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28 Cards in this Set
- Front
- Back
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What is a saphena varix?
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dilation of the long saphenous vein in the groin, just proximal to its junction with the femoral vein
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Signs and symptoms
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Cough impulse - transmits thrill
Swelling of soft and diffuse Empties with minimal pressure and refills on release Venous hum on auscultation Bluish tinge Dissapears on lying down Usually substantial varicose veins elsewhere in the long saphenous system |
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How do you diagnse a saphena varix?
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doppler US
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How do you treat a saphena varix?
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high saphenous ligation, varicose vein excision
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What is the aetiology of psoas abscesses?
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Collection of pus in the ileopsoas mm compartment
Can arise from haematogenous spread, contiguous spread from intraabdominal or pelvic process or nearby bony structures |
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What are the organisms commonly found in psoas abscesses?
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S. aureus, mix or enteric organisms including aerobic and anaerobic gram -ve bacilli
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What is the sign that can elicit tenderness of the psoas muscle
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Psoas sign - pain brought on by hip extension
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Clinical presentation of psoas abscess?
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Fever
Lower abomdinal or back pain or pain referred to hip or knee + psoas sign - pain brought on by extension of the hip Hip pain is diminished with hip flexion inguinal mass limp, anorexia, weight loss |
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What is the most useful diagnostic test for psoas abscess?
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CT
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How do you treat psoas abscess?
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CT guided drainage and antibiotics, surgical drainage if no clinical improvement after 2 days
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What is a lipoma?
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Benign tumour of fat
= commonest form of benign soft tissue tumours |
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What are the characteristics of a lipoma?
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Soft and non tender
Asymptomatic Fluctulant and lobulated Neither fixed to skin or deep tissues Usually do not enlarge quickly |
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Management of lipoma
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Conservative
Surgery if: painful, enlarging, pressure effects on adjacent structures, > 5cm, deep to the deep fascia (more likely to be malignant if in limbs) |
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What are the 3 main causes of enlarged lymph nodes?
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Infective
Neoplastic - lymphoma/other malignancies Reactive - CT, sarcoidosis, amyloidosis, drugs |
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Hwere do the inguinal lymph nodes lie?
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Horizontal group lies along the inguinal ligament
A vertical group lies beside the great saphenous vein in the proximal thigh |
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Which lymph nodes do tumours of the testis and scrotal cancer met to?
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They met to the paraaortic nodes and do NOT involve the inguinal nodes
Scrotal cancer spreads to the inguinal nodes |
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Differential of localised inguinal lymph nodes
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STIs
Malignant melanoma of lower limb Anal or vulval or scrotal cancer |
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Are lymph nodes reducible?
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no
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Symptoms of lymphadenopathy?
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Tender - reactive
Non-tender - haematological disease Can be fixed or mobile Are not reducible soft or firm, rubbery, hard, discrete, matted |
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What do nodes containing metastatic cancer feel like?
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hard, nontender, nonmovable
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What do nodes containing lymphoma feel like?
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large, discrete, symmetric, rubbery, firm, mobile, non tender
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What is the most common peripheral aneurysm?
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femoral artery
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How do femoral artery aneurysms present?
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Asymptomatic
Local pain or pulsatile groin mass severe ischaemia of lower extremity - claudication, rest pain, gangrene (42% of patients) |
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Indications for surgical management of femoral artery aneurysms?
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local symptoms, limb threatening sx
> 2.5cm |
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What is a femoral neuroma?
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= a nerve cell tumour that arises either sponardically as cutaneous nodules or due to previous trauma
Commonly associated with type 1 neurofibromatosis |
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Symptoms of a femoral neuroma?
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Compression causes pain and paraesthesia in the distribution of the femoral nerve
small, firm in texture |
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What is a cord lipoma?
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It is the most common benign tumour of the spermatic cord
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What is a hydrocele?
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fluid remnant within the remnant processus vaginalis
Noncommunicating - processus has closed proximally (Normal spermatic cord can usually be palpated above the level of the hydrocele) |
