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24 Cards in this Set
- Front
- Back
Charcots triad |
In acute cholangitis - fever - pain - janfuice If +2 symptoms=Reynolds pentod - hypotension - confusion |
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Acute cholecystitis complications 10 examples |
Life threatening complications - GB mucocele ( hydrops) - abscess - empyema -gangrene- > perforation -> abcess / biliary peritonitis/ sepsis - biliary enteric fistula -> gallstone illeus |
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Gilberts syndrome ethiology and leads to |
AD mutation of UDP- glucurpnyl transfers se enzyme Leads to : Increased unconjugated |
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Cringler- najjar syndrome Cause, types, symptoms, treatment |
AR type 1 - complete abcensce of Enzyme glucuronyl transfers se Leads to : Severe increase in u conjugated bilirubin - Severe hyoetbilirubinemia - kernicterus ( brain damage) TX : exchange transfusion+ photo therapy + liver transplant AD- type 2- partial loss of Enzyme glucuronyl transfers se - without neurological problems TX: phenobarbital |
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Unconjugated hereditary hyperbilirubinemia |
Gilberts syndrome Cringler najjar syndrome |
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Unconjugated hereditary hyperbilirubinemia |
Gilberts syndrome Cringler najjar syndrome |
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Conjugated hereditary hyperbilirubinemia |
Dubin- Johnson syndrome Rotor syndrome |
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Porcelain gall bladder |
Chronic inflammation of gallbladder increase the risk of gallbladder carcinoma |
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Chronic cholecystitis - most common complication |
Gallbladder carcinoma from porcelain gallbladder - excessive calcification due to fibrosis |
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Mirizzi syndrome |
Cholestasis Due to large stone on cystic duct causing extra luminal compression of common bilder duct 4 stages |
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3rd most common cancer |
Colorectal cancer ( after lung/prostate/beast) |
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2nd most common cause of cancer DEATH |
Colorectal cancer cuz diagnosed in late stage |
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Risk factors of colorectal cancer |
1.Family history- inherited polyposis syndromes - FAP, HNPCC 2. Diet - animal fat, red meat, sugar 3. Chronic inflammatory bowel disease ( especially active UC) 4. Obesity 5. smoking 6. Smoking 7. Acromegaly and DM 8. Abdominal radiotherapy
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Protective agents for colorectal cancer |
Diet - increase fiber, vitamin d and calcium Exercise Long term use of aspirin or otherNSAIDS |
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Duke's staging |
Staging Duke's system and TNM Duke's staging Stage A: Tumour confined within bowel wall (prognosis: 80%) Stage B: Extension through bowel wall (prognosis: 60% Stage C: Tumour involving lymph nodes (prognosis(35%) Stage D: Distant metastases (prognosis: 5%) |
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Colorectal cancer- non specific marker |
Carcinoembryonic antigen CEA Not used for screening Can be used in followup by measuring before, during and see if it changed |
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Acute abdomen anamnesis |
OPQRST O- onset: acute, subacute, chronic P- provocation : movement, rest Q- quality: sharp, dull, burning R- Radiation S- severity 0-10 T- time : when did it start |
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Peritonitis sign |
Blumbergs Defense muscularis Guarding, rigidity, tenderness, rebound tenderness |
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Acute appendicitis signs |
Mc Burney Rovsings Dunphy |
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Acute appendicitis signs |
Mc Burney Rovsings Dunphy |
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Acute cholecystitis signs |
Murphys sign Boas sign |
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Acute pancreatits signs |
Cullens sign ( bruising and discoloration around umbillicus) Grey turners sign ( bruising and discoloration left flank) |
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Acute abdomen which ones |
Acute appendicitis Acute cholecystitis Peritonitis Acute pancreatits Diverticulitis Paralytic illus ( non i flamma) |
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Acute abdomen when to operate |
-Peritonitis -Unstable pt (hemodynamically or septic) - tachycardia, hypotension - intestinal ischemia - pneumoperitoneum |