antithyroid drugs (thiouracil & carbimazole).

Pain, vomiting, dehydration, lying forward (Acute pancritis)

Mid ingiuanal point (femoral artary) midway between ASIS and symphysis pubis

Mid point of inguianal canal (internal ring) half an inch between pubic tubercal and ASIS

In pediatric: (Diffuse goiter + Hypothyroidism) due to congenital enzyme
deficiency →"Peroxidase (common)"
→"Dehydrogenase (rare)"
C/P: Deafness + Autism + Goiter

All the structure of abdomen may hernited except pancreas and spleen

Shutter mechanism assist to protect the body from herni by cotraction the internal ring (Facia transvercels)

Pomberton sign ⇒ raise upper limb up to see if there is dilated viens

❇️Amalgamated lymphnodes
Duo to carcinoma or Hodgking lymphoma lymph nodes
❇️matted
❇️ discrete

Type of pain :
Burning
Stapping
Heaving
Clam - like
Sharping
Dull- aching
Colicy
Bruising
Throbbing

DVT:
Stasis
Hypercoagubilty
Endothilal injury

Obstructive Jaundice :
Sudden
Intermittent
painful

Jaundice duo to tumor
Gradual
Progrosive
Painless
loss of wight
loss of appitite

Charcot’s triad
Seen in ascending cholangitis:
• Intermittent fever
• Intermittent pain
• Intermittent jaundice

Acute appendicitis:
– Complaints of pain abdomen within 1 week, associated with vomiting and
fever followed by features of abdominal lump formation.

Ileocecal tuberculosis:
– Features of subacute intestinal obstruction
- Vomiting
- Distension
- Colicky abdominal pain
- Constipation
– History of suggestive of tuberculosis
- Loss of weight/appetite
- History of evening rise of temperature
– History of chronic cough with expectoration

Carcinoma cecum:
– History of anemia, asthenia, anorexia
– History of gradual development of mass
– History of vague pain abdomen
– History of jaundice.
(Right side colonic malignancies usually produce anemia, bleeding and rarely
produce obstructive symptoms).

Murphy’s triad
Triad of:
– Pain
– Vomiting
– Fever in cases of acute appendicitis

 Boas's sign
below the right scapula can be a symptom in acute cholecystitis 

★Stage of chronic limb ischaemia:
-Stage 1👉symptomless
-Stage 2👉intermittent claudication
-stage3👉Rest pain
-Stage4👉Ulceration or gangrene



★((Magner's classification))[0-5] of diabetic ulcer based on ulcer depth :

-Grade 0👉Intact skin
-Grade1👉superficial ulcer
-Grade2👉deep ulcer to tendon bone joint((without infection))
-Grade3👉Deep ulcer with abscess or osteomyelitis((with Infection))
-Grade4👉forefoot gangrene
-Grade5👉Whole foot gangrene

★Bed ulcer stage :
-Stage1 👉skin inflamed but not broken
-Stage2👉partial thickness skin loss(superficial painful ulcer)
-Stage3👉Full thickness skin loss affection subcutaneous tissues ((deep painful ulcer
-Stage4👉massive tissue destruction
Structure deep to deep fascia ((tendon+bones +ligament))


★portal hypertension stage:
-stage 1👉hepatomegaly
-stage2👉hepatosplenomegaly
-stage 3👉Shrink liver and huge spleen
-Stage4👉Aciates+splenomegaly+shrink liver
-Stage5👉Cells liver failure

★grading of reflux esophagitis:
Grade l👉hyperaemic mucosa
Grade ll👉superficial ulceration of mucosa
Grade lll👉deep ulceration
Grade lV👉stricture or barrett's esophagus


★Stage of thrombosis:
-Stage1👉pale thrombus
-Stage2👉mixed thrombus(fibrin+RBC)
-stage3👉propagating thrombus(jelly-like)

Leriche syndrome:
Buttock IC + absent femoral pulse + impotence in male = aorto ileac stenosis.