SURGERY – LENS

 

 

Questions

 

1) What is   biliary rickets?

 

2) What is   Floating gall bladder ?

 

3) What is   Choledochal cyst ?

 

4 ) What is Pen Britton sign?

 

5) What are the Risk factors for deep vein thrombosis?

 

6) What are the features of PANCOAST syndrome ?

 

7) What are the features of Branchial sinuses ?

 

8) What are the features of Cystic hygroma ?

 

9) What are the features of Thyroglossal cysts?

 

10) What is Rovsing’s sign ?

 

 

Answers

 

1) What is   biliary rickets?

            Prolonged steatorrhoea  will result in  osteomalacia

 

2) What is   Floating gall bladder ?

             Torsion of gall bladder

 

3) What is   Choledochal cyst ?

            Commonest  type – fusiform dilatation of the common bile duct

Cysts will show  inflammatory changes

            There will be absence of epithelium

Treated  by  excision  or  choledochocystojejunostomy

 

 

4 ) What is Pen Britton sign?

            In retrosternal thyroid ,on lifting the upper limbs ,the face is suffused. .this is due to the pressure by the thyroid on the SVC.

 

 

5) What are the Risk factors for deep vein thrombosis?

              Immobility

 

6) What are the features of PANCOAST syndrome ?

( Mnemonic –PANC )

            - Pulmonary tuberculosis

            - Arm pain      

            - Nerve roots   are compressed

            - Compression of cervical sympathetic chain 

            - Chest pain  due to erosion of  ribs  and  vertebra

 

7) What are the features of Branchial sinuses ?

- seen along the anterior border of sternocleidomastoid muscle.

-  seen along the course of the first and second branchial clefts due to improper closure of the branchial cleft in the embryonic life.

- They may drain into the skin or pharynx.

 

8) What are the features of Cystic hygroma ?

-Cystic hygroma is lymphangioma in the head and neck region, which appears early in life.

-These may present as unilocular or multicystic masses with

-Thin, transparent walls.

-Compressible

-Non tender.

-They do not resolve spontaneously and should be resected completely

 

9) What are the features of Thyroglossal cysts?

              Moves  up on swallowing

 

10) What is Rovsing’s sign ?

Tenderness in the right iliac fossa can be elicited   by applying pressure over the left iliac fossa . This is due to stretching on the inflammed  peritoneum .

 

 

 

 

 

11) What is Balance Sign?

 

12) What are the features of  cystic hygroma ?

             

13) What is Anderson Hyne surgery ?

 

14) What is Lock wood surgery ?

             

15) What is   Torniquet time ?

             

16) What is   Phrygian cap ?

             

17) What is floating gall bladder?

 

18) What is Ramsted  operation

19) What is Cock’s peculiar  tumour ?

            Infected sebaceous cyst

 

20) What is Turbon tumour ?

            Cylindroma  of  scalp is  a rare  tumour  of  scalp skin , locally  malignant  an slowly growing

 

 

 

 

11) What is Balance Sign?

            Hemorrhage  around the spleen will clot and  will  clot and   will be dull on percussion

 

12) What are the features of  cystic hygroma ?

            Soft ,cystic

            Transillumination positive

 

13) What is Anderson Hyne surgery ?

           For Hydronephrosis

14) What is Lock wood surgery

            Done for  lower femoral hernia

 

15) What is   Torniquet time ?

            This is the time  that a Torniquet  can be applied  at  part of  a body 

 

16) What is   Phrygian cap ?

            Seen in the  gall bladder

 

17) What is floating gall bladder?

            Gall bladder  hangs on a mesentry .This   will increase the  risk of torsion

 

18) What is Ramsted’s  operation ?

 

19) What is Cock’s peculiar  tumour ?

            Infected sebaceous cyst

 

20) What is Turbon tumour ?

            Cylindroma  of  scalp is  a rare  tumour  of  scalp skin , locally  malignant  an slowly growing

 

 

 

POINTS 

1)      What are the Complications of undescended testis?

Mnemonic - TESTIS

           

T

Torsion

E

Epididymo- orchitis

S

Sterility

T

Trauma (more prone for trauma). Recurrent trauma may result in atrophy

I

Inguinal hernia, indirect

Interstitial hernia

S

Seminoma

 

·         What are the indications of SPLENECTOMY ?

Mnemonic -  SHIRTS

Indications for splenectomy are as follows:

 

S

Splenic abscess

Splenomegaly (massive)

H

Hypersplenism

Haemolytic anaemia—hereditary spherocytosis, autoimmune haemolytic anaemia not responding to steroids

I

Idiopathic thrombocytopenic purpura (chronic)

R

Rupture of spleen—trauma

T

Thrombosis of splenic vein-extrahepatic portal hypertension

S

Staging laparotomy in Hodgkin’s disease(rarely done now) and lymphoreticular  malignancies

 

·         What are the  features of  Meckel’s diverticulum ?

            - 2 -3  % of the  population

            - 2 feet proximal to the  ileocecal junction

            - Peak incidence in the first 2 years of life

 

- Abdominal pain

            - Painless rectal bleeding

- Periodicity

-  99 Technetium scan

- Excision of the diverticulum  is the treatment of choice

- Ectopic  gastric or pancreatic   tissue may be present  in 35 % of  cases

 

- Ileo ileal intussusception

- Littre hernia (when the Meckel’s diverticulum lies in the indirect inguinal hernia)

- Volvulus can occur

- Leading point for intussusception

 

·         What are the  Risk factors for  deep vein thrombosis ?

-  Antithrombin III deficiency

            -  Bed rest

            -  Cancer

            -  Deficiency of protein C , protein S

            -  Estrogen therapy

            -  Fractures

-  Geriatric age

-  Homocystinuria

            -  Immobility

-  Increased weight -Obesity

            -  Chronic deep venous insufficiency

-  Lupus anticoagulant

 

 

 

 

·   What are the features of Thyroglossal cysts ?

-Thyroglossal cysts are situated in the midline of the neck.

-They may extend up to the base of the tongue.

-On moving the tongue, the swelling moves upwards.

-The cyst may contain mucinous material or, sometimes, thyroid tissue.

-The cyst should be excised surgically. Try to preserve the thyroid tissue. In a few cases, removal of the thyroid tissue in the cyst may result in hypothyroidism.

 

 

surgery

 Condition

Lockwwood surgery

Lower femoral hernia

Heller’s

 

Achalsia cardia

Ramsted

 

Anderson hyne’s

 

Hydronephrosis

Rovisng’s

Polycystic kidney

 

What  are the indications for  splenectomy ?

TIIPS

What is   the treatment of  esophageal  varices ?

            Medical

Sclerotherapy

Banding

 

Lee Forte fractures- fracture of  skull

 

What is   Raccoon eyesdue  to  trauma

What is   Riedl lobeliver

.

 

What is   Warthin’s tumour ?

-parotid tumour. papillary cystadenoma lymphomatosum .

 

 

Torniquet time upper limbs

                    lower limbs

 

Gall stones-  mixed  tones are  the most common type

Increased  risk  for  gall stones

            Fat

            Fertile

            Flatulent

            Female

            Fifty years of age

 

 

·         Seminomas are radiosensitive

SURGERY

          Rolling hernia- Para esophageal hernia .

          Phantom hernia- Poliomyelitis

          Phantom limb- After amputation of the limb

           Saint’s triad- Gall stones, diverticulitis coli, hiatus hernia.

           Spring water cyst-Mediastinal cyst, pleuro-pericardial cyst.

           Water Lilly appearance- Hydatid cyst.

           Potato tumour- carotid body tumour

           Curranino’s triad – Sacral defect ,imperforate anus, presacral mass.

           Whipple‘s triad -……….------------

           Caffey’s disease- Infantile cortical hyperostosis.

            Brun‘s triad-

            Cork screw esophaguspresbyoesophagus (Diffuse spasm )

Robert pelvis- Bilateral Naegele pelvis .

Hartmenn’s pouch  -Dilatation of the neck of the gall bladder due to a stone .

Littre’s hernia – Meckel’s diverticula in the hernial sac.

Ulcerative colitis –

Loss of haustration (earliest sign)

Pseudopolyposis

Pipe stem colon

Toxic dilatation

Crohn’s disease- Skip lesions, String sign of Kantor

Jeep bottomPilonidal sinus.

Turban tumour-Cylindroma

Calcifying epithelioma of malherbe- Pilomatrixoma  ,a benign tumour from the hair follicle.

Grawitz tumour-Hypernephroma

Pott’s puffy tumour-associated with osteomyelitis  of the skull associated with subperiosteal swelling and edema.

Cocks peculiar tumour-a complication of sebaceous cyst.

Putty kidney / cement  kidney- Tuberculous kidney where the caseous mass is divided by fibrous septa.

Dietel’s crisis-Ectopic kidney

Thimble bladder –Tuberculous cystitis, the capacity of the bladder is reduced.

Foster kenedy syndrome-Frontal lobe lesions

Valves of Housten- Rectum

Proctalgia Fugax       -Segmental cramp of pubococcygeus

Froin syndrome-in spinal cord obstruction.

Prostatic carcinoma metastasis –Osteoblastic lesion

Renal cell carcinoma metastasis - Osteolytic lesion.

Most common-

Bone metastasis commonly occurs from carcinoma breast (Followed by carcinoma prostate)

Most common site of bone metastasis is vertebra (Followed by pelvis, ribs, proximal femur in that order)

Least common site for bone metastasis is distal part of the limbs.