Week 7 Flashcards
Classifications of Hypospadias
From distal to proximal
Glandular
Coronal
Proximal penile
Mid shaft
Distal penile
Penoscrotal
Scrotal
Perineal
Differential diagnosis for hypospadias?
Megameatus
Ventral urethra avulsion
Ambiguous genitalia
The components of hypospadias repair?
Orthoplasty
Urethroplasty
Glanuloplasty
Meatoplasty
Scrotoplasty
Spongioplasty
Skin cover
Orthoplasty - ___________
Urethroplasty - ___________
Glanuloplasty -_________
Meatoplasty -_____________
Scrotoplasty -________________
Spongioplasty -____________
Skin cover -_____________
Straightening of the penis
Correction of damage to the urethra
plastic surgery carried out on a glans
type of surgery to enlarge the urethral meatus at the end of the penis
surgical procedure used to either repair or treat an existing scrotum or to create a new scrotum
Surgery done on the corpus spongiosum to prevent urethrocutaneous fistula
It is vital to never carry out circumcision in a child with any degree of hypospadias
T/F
With reason
The preputial skin may be needed for corrective surgery
Hypospadias is a congenital malformation seen in 1 in ______ ______
300 boys.
The 5Ps?
Pain
Pallor
Pulseless
Paresthesia
Paralysis
the 4Ds indications for amputation
Dead/limb gangrene
Dying
Damn nuisance
Dangerous
Timing of hypospadias repair is influenced by _________, __________, and ________
penile size, genital awareness, and anesthetic risks
In select patients the __________ is a useful procedure for the correction of congenital or acquired chordee.
Nesbit operation
What is continuous bladder irrigation? Continuous bladder irrigation (CBI) is a medical procedure that ____________________. It also __________________________ at the same time. Healthcare providers often use it to ______________________ after surgery on the urinary system.
flushes your bladder with a sterile liquid
removes urine (pee) from your body
prevent or remove blood clots
Do not take _____ when you have cancer
Flagyl
Risk factors for DVT
Mention 10
Age
Immobilization
Pregnancy
Injury or surgery
Cancer
OCP/ HRT
Smoking
IBD
genetics
Past history of DVT
Bad girls get _______
Good girls get ________
Pregnancy
Fibroid
Auscultation: bowel sounds
Peristalsis produces a ______ noises because the bowel contains a mix- ture of _____ and _______.
gurgling
fluid and gas
Auscultation: bowel sounds
Normal bowel sounds are _____-pitched gurgles that occur every __________.
The absence of bowel sounds indicates that ________________. This may either be a primary or a secondary phenomenon.
low; few seconds
peri- stalsis has ceased
If you can hear the heart and breath sounds but no bowel sounds over a 30-second period, the patient probably has a _____________.
para- lytic ileus
Distension of the bowel caused by a mechanical intestinal obstruction is associated not only with ______eased bowel sounds, but also with a change in the _____________. They become _______ in nature with runs of ______- frequency gurgles, sounding like sea water enter- ing a large cave through a narrow entrance, often described as ‘ __________ ’.
incr; character of the sounds
amphoric; high
tinkling
Having assessed the quality of the bowel sounds, it is important to listen for any systolic vascular bruits, which indicate ___________ or increased blood flow through, for example, a _______.
arterial stenosis
fistula
Percussion of the abdomen causes pain if ___________ is present and is a useful method for mapping out a tender area
peritonitis
When a part or the whole of the abdomen appears distended, the patient should be held at the ______ and the abdomen ________________ .
________ sounds – a ___________ – indicate that there is an intra-abdominal viscus, usually the _________, distended with a mixture of fluid and gas.
hips
shaken from side-to-side
Splashing; succussion splash
stomach
An enlarged kidney can be pushed back and forth between the anterior and posterior hands. This is called ________.
It feels like patting a ball back and forth in a pool of water. Balloting is also used to palpate a _____ in a ___________
balloting
fetus; pregnant uterus.
Acute pancreatitis is a condition in which _________________________ the pancreatic gland.
It may be caused by ______ of the pan- creatic duct, usually by a __________ obstructing the ampulla of Vater. It is also commonly secondary to _________
activated pancreatic enzymes autodigest
obstruction; small gallstone
alcohol abuse.
The common presenting symptom in acute pancreatitis is ______ that begins suddenly, high in the ________, and steadily increases in severity until it is very severe, causing the patient to ________ and breathe __________.
It usually radiates through to the ———-.
pain; epigastrium
lie still ; shallowly; back
In acute pancreatitis
________ relieves the pain, which is exacerbated by ________.
Frequent ________ and ———— are very common, and are an important pointer to the correct diagnosis.
There is persistent ______ between the bouts of vomiting.
Nothing; movement
vomiting and retching
nausea
Inflammation of a Meckel’s diverticulum produces symptoms and signs that are indistinguishable from those of ________, although the pain and tenderness are generally felt more towards the __________ than in the __________.
acute appendicitis
centre of the abdomen
right iliac fossa
Acute Crohn’s disease may present with ________ or ___________ discomfort and signs similar to those of appendicitis.
A thick and tender _________ may be palpable in the ___________, and thickened ____________ may also be palpable in the ______________.
central or right iliac fossa
terminal ileum ; right iliac fossa
ileum and jejunum
umbilical region.
The normal visceral innervation of the appendix comes from the __________ spinal segment. The corresponding somatic dermatome encircles the abdomen at the level of the ______________
tenth thoracic
umbilicus (T10).
The inflamed appendix most commonly lies behind the ________ ( ________ ) so causes pain in the lateral part of the ___________ and the _______, but it may hang down into the pelvis and lie against the ________ or a ________________. In these circumstances, the patient may present with misleading ________ or ________ symptoms.
caecum; retrocaecal
right iliac fossa ; flank
bladder; loop of large bowel
bladder or large bowel
Acute appendicitis may also present with intestinal obstruction –_______ and __________ – if the appendix ___________________________________ .
colic and abdominal distension
lies too close to and inflames the terminal ileum (preileal or postileal)
Acute appendicitis
A _________ usually precedes the onset of pain by a few hours, and most patients feel slightly nauseated. Many patients vomit _________.
loss of appetite
once or twice
Most patients with appendicitis state that they had been __________ for a few days before the pain started, but a few complain of _________, which may lead to a mistaken diagnosis of __________, especially in children.
constipated
diarrhoea; gastroenteritis
Acute appendicitis
Some patients present with symptoms of generalized peritonitis – generalized abdominal pain, nausea and vomiting, sweating and sometimes rigors – especially if the ___________________.
initial stages of the disease go unoticed
A tender, indistinct mass may be felt in the right iliac fossa. It is usually impossible to feel below it because it is _______________. It is _____ to percussion.
___________ usually takes a few days to develop. ___________ should be suspected if the temperature is high and the mass is very tender
fixed posteriorly
dull; An appendix mass
An appendix abscess
The causes of abdominal distension can be remembered by repeating the letter ‘F’ six times: ______,_____,______,______,_____,_______ ; and other solid tumours (
fetus, flatus, faeces, fat, fluid and fibroids
Spigellian hernia
These hernias appear at the ______ edge of the ____________ muscle along the ____________. The lump is still palpable when the abdominal wall muscles are _________, and it is felt to lie above them
outer; rectus abdominis
linea semilunaris
contracted
Resolved inflammed appendix gives rise to???
Mucocele of the appendix
