Variants of Surgical Diseases Flashcards
.What is the definition of “Richter’s hernia’?
Hernia that contains part of the circumference of the bowel wall, which can cause strangulation without obstruction.
What does “Morgagni hernia” mean?
Morgagni hernia is a type of diaphragmatic hernia that occurs through sternocostal triangle.
- Morgagni hernias are most often right-sided, probably because left-sided defects are covered by the heart and pericardium, and are often associated with obesity.
- The hernia sac usually contains omentum but may contain transverse colon or, rarely, stomach, small bowel, or liver.
Which are the complications of ulcerative colitis?
- Toxic megacolon (acute dilatation),
- massive haemorrhage,
- malignant degeneration.
What is the gross pathology appearance in ulcerative colitis?
Ulcerative colitis is a disease largely limited to the mucosa and submucosa of the colorectum.
- The rectum is always involved, and the disease presents from this point proximally.
- There are numerous ulcers with areas of regenerating mucosa, called pseudopolyps and superficial fissures are seen.
. What is the definition of ‘‘blunt abdominal trauma”?
Blunt abdominal trauma (non- penetrating) is a trauma in which traumatic object does not break the skin and doesn not pierce the parietal peritoneum.
- Blunt trauma can result in the laceration of solid organs usually causing bleeding, which in its most severe form manifests as hemorrhagic shock or as visceral perforation of the gastrointestinal tract
Which classification is used to determine the endoscopic severity of stomach and duodenal ulcer bleeding?
Forrest classification is used to determine the endoscopic severity of stomach and duodenal ulcer bleeding.
What is the definition of “toxic adenoma”?
It is a benign single thyroid nodule consisting of hyperplastic epithelium with overproduction of thyroid hormones.
- This nodule is autonomous in its overproduction of thyroid hormones and is surrounded by acini in the resting phase [due to the negative feedback loop regulation of TSH secretion].
- Women are more likely than men to be affected with this type of hyperthyroidism, and its maximum prevalence occurs between the ages of 40 and 60 years, although children may also be affected.
What is the classic triad of presenting symptoms in achalasia?
The classic triad of presenting symptoms in achalasia consists of: dysphagia, regurgitation, and weight loss.
What does “hypersplenism” mean?
Hypersplenism is increased splenic function that is manifested clinically by the decrease in one or more of the circulating blood elements
What is the usual clinical presentation of liver microabscesses?
Patients with microscopic liver abscesses usually have an acutely septic clinical presentation, with
- fever, rigors,
- as well as right upper quadrant pain that can be quite severe
What does “caput medusae” mean?
“Caput medusae” means recanalized umbilical vein from the left portal vein to the epigastric venous system due to the portal hypertension.
There are defined three stages (phases) of empyema. Which are they?
The American Thoracic Society, in 1962, divided the formation of an empyema into three distinct stages (phases), indicative of disease progression in the pleural space:
- Exudative phase (stage I)
- Fibrinopurulent phase (stage II)
- Phase of Organization (stage III)
- What is the definition of “advanced gastric cancer”?
“Advanced gastric cancer” is tumor with deeper invasion than stomach mucosa and submucosa
When does tension pneumothorax develop?
A tension pneumothorax develops when a ‘oneway-valve’ air leak occurs, either from the lung or through the chest wall.
- Air is forced into the thoracic cavity without any means of escape, completely collapsing the affected lung.
- The mediastinum gets displaced to the opposite side, decreasing venous return and compressing the opposite lung
What is the definition of “pancreatic pseudocyst”?
Pancreatic pseudocyst is a formation of the retroperitoneal space due to its inflammatory process causes by acute pancreatitis. In up to 10% of patients with acute pancreatitis, retroperitoneal acute fluid collections progress to develop a wall of fibrous granulation tissue, at which point they are classified as pseudocysts.
What is the definition of “spigelian hernia”?
Spigelian hernia is an interparietal hernia in the line of the linea semilunaris (the lateral margin of the rectus sheath, running from the tip of the ninth costal cartilage to the pubic crest)
Which are the nonsurgical treatment options of achalasia?
The nonsurgical treatment options of achalasia are medications and endoscopic intervention pneumatic (balloon) dilatation.
Medical treatment with
- sublingual nitroglycerin,
- nitrates,
- calcium channel blockers may offer hours of relief of chest pressure before or after a meal.
Pneumatic dilatation is the most effective nonsurgical therapy for achalasia.
Three types of hiatal hernia have been described. Which are they?
The classic sliding hiatal hernia (type I) is the passage of the gastroesophageal junction and variable amounts of the cardia above the diaphragm.
paraesophageal or rolling hernia(type II) , the gastroesophageal junction remains below the diaphragm but the fundus rolls up, generally in an anterior location, next to the esophagus.
The type III hiatal hernia Is a combination of a sliding and paraesophageal hernia.
. What does “superior sulcus tumor” mean?
Superior sulcus tumor is a peripheral lung cancer that is localized in superior pulmonary sulcus.
Anatomically, the pulmonary sulcus comprises
- the costovertebral gutter extending from the first rib to the diaphragm.
- The superior pulmonary sulcus lies at the uppermost extent of this recess.
What is the clinical presentation of carcinoid syndrome?
The carcinoid syndrome is characterized by flushing, diarrhoea and wheezing,
- occurs when carcinoid tumour metabolites are secreted directly into the systemic circulation from hepatic metastases or from a primary lesion
. What is the definition of “intussusceptum” and “intussuscipiens”?
intussusceptum segment invaginates into the intussuscipiens
resulting in obstruction and ischemic injury to the intussuscepting segment.
What is the definition of “sentinel lymph node”?
A sentinel lymph node is defined as the first lymph node that receives drainage from a cancer
What is the definition and clinical features of “de Quervain’s thyroiditis”?
De Quervain’s thyroiditis is subacute thyroiditis
- a history of an upper respiratory infection before the onset of thyroiditis can be elicited.
- Patients have diffuse swelling in the cervical area and a sudden increase in pain.
- Approximately two thirds of patients demonstrate fever, weight loss, and severe fatigue
What is the clinical presentation of noninfected thyroglossal cyst?
- Presentation of thyroglossal cyst is commonly during the second or third decades of life.
- The mass is usually midline, between the thyroid notch and hyoid bone, and moves upwards on protrusion of the tongue
Primary liver cancer includes two main histological types. Which are they?
Primary liver cancer includes two major types: hepatocellular carcinoma (more than 90 %) and cholangio-carcinoma (intrahepatic bile duct cancer).
. What is the treatment of the open pneumothorax during the primary survey?
The treatment of the open pneumothorax during primary survey is aimed at returning normal ventilation and closing the chest wound.
- The first step is place an occlusive dressing over the chest wound to promote normal ventilation
- A standard method involves placing a nonporous dressing over the wound and taping it on 3 sides.
- This acts as a 1-way valve, allowing air to escape during expiration but becomes occlusive during inspiration
Which are the most common mediastinal neurogenic tumors in adults?
The most common mediastinal neurogenic tumors in adults are neurofibromas. They arise from the nerve sheath
. What is the definition of “colon diverticulosis”
and definition of “colon diverticulitis”?
- “diverticulosis” is used to describe colonic diverticula with no associated inflammation,
- “Diverticulitis” indicates associated inflammation.
Why are Pancreatic injuries are serious problem, in abdominal trauma, resulting in high mortality
High mortality rates in pancreatic injuries can frequently be attributed to delays in their diagnosis and treatment.
Because of the caustic nature of pancreatic enzymes, delays in managing pancreatic injuries result in massive systemic inflammation -> SIRS -> MODS
. What is the primary goal of prophylactic treatment of splenectomized patients?
The primary goal of this prophylaxis is to prevent overwhelming postsplenectomy infection.
Done with Pneumococcal vaccine weeks before surgery
What does the term “taxis” mean?
Taxis is non-operative treatment of intestinal obstruction = manual repositioning
What is the definition of “acute abdomen”?
The term “acute abdomen” refers to signs and symptoms of abdominal pain and tenderness, a clinical presentation that often requires emergency surgical therapy
. What does the term “functional obstruction” mean?
There are neurogenic or functional obstructions in which luminal contents are prevented from passing because of disturbances in gut motility that prevent coordinated peristalsis from on region of the gut to the next
What is the definition of Hashimoto’s thyroiditis?
Hashimoto’s thyroiditis is a chronic, autoimmune disease, also known as lymphocytic thyroiditis.
This condition was described by Hashimoto in 1912 as struma lymphomatosa based on the histologic findings.
What does “Courvoisier’s sign” mean?
Palpable enlarged gallbladder.
- Two-thirds of patients with pancreatic cancer and obstructive jaundice exemplify Courvoisier’s law, which states that this finding in the abscence of pain indicates a malignant & distal biliary obstruction.
. What is the definition of “mastitis”?
Mastitis is infection of the breast that fall into two general categories:
- Lactational infections
- chronic Subareolar infections associated with duct ectasia.
- Lactational infections are thought to arise from entry of bacteria through the nipple into the duct system and are characterized by fever, leukocytosis, erythema, and tenderness.
- Infections are most often caused by Staphylococcus aureus and may be manifested as cellulitis with breast parenchymal inflammation and swelling.
- Acute mastitis in the lactating women usually is presented as cellulitis with fever, pain, redness, and swelling of the affected breast.
What is the definition of “achalasia”?
Achalasia is a motility disorder of the esophagus characterized by
- failure of the lower esophageal sphincter to relax in response to swallowing and by an absence of peristalsis in the esophageal body.
- The disease is most often progressive, leading to gradual dilatation of the esophagus above the sphincter.
What does “superior vena cava syndrome” mean?
The superior vena cava syndrome constitutes a constellation of signs and symptoms resulting from either extrinsic or intrinsic obstruction of the superior vena cava and causing congestion of venous outflow from the head, neck, and upper extremities.
A resulting increase in venous pressure leads to dramatic signs and symptoms
What does “Ludwig’s angina” mean?
Ludwig’s angina is a subtype of severe deep neck infection.
It is a diffuse cellulitis, involving the bilateral submental, submandibular, and sublingual spaces.
