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SURGICAL DISEASES > TH2 ACUTE ABDOMEN > Flashcards

TH2 ACUTE ABDOMEN Flashcards

1
Q

ACUTE ABDOMEN

A

SIGNS + SYMPS OF ABDOMINAL PAIN + TENDERNESS

CLINICAL PRESENTATION OFTEN REQUIRES EMERGENCY SURGICAL THERAPY

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2
Q

MOST COMMON SURGICAL ACUTE ABDOMINAL CONDITION PRESENTED WITH ACUTE ABDOMEN?

A 
ABDO. ORGAN INFECTION 
ABDO. ORGAN ISCHEMIA 
INTRA ABDOMINAL HEMORRHAGE 
GASTRO INTESTINAL PERFORATION 
ILEUS
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3
Q

WHAT IS THE ORDER OF EXAMINATION FOR ACUTE ABDOMEN

A

HISTORY
PHYSICAL EXAMINATION
LAB TESTS
IMAGING STUDIES

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4
Q

MOST COMMON GENERAL SURGICAL EMERGENCY

A

ACUTE APPENDICITIS

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5
Q

ACUTE APPENDICITIS

A

ACUTE INFLAMMATORY PROCESS OF APPENDIX

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6
Q

POSITION OF APPENDIX IN RELATION TO CAECUM?

A 
MEDIAL 
RETROCECAL
LATEROCECAL
SUBHEPATIC 
TIP CLOSE TO LEFT COLON 
PELVIC
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7
Q

HOW DOES HISTORY OF ACUTE APPENDICITIS BEGIN?

A

CENTRAL ABDOMINAL PAIN OF VISCERAL TYPE

ILL LOCALISED
> USUALLY AROUND UMBILICUS/ EPIGASTRIUM

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8
Q

MOST SENSITIVE SIGN OF ACUTE APPENDICITIS WITH LOCAL PERITONEAL IRRITATION

A

RIGHT LOWER ABDOMINAL QUADRANT PAIN

> SOMATIC PHASE OF PAIN

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9
Q

MOST COMMON ABDOMINAL PHYSICAL FINDING IN ACUTE APPENDICITIS?

A

LOCAL TENDERNESS

GUARDING IN RLQ

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10
Q

HALLMARK FOR DIAGNOSING ACUTE ABDOMEN

A

TENDERNESS OVER SITE OF APPENDIX

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11
Q

MANAGEMENT OF ACUTE APPENDICITIS

A

APPENDECTOMY

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12
Q

PERIAPPENDICULAR INFILTRATE

A

PERFORMATION OF APPENDIX > LEADING TO PERIAPPENDICULAR ABSCESS

> host defence reaction against spreading of inflammation from appendix into peritoneal cavity

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13
Q

WHY ACUTE APPENDICITIS IN OLDER PX CAN BE DIFFICULT TO DX?

A

PX DELAY SEEKING CARE + PRESENTATION MAY BE ATYPICAL

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14
Q

AGED GROUP OF PERIAPPENDICULAR INFILTRATE?

A

ELDERLY PX DUE TO LATE COURSE OF ACUTE APPENDICITIS

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15
Q

OTHER CONDITIONS CLINICALLY PRESENTED LIKE PERIAPPENDICULAR INFILTRATE?

A

CANCER OF CECUM ACCOMPANIED BY PERITUMOUR INFLAMMATION

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16
Q

PRESENTATION OF PERIAPPENDICULAR INFILTRATE ON PHYSICAL EXAMINATION?

A

MODERATE PAINFUL PALPABLE MASS IN RLQ

17
Q

WHY IS DX OF APPENDICITIS IN PREGNANCY DIFFICULT?

A

APPENDIX DISPLACED BY GRAVID UTERUS + ABDOMINAL WALL LIFTED FROM APPENDIX BY GRAVID UTERUS

18
Q

MECKELS DIVERTICULUM

A

true diverticulum of variable size derived from intestinal remnant of yolk stalk/ omphalomesenteric duct

19
Q

LOCALISATION OF MECKELS DIVERTICULUM?

A

ANTIMESENTERIC BORDER OF TERMINAL ILEUM

APPROX. 40-50cm FROM ILEOCECAL VALVE IN ADULTS

20
Q

COMPLICATION OF MECKELS DIVERITCULUM?

A 
GI BLEEDING 
PERFORATION 
SMALL INTESTINE OBSTRUCTION 
DIVERTICULITIS 
ENTEROLITHS
FOREIGN BODIES INTO DIVERTICULUM
21
Q

CROHNS DISEASE

A

CHRONIC TRANSMURAL INFLAMMATORY DISEASE OF GIT

> UNKNOWN CAUSE

22
Q

WHICH ALIMENTARY TRACT IS MOST COMMONLY INVOLVED IN CROHNS DISEASE?

A

SMALL INTESTINE +

COLON

23
Q

STAGES OF CROHNS DISEASE?

A

ACUTE
- transmural abscess + perforation of intestinal wall

SUBACUTE
- granulomas + ulcers onto intestinal mucosa produced

CHRONIC
- fibrotic transformation of intestine wall

24
Q

MOST COMMON CLINICAL PRESENTATION OF ACUTE STAGE OF CROHNS DISEASE?

A

ABDOMINAL PAIN

MELENA/ DIARRHOEA WITH BLOOD (mucosal ulcer)

25
Q

COMPLICATION OF CROHSN DISEASE?

A

SIGNIFICANT INTESTINAL BLEEDING
ACUTE PERITONITIS (small intestinal perforation)
BOWEL OBSTRUCTION
INTESTINE FISTULA

26
Q

NON SURGICAL CAUSE FOR ACUTE ABDOMEN?

A

DIABETIC CRISIS

> acute pancreatitis

27
Q

MURPHYS SIGNS?

A

INSPIRATION DURING PALPATION OF RIGHT UPPER QUADRANT > RESULTS IN SUDDEN WORSENING OF PAIN

28
Q

MOST COMMON NON-OBSTETRIC DISEASE REQUIRING SURGERY IN PREGNANT WOMEN?

A

APPENDICITIS

29
Q

CARDIOPULMONARY BYPASS ASSOCIATED WITH THE FOLLOWING ACUTE ABDOMINAL ILLNESS?

A

PARALYTIC ILEUS
MESENTERIC ISCHEMIA
STRESS PEPTIC ULCERATION
OGLIVIE SYNDROME

30
Q

WHICH IS THE SIGN TYPICAL FOR ACUTE APPENDICITIS?

A

ROVSING SIGN

pain elicited on RLQ when palpating left side of abdomen

31
Q

KEHRS SIGN

A

acute pain in tip of shoulder due to blood/ other infiltrates in peritoneal cavity when px lying down + legs elevated

32
Q

CHARCOT SIGN

A

billiary obstruction with upper abdominal pain with jaundice + fever

33
Q

REFFERED PAIN IN RIGHT SHOULDER CAN ORIGINATE FROM?

A

GALL BLADDER

34
Q

WHAT IS THE NON OPERATIVE TX FOR DELAYED PRESENTATION OF APPENDICITIS?

A

ABX + BEST REST

> NON OPERATIVE

SURGICAL DISEASES (13 decks)

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