■ 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

■ مساء الخير يا شباب الناس اللي بتبعت ليا عشان ent غالبا هيكرر من أسئلة امتحانات سابقة
بس ضيفوا عليهم لو حب يعمل مفاجأة ال labyrinthitis & otogenic brain abscess

■ كان في case on GE :

● بس خلي بالك any women with reproductive age with abdominal pain should have urinary pregnancy test دي أول حاجة تعملها في case كان ve-

● Keywords : altered bowel habits + abd pain +nausea + increase CRP ( inflammatory condition )

● ttt : bed rest + IV fluids + analgesic

● خلي بالك if these symptoms not resolved لازم تعمل stool culture

● طيب if symptoms is persistent or recurrent لازم تفكر ف CD or UC

■ أهم notes ف كيسات النسااا :-  ( part 1 )

● torsion of ovary :
♤ keywords : unilateral lower abdominal pain associated with N & V + hx of ovarian cyst
♤ ttt : laparotomy

●  placental abruption :

♤ keywords : more common in 2nd & 3rd trimester & hypertensive 
  vaginal bleeding & associated with tender uterus & abdominal pain ( midline persistent uterine) & abnormal fetal heart tracings

♤ TTT : Delivery

● Ectopic pregnancy :

unilateral abd pain + vaginal bleeding +
  ( +ve pregnancy test )
● طبعا بنشخصه عن طريق combined US + B-HCG
● خلي بالك بنعمل salpingectomy if the tube is diseased
طيب لو contralateral tube is healthy هنشيلها salpingectomy طيب لو كانت damaged هنعمل salpingotomy

● تاني حاجة بنستخدم MTX لو كان فيه no fetal heart activity & hemodynamic stable &
  B-HCG  < 3000 & adnexal mass < 3.5 cm
 

■ part 2 :

■ complicated corpus luteal cyst into hge :

● keywords : ♡ common at time of ovulation

♡ sudden abdominal pain then  radiate to right iliac fossa & right thigh

♤ tenderness & slight rebound tenderness in right iliac fossa
( no signs of peritonism )
♤ no systemic symptoms ( no fever ) + urine analysis is negative
يبقى كداا تم استبعاد appendicitis or ureteral stone 
♤ urinary pregnancy test is +ve
♤ بنشخصها ب color doppler US هنلاقي فيه (ring of fire apperance ) hemorraghe  
♤ spider web or reticular pattern of echoes
within cyst

♤ ttt : supportive with analgesia
خلي بالك بنعطي أول حاجة paracetamol followed by codeine derivative s if necessary
اعطناها كدااا عشان ال pateint is hemodynamic stable
طيب افرض كانت hemodynamic unstable & pain not controlled & with signs of peritonsim لازم تعمل laparoscopic lavage by cystectomy or hemostatic manuever

■ أهم نوتس على كيسات النسااا :-

● ملف مجمع لكل النوتس :
https://t.me/med_Notes2/740

● part 1:
https://t.me/med_Notes2/697

● part 2 :
https://t.me/med_Notes2/699

● part 3 :
https://t.me/med_Notes2/693

● part 4 :
https://t.me/med_Notes2/703

● part 5 :
https://t.me/med_Notes2/709

● part 6:
https://t.me/med_Notes2/718

■ أهم notes على كيسات النساا :

● the earilest indicator of hypovolemic shock is tachycardia

● any patient with hypovolemic or hemorrahegic shock must be resuscitated
( ABC)

● appendicitis :
♤ the growing uterus pushing appendix superior ( right hypochodrium ) & lateral
( right flank)
♤ keywords : *abdominal pain in right iliac fossa associated with fever & N & V & leukocytosis
* tenderness on right lateral aspect at the level of umbilicus & mild right flank
But urine analysis is normal
كدا استبعدت  ureteral stone

■ cholelithiasis :
♤ keywords : ♤ right colicky abd pain in right hypochodrium with N & V & fever + leucocytosis + pain radiated to Rt shoulder
♤ FH of DM
♤ common after 1st trimester

■ pancreatitis :
♤ keywords : severe midepigastric pain radiate to the back with N , V , tenderness & diffuse rebound tenderness on Abd examination
* sr amyalse is markedly elevated