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频道帖子
تجميعة اسكيمة ل examination هترتب دماغكم في الجراحة من زميلنا جزاه الله خير
الفيديو متسرع على 2
| 2 | اسئلة السنين السابقة مش بيطلع منها وعد بإذن الله اكتر من 95 % مع تعلن الاكزامينيشن دكتور احمد كامل كان عاملها لكن من دون اجابات فأنا جمعتها بالإجابات والحاجات اللي عاوزين يسمعوها منكم في الاوسكي
يغني عن المزاكرة النظري بشكل كبير جداً
ادعولي بطمأنينة القلب انا وأهلي | 1 804 |
| 3 | +1 Surgery Past Stations - Dr. Kamel .pdf | 1 946 |
| 4 | git surgery OSCE .pdf | 1 056 |
| 5 | لو حد مزنوق جدا وعاوز بفضل ربنا يضمن 90 % من امتحان الباطنة بأقل مجهود وتركيز ع المهم . تعبت جدا لما جمعتهم دول عباره عن كل اللي جه ل 61 وايه المهم وايه لا والاسئله متجاوب عليها مع تركيزات الميتينج اتمنى تدعولي كتير | 1 818 |
| 6 | +2 OSCE_Batena_Organized.pdf | 2 185 |
| 7 | Abdominal Examination Round.pdf | 1 727 |
| 8 | Abdominal Examination Round
⁃ examine the abdomen (abdominal mass, etc.)
⁃ You have to ask general or local (often forgotten) ⭐️
⁃ Local examination
⁃ Stand on the right side
⁃ Say hi to the patient !
⁃ Verbal consent [not written]
⁃ Exposure
⁃ Patient position (abdominal examination -> supine (mainly) and knee is slightly flexed to relax abdominal muscles and feel spleen and feel masses???) - digital rectal examination (from supine to left lateral)
Main-> Inspection, palpation, percussion
Additional:
⁃ Digital rectal examination
⁃ Back of the patient
⁃ Back of the spine
⁃ Back of scrotum
Inspection ⭐️
⁃ Look ay the abdominal contour
⁃ Movement with respiration
⁃ Anatomical points (costal margin umbilicus suprabupic hair dilated veins stria)
Palpation ⭐️
⁃ Superficial
⁃ tenderness (you look the at patient’s face while palpating if he’s in pain theres tenderness)
⁃ Rebound tenderness -> comes after you remove your hand
⁃ Signs of peritoneal irritation or per
⁃ tenderness, rebound tenderness, rigidity
⁃ Deep
⁃ Organs and masses
⁃ Liver, spleen, kidney, colon (organs palpaed in the abdomen)
⁃ Say 2 only so he doesn’t ask you 5alas b2a say how to palpate the kidney
⁃ When is the gall bladder palpable? When it’s obstructed
Percussion
⁃ Resonance, dull percussion of ascites, etc.
⁃ Dull -> in obstruction
Auscultation
⁃ For abdominal sounds
⁃ Intestinal obstruction-> hyper-audible
• Hyper-audible -> mechanical intestinal obstruction
• Lost or no sound -> paralytic ileus (usually secondary to peritonitis/ inflammation)
—————
Spleen from right iliac fossa to the right? Border of the spleen
Items that are specific to the PAIN!! in present history (other than onset coarse duration…)
⁃ SITE ⭐️
⁃ Character (cholicy..)
Any symptom in surgery:
Lump -> complain
Swelling -> present history
Disturbance of function
Calcular or non-calcular to know if you’ll do US
Calcular in 80% of patients
Abdominal US ⭐️!! (Gives you the mark)
⁃ What is the next step in work up that would confirm diagnosis ? US !! ⭐️- diagnostic test of choice
⁃ US Describes gall bladder and things associated with it and most importantly the biliary cyst
⁃ US shows biliary system, liver, pancreas since they could have complications because of calcular cholecystitis
Lab is the Second choice
⁃ CBC
⁃ Liver function
⁃ Amylase
Liver function tests
Bilirubin (total and direct) ⭐️
Alkaline phosphatase (AP)
Gamma glutamyl transferase (GGT)
AP and GGT increase only in inflammation of biliary epithelium due to the stones passing
⁃ Mild elevation (acute cholecystitis), but if severe (thousands) -> pathology isn’t in gall bladder it’s in liver
⁃ Lipase is more specific than amylase ⭐️
⁃ Lipase rules out pancreatitis ?
⁃ Provisional -> after history and examination
⁃ Investigation -> diagnosis
⁃ Surgery and sample ? -> definitive diagnosis
What’s the difference between obstructive jaundice and cholangitis ?
Jaundice
⁃ Pain and jaundice
Cholangitis
⁃ patient presents with sepsis so you have to be quick and tl7a2o
Cholangitis is originally -> obstructive jaundice + infection
fever, tenderness in right hypochondria (charcott’s triad)
Hypotension and fever -> cholangitis complicated with septic shock
Presentation of patients with gall stones ⭐️
Pancreas and gallstone ileus are commonly forgotten
Gall stone ileus (question of full mark) - gall stone MECHANICAL ILEAL SMALL INTESTINAL OBSTRUCTION is the correct name
Most catastrophic complication of gall bladder stone is cholangitis ⭐️!!!
Early laparoscopic cholecystectomy is the solution now
Prophylactic cholecystectomy
⁃ Diabetic
⁃ Immunocompromised
⁃ Renal transplant
⁃ Typhoid (added by dr)
Treat without operation WHEN?
⁃ patient unfit for surgery and anesthesia | 1 636 |
| 9 | نوتس الدكتور ركز عليها في راوند الulcer | 1 266 |
| 10 | Ulcer has to come as a question ⭐️⭐️.pdf | 1 497 |
| 11 | .
1) Pleomorphic Adenoma (Mixed Parotid Tumor)
Features
Most common salivary gland tumor.
Usually parotid gland.
Encapsulated but incomplete capsule.
Multicentric (satellite nodules).
Clinical picture
Painless.
Slowly growing.
Well defined swelling.
Elevation of ear lobule.
No facial nerve affection.
Investigations
U/S, CT, MRI.
FNAC.
Treatment
Superficial conservative parotidectomy.
Total conservative parotidectomy if deep lobe involved.
⸻
2) Warthin Tumor
Origin
Epithelial tumor arising in parotid lymph node.
Incidence
Old males >50 years.
10% of parotid tumors.
10% bilateral.
Clinical picture
Painless.
Slowly growing.
Lower pole of parotid.
Does not elevate ear lobule.
Treatment
Enucleation.
⸻
3) Malignant Salivary Gland Tumors
Features
Non-capsulated.
Fixed.
Perineural invasion.
Facial nerve palsy may occur.
Treatment
Surgery
Total radical parotidectomy.
Facial nerve sacrifice if infiltrated.
LN dissection if needed.
Radiotherapy
⸻
4) Acute Sialadenitis
Causes
Ascending infection through duct.
Clinical picture
Painful swollen gland.
Fever.
Tenderness.
Treatment
No abscess
Oral hygiene.
Fluids.
Lozenges.
Antibiotics (Clindamycin).
Abscess
Incision and drainage.
⸻
5) Chronic Sialadenitis
Causes
Recurrent inflammation.
Stones.
Symptoms
Recurrent pain during meals.
Signs
Enlarged tender gland.
Stone may be palpable.
Investigation
X-ray:
Radio-opaque stone.
Treatment
Duct stone → Sialendoscopy.
⸻
6) Sialolithiasis
Definition
Salivary gland stones.
Common site
Submandibular gland (80%).
Clinical picture
Meal time syndrome.
Pain increases during eating.
Swelling.
Investigations
X-ray.
U/S.
Treatment
Small stone
Conservative.
Impacted stone
Sialendoscopy.
Large stone
Surgical removal.
Recurrent disease
Sialadenectomy.
⸻
7) Sjogren Syndrome
Definition
Autoimmune sialadenitis.
Clinical picture
Xerostomia.
Xerophthalmia.
Dry mouth.
Dry eyes.
Arthritis.
Investigations
RF positive.
Hypergammaglobulinemia.
Schirmer test.
Treatment
Artificial tears.
Fluids.
Steroids.
⸻
8) Thyroglossal Cyst
Features
Midline neck swelling.
Moves with swallowing.
Moves with tongue protrusion.
Symptoms
Dysphagia.
Dyspnea if large.
Treatment
Sistrunk operation.
⸻
9) Branchial Cyst
Site
Anterior border of upper and middle third of SCM.
Features
Soft.
Smooth.
Slow growing.
Painless.
No movement with deglutition.
Treatment
Surgical excision.
⸻
10) Ranula
Definition
Mucous retention cyst of sublingual gland.
Clinical picture
Bluish.
Fluctuant.
Frog belly appearance.
Slow growing.
Treatment
Excision of ranula + sublingual gland.
حفظة ليلة الامتحان
لو الوقت ضيق جدًا:
Pleomorphic adenoma
Warthin tumor
Sialolithiasis
Acute sialadenitis
Sjogren syndrome
Thyroglossal cyst
. | 1 996 |
| 12 |  +2没有文字... | 1 768 |
| 13 |  #Surgery_GIT_L2 | 1 556 |
| 14 |  #Surgery_GIT_L9 | 1 434 |
| 15 | General_Surgery_Lectures_Questions.pdf | 1 938 |
| 16 | surgery_quick_ref.PDF | 1 747 |
| 17 | Peptic_Ulcer_Disease_Clinical_Reference_202606121521_05517.pdf | 1 507 |
| 18 | تجميعة كل scores و classifications GIT | 1 723 |
| 19 | بصمجوا رانسون مهمة | 1 489 |
| 20 | Eraky Mnemonic For Ranson criteria
يحكي رانسون :
وأنا سني ٥٥ كان عندي ولد أبيض عنده ١٦ سنة سكره كان بيعدي المتين قلتله ظبط أكلك ياض قالي يا أسطى (AST) دا بيعدي ال ٢٥٠ قلتله لا ده (LDH ) كده هيعدي ال ٣٥٠
قاعد جوعان ( base deficit) أكلت فطيرة ( BUN increase) وشربت عصير ( fluid deficit ) قلت لهم كفاية عصير أنا عاوز كالسيوم عشان هكت (Hct decrease) من هنا عشان مفيش أكسجين في المكان
٤
٥
٦
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١٠
٦٠ | 1 332 |
