البورد الأميركي ،آخر تحديث.

-Latest .

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Guidelines in this amazing series such as:

• American College of Cardiology (ACC)
• American Heart Association (AHA)
• American Academy of Physician Assistants (AAPA)
• Association of Black Cardiologists (ABC)
• American College of Preventive Medicine (ACPM)
• American Geriatrics Society (AGS)
• American Pharmacists Association (APhA)
• American Society of Hypertension (ASH)
• American Society for Preventive Cardiology (ASPC)
• National Medical Association (NMA)
• Preventive Cardiovascular Nurses Association (PCNA)
•American Diabetic Association
•American College of Chest Physicians
•American College of Gastroenterology
•American College of Endocrinology
•American Thoracic Society
•Canadian Thoracic Society
•American Academy of Otolaryngology-Head and Neck Surgery
•European Academy of Allergy and Clinical Immunology
•European Respiratory Society
•British Thoracic Society
•European Society of Cardiology
•European Stroke Organisation
•National Institute for Health and Care Excellence"NICE"
•National Stroke Foundation (Australia)
•American Stroke Association
•European Stroke Organisation (ESO)
•World Health Organization (WHO).

...etc

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Remember:

Ideal time of treatment.

#Surgery

Remember:

Appendix:

•5–10 cm in size but can be variable. •Size of its lumen is that of matchstick.
•Diameter of appendix is 3–8 mm;
•Diameter of lumen is 1–3 mm (matchstick)..

-Blood supply is from appendicular artery, a branch of ileocolic artery, ileocolic artery is the lowest branch arising from the concavity of the superior mesenteric artery.
-SMA arises from the front of abdominal aorta at the level of lower border of L1.
-SMA supplies the midgut from the levelof ampulla of Vater till the right 2/3 of the transverse colon.

Branches:
1-lnferior pancreaticoduodenal artery.
2-Jeiunal & ileal branches (12- 15)
3-Right colic artery
4-Middle colic artery

#Surgery

Remember:

-Widest portion of colon: Cecum

-Narrowest portion of colon: Sigmoid

-MC site of colonic rupture caused by distal obstruction: Cecum

-Colon absorbs water, NaClQ; secretes K+, HCO3 and mucus

-MC site of ischemic colitis: Splenic flexure.

Most Common Type of Stones.

#Surgery

Lipoma.

#Surgery

What are the differential diagnoses of Undescended Testis?

1-Ectopic testis:
-On raising the legs, ectopic testis in superficial inguinal pouch becomes more prominent but not is case of undescended testis located in inguinal canal.
-Simply during contraction of EO muscle, the ectopic testis will be more prominent because it's superficial to muscle, but undescended testis will be less or not appear because it's deep to the muscle.

2-RETRACTILE TESTIS:
-Here everything is normal, but there is overaction of cremaster.
-Testis is pulled up, to stay near the external ring and often mistaken for undescended testis.
-To differentiate by Orr chair test or squatting position, ask the child to sit on chair and see the testis, if it's descended to the scrotum, then it's retractile because of increased IP pressure, if not, it's undescended testis.
-Also retractile can be pulled down to its scrotum, but undescended can not because of short blood vessels.
-In warm condition, can be returned to its position.

3-Agenesis of testis which is called Anorchism.
Here no testis, so use US or CT.

4-Atrophy of testis:
-Hx of infection such as mumps.

5-Hermaphroditism:
-If bilateral, this should be excluded.

6-Other causes of groin swelling: lymph nodes, soft tissues, hernia, etc.


#Surgery

Liver can persist or live without hepatic artery i.e (presence of portal vein only) but if the liver is healthy.
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Qaudate lobe is the only lobe which does not drain its venous blood to hepatic vein
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We don't put tube in case of TB abscess or amoebic abscess because this procedure lead to formation of fistula .
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The commonest site for rupture of amebic abscess is the peritoneal cavity.


د ناجي حومش.

#Surgery

Three questions to ask patient in a short case history:

-What happened? "CC"
-When happened? "Duration"
-What is the current situation? "Complications, investigations, or ttt and surgery".

#Surgery

Apparent leg length discrepancy:

-Measuring distance from the umbilicus or xiphisternal junction to the medial malleoli.

-Unequal distance signifies apparent leg length discrepancy, especially if there is not a true leg length discrepancy.

-It may be caused by pelvic obliquity or adduction or flexion deformity in the hip joint.

-Note:
It's performed after doing true leg length discrepancy.

#Surgery

مثل هذه الملاحظات عبارة عن معلومات كانت إجابات لأسئلة الدكاترة اللي وردت في تجارب الطلاب في الدفع السابقة و كذلك بعض تجارب دفعتنا...

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Clinical Surgery Pearls.

It's a nice clinical book in selected issues in surgery, in form of questions and answers with focus on practical side.

It's really an amazing book, especially the layout of information .