

Diverticulitis

Urolithiasis

20
Q

Causes of acute LIF pain in a female?

A 
Diverticulitis
Urolithiasis
Ectopic pregnancy
PID
Ovarian cyst rupture
21
Q

Causes of acute flank pain?

A 
Urolithiasis
Pyelonephritis
Abdominal aortic aneurysm
PUJ obstruction
Renal infarction

Surgery (3 decks)

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