NOTE :

Strangulated hernia is commonly caused by femoral hernia by 15_20% , but now Strangulated inguinal hernia is more common about 50%.


Direct inguinal hernia come directly from post. Wall of inguinal canal..


Comments cause of hernia in females is ( indirect inguinal hernia).


Most common cause of incsional hernia is ( surgical infection )

About papillary thyroid cancer all the following are true except
A. It's the commonest thyriod cancer B. It's usually affects teenage
C. It's usually spread by lymphatic
D. A high TSH helps it's growth
E. It secrets calcitonin

Hypertension in a patient with a family history of medullary thyroid carcinoma is most often due to
A. Renal artery stenosis
B. Glomerulernephritis
C. Cushing syndrome
D. Hyperparathyroidism
E. Pheochromocytoma

All of the following are typical storage lower urinary tract symptoms associated with benign prostatic hyperplasia except:
a. Urgency
b. Frequency
c. Nectouria
d. Dysuria
e. Weak urinary stream

🛑Important note for oral question:🛑

Pre_operative preparation by I_V fluid for any patient who has operation or postoperative fasting calculated by :


A_ as maintainice dose = for 24 hrs calculated by assumption
( 100 ml/kg for is first 10kg) +
(50 ml/kg for 2nd 10kg )+
(20 ml/kg for remaining of patient weight)


B_ if for one houre calculated by :

4 ml/kg for first 10kg +
2ml/kg for 2nd 10kg +
1ml/kg for remaining of patient weight.

{ لا يُقاتِلونَكُم جَميعًا إِلّا في قُرًى مُحَصَّنَةٍ أَو مِن وَراءِ جُدُرٍ بَأسُهُم بَينَهُم شَديدٌ تَحسَبُهُم جَميعًا وَقُلوبُهُم شَتّى ذلِكَ بِأَنَّهُم قَومٌ لا يَعقِلونَ }

{ قاتِلوهُم يُعَذِّبهُمُ اللَّهُ بِأَيديكُم وَيُخزِهِم وَيَنصُركُم عَلَيهِم وَيَشفِ صُدورَ قَومٍ مُؤمِنينَ }[ التوبه: ١٤ ]



اللهم جهاداً في سبيلك لاعلاء كلمتك.
اللهم نصرك الموزّر.
اللهم نصرك الذي وعدت.
الله تمكينك 🤲🏻❤️

(قَاتِلُوهُمْ يُعَذِّبْهُمُ اللَّهُ بِأَيْدِيكُمْ وَيُخْزِهِمْ وَيَنْصُرْكُمْ عَلَيْهِمْ وَيَشْفِ صُدُورَ قَوْمٍ مُؤْمِنِينَ).
هنا شفاء الصدور.
دعواتكم لإخواننا في غزة بالثبات والنصر .
لا تكل ألسنتكم ولا تملوا من الدعاء لهم .
من كان امنيتة ان يكون معهم فعلية بالدعاء فالدعاء سلاح المؤمن .
اللهم نصرك .
اللهم تمكينك .
#-عملية طوفان الأقصى .
#٧ أكتوبر يوم تاريخي لفلسطين.

Q_ differentiated between cardiac temponac and tention pneumothorax (definition
,causes ,clinical presentation , treatment )

إجابة مختصرة بالذكاء الإصطناعي:

Cardiac tamponade and tension pneumothorax are two distinct medical conditions that can have serious implications if not promptly recognized and treated. Here's a breakdown of each condition:

Cardiac Tamponade:
- Definition: Cardiac tamponade refers to the accumulation of fluid or blood in the pericardial sac, which surrounds the heart. This buildup of fluid puts pressure on the heart, impairing its ability to pump effectively.
- Causes: The most common cause of cardiac tamponade is trauma, such as a motor vehicle accident or penetrating injury. Other causes include infections (such as pericarditis), cancer, kidney failure, and certain medical procedures.
- Clinical Presentation: Patients with cardiac tamponade may present with symptoms such as shortness of breath, chest pain, rapid heartbeat, low blood pressure, fainting, and anxiety. They may also exhibit signs of jugular venous distention (JVD), muffled heart sounds, and pulsus paradoxus (a decrease in blood pressure during inspiration).
- Treatment: The primary treatment for cardiac tamponade is an emergency procedure called pericardiocentesis. This involves inserting a needle or catheter into the pericardial sac to drain the accumulated fluid or blood. In some cases, surgery may be required to repair any underlying causes.

Tension Pneumothorax:
- Definition: Tension pneumothorax occurs when air accumulates in the pleural space surrounding the lungs and cannot escape. This leads to increased pressure on the affected lung(s) and can cause them to collapse.
- Causes: Tension pneumothorax is commonly caused by trauma or injury to the chest wall that results in a punctured lung. It can also occur spontaneously in individuals with underlying lung diseases like chronic obstructive pulmonary disease (COPD).
- Clinical Presentation: Patients with tension pneumothorax typically experience sudden onset severe chest pain, shortness of breath, rapid breathing, decreased breath sounds on one side of the chest, cyanosis (bluish discoloration), tracheal deviation away from the affected side (in severe cases), and distended neck veins.
- Treatment: Immediate treatment for tension pneumothorax involves decompression using a procedure called needle thoracostomy. A large-bore needle is inserted into the affected side of the chest to release trapped air. Definitive treatment usually involves placing a chest tube to drain any remaining air or fluid.

It's important to note that both cardiac tamponade and tension pneumothorax are medical emergencies that require prompt recognition and intervention by healthcare professionals.

🛑 Important note 🛑

عشان تعملوا management صح بالحالات حسب المعطيات

Managment of obstructive jauindce due to common bile duct stone :

Definitive ttt is ( remove of stone & sources of stone *mostly* cholecystectomy.

🟣 A_ if patien has cholangitis :🟣

Charcot triad ( RUQ pain , jauindce , fever fever fever 🤒 )


1_ admission to hospital
NPO
IV fluid
Broad spectrum antibiotics
Analgesic
Vasopressin( if pt is shocked)

IF NOT improve within 24 hrs :

Biliary decompression by:
Insertion of Stent by ERCP & Sphenectrectomy and removal of stone or by PTC until patient fit to surgery do cholecystectomy.


IF we can't do ERCP or PTC ( exploration of CBD&Removal of stone &cholecystectomy at same time )



🟣B_IF patient has no Cholangitis :🟣

Pre_operative managment :.
NOP
IV FLUID
Broad A.b
Injection of Vitamine K
والفحوصات تبع الكبد والفصيلة وووو.

THEN do ( ERCP &Extraction of stone &cholecystectomy)

If ERCP NOT avaliable :

Exploration of CBD & removal of stone and Do cholecystectomy..