Progress 18 NME (Page 279-310)

mbch4kz2's version from 2016-05-13 09:31


Question Answer
How would you define a direct inguinal hernia?Passes through the superficial inguinal ring and through the inguinal canal. It is medial to the inferior epigastric vessels. Unable to extend into the scrotum
What is Hasselbach's triangle?Edge of rectus abdominus, the inguinal ligament and the inferior epigastric artery
How would you define an indirect inguinal hernia?Results from the failure of the deep inguinal ring. Protrudes through the superficial inguinal ring. They are lateral and superior to the inferior epigastric vessels, lateral to Hasselbach's triangle and protrude through the deep inguinal ring. It passes inferomedially to pass through the superficial ring and, if large enough, extend into the scrotum.
What is a cause of pulsating groin swelling?Aneurysm of the femoral artery
When would you conduct an open surgical repair of a hernia?In an elderly patients or one who is unfit for GA
What are the steps of interpretating an abdominal X-ray?1. Type of X-ray (abdo/chest- ie. plain film of the abdomen) 2. Name, age, DOB 3 Quality (symmetry, penetration and exposure ie. film is of satisfactory quality in terms of positioning and penetration) - Abdo. X-rays always AP 4. Interpret the film 5. Plan and management- request more investigations, pain relief, bloods, admit, ons, refer
What is a percutaneous transhepatic cholangeogram?Where you pass a wire through the bile ducts, into and liver and into the common hepatic duct- can place a stent here
What is gallbladder ileus?Where a fistula forms between the gallbladder and duodenum. A stone can cause an obstruction. Would see dilated loops of small bowel from obstruction. Also air can get into the gallbladder which you can see on X-ray
What is the management of pancreatitis?Conservative treatment, fluids in case of dehydration- early US scan to see if there is an obstructed biliary tree from gall stones
What is the effect of pancreatitis on the renal system and how would you elicit this affect and treat?Pancreatic enzymes affect the renal system first. Catheterise to get an hourly urine output (0.5ml/kg/hr is bad). Be careful giving fluids if dehydrated as if the kidneys are not working then too much fluid can cause pulmonary oedema. Can see fluid overload from the central venous pressure- insert a central line to assess filling status.
What is the effect of pancreatitis on the lungs?Pancreatic enzymes may cause an acidosis (not excreting acid). Cause patient to hyperventilate- may become hypoxic. May cause respiratory failure
What are the causes of pancreatitis?G- Gall stones E- Ethanol (alcohol) T- Trauma S- Steroids M- Malignancy and mumps A- Autoimmune S- Scorption stings/spider bites H- Hyperlipidaemia/Hypercalcaemia/Hyperparathyroidism (metabilic disorders) E- ERCP D- Drugs
What would you use for irrigation of the urethra and bladder?Glycine as non-conductive
Name 5 types of herniaInguinal, Femoral, Epigastric, Incisional, Umbilical, Parstomal, Hiatus, Diaphragmatic, Obturator, Spigalion, Lumbar (last 3 uncommon)
What is the most common cause of hypercalcaemia?Bone metastases
Name 3 causes of polyurea and thirst?Diabetes mellitus, hypercalcaemia and diabetes insipidus
What is normal glucose post-meal?Not >7
What is normal glucose pre-meal?Not <3.5
On random glucose, what level of blood glucose can you diagnose diabetes?>13
What level of fasting glucose (twice) can a diagnosis of glucose be made?>7
What is the HbA1cGlucose reacts with all proteins. Hb is the most convenient. Amount of glucose covalently bonded to Hb is a reflection of the average glucose over the past 3 months

Recent badges