A 25-year-old male came to the ER after a road traffic accident.
The chest wall showed multiple bruises with bulging of the Rt side. The patient had dyspnea with decreased chest movement. Percussion revealed hyper-resosnance on the Rt side & auscultation revealed dimnished breath sounds.
The chest wall showed multiple bruises with bulging of the Rt side. The patient had dyspnea with decreased chest movement. Percussion revealed hyper-resosnance on the Rt side & auscultation revealed dimnished breath sounds.
Provisional diagnosis:
Anonymous Quiz
80%
Rt tension pneumothorax
3%
Lt tension pneumothorax
14%
Rt hemothorax
3%
Lt hemothorax
The 1st step in management of this case is:
Anonymous Quiz
11%
Chest x-ray
9%
CT chest scan
66%
Needle decompression
14%
Intercostal chest tube insertion
0%
Emergency thoracotomy
Chest x-ray is expected to show:
Anonymous Quiz
60%
Jet black opacity on the Rt side
14%
Shift of the mediastinum to the Rt side
6%
Enlarged cardiac shadow
20%
Obliterated costo-phrenic angle
All of the following are causes of spontaneous pneumothorax, except:
Anonymous Quiz
14%
TB
14%
COPD
54%
Thoracoscopy
17%
Ruptured apical bleb
1st aid management of flail chest does NOT include:
Anonymous Quiz
9%
Maintenance of adequate ventilation
22%
Fluid management
16%
Pain management
38%
Thoracotomy
16%
Pulmonary toilet
All the following are indications of intercosral chest tube insertion EXCEPT
Anonymous Quiz
6%
Evacuation of pleural collections e.g. empyema & chylothorax
9%
Resistant bilateral pleural effusion
36%
1st aid management in tension pneumothorax
21%
Palliative in malignant pleural effusion
27%
2ry pneumothorax > 2 cm
Indications of emergency thoractomy in cases of hemothorax:
Anonymous Quiz
6%
As 1st aid management in all cases
35%
In persistent cases after chest tube insertion
35%
If there's immediate output of 1000 cc blood from the chest tube insertion
24%
If the rate of ongoing blood loss is 100 cc blood per hr over successive 4 hrs
يقال إن البروف مجدي يعقوب تخرج من جامعة القاهرة بتقدير مقبول... لكن هذا لم يمنعه أن يصبح واحداً من أعظم جراحي القلب في العالم.
الرسالة واضحة: لا تثق كثيرا في الأرقام والتقديرات، ولا تجعلها مقياسك الوحيد. الجامعة والممتحن يقيمون ورقة، لكن الحياة تقيم شغفك، اجتهادك، واستمرارك في السعي.
عبي رأسك معلومات واشتغل على نفسك، وإياك أن تقارن نفسك بأحد؛ فإن قارنتها بمن هم أعلى منك حطمت نفسك، وإن قارنتها بمن هم أقل منك ثبطت همتك.
المقارنة الوحيدة المسموحه هي مقارنتك مع نفسك بالأمس واعلم أن يوم لم تتعلم فيه فأنت لاتستحقه. لذلك احرص كل يوم على تعلم درس أو معلومة في أي جانب بالحياة.
وفي النهاية اكررها لكم جميعاً أن الامتحان يقيس ذاكرة الطالب فقط وليس تعلمه ومعرفته
⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
Exam is only to measure student memory not his learning and knowledge.
#ذاالنون القحطاني
@Surgery_Practice
الرسالة واضحة: لا تثق كثيرا في الأرقام والتقديرات، ولا تجعلها مقياسك الوحيد. الجامعة والممتحن يقيمون ورقة، لكن الحياة تقيم شغفك، اجتهادك، واستمرارك في السعي.
عبي رأسك معلومات واشتغل على نفسك، وإياك أن تقارن نفسك بأحد؛ فإن قارنتها بمن هم أعلى منك حطمت نفسك، وإن قارنتها بمن هم أقل منك ثبطت همتك.
المقارنة الوحيدة المسموحه هي مقارنتك مع نفسك بالأمس واعلم أن يوم لم تتعلم فيه فأنت لاتستحقه. لذلك احرص كل يوم على تعلم درس أو معلومة في أي جانب بالحياة.
وفي النهاية اكررها لكم جميعاً أن الامتحان يقيس ذاكرة الطالب فقط وليس تعلمه ومعرفته
⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
Exam is only to measure student memory not his learning and knowledge.
#ذاالنون القحطاني
@Surgery_Practice
❤8👍1
Surgical Practice Dr. alqhatani
اهم امسكيوهات وبنوك الجراحة #د_علي_برط والموقع هذا لا تنسوه اعملوا له لفه قبل الإمتحان ⬇️ Chapter 29 Chest Injuries | Quizlet https://quizlet.com/547976088/chapter-29-chest-injuries-flash-cards/ #Surgery https://t.me/Surgery_Practice
اتطلعوا على نماذج الدفع السابقة
وبنك المطري القديم*
وبعدهن القصر العيني
مهم جدا
وبنك المطري القديم*
وبعدهن القصر العيني
مهم جدا
彡 Dr_Thaalnoon_ALqahatani ⁞²⁰²³彡
❇️ SIRS criteria ❇️ Factor predisposing to sepsis #shock https://t.me/Surgery_Practice
🔴 Early Goal-Directed Therapy (EGDT) – Septic Shock
EGDT is a structured approach for managing septic shock in the first hours:
📌 Key targets (initial resuscitation):
❇️ MAP ≥ 65 mmHg
❇️ Urine output ≥ 0.5 mL/kg/hr
❇️ Central venous pressure (CVP) 8–12 mmHg
❇️ ScvO₂ ≥ 70%
📌 Management bundle:
• Early broad-spectrum antibiotics (within 1 hour)
• Rapid IV crystalloids (30 mL/kg)
• Vasopressors (norepinephrine first-line) if hypotension persists
• Source control (drainage / surgery if needed)
⚠️ Delay in antibiotics significantly increases mortality in septic shock.
❇️ Clinical tip: If hypotension persists after fluids → think vasopressor-dependent septic shock.
🚨 Important note: EGDT is time-critical → “golden hour” concept in sepsis.
#Surgery
#Shock #Sepsis
https://t.me/Surgery_Practice
EGDT is a structured approach for managing septic shock in the first hours:
📌 Key targets (initial resuscitation):
❇️ MAP ≥ 65 mmHg
❇️ Urine output ≥ 0.5 mL/kg/hr
❇️ Central venous pressure (CVP) 8–12 mmHg
❇️ ScvO₂ ≥ 70%
📌 Management bundle:
• Early broad-spectrum antibiotics (within 1 hour)
• Rapid IV crystalloids (30 mL/kg)
• Vasopressors (norepinephrine first-line) if hypotension persists
• Source control (drainage / surgery if needed)
⚠️ Delay in antibiotics significantly increases mortality in septic shock.
❇️ Clinical tip: If hypotension persists after fluids → think vasopressor-dependent septic shock.
🚨 Important note: EGDT is time-critical → “golden hour” concept in sepsis.
#Surgery
#Shock #Sepsis
https://t.me/Surgery_Practice
❤4
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Surgical Practice Dr. alqhatani
A 19-year-old male is brought to the hospital after sustaining an abdominal injury while playing rugby. He is complaining of left upper abdominal pain and has some bruising over the same area. His pulse is 140/min and his BP is 100/82 mmHg.what is the type…
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Surgical Practice Dr. alqhatani
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A 55-year-old woman with poorly controlled hypothyroidism is found comatose. She is
hypothermic. Her pulse is irregular and her BP is 96/70 mmHg. what is the type of shock?
hypothermic. Her pulse is irregular and her BP is 96/70 mmHg. what is the type of shock?
Surgical Practice Dr. alqhatani
A 55-year-old woman with poorly controlled hypothyroidism is found comatose. She is hypothermic. Her pulse is irregular and her BP is 96/70 mmHg. what is the type of shock?