A serum amylase level four times above the normal is indicative of acute pancreatitis.

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Bacteremia:
-Circulating bacteria in the blood without producing disease.

Pyemia:
-Circulating infective emboli composed of masses of organisms, vegetations and infected clots in the bloodstream.

Septicemia:
-Circulation of bacteria in blood producing disease.

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#Surgery

In Breast Carcinoma:

-Skin tethering and fixity:
The skin tethering is due to early involvement of ligaments of Cooper.

-Manifested as puckering of the skin:
The underlying lump can be moved independently of the skin to some extent.

-Skin fixity:
-It is because of invasion of carcinoma along the ligaments of Cooper to the skin.The lump and the skin cannot be moved separately.

-Retraction (Recent) of nipple:
Extension of growth along the lactiferous duct and subsequent fibrosis.

-Peau d’ Orange appearance:
It is due to blockage of the lymphatics draining the skin—cutaneous lymphedema. The hair follicles are more firmly fixed to the subcutaneous tissue than the rest of the skin. The hair follicles appear to be retracted and the between areas swell giving the orange peel appearance.

-Multifocal:
Tumor foci in the same quadrant are called multifocal.

-Multicentric:
Tumor foci in different quadrants are called multicentric.

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Constipation:
- A bowel frequency of less than one every 3 days. (Fewer than two per week).

Obstipation:
-(Absolute constipation): Absence of passage of both stool and flatus.

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Cough Impulse:
-Expansile impulse seen or felt over a swelling when the patient coughs, cries or strains.

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Crepitus:
-Grating or crackling sensation imparted to the examining fingers.
-May be present when the joint contain loose bodies.

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Flail chest:
-Three or more ribs fractured in 2 or more places.
-Bilateral costochondral separation will result in flail sternum.

Goiter:
- Any enlargement of thyroid gland is called goiter.

Grading of goiter: WHO (1990) Perez Classification
Grade 0 No goiter
Grade Ia Not visible, but palpable
Grade Ib Visible with neck extended and palpable
Grade II Visible with neck in normal position and palpable
Grade III Large gland evident from a distance.

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Hydronephrosis:
-Aseptic dilatation of pelvicalyceal system due to partial or intermittent obstruction.

Renal angle:

-Angle between the 12th rib and the edge of the erectorspinae muscle.
-Normally this is empty and resonant.
-There should not be any tenderness.

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Phimosis:
-Inability to retract the foreskin to expose the glans.
Paraphimosis:
-Inability to reduce a previously retracted foreskin.

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Massive hemothorax:-
When 1500 mL or more of blood is acutely removed from the pleural space, then it is called massive hemothorax.

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Lower GI bleed:
-It is a bleeding from distal to the ligament of Treitz.

Upper GI bleed:
-It is a bleeding from proximal to the ligament of Treitz.

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Tension pneumothorax:

-Presence of air in the pleural cavity with signs of mediastinal shift like:
Tracheal shift or and Shift of Apex beat.

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A tension pneumothorax impairs venous return by caval distortion from mediastinal shift and raised intrathoracic pressure with compression of the contralateral lung.


Radiological signs of tension pneumothorax:
1-Tracheal shift
2-Spreading of the ribs (Space between ribs increased)
3-Lowering of hemidiaphragm.

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Third day fever:

-If a patient is developing fever on the third postoperative day of surgery, suspect septic foci in the IV cannula.

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Weight loss:
-Loss of more than 10% body weight over a period of 6 months.

#Medicine

Varicose vein: (WHO Definition)

-Abnormally dilated saccular or cylindrical superficial veins which can be circumscribed or segmental.

#Surgery

Seddon’s Classification - Types of nerve injury:

•Neurapraxia
Axons are intact. Spontaneous recovery is complete.

•Axonotmesis:
Axons divided.Connective tissue intact. Wallerian degeneration occurs. Axons then regenerate slowly.

•Neurotmesis :
Whole nerve severed. Recovery may occur if cut ends are apposed.

#Surgery

In the normal adult erect film, usually upto 3 fluid levels are normal. They are:

1.One at the fundus of the stomach
2.One at the duodenal cap
3.One in the terminal ileum.

Porcelain gallbladder:

-Calcification of the gallbladder in plain X-ray is called porcelain gallbladder.
-The importance of this appearance is an association of carcinoma in up to 25% of patients.

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