•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.

#Surgery
#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.

#Surgery
#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.

#Surgery
#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.

#Surgery
#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.

#Surgery
#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٪.

#Surgery
#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.

#Surgery
#Stomach

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

#Surgery
#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.


#Medicine
#Endocrine

•Why it is called acromegaly?

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

#Medicine
#Endocrine

•What are the causes of prominent supraorbital ridge?

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

#Medicine
#Endocrine

•What are the causes of macroglossia?

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

#Medicine
#Endocrine

•What are the causes of baggy eyelids?

1-Old age
2-Myxedema
3-Acromegaly
4-Alcoholism
5-Nephrotic syndrome or acute glomerulonephritis.

#Medicine
#Endocrine

•What are the signs of active acromegaly?

-Signs of activity:
1-Progressive increase in the size of the body
2-Excessive sweating
3-Increasing visual field defect
4-Large skin tags (Molluscum fibrosum)
5-Presence of glycosuria (diabetes mellitus)
6-Hypertension
7-Progressive headache
8-Enlarging thyroid.

#MCQ
#Medicine
#Endocrine

•What are causes of death in acromegaly?

1-Heart failure
2-Complications of hypertension
3-Complications of DM
4-Coronary artery disease
5-Tumor expansion (mass effect) 6-There is an increased death due to neoplasia, especially colon tumor
7-Pituitary apoplexy.

#Medicine
#Endocrine

•ACUTE GASTRIC DILATATION

-It is an enormous acute dilatation of stomach with atonic gastric wall without peristalsis.
-Stomach distends enormously occupying most of the abdomen and pelvis causing sequestration of lots of fluid resulting in hypovolaemia.

#Surgery
#Stomach

•Causes of Acute Gastric dilatation:

1-After major surgery (abdomen,. neurosurgery).
2-Trauma, burns.
3-Retroperitoneal haematoma.
4-Electrolyte imbalance.
5-Other causes: Anorexia nervosa, bulimia, polyphagia, drug abuse, diabetes, anaesthesia, debilitating diseases, spinal cord diseases, muscle dystrophy.

#Surgery
#Stomach

•COMPLICATIONS OF GASTRIC SURGERY:

1-Haemorrhage.
2-Stomal obstruction.
3-Biliary fistula.
4-Injury to CBD.
5-Duodenal blow out—on 4th postoperative day.
6-Pancreatitis.
7-Recurrent ulcer/stomal ulcer.
8-Gastrojejunocolic fistula.
9-Dumping syndrome (Postcibal syndrome).
10-Nutritional disturbances, diarrhoea.
11-Pulmonary tuberculosis.
12-Carcinoma in gastric remnant (after 10–15 years).
13-Gallstone formation.
14-Alkaline gastritis.
15-Afferent and efferent loop. syndrome.
16-Afferent loop obstruction-common.
17-Efferent loop obstruction.

#Surgery
#Stomach

•HYPERTROPHIC PYLORIC STENOSIS

-There is increased risk of developing the condition if new- born gets erythromycin or azithromycin in first 14 days after birth.

#Medicine
#Pediatrics