General Surgery

Transplant Medicine

Transplant types Autologous → From the patient himself Allogenic → From genetically different donor Syngeneic → From identical twin Drugs Immunosuppressant Prednisone MMF Tacrolimus (FK506) Antilymphocyte Ab (OKT3) Antibiotic TMP/SMX Ganciclovir Ketoconazole Rejection reactions Hyperacute Within minutes ABO incompatibility → Preformed Ab Vascular thrombi ⇒ Tissue ischemia Cytotoxic agents...

Cardiothoracic Surgery

Surgical Hypertension

Endocrine Surgery

Gallbladder Surgery

Hernia

Hernia Etiology Inguinal Indirect Most common Congenital patent processus vaginalis LATERAL to inferior epigastric vessels Through both internal and external inguinal rings Direct Breakdown of fascia transversalis MEDIAL to inferior epigastric vessels Through floor of Hasselbach triangle Medial → Rectus sheath Superolateral → Inferior epigastric vessels Inferior → Inguinal ligament Femoral Women > Men Weakened...

Obstructive Jaundice

Choleducolithiasis Pancreatic cancer Colangiocarcinoma Ampula of Vater cancer

Pancreas Surgery

Colorectal Surgery

Esophagus Surgery

Hiatal Hernia Sliding Gastroesophageal junction + part of stomach displaced above diaphragm Medical + Lifestyle change → ↓GERD Paraesophageal Gastroesophageal junction in place Stomach fundus displaced above diaphragm Gastropexy → Prevent gastric vulvulus Esophageal Cancer SCC Most common worldwide Upper/Middle third Alcohol Tobacco Nitrosamines Adenocarcinoma Most common in US Lower...

Abdominal Pain

Abdominal Pain Referred Pain MI → Left chest, Jaw, Left arm Gallbladder → Right shoulder, Scapula Pancreas → Back Pharynx → Ears Prostate → Tip of penis, Perineum Appendix → RLQ Esophagus → Substernal Pyelonephritis → CVA Nephrolithiasis → CVA, Perineum Cold food → Brain freeze Rapid temp change...

Postop Complications

Postop Chest Pain Postop Confusion Etiology Hypoxia PE Atelectasis Pneumonia Sepsis Presentation Confusion!! Diagnosis ABG CXR Blood culture Urine culture CBC Treatment ARDS Presentation Sever hypoxia Tachypnea Accessory ventilatory muscle use Hypercapnia No JVD Diagnosis CXR → Bilateral infiltrate No JVD → Rule out CHF...