Remember:

-Oral contraceptive pills are not a risk factor now in cancer breast!

-It's only progesterone only (mini pills) pills that have the risk of cancer breast.

#Surgery

In sebaceous cyst:

-Presence of bluish black spot, called punctum indicating the site of blockage at the opening of the duct, which is diagnostic.

-The punctum is adherent to the cyst.
-On squeezing the cyst putty-like or cheesy sebaceous material with an unpleasant smell may come out through the punctum.

#Surgery

Remember:

-Varicocele is common in tall, thin young men.

-Varicocele causes increased temperature in the scrotum which depresses the spermatogenesis and so causes infertility (correctable infertility).
#Surgery

Grading of varicocele:

I–small;
II–moderate;
III-large;
IV - severely tortuous.

#Surgery

Sites of Pilonidal Sinus:

1-Natal cleft(commonest)
2-Axilla
3-Umbilicus
4-Between fingers
5-Genitalia
6-Amputation stump.

#Surgery

Varicocele Classification:

Subclinical:
Not palpable or visible.

Grade I: Palpable during Valsalva maneuver.
Grade II: Palpable at rest ,but not visible
Grade III: Visibleand palpable at rest.

#Surgery

What is Bow sign?

-On lying down it gets reduced slowly and spontaneously (except in renal cell carcinoma) in primary varicocele.

#Surgery

Retrosternal goiter:

-Common in short neck individuals and males with strong pretracheal muscles

Types:

1.Substernal—part of nodule palpable in lower neck
2.Plunging—on increased intrathoracic pressure gland forced into neck
3.Intrathoracic goiter.

Classes:
1-Primary: rare, congenital.
2-Secondary: more common, acquired as in a large MNG.

#Surgery

-The only effective treatment of Retrosternal goiter is surgery.

-The antithyroid drugs in pre-operative preparation or treatment are contraindicated, Why?

-Because they will lead to ↓in thyroid hormones levels which lead to feedback activation of TSH that causes increased thyroid growth and size with more obstruction at neck without effect on hormone levels!!

So they use BB as Propranolol.
#Surgery

INDICATIONS OF CBD EXPLORATION:

1. History of charcot’s triad
2. USG proven stones in CBD
3. Dilated CBD (>1cm)
4. OTCshows filling deffect
5. Palpable stones in CB.

#Surgery

When would you find appendicitis and jaundice?

-In portal pyemia. "rare complication".

#Surgery

Remember:

-Celsius, Fahrenheit and Kelvin are the three common temperature scales.

-F° denotes for Fahrenheit , this is considered an American"US" system.

-C° means Celsius, it's used by UK "British system "and rest of the world.

Celsius is invented in 1742 by the Swedish astronomer Anders Celsius.

#Surgery

Remember:
Imp.

-In taking history in patients with hernia or varicocele, do not forget to ask about other swellings and features that suggest congenital weaknesses of mesenchyme such as Varicose veins, flat foot, piles, visceroptosis, muscle weakness..etc

-Because mesenchyme gives cells of convective tissues such as muscles of walls of blood vessels" varicocele, varicose veins, piles", fibrous tissue " hernia, ligaments "flat foot due to weaknesses of ligaments"..etc

-Also in examination examine if there is manifestations of weak mesenchymal syndrome, such as above plus:
-Rising test if there is recti diverication due to poor muscles.
-Also Malgaign's sign, bulge of multiple swellings in hernial regions"phantom hernia"
-Visceroptosis by local examination.

#Surgery

What is Slipped capital femoral epiphysis?

-Displacement of the metaphysis of the femoral neck from the epiphysis of the femoral head through the growth plate/physis.
-Likely due to obesity and overloading of the physis, less commonly due to a weakened growth plate from an endocrinological disorder; the femoral neck displaces anteriorly and superiorly relative to the femoral epiphysis;
-Typically presents at age 10–16 years.

#Surgery

What Is the  Treatment of Extremity Compartment Syndrome?


-Treatment is immediate decompressive fasciotomy of all the compartments of the affected limb.


Goal: first save life,save limb.
#Surgery

What Is the  Terrible (aka “Unhappy”) Triad of the Knee?

-A combination of MCL, ACL, and medial meniscus injuries.

#Surgery

Technique for examination of thyroglossal cyst and name of operation:


-Elicit fluctuation by Paget’s method or test.
-It may appear as firm or tense cystic.
-Some cysts are too small to fluctuate.

-Sistrunk’soperation is the surgery of choice:
consists of removal of the  thyroglossal cyst along with  the  entire thyroglossal tract up to the foramen cecum. The central part of the body of the hyoid bone (1cm) is excised during the process of excision of the tract , to prevent recurrence.

#Surgery

What is Curtain sign?

Curtain sign is—deep fascia/ parotid sheath is attached above to the zygomatic bone and so swelling arising from parotid gland cannot be moved up beyond zygomatic bone wherein deep fascia acts like a curtain to prevent its further mobility.

-It's seen in pleomorphic adenoma.

#Surgery

-Swelling superficial to deep fascia of parotid can be moved beyond the level of the zygomatic bone above.

#Surgery

Amount of secretions of gut.

#Medicine