Surgery videos & books

2023-05-19 13:55:04 Correct Answer - A
Answer- A. Tension Pneumothorax

Tension pneumothorax air become trapped in pleural space under pressure.
It develop one way valve air leak from either from chest wall or lung.

Causes are
.Penetrating chest trauma
.blunt chest trauma
. iatrogenic lung puncture(ie due to subclavian Venepuncture)
.postive mechanical ventilation pressure

Clinical
.dyspnea,tachypnea , hypotension, diaphoresis, distended neck vein.

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2023-05-14 10:23:01 Correct Answer - D
Answer-D
Pneumatocele formation occurs as a sequela to acute pneumonia,
commonly caused by Staphylococcus aureus. However,
pneumatocele formation also occurs with other agents, including
Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli, group A streptococci, Serratia marcescens, Klebsiella
pneumonia, adenovirus, and tuberculosis.


Noninfectious etiologies include hydrocarbon ingestion, trauma, and
positive pressure ventilation.
In premature infants with

respiratory distress syndrome,
pneumatoceles result mostly from ventilator-induced lung injury.

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2023-05-10 06:28:01 Correct Answer - A
Ans: A. Partial nephrectomy
Partial nephrectomy is now being used as primary surgical therapy
for patients with a tumor less than 4 cm in size. Earlier Radical
nephrectomy was the treatment of choice for tumors of any size.
Classic radical nephrectomy consists of removal of the kidney,
perirenal fat, adrenal gland, and regional lymph nodes. Most stage I
and stage II tumors.
Partial nephrectomy- is indicated for patients with a T1 tumor
(according to the UICC TNM staging system) and a normal
contralateral kidney.
Intervention should be considered for growth to >3-4cm or by
>O.5cm per year.
Stage T1aN0M0
Partial nephrectomy recommended. This can be done via
open/laparoscopic/robotic procedures
Stage T1bN0M0
PN (open/laparoscopic/robotic) in cases where technically feasible
Laparoscopic RN should be offered if a PN is not feasible
Open RN if laparoscopic surgery is not possible.
Stage T2N0M0
RN – open/laparoscopic/robotic
PN – open/laparoscopic/robotic
Stage T3
RN – open, laparoscopic or robotic-assisted
Resection of vascular thrombosis when applicable (usually open)
Resection of all gross disease including hilar or retroperitoneal
extension
PN may be attempted in highly selected cases by experienced
surgeons
Ref- Bailey and Love, Short practice of surgery, 27th edition
published in 2018 Pg 1420
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2023-05-04 22:50:01 Correct Answer - C
Answer- C. Proximal cholangiocarcinoma
ERCP is not technically possible in proximal biliary obstructions.
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2023-04-30 17:05:01 Correct Answer - B
Answer- B. Endoscopic dilation
The symptom & sign complex indicates diagnosis of Achalasia.
One of the treatment modalities for achalasia cardia is endoscopic
dilation.
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2023-04-26 09:35:04 Correct Answer - C
Answer- C. Silk
Reaction to catgut depends on the stage of absorption and is mainly
histocytic in type. Nonabsorbable sutures are encapsulated by a rim
of connective tissue, while near the suture histocytes, giant cells and
lymphocytes are found. This is most marked with silk and cotton,
less so with Dacron, and least with nylon and wire.
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2022-06-22 18:01:37 63) During initial exploration in a patient scheduled to undergo a right hemicolectomy for colon cancer, a deep 4-cm liver mass is seen in the right lobe of the liver. The left lobe appears to be normal. Intraoperative biopsy of the lesion is positive for… Open / Comment

2022-06-22 18:00:26 63) During initial exploration in a patient scheduled to undergo a right hemicolectomy for colon cancer, a deep 4-cm liver mass is seen in the right lobe of the liver. The left lobe appears to be normal. Intraoperative biopsy of the lesion is positive for metastatic colon cancer. The best management of this patient includes which of the following? Open / Comment

2022-06-17 11:48:01 Anal carcinoma can arise from several epithelial cell types in the anal canal including squamous, basaloid, cloacogenic, and mucoepidermoid. For early, superficial lesions less than 2 cm, an attempt can be made to excise the lesion completely with negative margins. Otherwise, the standard of care is a multimodality chemoradiation protocol, which classically includes mitomycin C and 5-FU in combination with external beam radiation therapy to the tumor and the pelvic and inguinal lymph nodes. The long-term survival rate after chemoradiation alone compares favorably with radical surgery. Abdominal perineal resection is reserved for persistent or recurrent disease. Low anterior resection refers to resection of the upper and middle rectum and plays no role in the treatment of anal cancer. Inguinal lymph node dissection is not indicated. Any clinically suspicious node should be biopsied, and if positive, treated with radiation. Thus, even a small anal cancer with a positive lymph node should be treated with chemotherapy instead of surgery. Open / Comment

2022-06-16 11:47:35 62) A 46-year-old female presents to your office with rectal bleeding, itching, and irritation. On examination, a 3-cm ulcerating lesion is seen in the anal canal. Biopsy of the lesion reveals squamous cell carcinoma (SCC). Which of the following is the most… Open / Comment