-The most common cause of hypercalcemia in outpatients is hyperparathyroidism.

-The most common cause of Hypercalcemia in hospitalised patients is malignancy .

-The most common malignancy leading to hypercalcemic crisis is breast cancer.

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#Endocrine

•Whipple's triad

-Typical presentation of insulinomas.
Consists of :

1-Symptomatic fasting hypoglycemia.

2-Plasma glucose less than 50 mg/dl during the attack .

3-Dramatic improvement after administration of glucose.

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#Endocrine

Courvoisier sign aka Courvoisier-Terrier sign:

-It states that in a patient with painless jaundice and an enlarged gallbladder (or right upper quadrant mass), the cause is unlikely to be gallstones and therefore presumes the cause to be an obstructing pancreatic or biliary neoplasm ( mostly carcinoma of head of the pancreas ) until proven otherwise .

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#Biliary

-When pheochromocytomas are found in places other than the Adrenals they are called Paragangliomas .

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#Endocrine

◼️ Remember that Hypercalcemia can lead to Acute pancreatitis , and acute pancreatitis itself causes Hypocalcemia .


◾️In this Case you may find the serum Calcium level Normal if Acute pancreatitis is caused by hypercalcemia .

#Surgery
#Pancreas

Pancreatitis.

◾️MCC of acute pancreatitis in Adults is Gallstones.

◾️MCC of acute pancreatitis in Children is Trauma

◾️MCC of chronic pancreatitis is chronic Alcohol intake


◾️Acute pancreatitis is the most common complication of ERCP.

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#Pancreas

•Most common cause of upper limbs lymphedema is Post mastectomy lymphedema.


•Most common cause of lower limbs lymphedema is Filariasis .

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#Vascular

•The most important prognostic factor in breast cancer is axillary lymph nodes status .

•And the most important prognostic factor in metastatic breast cancer is ER, PR status.

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#Breast

•Important Note :

-Male breast cancer is preceded by gynaecomastia in 20 % of cases But gynaecomastia is not a risk factor for male Breast cancer.

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#Breast

•Conditions that could be diagnosed using FNAC :

1. Colloid nodules
2. Thyroiditis
3. Papillary carcinoma
4. Medullary carcinoma
5. Anaplastic carcinoma
6. Lymphoma

-Note that ALL types of thyroid malignancies can be diagnosed used FNAC except Follicular type as it's diagnosis is based on Histology rather than cytology to demonstrate capsular and vascular invasion.

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#Thyroid

•Hour glass contracture:
-It is a complication of gastric ulcer, occurs exclusively in women, is due to cicatricial contracture of lesser curve ulcer.

•Tea-pot deformity (Hand-bag stomach):
-It is a complication of GU, it's due to cicatrisation and shortening of the lesser curvature.

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#Stomach

-Acute ulcers after major burns are called as Curling’s ulcers.

-Acute ulcers after cerebral trauma or neurosurgeries are called as Cushing’s ulcers.

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#Stomach

•Types of gastric ulcer (Daintree Johnson):

Type I 👉🏼 In the antrum, near the lesser curve,55٪.

Type II 👉🏼 Combined gastric ulcer (in the body) with duodenal ulcer, 25٪.

Type III👉🏼Prepyloric ulcer, 15٪.

Type IV👉🏼Gastric ulcer in the proximal stomach or cardia, 5٪.

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#Stomach

-Carcinoma in proximal stomach is common in young and upper socioeconomic group.

-Carcinoma in distal stomach is common in old and lower socioeconomic groups.

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#Stomach

-Carcinoma stomach is the commonest cause of Krukenberg’s tumour.

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#Stomach

Cave!

-Ceftriaxone is contraindicated in patients aged < 1 month because of a higher risk of biliary sludging and kernicterus.

#Medicine

Cave!

Tetracycline is contraindicated in:
-Children < 8 years of age
-Pregnant women
-Breastfeeding women.

#Medicine

•What is acromegaly?

-Acromegaly is characterized by generalized enlargement of the whole body, due to excess growth hormone secretion from pituitary macroadenoma (> 10 mm) after union of epiphysis.
-If occurs before the union of epiphysis, it is called gigantism.


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#Endocrine

•Why it is called acromegaly?

-Because of the enlargement of peripheral (acral) parts of body (acral means periphery and megaly means big).

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#Endocrine

•What are the causes of prominent supraorbital ridge?

1-Ricket
2-Paget's disease
3-Achrondroplasia
4-Hydrocephalus
5-Hereditary hemolytic anemia.

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#Endocrine

•What are the causes of macroglossia?

1-Acromegaly
2-Hypothyroidism
3-Amyloidosis
4-Down's syndrome.

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#Endocrine