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14.03.19 Placement notes

Causes of Ogilvie syndrome (pseudo-onstruction / ileus)
  • Chest infection
  • Acute myocardial infarction
  • Stroke
  • Acute renal failure
  • Puerperium
  • Trauma
  • Severe hypothyroidism
  • Electrolyte disturbance
  • Diabetic ketoacidosis

IgG4–related systemic disease (IgG4-RSD)
  • => Fibrosis in one or more organs
  • Elevated IgG4 in tissue samples and serum
  • Associated conditions:
    • Autoimmune pancreatitis
    • Retroperitoneal fibrosis
    • Mediastinal fibrosis
    • Riedel's thyroiditis
    • Mikulicz's syndrome
    • Kuttner's tumor
    • Inflammatory pseudotumor

Neck lumps
  • Superficial 
    • Sebaceous cyst
    • Lipoma
    • Abscess
    • Dermoid cyst
  • Anterior triangle
    • Lymph nodes
    • Salivary gland swelling, calculus or tumour
    • TB
    • Branchial cyst
    • Cystic hygroma
    • Carotic aneurysm
    • Carotid body tumour
    • Sternomastoid tumour
    • Laryngocele 
  • Posterior triangle
    • Lymph nodes
      • TB, glandular fever, HIV, lymphoma, metastases (esp. nasopharyngeal carcinoma)
    • Cervical rib
    • Subclavian artery aneurysm.
    • Pharyngeal pouch
    • Cystic hygroma
    • Branchial cyst

Notes
  • Ca125 = Ovary
  • Neostigmine
    • Parasympathomimetic; Reversible acetylcholinesterase inhibitor
    • Myasthenia gravis, Reversal of non-depolarizing muscle relaxants, Post-op urinary retention, Curariform toxicity, Ogilvie syndrome
  • Postcholecystectomy Syndrome
    • Oesophagitis / gastritis 
    • Diarrhoea
    • Continued symptoms from stones
  • Possible to still get CBD stones after cholecystectomy
  • Early cholecystectomy (within 72 hrs of symptoms) seems better than delayed
  • ELPQuiC
    • Emergency Laparotomy Pathway Quality Improvement Care-Bundle
  • Fowler's syndrome 
    • Failure of the urethral sphincter to relax appropriately
    • Cause of idiopathic urinary retention, typically in women in their 20s-30s 
  • Gentamycin
    • Renal function should be checked at least three times a week
    • Check levels twice weekly during a treatment course, provided that renal function and urine output are stable
    • Target trough levels are <1mg/ml and should be taken 0 to 6 hours prior to next anticipated dose
    • Use multiple daily dosing regime in renal impairment and take a peak level too (1 hour post-dose)
  • Autoimmune pancreatitis is rare, and it is mandatory to rule out carcinoma prior to making a diagnosis
  • A thyroglossal cyst will move upwards with protrusion of the tongue
  • Robinson’s drains work just using gravity
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