A 45 yr old male patient, presented to clinic with recurrent reducible right inguinal hernia which was repaired 10 years ago (open mesh repair). What is your advice?
#USMLE #SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
#USMLE #SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
Laparoscopic Hernioplasty ✅
Due to suspected adhesions:
Open ▶️ Recurrent ▶️ Lap.
Lap. ▶️ Recurrent ▶️ Open
Due to suspected adhesions:
Open ▶️ Recurrent ▶️ Lap.
Lap. ▶️ Recurrent ▶️ Open
Injuries that severely impair breathing/ventilation include: tension pneumothorax, flail chest with pulmonary contusion, massive hemothorax, and open pneumothorax. These should be detected during primary survey and need immediate interference. (cont.)
Tension pneumothorax ✅ occurs when intrapleural air increases its pressure and causes shifting of the mediastinum, which decreases venous return and results in decreased cardiac output.
<6 months post-op: persistent, most common: missed adenoma ✅
>6 months post-op: recurrent, most common: hyperplasia
>6 months post-op: recurrent, most common: hyperplasia
A 70-year-old man with Hep.C cirrhosis. He presented to regular follow up clinic with no new complaints. Vitally stable and afebrile. What would you request?
#USMLE #SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
#USMLE #SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
💌 "الزملاء" أطباء الامتياز.. في أول يوم من حياتكم العملية: راقب الله، وتعامل مع مرضاك كما تعامل أقرب الناس لك.
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
HCC screening: Annual Ultrasound ✅
AFP is not recommended as screening method anymore (cost and false-positive)
AFP is not recommended as screening method anymore (cost and false-positive)
20 yr old lady presented to ER with painful lump in the midline between the gluteal folds. It’s tender and fluctuant with normal per rectal exam. Dx?
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
Pilonidal abscess ✅
A 30 y.o. bodybuilder presented to ER with sudden painful swelling at Rt groin during lifting. Exam: Tender erythematous swelling (right groin). Normal scrotum. Next step?
#USMLE #SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب
#USMLE #SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب
DDx: strangulated inguinal hernia. Mx: Explore and hernia repair ✅
Why it’s not recommended to attempt forceful reduction of hernia❓
Why it’s not recommended to attempt forceful reduction of hernia❓
To avoid “reduction en masse” 👇🏼
☝🏼
A thread to discuss surgical MCQs ✂️♨️
For medical interns & final year medical students 👨🏻⚕️👩🏻⚕️
#USMLE #SMLE #Medicine #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
👇🏼
A thread to discuss surgical MCQs ✂️♨️
For medical interns & final year medical students 👨🏻⚕️👩🏻⚕️
#USMLE #SMLE #Medicine #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
👇🏼
Adult patient presented to your clinic complaining of unilateral groin pain/discomfort since few weeks. It is exacerbated by exercise and lifting his child. Normal exam of groin and genitalia. What is the next step?
#SMLE #طالب_طب #مدونة_طالب_طب
#SMLE #طالب_طب #مدونة_طالب_طب
DDx: Occult hernia
Initial test: Ultrasound ✅
Initial test: Ultrasound ✅
❓❓❓
I might agree with the DDx: "Sports hernia" if: athletic pubalgia in sports with high-speed changes in direction and twisting (hockey, soccer, wrestling, football) + pain with motion (hip adduction). in this case (MRI). Keep in mind it's a misnomer!
I might agree with the DDx: "Sports hernia" if: athletic pubalgia in sports with high-speed changes in direction and twisting (hockey, soccer, wrestling, football) + pain with motion (hip adduction). in this case (MRI). Keep in mind it's a misnomer!
A patient was referred to surgery clinic after screening sigmoidoscopy with finding of mass at Sigmoid colon. Biopsy: Adenocarcinoma. What is the next step?
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
Full colonoscopy to rule out synchronous tumor or pathology ✅
A 22 y.o. victim of RTA, conscious and complaining of abdominal pain. HR 112, BP 110/85, Tender LUQ and distended abdomen. Hgb 8 g/dL. IV fluids started. What is the next step?
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
Stable + no peritonitis >> go for CT scan ✅
FAST scan can be done, with low sensitivity. So it’s not the best answer here ❌
Exploration surgery is not justified as a next step here ❌
FAST scan can be done, with low sensitivity. So it’s not the best answer here ❌
Exploration surgery is not justified as a next step here ❌
The previously mentioned patient underwent CT scan. It showed grade 3 splenic injury without blush of contrast. No other injury was identified. HR 90/min, BP 120/85. How would you manage this patient?
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب
- Stable + No active bleeding: Conservative management ✅
- Stable or stabilized + active blush (bleeding): Angio embolization
- Unstable patient, or if there was another indication for laparotomy: Splenectomy
- Stable or stabilized + active blush (bleeding): Angio embolization
- Unstable patient, or if there was another indication for laparotomy: Splenectomy
Hx of Hashimoto's thyroiditis. Presenting now with rapidly growing neck swelling, compression symptoms, and fever. FNA: Suspicious of malignancy (Bethesda V). Top DDx?
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
#SMLE #Surgery #طالب_طب #مدونة_طالب_طب #فضفضة_طبيب #كلية_الطب
- Hx of Hashimoto >> think Lymphoma or PTC
- Rapid growing >> think Lymphoma or Anaplastic
Answer: Lymphoma ✅
FTC ❌ (Bethesda III/IV), not related to Hashimoto, nor rapidly growing
- Rapid growing >> think Lymphoma or Anaplastic
Answer: Lymphoma ✅
FTC ❌ (Bethesda III/IV), not related to Hashimoto, nor rapidly growing
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