Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 Gen Surg > Upper GI Surgery > Flashcards

Upper GI Surgery Flashcards

1
Q

where are the three areas of constriction of the oesophagus?

A

level of cricoid
posterior to left main bronchus and aortic arch
LOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the oesophagus lined with?

A

non keratinising squamous epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

state some inflammatory causes of dysphagia?

A 
tonsilitis 
oesophagitis 
GORD 
oral candidiasis 
aphthous ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

state some neurological/motility causes of dysphagia?

A 
achalasia 
diffuse oesophageal spasm 
nutcracker oseophagus 
bulbar/pseudobulbar palsy 
systemic sclerosis 
MG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

state some obstructive causes of dysphagia?

A 
foreign body 
benign stricture - web (plummer vision), oesophagitis, trauma) 
malignant stricture 
pharyngeal pouch 
retrosternal goitre 
rolling hiatus hernia 
lung cancer 
mediastinal LNs 
thoracic AA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What surgery can be done for achalasia ?

A

Heller’s cardiomyotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the area of weakness in the inferior pharyngeal constrictor that causes pharyngeal pouch?

A

Killian dehiscence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the presentation of pharyngeal pouch?

A

Regurgitation, halitosis, gurgling sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does diffuse oesophageal spasm look like on barium swallow ?

A

corkscrew oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the presentation of nutcracker oesophagus ?

A

Intermittent dysphagia ± chest pain

􏰀 ↑ contraction pressure ̄c normal peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

is plummer vision syndrome pre malignant?

A

yes

20% risk of SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what causes plummer vision syndrome ?

A

iron deficiency anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what oesophageal feature is seen in plummer vision syndrome?

A

pharyngeal web from hyperkeratinisation of upper 3rd of oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are two syndromes caused by violent emesis ?

A

Boerhaave’s syndrome

Mallory Weiss syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the difference between Boerhaave’s syndrome and Mallory Weiss syndrome ?

A

Boerhaave syndrome is a transmural perforation of the esophagus to be distinguished from Mallory-Weiss syndrome, a nontransmural esophageal tear also associated with vomiting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the features of oesophageal rupture ?

A

Odonophagia
􏰀 Mediastinitis: tachypnoea, dyspnoea, fever, shock
􏰀 Surgical emphysema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the treatment of oesophageal rupture?

A

PPI, NGT, Abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the commonest cause of oesophageal rupture?

A

iatrogenic - endoscopy, biopsy, dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

state a secondary cause of achalasia ?

A

Chages disease

- caused by T cruzii parasite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what medication can increase risk of GORD?

A

anti-AChM, nitrates, CCB, TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what surgical procedure can increase risk of GORD?

A

hellers myotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the epithelial changes seen in barretts oesophagus?

A

Metaplasia → dysplasia → adenocarcinoma

23
Q

what are extra oesophageal features of GORD?

A

Nocturnal asthma
􏰀 Chronic cough
􏰀 Laryngitis, sinusits

24
Q

what are DD for GORD?

A

oesophagitis
peptic ulcer disease
oesophageal cancer

25
Q

what PPI should be used for GORD and for how long ?

A

Lansoprazole 30mg OD

1-2months

26
Q

what is Ranitidine and whats it used for?

A

H2RA

- used for GORD

27
Q

what three criteria has to be met for nissen fundoplication for GORDD?

A

Severe symptoms

􏰁 Refractory to medical therapy

􏰁 Confirmed reflux (pH monitoring)

28
Q

state some complications of fundoplication?

A

􏰁 Gas-bloat syn.: inability to belch / vomit 􏰁

Dysphagia if wrap too tight

29
Q

what is a sliding hiatus hernia associated with

A

GORD

30
Q

is a sliding or paraoesophagheal hiatus hernia more common?

A

sliding (80%)

31
Q

what hiatus hernia requires surgery and why?

A

paraoesophageal because it may cause strangulation and ischaemia

32
Q

what makes duodenal ulcers worse and better?

A

worse before meals and at night

better by eating

33
Q

what makes gastric ulcers worse and better?

A

worse on eating (which can result in weight loss)

relieved by antacids

34
Q

state some risk factors for peptic ulcer disease ?

A 
H pylori 
NSAIDs, Steroids 
Smoking 
EtOH 
Stress
35
Q

what causes cushings ulcer?

A

gastric ulcer associated with elevated intracranial pressure.

36
Q

what causes curling ulcers ?

A

complication from severe burns when reduced plasma volume leads to ischemia and cell necrosis

37
Q

what do peptic ulcers look like?

A

punched out ulcers

38
Q

are duodenal ulcers or gastric ulcers more common?

A

duodenal ulcers are more common

39
Q

what tests can be done for peptic ulcers ?

A

FBC, urea
C13 urea breath test
CLO / urease test for H. pylori
Gastrin levels if Zollinger-Ellison suspected

40
Q

what is gastric acid stimulated by?

A

gastrin, histamine and ACh from vagus nerve increases acid production

41
Q

state some features of dumping syndrome ?

A

Abdo distension, flushing, n/v, fainting, sweating 􏰁 Early: osmotic hypovolaemia
􏰁 Late: reactive hypoglycaemia

42
Q

decreased activity of parietal cells will result in what deficiency ?

A

B 12

43
Q

what is blind loop syndrome ?

A

associated with bacterial overgrowth in limb of intestine excluded from flow after a subtotal gastrectomy which causes malabsorption and diarrhoea

44
Q

what is Mg trisilicate used for?

A

antacid

45
Q

what is the management of upper GI bleeds ?

A

Beta blockers
endoscopic banding
TIPSS (Transjugular Intrahepatic PortoSystemic Shunt)

46
Q

what is a DD of a perforated peptic ulcer?

A

pancreatitis
acute cholecystitis
AAA
MI

47
Q

what is Chailaditi’s sign?

A

when loop of large intestine (usually transverse colon) in between the diaphragm and the liver

48
Q

what should be seen on a CXR with a ulcer perforation ?

A

Air under the diaphragm seen in 70%

49
Q

state the presentation of gastric outlet obstruction?

A

Copious projectile, non-bilious vomiting a few hrs after meals.
􏰁 Contains stale food.
􏰁 Epigastric distension + succussion splash

50
Q

what does a AXR show for gastric outlet obstruction?

A

Dilated gastric air bubble, air fluid level

􏰁Collapsed distal bowel

51
Q

what surgical interventions can be done for gastric outlet obstruction?

A

Endoscopic balloon dilatation
􏰁Pyloroplasty
Stenting

52
Q

what gender is most affected by hypertrophic pyloric stenosis ?

A

males

53
Q

what is the presentation of hypertrophic pyloric stenosis ?

A

Projectile vomiting minutes after feeding
􏰀 RUQ mass: olive
􏰀 Visible peristalsis

54
Q

what are the 5 criteria for bariatric surgery?

A

BMI ≥40 or ≥35 ̄c significant co-morbidities that
could improve ̄c ↓ wt.

􏰁 Failure of non-surgical Mx to achieve and
maintain clinically beneficial wt. loss for 6mo.

􏰁 Fit for surgery and anaesthesia

􏰁 Integrated program providing guidance on diet,
physical activity, psychosocial concerns and
lifelong medical monitoring

􏰁 Well-informed and motivated pt.

Y4 Gen Surg (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions