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49 Cards in this Set
- Front
- Back
Amyand's hernia |
Appendix |
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Herniorrhaphy vs hernioplasty |
Herniorrhaphy: herniotomy + inguinal floor reconstruction with sutures Hernioplasty: herniotomy + inguinal floor reconstruction with MESH |
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Gold standard for inguinal hernia repair |
Lichtenstein repair i.e. anterior tension free repair |
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Primary tension free repair of inguinal hernia |
1. Bassini 2. Shouldice |
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Bassini's repair |
✓ Triple layer repair ✓ Internal oblique + transverse abdominis + fascia transversalis ✓ increased tension in tissue ---> increased recurrence rate |
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Shouldice |
✓ Four layered repair ✓ double breasting of fascia transversalis ✓ relatively low tension in tissues ----> low recurrence rate |
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Modified Shouldice |
✓ Double breasting of internal oblique, transverse abdominis, fascia transversalis ✓ Aka six layered repair |
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Space of Bogros |
Aka retroinguinal space Extra peritoneal space located deep to inguinal ligament Situated laterally and cranially to the space of Retzius |
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1. Diameter of femoral ring 2. Length of femoral canal 3. Ln in femoral canal |
1. 1.25 cm 2. 1.25 cm 3. Cloquet group of nodes |
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Inguinal floor reconstruction techniques 1. Primary tissue repair 2. Anterior tension free repair 3. Lap |
1. Bassini's repair and shouldice repair 2. Lichtenstein 3. TEP & TAPP |
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Approaches for repair of femoral hernia |
1. Sub inguinal incision: Lockwood 2. Inguinal incision: Lothiessen 3. Supra inguinal : Mc Evedy |
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TOC of femoral hernia |
Henry's procedure ( midline abdominal extraperitoneal femoral hernioplasty) |
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Variants of femoral hernia |
1. Laugier 2. Narath 3. Cloquet |
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Management of lumbar hernia |
DOWD'S OPERATION |
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Boundaries of superior and Inferior lumbar triangle |
Superior triangle P: para spinal muscle A: internal oblique S: 12th rib Inferior triangle P: lattisimus dorsi A: external oblique I: iliac crest |
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Skinny old lady hernia |
Obturator hernia |
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French hernia |
Obturator hernia |
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1. Howship Romberg sign 2. Hannington Kiff sign |
Both seen in obturator hernia 1. Compression of obturator nerve: pain along the medial aspect of thigh radiating to I/L knee joint 2. Absence of obturator reflex |
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Fatty hernia of linia alba |
Epigastric hernia |
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Mesh is used in case of epigastric hernia if |
Defect is > 4cm |
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Indications of surgery in umbilical hernia |
1. If it persists beyond 5yrs of age 2. Symptomatic pts 3. Strangulation 4. Size > 2cm 5. Progressive enlargement of hernia after 1-2 yrs Small defects are closed primarily If size > 3cm: prosthetic mesh used |
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Vests over pants repair |
Aka Mayo's repair Used in umbilical hernia |
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Bechwidth wiedeman syndrome |
Hemihypertrophy Macroglossia Visceromegaly Omphalocele Hepatoblastoma |
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Gastroschisis is associated with |
Intestinal atresia |
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Maternal drug intake associated with gastroschisis |
Aspirin during first trimester Ibuprofen Pseudoephedrine |
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Gold standard treatment of incisional hernia |
IPOM ( Intra Peritoneal Onlay Mesh repair) |
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1. Risk of desmoid tumor is increased in ____ syndrome 2. IOC in desmoid tumor |
1. Gardner's syndrome 2. MRI - bcz it is a soft tissue tumor ( arises from musculoaponeurotic structure in infra umbilical region ) |
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Named hernias 1. Gibbons 2. Berger's 3. Beclar's 4. Ogilvie's 5. Stammer's 6. Peterson 7. Velpaeu's 8. Serafini's 9. Holthosue # Ogilvie's Syndrome |
1. Hernia + hydrocele 2. Hernia into pouch of Douglas 3. Hernia through saphenous opening 4. Hernia through defect in conjoint tendon 5. Hernia through transverse mesocolon after retrocolic Gastro-jejunostomy 6. Hernia behind Roux limb after Roux-en-Y gastric bypass ( mc bariatric surgery) 7. Prevascular hernia ( sac is in front of femoral vessels) 8. Retrovascular hernia ( sac is behind femoral vessels) 9. Type of inguinal hernia; extension of bowel along inguinal ligament # colonic pseudo obstruction |
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Pendred syndrome |
Congenital SNHL + Goitre Chr 7q |
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Retetoff syndrome |
End organ resistance to T4 |
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Thyroglossal cyst 1. Age of presentation 2. Mc location 3. Increased risk of ____ carcinoma of thyroid 4. TOC |
1. 15-30yrs 2. Subhyoid 3. Papillary ca of thyroid 4. Sistrunk operation ( en Bloc removal of central part of body of hyoid bone + cyst ) |
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Retrosternal goiter |
If > 50% of thyroid tissue is located below the opening of thoracic cage |
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Pemberton sign |
If b/l upper limb elevated above forehead , facial puffiness and facial congestion seen. Goiter |
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Radioisotopes used in relation to goiter |
1. I-123: t1/2= 13hrs ; diagnostic purpose 2. I-131: t1/2 = 8 days; treatment... ablation |
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1. I-131 emits 2. Depth of penetration |
1. Beta rays - 90% Gamma rays - 10% Beta rays are responsible for the therapeutic effects ( ablation) Gamma rays are responsible for side effects and used in tracer studies 2. 0.5mm ; ablates only thyroid , even parathyroid are unaffected |
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Hartley- Dunhill Procedure |
Type of thyroidectomy leaving behind 4-6 gms of thyroid in one lobe with removal of rest of thyroid gland |
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Subtotal vs near total thyroidectomy |
Subtotal : 3-4 gms of thyroid tissue left in each lobe superiorly Near total: < 1gm of thyroid tissue adjacent to recurrent laryngeal nerve near ligament of berry |
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Only indication of subtotal thyroidectomy |
Multinodular goiter in elderly pt |
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Mv solitary thyroid nodule |
Colloid goiter > follicular adenoma |
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Solitary thyroid nodule 1. First investigation 2. IOC |
1. TFT 2. FNAC |
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Side effects of 1. methimazole 2. Propylthiouracil |
Increased risk of choanal atresia 1. Increased risk of Aplasia cutisIncreased risk of choanal atresiaAgranulocytosis2. Hepatic failure in females and children Agranulocytosis cutisIncreased risk of choanal atresiaAgranulocytosis2. Hepatic failure in females and children 2. Hepatic failure in females and children |
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Antithyroid DOC ds 2. In pregnancy 1. In Graves ds2. In pregnancy3. In thyrotoxic crisis 3. In thyrotoxic crisis |
1. Methimazole 2. Carbimazole 3. Propylthiouracil |
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Mcc 1. Large bowel obstruction 2. Small bowel obstruction |
1. Malignancy 2. Adhesions |
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First symptom of small bowel obstruction |
Colicky abdominal pain |
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After adequate tissue perfusion, urine output should be ___ in 1. Adults 2. Children |
1. 1ml/min 2. 0.5-1ml/min |
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Normal air fluid levels in adult |
3-5 |
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IOC for small bowel obstruction |
X-ray ( supine > erect)
In low grade intermittent SBO - IOC is Enteroclysis |
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Named hernia 2 1. Romberg hernia 2. Hesselbach's hernia 3. Serofini 4. Teale 5. Maydl's 6. Mery's 7. Barth's 8. Holthouse's 9. De Garengeot's 10. Ritcher's |
1. Saddle hernia 2. Lateral to femoral artery 3. Behind femoral vessels 4. In front of femoral vessels 5. 'W' hernia 6. Perineal hernia 7. Between abdominal wall and persistent vitellointestinal duct 8. Inguinal hernia that has turned outwards into the groin 9. Incarcerated appendix in femoral hernia 10. Part of circumference of bowel wall is gangrenous
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Categorisation of GCS A. COMA B. Mild head injury C. Moderate head injury D. Severe head injury |
A. No eye opening, no ability to follow commands, no word verbalizations ( 3-8) B. 13-15 C. 9-12 D. 8 or less |