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