🗯🗯 مساء الخير يا شباب كذا حد يبعت بخصوص المسالك محدش يبصمج ، السنة اللي فات قسم المسالك جاب كل mcq بناء ع الفهم و ما بين السطور ، استنوا بكرا هنزل نوتس مهمة ع الحاجات اللي ممكن تتسأل فيها.

■ Notes on urology :- " part 1"

●  fowlers syndrome is one of causes of AUR for women

● post obstructive diuresis is diagnosed when urine output exceeds :
*200cc/ h for 2 consecutive hr
* more than 3 liters in 24 hr

● stones are the most common cause of ureteral obstruction

● stone is diagnosed by US or CT scan

● ICI is the most common cause of low flow priapism

● sickle cell disease is the most common cause of low flow priapism in children

● color doppler US & pudendal angiography are the most important investigation in priapism

● fournier's gangrene is the life threatenting necrotizing  condition & must be ttt by aggressive surgical debridement combined with broad spectrum antibiotics

● testicular salvage occurs within 6-8 hrs , while testicular necrosis if 24 hrs or more


● D.D of testicular torsion : orchitis , testicular tumor , hematocele , hyrocele ,  epididymitis


● testicular torsion differentiates from acute epididmyitis by cold spot & ring signs

● surgical ttt of testicular torsion :
♤ If viable : Ipsilateral detorsion + contralateral orchiopexy 
♤ If > 24 hours : orchiodectomy

● the three most common causes of acute scrotum is testicular torsion , appendiceal torsion , acute epididymo-orchitis

● Acute scrotal swelling in children indicates torsion of the testis until proven otherwise 

●  paraphimosis : when the foreskin trapped behind the penile corona

■ Notes on urology : part 2

● uretheral catheter is CI in case of bleeding per urethra

● 70 % of renal injuries are minor doesn't require surgical intervention

● degree of hematuria may not predict severity of renal injuriy & abscent in 10-25%

● CT with contrast on abdomen & pelvis is the goldstandard in staging of renal injuries & must the patient is the hemodynamically stable

● 80% of cases with renal blunt trauma injuries : bleeding stop with bed rest & hydration


● surgical expolration is the role in penetrating renal injuries except when staging show minor parenchymal injury

● Ascending cystogram is the best choice in case of bladder injuries

● tea drop deformity is seen in extraperitoneal rupture of bladder

● Urine catheter : make damage for posterior urethra

● retrograde urethrography should be done for all cases of urethral injury 

■ بالنسبة للسؤال meningitis :-

● خلي بالك أكثر حاجة بأثر على pia and arachnoid

●بشخص meningitis ب triad :
♤neck rigidity
♤fever ( 39-40 )
♤DCL
●خلي بالك عيان meningitis بموت بسبب septicemia و DIC و addisonian crisis

● انا بعمل CT أو MRi عشان بس to exclude SAH or brain abscess

● lumbar puncture Is the single most important investigation and it is the cornerstone of the diagnosis

● Once suspected meningitis should start ttt immedialty even before culture results

● the best first choice is third generation of cephalosporine and the second is penicillin

الجدول ده مهم

■ مساء الخير يا شباب كذا حد يسألني عن النسااا و الولادة بصراحة حاول تبص ع كل case عن ايه و ليكن في case عن placental abruption تبص عليها بعد كدااا تقرأها من الكتاب دي أول حاجة
بعد كداا الحاجات اللي مش ذكرت في ملف cases ، تقرأها من الكتاب
أي جدول موجود أو أي نوت معينة موجودة في داتا ملف ال cases لازم تبص عليهم احتياط

■ توضيح سؤال femoral neck fracture :

♧ لما يحصل كسر ف femoral neck بيحصل muscle spasm حوالين الكسر ف Adductor muscles of thigh بيحصل ليها spasm و لأنها الأقوى يبقى تشد ال affected limb ف اتجاهها

● حصل external rotation بسبب irritation of iliopsoas ms اللي من ضمن ال action بتاعها بتعمل flexion & external rotation of the limb و سبب تاني بسبب weight of the limb

● حصل Shortented : نتيجة أول ما يحصل كسر ف feomral neck بيطلع greater trochanteric لفوق الكسر فبيحصل real shortened

■ السؤال دا عاوز الاجابة الغلط هي d
* EDTA is universal antidote
يعني بنفع اعطيته for any unknown chemical substance
قالها دكتور أحمد أشرف في شرحه
* Copious irrigation of eye from 15 to 30 mintues
لانه الوقت داا لحتى اعمل فيه till balance of PH of conjunctivia

🗯🗯 توقعات امتحان surgical emergency :-

■ الجراحة العامة :
1- Describe C/P & ttt of rupture spleen

2- etiology & C/P & ttt of paralytic ileus or C/P & complicaton & investigation of vulvolus of sigmoid colon

3- pathology & C/P & investigation of generalized peritonitis

4- pathology & C/P & ttt of mekel's diverticulum or pathology & C/P & investigation of acute pancreatitis

● جراحة العظام :
1- complication of femoral fractures

2- C/P & ttt of shoulder dislocation or hip dislocation

● الرمد :
1- def of chalcosis bulbi , commito retinae

2- list complication of cornea or retina or iris due to blunt trauma

3 - C/P & ttt of sympathetic ophthalmia

4- outline1st aid of lime eye injury

● الشرعي :

1-Compare between inlet & exit of firearm injury

2- mechanism of compression or mechanism of polar fracture

3- factors affecting on prognosis of burn

4- types of medical errors or harm scale

■ ENt :

1- describe cavernous sinus thrombosis

2- pathology & C/P & ttt of lateral sinus thrombosis

السؤال ده حله e

■ صباح الخير يا شباب بالنسبة للجراحة العامة قبل كداا السؤالين دول جه قبل كدااا ذاكرهم احتياط تجنباً لعدم المفاجاة من القسم
1- enumerate causes of Acute abdomen

2- D.D of mass in right iliac fossa