معلومات مهمة عن
Types of polyps??

✨Hamartomas
يندرج تحتها نوعين
a/juvenile polyps
b/peutz jegher's polyps

✨inflammatory
من ضمنها psudeocyst حق ال ulcerative colitis.
✨neoplastic

ويندرج تحتها
?Adenomatous polyp:
وهي ثلاثة انواع
a/tabular adenoma.

b/villous or tubular villous adenoma.

c/serrated adenoma.

?FAP(Familial adenomatous polypsis.)

?Gardener Syndrome.

كل الأنواع لو دخلت ب colonoscope نبعدها...

لكن ال adenomatous هي الاخطر والتي تتحولcolon cancer..

#surgery_note

✨متى تكون Neck veins?

• Congested = T. Pneumothorax -Tamponed.

ومتى تكون ?
• Collapsed = hypovolemia = hemorrhage

#surgery_note

Causes of Mallory weiss tears ?
✨-alcohol
✨-hyperemesis gravidarum

✨-pancreatitis

#أصالة_الأسدي
#surgery_note

#الدكتور_عبد_الفتاح

? 6S of tangue ulcer :
_syphilis
_smoking
_SCC
_spicy food
_spirit
_sharp tooth ➡️ chronic irretation

? D.D of halitosis
_dental diseases
_esophageal diseases as achalasia, GERD
_liver failure
_D.M
_respiratory tract infection due to klebsiella, clostridium , or psedomonas

?clostridium septicum ➡️ associated with colon cancer
? قال الدكتور إنوه بيسأل عليها في العملي

?Bouveret's syndrome triad
_gastric outlet obstruction
_pneumopilia
_ectopic stone
?ذيه السندروم بسبب ال gall stone ileus بس أنوه الاستون بتحنب في ال
distal duodenum or at the pylorus
?م يهمش هذا الهدار المهم يكون عندكم خلفية بإسم السندروم لو سأل الدكتور و ال triad هيه نفسها حق rigler triad بس فيها
gastric outlet obstruction
بدل intestinal obstruction

? hypercarotenemia : yellowish discolouration of whole skin EXCEPT sclera

#د_عبدالملك_العليمي

#surgery_note

How can Total parental nutrition (TPN) cause septicemia:

1. Central venous catheter infection which lead to septic thrombophlebitis and finally septicemia .

2. prolonged absence of enteral nutrition lead to failure of gut barrier
   , which include atrophy of intestinal mucosa and translocation of bacteria to the blood stream.

#surgery_note

D.Dx of a mass prolapsing from the anus :

Rectal prolapse
Prolapsed hemorrhoid
Prolapsed Polys
Prolapsed Intussusception

#surgery_note

بعض الملاحظات المهمة  من محاضرة اليوم للدكتور مجاهد الجرادي

*Investigation of thyroid disorders
-TSH , T4 ,T3
-Anti-thyroid antibodies , anti-thyroglobulin
-Ultrasound
-Radioisotopes by Radioactive iodine( I123)→ (warm, hot , cold nodule)
-biopsy by FNAC under guideline of ultrasound

في حالة الgoiter عند فحص الthyroid function test  قد تكون النتيجة
1-Hyerthyroid
2-or Euthyroid يخوف (suspicious malignancy )
3-Hypothyroid

*Benefits of ultrasound in thyroid goiter
1-determine single or multiple nodules
2-determine shape of lesions
3-differentiate between cystic and solid lesions
4-hyperechoic or hypoechoic
5-show hypervascularity of goiter(hyperfunctioning goiter)
6-show there is calcification or not
7-extension of retrosternal goiter
8-show trachea if compressed or deviated by goiter
9-show lymph nodes metastasis
10-guidline for FNAC

*Types of thyroid tumor in FNAC
1-papillary carcinoma
2-follicular (can't determine by FNAC if adenoma or adenocarcinoma)
3-anaplastic carcinoma
4-lymphoma
5-medullary carcinoma

بشكل عام
Management of thyroid tumor
1-surgical
2-radiotherapy (external beam radiation or radioiodine I 131)
3-chemotherapy
4-hormonal therapy

*Indications of radioiodine ablation
1-toxic goiter
2-recurrent
3-.....

*Approach to management of  follicular tumor(diagnosed by FNAC)
-Hemithyroidectomy
-Send for histopathology
-if finding is adenocarcinoma then complete thyroidectomy
-if finding is adenoma  خلاص الأمور طيبة
بس عندنا يعملوا total thyroidectomy من أو مرة بعدين نمشي المريض على L-thyroxine

*After total thyroidectomy, pt should given L-thyroxine 0.2 mg/day to suppress TSH production below 0.1 mU/L as most thyroid carcinoma TSH dependant
إذا ما استخدم العلاج يرتفع TSH يقوم يحفز بقية الخلايا التي بقيت بعد العملية فيحدث recurrent thyroid carcinoma

In Radioisotopes of thyroid nodules show one of three
1-Hot (hyperactive)
2-warm(normal)
3-cold (non-functioning , suspicious of malignancy)

?حالات asymptomatic cholecystitis
بنمشها ع conservative ttt لكن به استثناءات بندخل المريض جراحة 
?what are the indications of cholecystectomy in asymptomatic pt ?!

1_large stone >3cm ? risk for malignancy

2_Porcelain GB ? risk for malignancy

3_pt with haemolytic anemia

4_if splenoectomy will be done

5_ileal resection

6_stones with polyps

7_in cardiac transplantation ? due to injection of cyclosporine which leads to stone formation

8_elderly diabetic pt in silent chronic calcular cholecystitis

#د_أمل_قعشة
#surgery_note

.

ملف لاغلب مواضيع الجراحه ع شكل سؤال وجواب ممتاز بعد مذاكرة كل موضوع من المكان المعتمدين عليه ونثبت منه

#ملفات_جراحه