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