Notes

Abdominal Trauma

Shock

Pre-Shock → SIRS Presence of 2 or more of Temp <36℃ >38℃ HR >90 Respiration RR >20 PCO2 <32 WBC <4000 >12000 Shock Main First → Tachycardia Then → Hypotension Brain Confusion Kidney ↑ BUN/Cr ratio Liver ↑ AST and ALT Heart Chest pain SOB Blood ↑ Lactic acid Cardiac Index (CI) = CO/BSA → Range...

Congenital Adrenal Hyperplasia

Congenital Adrenal Hyperplasia Etiology Inherited defect in steroid synthesis 21-hydroxylase (>90%) 11β-hydroxylase 17α-hydroxylase   Presentation Most common → Hypotensive child with severe electrolyte abnormalities Deficiency 21-hydroxylase 11β-hydroxylase 17α-hydroxylase Aldosterone ↓ ↓ ⬆︎ Cortisol ↓ ↓ ↓ Sex hormones ↑ ↑ ↓ 17-OH progesterone ⬆︎ — — 11-deoxycorticosterone (11-DOC) — ⬆︎...

Brain Tumors

Urology

Scrotal Swelling Painless Hydrocele Transilluminates Types Non-communicating No change in size Communicating ↑ in size with valsalva Patent processus vaginalis Resolves spontaneously ↑ Risk of indirect inguinal hernia Varicocele Bag of worms above testis Left > Right Does NOT transilluminate ↑ in size with valsalva No need to treat...

Urologic Cancers

Simple renal cyst → Incidental finding, No treatment needed, Reassurance only Renal Cell Carcinoma Adenocarcinoma Etiology Male Smoking Obesity Cysts due to ESRD von-Hippel-Lindau Angiomatosis Visceral cysts RCC CNS tumors Presentation Triad Hematuria Flank pain Flank mass LEFT-SIDED varicocele Fever Malaise ↓ Weight Anemia 5-10% → Polycytemia Diagnosis Best initial →...

Cardiothoracic Surgery

Cardiothoracic Abnormalities

Surgical Hypertension

Endocrine Surgery

Genitourinary Abnormalities

Hydrocele Fluid filled sac in scrotum Painless Along spermatic cord Transilluminates Remnant of tunica vaginalis Resolves in 6 months Differentiate from inguinal hernia Varicocele Swelling in scrotum Dull ache and heaviness in scrotum Varicose vein in scrotal veins Enlarged pampiniform plexus Increased with pressure Diagnosis Best initial → Physical exam...

Gallbladder Surgery