Among the sources of bleeding, fractures are not to be taken lightly,
-For each rib fracture, blood loss can range from 100-200 mL,
-Tibial fractures can yield 300-500 mL,
-Femoral fractures can produce 800-1000 mL,
-Pelvic fractures may cause loss of more than 2000 mL.
#Surgery
-For each rib fracture, blood loss can range from 100-200 mL,
-Tibial fractures can yield 300-500 mL,
-Femoral fractures can produce 800-1000 mL,
-Pelvic fractures may cause loss of more than 2000 mL.
#Surgery
Sure signs of fracture:
1-Deformity.
2-Length discrepancy.
3-Abnormal movement.
4-Crepitus.
#Surgery
1-Deformity.
2-Length discrepancy.
3-Abnormal movement.
4-Crepitus.
#Surgery
Post-operative return of GI function:
-Small bowel: 12-24h.
-Stomach: 24-48h.
-Large bowel: 48-72h.
#Surgery
-Small bowel: 12-24h.
-Stomach: 24-48h.
-Large bowel: 48-72h.
#Surgery
Stages of bone healing:
1- Hematoma 👉🏼0-3 wk
2-Callus+Osteoclast 👉🏼3-6wk
3-Bone formation in callus 👉🏼6-12wk
4-Cortical gap is bridged by bone 👉🏼6-12 m
5-Remodelling"Normal architecture"👉🏼1-2 yr.
-Tornoto notes
#Surgery
1- Hematoma 👉🏼0-3 wk
2-Callus+Osteoclast 👉🏼3-6wk
3-Bone formation in callus 👉🏼6-12wk
4-Cortical gap is bridged by bone 👉🏼6-12 m
5-Remodelling"Normal architecture"👉🏼1-2 yr.
-Tornoto notes
#Surgery
-Ascitic fluid less than 500 cc cannot be detected clinically.
-Minimal Ascites (500-1000cc).
-Moderated Ascites (1000-2000cc).
-Severe Ascitis (>2000 cc)
•Moderate amount: Shifting dullness.
•Tense: transmitted thrill.
•Minimal: knee - elbow.
#Surgery
-Minimal Ascites (500-1000cc).
-Moderated Ascites (1000-2000cc).
-Severe Ascitis (>2000 cc)
•Moderate amount: Shifting dullness.
•Tense: transmitted thrill.
•Minimal: knee - elbow.
#Surgery
Quick Notes
NON-UNION: -Fracture not united at end of 9 months and there is no progress in fracture healing in last 3 months is Non-union. #Surgery
Types of non-union:
1- Non-union with a gap.
2- Fibrous non-union: F.T. holds the fragments.
3- Hypertrophic non-union: a massive bone around the ends of the
fracture.
4- Atrophic non-union: The bone ends are rounded, narrow osteoporotic.
5- Pseudoarthrosis: is a form of non-union due to formation of an adventitious bursa (i.e. bursa in an abnormal site) between the
sclerosed ends of the fragments with formation of a new joint with a new range of mobility .
#Surgery
1- Non-union with a gap.
2- Fibrous non-union: F.T. holds the fragments.
3- Hypertrophic non-union: a massive bone around the ends of the
fracture.
4- Atrophic non-union: The bone ends are rounded, narrow osteoporotic.
5- Pseudoarthrosis: is a form of non-union due to formation of an adventitious bursa (i.e. bursa in an abnormal site) between the
sclerosed ends of the fragments with formation of a new joint with a new range of mobility .
#Surgery
Remember:
-In hypospadias, circumcision is contraindicated as prepucial skin is required for future urethroplasty.
#Surgery
-In hypospadias, circumcision is contraindicated as prepucial skin is required for future urethroplasty.
#Surgery
Remember:
-Fracture pain is sharp and stabbing in its character, aggravated by attempted movement, and relieved by rest and splintage.
-Muscle pain is often described as ‘stiffness’ or aching, and is aggravated by use of the affected muscle(s).
#Surgery
-Fracture pain is sharp and stabbing in its character, aggravated by attempted movement, and relieved by rest and splintage.
-Muscle pain is often described as ‘stiffness’ or aching, and is aggravated by use of the affected muscle(s).
#Surgery
Remember:
Fav for MCQ's
-The most common cause of death in DM is IHD
-The most common cause of death in Guillain-Barré syndrome is cardiac arrhythmia "Update" previously was Respiratory Failure.
-MC cause of death in Sarcoidosis is RHF" Cor pulmonale"
#Medicine
Fav for MCQ's
-The most common cause of death in DM is IHD
-The most common cause of death in Guillain-Barré syndrome is cardiac arrhythmia "Update" previously was Respiratory Failure.
-MC cause of death in Sarcoidosis is RHF" Cor pulmonale"
#Medicine
Remember:
-MC cause of death in Systemic sclerosis is PAH but some say it is ILD.
-MC cause of death in Rheumatoid arthritis is Coronary artery disease.
-MC cause of death in SLE is infections. Renal impairment.
-MC cause of death in Hemochormoatosis is HCC.
#Medicine
-MC cause of death in Systemic sclerosis is PAH but some say it is ILD.
-MC cause of death in Rheumatoid arthritis is Coronary artery disease.
-MC cause of death in SLE is infections. Renal impairment.
-MC cause of death in Hemochormoatosis is HCC.
#Medicine
Remember:
-MC cause of death in Upper GIT bleeding is MI, arrhythmia.
-MC cause of death in Kala-azar is infections, bleeding.
-Most common cause of death in Hemophilia is Intracerebral bleeding.
-MC cause of death in MND is bronchopneumonia, respiratory failure and complication of immobility.
-MC of death in ankylosing spondylitis is amyloidosis,spinal fracture.
#Medicine
-MC cause of death in Upper GIT bleeding is MI, arrhythmia.
-MC cause of death in Kala-azar is infections, bleeding.
-Most common cause of death in Hemophilia is Intracerebral bleeding.
-MC cause of death in MND is bronchopneumonia, respiratory failure and complication of immobility.
-MC of death in ankylosing spondylitis is amyloidosis,spinal fracture.
#Medicine
•Why the healing of fracture in children is more rapidly and takes short time?
-Because the periosteum is thick has very rich blood supply and growth cells.
#Surgery
-Because the periosteum is thick has very rich blood supply and growth cells.
#Surgery
How do you know that the appendix has been raptured ?
Simply
1. Generalized abdominal pain
2. Gaurdening and rigidity all over the abdomen
3. Shifting dullness ( due to fluid)
4. Diminished the liver dullness on percussion
5. Increase of body temperature (39-40)
6. US : fluid around the appendix and peritoneal cavity
7. CXR: air under diaphragm.
#Appendix
#Surgery
Simply
1. Generalized abdominal pain
2. Gaurdening and rigidity all over the abdomen
3. Shifting dullness ( due to fluid)
4. Diminished the liver dullness on percussion
5. Increase of body temperature (39-40)
6. US : fluid around the appendix and peritoneal cavity
7. CXR: air under diaphragm.
#Appendix
#Surgery
-Fever and tachycardia are commonly absent in acute cholecystitis; maintain
a high index of clinical suspicion!
-Fever is also absent in case of cystitis.
#Surgery
a high index of clinical suspicion!
-Fever is also absent in case of cystitis.
#Surgery
Remember:
In compartment syndrome.
-Pain out of proportion to injury (typically first and most significant symptom).
-Pain with passive stretch (most sensitive sign).
-5Ps:late signs-do not wait for these to develop to make the diagnosis!!
-Tornoto notes
#Surgery
In compartment syndrome.
-Pain out of proportion to injury (typically first and most significant symptom).
-Pain with passive stretch (most sensitive sign).
-5Ps:late signs-do not wait for these to develop to make the diagnosis!!
-Tornoto notes
#Surgery
Quick Notes
This is a polypropylene mesh used for hernioplasty, this provides structural support to a weak defect, it gained widespread popularity especially with inguinal hernias (Lichtenstein tension-free hernioplasty), it can be used for recurrent paraumbilical hernias…
Indications
-Direct hernia.
-Recurrent hernia.
-Re-recurrent hernia.
-Incisional hernia.
-Old age.
-Hernia with weak abdominal muscle tone.
-Sliding hernia.
Complications:
-Infection.
-Mesh extrusion.
-Foreign body reaction.
-Mesh inguinodynia causing hyperaesthesia and pain along the distribution of ilioinguinal or iliohypogastric nerve.
Contraindications:
-In strangulated hernia, Why?
Because the field is potentially infected.
#Surgery
-Direct hernia.
-Recurrent hernia.
-Re-recurrent hernia.
-Incisional hernia.
-Old age.
-Hernia with weak abdominal muscle tone.
-Sliding hernia.
Complications:
-Infection.
-Mesh extrusion.
-Foreign body reaction.
-Mesh inguinodynia causing hyperaesthesia and pain along the distribution of ilioinguinal or iliohypogastric nerve.
Contraindications:
-In strangulated hernia, Why?
Because the field is potentially infected.
#Surgery