Question 1:
Principles of management of benign prostatic hyperplasia.
Reference Answer
1. Observe and wait, if the symptoms are mild and do not affect life and sleep, generally no treatment is needed can observe and wait.
2. Medication: There are many medications used to treat prostate enlargement. Adrenergic receptor blockers, 5?reductase inhibitors and so on.
3. Surgical treatment of severe symptoms, the presence of obvious obstruction or complications should be selected in the surgical treatment. Transurethral resection of the prostate (TURP) is suitable for most patients with benign prostatic hyperplasia and is currently the most commonly used surgical procedure.
4. Other therapies: transurethral balloon dilatation, prostatic urethral stenting, and transrectal high-intensity focused ultrasound (HIFU) have been shown to be effective in relieving the symptoms of obstruction caused by prostatic hyperplasia, and are suitable for patients who cannot tolerate surgery.
Question 2:
The indications for surgical treatment of gallbladder stones are.
Reference Answer
Cholecystectomy is the preferred treatment for symptomatic and/or complicating gallbladder stones.
Laparoscopic cholecystectomy is routinely performed and has the advantages of minimal injury, rapid recovery, mild pain, and scarring that is not easily detectable.
The following cases should be considered for surgical treatment:
① The number of stones and stone diameter?2-3cm;
② Calcification of the gallbladder wall or ceramic gallbladder;
③ Accompanied by gallbladder polyps?1cm;
④ Thickening of the wall of the gallbladder (>3mm) that is, accompanied by chronic cholecystitis.
Question 3:
Indications for choledochal exploration.
Reference Answer
When cholecystectomy is performed, choledochotomy should be performed at the same time in the following cases:
(1) Preoperative history, clinical manifestations, or imaging suggests that there is obstruction of the common bile duct, including obstructive jaundice, choledochotomy stones, recurrent episodes of biliary colic, cholangitis, and membranous adenitis.
(2) intraoperative confirmation of pathology in the common bile duct, such as intraoperative cholangiography confirmed or palpated stones, roundworms, masses in the common bile duct;
(3) dilatation of the common bile duct with a diameter of more than 1 cm, significant thickening of the gallbladder wall, pancreatitis or pancreatic head swelling, bile duct puncture to extract pus, bloody bile, or sludge bile pigment particles;
(4) gallbladder stones are small, and there is a may enter the common bile duct through the cystic duct. Intraoperative cholangiography or choledochoscopy should be sought to avoid unnecessary complications caused by blind biliary exploration using a metal biliary probe. T-tube drainage is usually required after choledochal exploration.
Question 4:
Principles of treatment of hydroelectrolyte disorders and acid-base balance disorders.
Reference Answer
(1) Aggressive treatment of the primary disease is the most important treatment.
(2) Actively restore the patient's blood volume and ensure good circulatory status. Prevention and treatment of shock.
(3) The patient may have multiple fluid disorders, and the life-threatening fluid disorders should be treated first or corrected simultaneously.
(4) Actively correct hypoxia.
(5) Correct severe acidosis or alkalosis, preferring acid to alkali.
(6) Prevent hyperkalemia, hypokalemia.