Important knowledge

⚡️تناقظات ال anus -------------- ▪︎ ال hemorrhoids من نشيلها بعملية ممكن يصير عدنا fissure ك complication نتيجة ال spasm الي يصير بال sphincter من ال pain ▪︎اذا شلنا ال abcess ال track الي فتحناها ممكن تصير fistula وكذلك اذا عدنا fistula وشلناها (كحورناها ) المنطقة الي بقت ممكن يتجمع بيها pus وتصير abcess

⚡️Tubular adenomas most common type of rectal polyp

⚡️normal looking pancreas on CT or MRI does not rule out chronic pancreatitis

⚡️Pancreatic truma ---------------------------- 🔸️blunt trauma ▪︎Hemodynamicly stable = conservative Mx ▪︎unstable , peritonitis , Pancreatic duct disruption = surgery 🔸️penetrating trauma ▪︎almost always surgery

⚡️Thyriod cancers tricks ---------------------------------------- ▪︎Papillary Carcinoma = cervical lymph node enlargement ▪︎Follicular Carcinoma = Hürthle cell tumours , not diagnosed by FNA ▪︎Anaplastic carcinoma = metastasis (غالبا ) ▪︎Medullary Carcinoma = elevated levels of calcitonin , part of MEN ▪︎Lymphoma = history of Hashimoto’s thyroiditis

⚡️Haemangioma is the most common benign tumor of liver & splen

⚡️indication of surgery in splenic artery aneurysms ▪︎Symptomatic patients ▪︎asymptomatic with lesions >2 cm ▪︎ pregnant women ▪︎ women of childbearing age with SAA > 1 cm

⚡️T tube Put in place for : ▪︎2w .... if there is no residual stone ▪︎6w .... if there is residual stones

⚡️Non-operative treatment of acute cholysistitis --------- ▪︎Nil per mouth (NPO) ▪︎intravenous fluid administration ▪︎analgesics ▪︎antibiotics till pain resolved ( except antibiotics complete the course)

⚡️Types of Gallstones د.موسى 1) pigmented stones 5% ▪︎black = excessive hemolysis (Calcium bilirubinate) ▪︎brown = ♧ infection (cholangitis) ♧foreign body ( parasite , stent ) Other types of calcium except calcium bilirubinate ) 2)cholesterol stones 3-5% 3)mixed stones 90% ( most common) (40% cholesterol + 60% calcium)

⚡️Liver trauma ------------------------- 🔸️blunt trauma ▪︎Hemodynamic stable = CT with contrast ▪︎Hemodynamic unstable = laparatomy 🔸️penetrating trauma ▪︎Almost always = laparatomy

⚡️EUS is the most sensitive tool for diagnosing small bile duct calculi

⚡️The only known risk factor for the development of PHPT is a history of prior neck irradiation.

الجواب D

وزاري صعب 🤩 #جراحة

⚡️FNA cannot distinguish between a benign follicular adenoma and follicular carcinom in thyriod swelling

⚡️Any abcess in the body is removed by incision & drainage except TB abcess is removed by excision & drainage ( because it is Collar Stud abscess )

⚡️Salivary gland tumors -------------- ▪︎most common malignant Submandibular gland tumor .... Adenocystic carcinoma ▪︎ most common benign Parotid gland tumor .... pleomorphic adenoma ▪︎most common malignant Parotid gland tumor .... mucoepidermoid carcinoma

⚡️Submandibular gland stones ----------- ▪︎<4mm = Dormia basket remove ▪︎>4mm =extracorporeal or intracorporeal lithotripsy or pneumatic intraductal lithotripter (StoneBraker ) .... then remove at by Dormia basket