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Sports Hernia

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62. Appropriate Use Criteria: Imaging of the Abdomen & Pelvis

? Lasting more than three weeks with exceptions for immunocompromised patients ? Following standard work-up to localize the source Hematoma / hemorrhage Computed Tomography (CT) AbdomenCT Abdomen | Copyright © 2018. AIM Specialty Health. All Rights Reserved. 7 Common Diagnostic Indications Hernia ? For diagnosis of a hernia with suspected complications or presurgical planning including, but not limited to the following types of hernia: ? Femoral ? Internal ? Inguinal ? Spigelian (through semilunar line (...) , lateral to rectus abdominis muscle) ? Ventral Incisional hernia ? For diagnosis of a hernia with suspected complications or presurgical planning Note: Ultrasound should be considered as the initial imaging modality Infectious or inflammatory process ? Including but not limited to the following: ? Abscess ? Diffuse inflammation / phlegmon ? Fistula Iron deposition/overload in hemochromatosis ? When MRI is contraindicated; AND ? To exclude iron overload in patients with hemochromatosis who

2018 AIM Specialty Health

64. Paediatric Urology

. 182: 704. 107. Dieckmann, K.P., et al. Clinical epidemiology of testicular germ cell tumors. World J Urol, 2004. 22: 2. 108. Pettersson, A., et al. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med, 2007. 356: 1835. 109. Walsh, T.J., et al. Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. J Urol, 2007. 178: 1440. 110. Kapur, P., et al. Pediatric hernias and hydroceles. Pediatr Clin North Am, 1998. 45: 773. 111 (...) : Philadelphia. 118. Stylianos, S., et al. Incarceration of inguinal hernia in infants prior to elective repair. J Pediatr Surg, 1993. 28: 582. 119. Hall, N.J., et al. Surgery for hydrocele in children-an avoidable excess? J Pediatr Surg, 2011. 46: 2401. 120. Saad, S., et al. Ten-year review of groin laparoscopy in 1001 pediatric patients with clinical unilateral inguinal hernia: an improved technique with transhernia multiple-channel scope. J Pediatr Surg, 2011. 46: 1011. 121. Christensen, T., et al. New

2018 European Association of Urology

65. Urological Trauma

in 17,587 patients with a primary unilateral inguinal hernia. Surg Endosc, 2015. 29: 3750. 178. Balbay, M.D., et al. The actual incidence of bladder perforation following transurethral bladder surgery. J Urol, 2005. 174: 2260. 179. Nieder, A.M., et al. Transurethral bladder tumor resection: intraoperative and postoperative complications in a residency setting. J Urol, 2005. 174: 2307. 180. Welk, B.K., et al. Are male slings for post-prostatectomy incontinence a valid option? Curr Opin Urol, 2010. 20

2018 European Association of Urology

67. Required hospital capacity in 2025 and criteria for rationalisation of complex cancer surgery, radiotherapy and maternity services

, the Netherlands; Ministerie van Gezondheid, Welzijn en Sport, Den Haag, the Netherlands), Florien Margareth Kruse (Celsus Academy for sustainable healthcare, IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands), Mélanie Lefèvre (KCE), Yolande Lievens (Departement Radiotherapie, UZ Gent; Universiteit Gent), Patriek Mistiaen (KCE), Aude Vaandering (Cliniques Universitaires Saint-Luc), Elizabeth Van Eycken (Stichting Kankerregister), Ewout van Ginneken (European Observatory on Health

2017 Belgian Health Care Knowledge Centre

68. CRACKCast E095 – Large Intestine

(painless bleeding, often associated with NSAID use) Mis-diagnosis of colonic thickening as diverticulitis, when it is actually a malignancy 5) List the types and potential causes of large bowel obstruction. Much less common > SBO; usually is a symptom of some underlying malignancy (>50% are due to colo-rectal CA) Types: Mechanical vs. pseudo-obstruction (Ogilvie’s syndrome) Causes: Malignancy (53%) Adhesions Volvulus (17%) Diverticular disease (12%) Fecal impaction Strictures (due to IBD) Hernias (...) types: Organo-axial volvulus is more common in adults, responsible for 60% of presentations Mesentero-axial volvulus is more common in children Organo-axial volvulus more common of the two types in adults (60% of cases) RF: trauma or para-oesophageal hernia Pathophys: stomach rotates around long axis w/ antrum rotates anterosuperiorly fundus rotates posteroinferiorly Mesentero-axial volvulus More common is peds Pathophys: rotation around short axis from the lesser to greater curvature displacement

2017 CandiEM

69. CRACKCast E093 – Appendicitis

the right leg as it is flexed at the hip Sensitivity: 8 Specificity: 94 4) McBurney’s point tenderness has a low correlation with appendiceal location and is not highly sensitive for appendicitis, tenderness at this location does have a modest predictive value for appendicitis. 5) “A genitourinary examination should be performed to assess for testicular pathology or hernias in males and pelvic pathology in females. Cervical motion tenderness (CMT) is not specific for pelvic pathology and is noted in 28 (...) between a fellowship in critical care and making sure his toddler survives past age 5. - 59 mins ago Latest posts by Adam Thomas ( ) - July 2, 2018 - June 25, 2018 - June 21, 2018 Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors with his family, he's brewing a coffee or dreaming up

2017 CandiEM

70. CRACKCast E092 – Small Intestine

Rosen’s 9th Ed. Closed loop vs. open loop An open loop (or simple) obstruction = blockage at one point only (e.g. someone pinching a garden hose). A closed loop obstruction = TWO locations are pinched off. This creates a section of ischemic bowel E.g. internal hernia (mesentery twists on itself) → twice the mortality rate due to necrosis. Question 2) What are potential etiologies of mechanical small bowel obstruction? External = compress the gut from the outside, preventing peristalsis Adhesions (...) (scarring post-op) > 60% Hernias (internal or external) Volvulus Usually occurs in the normal abdominal cavity; may have increased incidence during Ramadan; small bowel volvulus can commonly occur in children < 1 month of age Compressing masses (tumours, abscess, hematomas) Internal = something stuck inside! Primary intra-intestinal neoplasm (e.g. polyp) Inflammatory strictures (Crohn’s disease, radiation enteritis) Infectious causes (intestinal TB) Intussusception #1 cause of intestinal obstruction

2017 CandiEM

71. CrackCAST E129 – Bacteria

eema Subconjunctival hemorrhage Petechiae Epistaxsis Hemoptysis Subcutaneous emphysema Pneumothorax Pneumomediastinum Diaphragmatic rupture Umbilical and inguinal hernias Rectal Prolapse [6] What is the mechanism of action of the tetanus toxin? What are 4 types of tetanus? Tetanus is a toxin-mediated disease characterized by severe uncontrolled skeletal muscle spasms. Respiratory muscle involvement leads to hypoventilation, hypoxia, and death. Mechanism of action – C. tetani produces the neurotoxin (...) . This post was copyedited and uploaded by Andrew Guy. (Visited 1,290 times, 1 visits today) Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors with his family, he's brewing a coffee or dreaming up an adventure….. Latest posts by Chris Lipp ( ) - July 2, 2018 - June 25, 2018 - June 21, 2018

2017 CandiEM

72. CRACKCast E089 – Esophagus, Stomach & Duodenum

are the types of gastric volvulus? List risk factors for each. Describe the ED management. This is a life-threatening closed-loop obstruction of the stomach! Because the stomach is only fixed a two points – it can easily twist on itself. Defined by a few different ways: Cause: primary vs. secondary Primary: subdiaphragmatic – stabilizing ligaments are too lax. Secondary: Supradiaphragmatic – due to diaphragmatic defects (hiatal hernia, gastric ulcer/cancer, diaphragm paralysis, and other). Anatomy: axis (...) of rotation Twisting on its long axis (organoaxial) Twisting on its short axis (mesenteroaxial) Onset: acute vs. chronic Look for the triad: severe epigastric pain and distension; vomiting with violent retching; inability to pass an NG tube. In children: look for sudden life-threatening events with apnea/cyanosis/respiratory distress! Risk factors: Age 40-50 yrs Paraesophageal hernia **20% of cases occur in infants due to a congenital diaphragmatic defect (secondary) Management: This disease can result

2017 CandiEM

73. CRACKCast E099 – Urological Disorders

stones Small bowel diseases (Crohns) [3] List 8 alternative diagnoses (other than renal colic) for pain associated with urolithiasis Random list AAA rupture / dissection Ectopic pregnancy Ovarian cyst Bowel obstruction Incarcerated inguinal hernia Pancreatitis Cholecystitis Renal infarction, thrombosis, malignancy PE Appendicitis Organized list, but not in order of life threats: Urologic disease Upper urinary tract Renal infarct Renal tumour Pyelonephritis Ureter Tumor Stricture / hemorrhage Lower (...) of the ipsilateral testicle is considered evidence of a normal reflex. This reflex normally is absent in 50% of male infants younger than 30 months.” [1] List causes of acute scrotal swelling by age groups (infant, child, adolescent, adult) Infant Child Adolescent Adult Hernia Hydrocele Hernia Torsion Epididymitis Epididymitis Torsion Trauma Epididymitis Hernia Trauma Tumor Torsion Fournier’s gangrene [2] Describe the physiology, diagnosis and management of testicular torsion Bimodal onset: <1 yr and at puberty

2017 CandiEM

74. CRACKCast E027 – Abdominal Pain

% mortality Mesenteric venous thrombosis – associated with hypercoagulable states Haematological, inflammation, trauma Types of lesions: Arterial occlusion – sudden / emboli / low flow atherosclerosis Symptoms: periumbilical then diffuse pain, with nausea and vomiting, at times postprandial. May have a normal exam Labs: Metabolic acidosis with lactic acidemia. NEED CT to diagnosis. Intestinal obstruction Peaks in infants and the elderly or post-operative Etiology: Adhesions , cancer, hernias, volvulus (...) , 1 visits today) Adam Thomas CRACKCast Co-founder and newly minted FRCPC emergency physician from the University of British Columbia. Currently spending his days between a fellowship in critical care and making sure his toddler survives past age 5. - 10 hours ago Latest posts by Adam Thomas ( ) - July 2, 2018 - June 25, 2018 - June 21, 2018 Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His

2017 CandiEM

75. CRACKCast E033 – Acute Pelvic Pain in Women

trimester ectopic pregnancy/ovarian hyperstimulation syndrome threatened abortion/non-viable pregnancy 2nd-3rd trimester placenta previa placental abruption round ligament pain/braxston hicks Intestinal tract Appendicitis / ischemic bowel / perforated viscous / IBS/IBD / etc. Urinary Tract Pyelonephritis / cystitis / ureteral stone Vascular Septic pelvic thrombophlebitis / ovarian vein thrombosis / sickle cell disease Musculoskeletal Muscular strain/sprain / hernia / abdominal wall hematoma Neuro (...) by Adam Thomas ( ) - July 2, 2018 - June 25, 2018 - June 21, 2018 Chris Lipp is one of the founding Fathers for CrackCast. He currently divides his time as an EM Physician in Calgary (SHC/FMC) and in Sports Medicine. His interests are in endurance sports, exercise as medicine, and wilderness medical education. When he isn’t outdoors with his family, he's brewing a coffee or dreaming up an adventure….. Latest posts by Chris Lipp ( ) - July 2, 2018 - June 25, 2018 - June 21, 2018 Follow CRACKCast

2017 CandiEM

79. Healthcare performance reporting bodies

of a dataset. This includes data of functional status and activities — the ICES in Ontario HEALTHCARE PERFORMANCE REPORTING BODIES | SAX INSTITUTE 13 • Use of Patient Reported Outcomes Measures (PROMs) in England (NHS England and the HSCIC) for four types of surgery — hip and knee replacements, varicose vein, and inguinal hernias • The widespread use of sets of hospital indicators as ‘ambulatory care sensitive’ or preventable hospitalisations, “these are conditions for which hospitalisation should be able

2016 Sax Institute Evidence Check

80. CRACKCast E038 – Pediatric Trauma

tube drainage operating room thoracotomy if: >15ml/kg of blood immediately exudes continuous air leak Pulmonary contusion: chest compliance in children puts them at increased risk of contusion even in the absence of external chest trauma Traumatic diaphragmatic hernia associated with MVC’s and lap belt use need to consider comorbid small bowel injury/hematoma and CHANCE fractures Treatment insert NG tube to decompress the stomach; avoid BVM; intubation and surgery Cardiac and vascular injuries (...) belt use: small bowel injury/hematoma pancreatitis chance fractures bike handlebar injuries duodenal hematoma pancreatic transection/trauma sports related: spleen, kidney, intestinal tract Diagnostic strategies and management: abdominal distention is common due to ingested air early foley catheter helps decompress the bladder and assess U/O FAST ultrasound: If positive and patient stable –> on to CT +/- angiography indications for laparotomy: hemodynamic instability despite aggressive resuscitation

2016 CandiEM

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