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Bedah 1
surgey finals
| Question | Answer |
|---|---|
| What is the diffential diagnosis of dysphsgia? | -In the lumen of esophagus -In the wall of esophagus -Outside the wall of esophagus -General |
| In the wall cause of dyspahagia | In the wall inflammatory stricture, caustic stricture, achalasia, tumour of oesophagus or gastric cardia, pharyngeal pouch, Plummer-Vinson syndrome, diffuse oesophageal spasm, scleroderma and oesophageal web |
| In the lumena and outside the wall cause of dyspahgia | Lumen-Foreign body Outside lumen- retrosternal goitre, enlarged left atrium bronchogenic carcinoma |
| General cause of dysphagia? | bulbar palsy,myasthenia gravis and hysteria |
| What is bulbar palsy? | impairment of function of the cranial nerves IX, X, XI and XII, which occurs due to a lower motor neuron lesion in the medulla oblongata or from lesions of the lower cranial nerves outside the brainstem. |
| What is pseudobulbar palsy? | impairment of function of cranial nerves IX-XII due to upper motor neurone lesions of the corticobulbar tracts in the mid-pons |
| Hx to focus on dyspagia | -onset -degree of dyspagia-solid/liquid/nothing at all Associated symptoms: 1. weight loss 2. dyspepsia qs 3. norturnal cough 4. hemetemsis 5. fatigue-anemia, upper gi bleed, PVS 6. brethlessness-a/bc/ap 7. neurological-sensation/upper limb |
| Early stoma complication? | HIROO-haemorrhage, ischemia, stoma retraction, obstruction(adhesion), high output(hypo K) |
| Delayed stoma complication? | FISH P2OD Fistulae, intussusception, stenosis, parastoma hernia, prolapse, psychosexual, obstruction, dermatitis |
| what is the primary gold standard in diagnosing dysphagia? | barium swallow |
| List all the investigation of dysphagia | -CXray-simple, non invasive -barium swallow-gold standard -esophagoscopy-bx in carcinoma -endoscopy u/s-staging -CT/MRI-stage -mannometry-strenght, coordination of perstalsis, pressure of spinchter -pH monitoring -Bronchoscopy |
| Risk of OGD procedure- | rare, 1/2000 1) Perforation to oesophagus or lining of stomach 2) bleeding 3) damage to teeth 4) risks associated with sedation 5) Aspiration |
| Early complication of partial gastrectomy | HADAR H-haemorrahge • Haemorrhage • Acute pancreatitis • Duodenal stump disruption • Anastomotic leak • Respiratory compromise |
| Late complication of partial gastrectomy | Dumping syndrome • Bile reflux and vomiting • Diarrhoea • Recurrent stomal ulceration • Metabolic abnormalities: iron deficiency, vit B12 deficiency |
Created by:
student_rc
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