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Mass in right hypochondrium.pptx
This document provides tips for using a PowerPoint presentation (PPT) for active learning sessions: 1. The PPT can be freely downloaded, edited, and modified. 2. Many slides are intentionally blank except for the title to facilitate discussion. The instructor should show blank slides, ask students what they know about the topic, and then show the content slide. 3. This process of blank slide + student input + content slide should be repeated for each topic across three revisions for optimal active learning. The PPT can also be used for self-study. 4. The notes section includes bibliographic references.
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Mass in right hypochondrium.pptx
- 1. Tips on usingmy ppt. 1. You can freely download, edit, modify and put your name etc. 2. Don’t be concerned about number of slides. Half the slides are blanks except for the title. 3. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. 4. At the end rerun the show – show blank> ask questions > show next slide. 5. This will be an ACTIVE LEARNING SESSION x three revisions. 6. Good for self study also. 7. See notes for bibliography.
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- 4. How to Diagnose •History • Physical Examination • Investigations • Laparotomy • Histpathology
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- 6. History • Age • Sex •Pain • Vomitings • Motions • Urination • Fever
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- 8. Physical Examination • General •Systemic • Local
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- 10. General Physical Examination •Appearance: • emaciated • Anemic, • jaundiced or • Lymph nodes, especially supraclavicular.
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- 12. Per Abdomen • Eyesfirst and the most • Hands next • Tongue not at all
- 13. Per Abdomen • Inspection •Palpation • Percussion • Auscultation
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- 15. Inspection • Abdominal distension •Visible peristalsis • Overlying skin • Position, size, shape and surface of the swelling • Movement of swelling on respiration • Check sites of hernia • Observe scrotum for any fullness
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- 17. Palpation • Whole abdomensoft or rigid • Tenderness
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- 19. Palpation of Lump •local temperature • Tenderness • Confirming positive findings of inspection • Margins • Consistency: Soft, firm or hard uniform or variegated • Mobility: • Level : Is swelling parietal or intra- abdominal?
- 20. • Percussion: – Dullor resonant – Fluid thrill • Auscultation: – For rub (perisplenitis and perihepatitis)
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- 22. Investigations • Laboratory Studies –Routine – Special • Imaging Studies • Tissue diagnosis – Cytology • FNAC – Histlogy
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- 24. Diagnostic Studies Imaging Studies •X-Ray • USG • CT • ERCP • MRI • Nuclear scan
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- 26. Other Studies • Endoscopy •Endosonography(EUS)
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- 28. D/D • Swellings inthe Abdominal Wall – Sebaceous Cyst – Lipoma – Parietal wall abscess
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- 30. D/D Intra-abdominal Swellings •Hepatic • Gall Bladder • Sub-Phrenic Abscess • Stomach and Duodenum • Hepatic Flexure of Colon • Right Kidney • Right Suprarenal c s
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- 32. Hepatic • 1. Itmoves with respiration but is not mobile sideways 2. The swelling is continuous with the liver dullness without a band of colonic resonance
- 33. Hepatic swellings • Amoebicabscess • Pyogenic abscess • Riedel’s lobe • Hydatid cyst • Hepatoma • Secondaries • Cirrhosis
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- 35. Sub-Phrenic Abscess 1 Painin the right hypochondrial region referred to the shoulders 2. Diffuse tender swelling in the right hypochondrial region 3. Signs of septicemia: High fever with rigors, sweating and marked tachycardia 4. Screening: Raised and fixed diaphragm with gas under it 5. Features of the causative condition e.g. perforated peptic ulcer, liver abscess
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- 37. Gall Bladder 1. Ovalsmooth swelling, the size of an egg 2. Moves with respiration, • Ca Gall bladder • Ca. Head of pancreas • Mucocele • Choledochus cyst
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- 39. Stomach and Duodenum •Ca Stomach • Cogenital hypertrophic pyloric stenosis • Sub-Acute Perforation of a Peptic Ulcer
- 40. Stomach and Duodenum CaStomach 1. There is irregular firm lump which moves on respiration 2. Patient is usually elderly and has anorexia and weight loss 3. Barium meal would show filling defect 4.Upper GI Endoscopy
- 41. Stomach and Duodenum Sub-AcutePerforation of a Peptic Ulcer 1. Localized, tender, inflammatory mass may be present with a central abscess 2. History of peptic ulcer 3. Barium meal would reveal the ulcer
- 42. Hepatic Flexure ofColon
- 43. Hepatic Flexure ofColon Carcinoma of Colon • 1. This commonly occurs in men above the age 40 years 2. Change in bowel habits, melena 3. The lump is irregular, firm and moves poorly on respiration 4. Occult blood may be present in stools 5. Colonoscopy
- 44. Hepatic Flexure ofColon Intussusception • 1. There is sudden intermittent abdominal pain with vomiting. 2.Passage of blood and mucus (red currant jelly) per anum without fecal odour. 3. There may be curved, sausage shaped lump 4. Barium enema would show typical pincer shaped ending of the radio-opaque material.
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- 46. Kidney swelling • Ballotable •Slight movement with respiration • Renal angle is full • Percussion- resonant
- 47. Kidney swellings • Hydronephrosis/Pyonephrosis •Carcinoma • Nephroblastoma –Wilm’s tumour
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- 49. Suprarenal swelling • Likekidney swelling • From cortex or medulla
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- 51. From adrenal cortex •Hyperplasia • Benign adenoma • Carcinoma
- 52. From adrenal medula •Pheochromocytoma • Neuroma • Neuroblastoma
- 53. Get this pptin mobile 1. Download Microsoft PowerPoint from play store. 2. Open Google assistant 3. Open Google lens. 4. Scan qr code from next slide.
- 54. Get this pptin mobile
- 55. Get my pptcollection • https://www.slideshare.net/drpradeeppande/ edit_my_uploads • https://www.dropbox.com/sh/x600md3cvj8 5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl =0 • https://www.facebook.com/doctorpradeeppa nde/?ref=pages_you_manage
Editor's Notes
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