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How to differentiate between Epidermoid cyst and dermoid cyst?

#Surgery
What is the syndrome associated with sebaceous cyst?

-Gardner’ssyndrome:
Osteomas
Intestinal polyposis
Sebaceous cyst.

#Surgery
What Are the Classic Nerve Injuries Associated with Fractures?

#Surgery
Differential diagnoses of thyroglossal cyst:

1-Median sublingual dermoid
2-Enlarged submental lymph node
3-Subhyoid bursa
-4-Enlarged Delphian node
5-Solitary thyroid nodule
6-Thyroid cyst.

#Surgery
-The lethal six injuries in chest injury.

#Surgery
This is an example of a thyroid case examination:

Local:
Inspection:

-There is a single swelling in the right. anterior triangle of the neck, about 2×3 cm in size , oval in shape, with irregular surface, no skin changes as redness dilated veins, sinus, scar or edema and no pulsation .
-It's movable with deglutition and does not move by tongue protrusion.
Palpation:

-There is neither hottness, tenderness. nor thrill.
-The trachea is central and both carotids are palpable.
-By palpating the left side of the neck, there is no palpable swelling.
-By palpation of the right side, here is a single lump in right anterior triangle of the neck, about 2×3cm size, oval in shape, with irregular surface and hard consistency, not mobile, border is ill-defined. The skin isn't attached, it's not fixed to the underlying structures such as SCM muscle, and I can get below it.

-By palpation of lymph nodes, there are about two palpable lymph nodes in the right anterior neck triangle, painless, rough, hard, and fixed.

Percussion:
-Resonant on sternum.

Ascultation:
-There is no audible bruit over the carotid or swelling.
Very important:

After local examination of thyroid, look for:

-Signs of Thyrotoxicosis"1°&2°"
-Signs of Myxedema.
-Signs of Retrosternal extension.
-Signs of Metastasis.
Signs of Primary Thyrotoxicosis:

1. Eye signs
2. Tachycardia
3. Tremors
4. Moist skin
5. Thyroid bruit
6. Peritibial myxedema
.
Here eye signs are more common.

-Signs of Secondary Thyrotoxicosis:

1-Signs of cardiac failure:
-Edema of ankles
-Orthopnea
2-Eye signs: Only lid lag and lid retraction can be seen
• No tremor • No exophthalmos, only seen in Primary type "Grave's disease".

Here CVS signs are more common than eye signs.
Signs of Myxedema"Hypothyroidism":

-Obese
-Dry inelastic skin
-Macroglossia
-Mask like facies
-Loss of hair in lateral eye brow
-Hoarseness of voice
-Pseudo myotonic reflex (delayed ankle jerk); also called ‘hung up’ reflex.
Signs of Retrosternal extension:

-As above examination, you can obtain them.
-Look at face, neck, upper chest for dilated veins, congestion, edema, puffiness, palpate tracheal rigns in SS notch, also below the lump, percuss over manibrium sterni for dullness, ask the patient to elevate both limbs for Pemberton's sign.
Signs of Metastasis:

1-Palpate neck of both sides for enlarged LN's.
2-Skull for hard nodules.
3-Look for bony deformity, tenderness in long bones.
4-Examine the abdomen for liver enlargement and ascites.
5-Examine the chest for signs of effusion and consolidation.
Ochsner-sherren regimen

#Surgery
Types of Mastectomy.

#Surgery
Timing of sutural removing.

#Surgery
The Differences between the thyriod surgeries.

#Surgery
TNM staging and Manchester staging of breast cancer.

#Surgery
Dr. Ramzi.

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