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الخميس، 22 ديسمبر، 2011

كلينكال جراحة


فيديوهات شرح للعملى على اليوتيوب ..

Full Swelling surgical Examination 
http://www.youtube.com/watch?v=j7h7bvYlzd4

Examination Of An Intra-abdominal Lump 
http://www.youtube.com/watch?v=fDzP9vLxU40&feature=related

Breast Lump.surgical examination 
http://www.youtube.com/watch?v=uxFG2q0d4zc&feature=related

Examination Of a Thyroid Swelling
http://www.youtube.com/watch?v=rtpfYZzyhq0&feature=related

Ulcer examination
http://www.youtube.com/watch?v=wpOBQjAnstU&feature=related

Examination of Scrotal Swelling
http://www.youtube.com/watch?v=0oMLtJR7VXI&feature=results_main&playnext=1&list=PL42E84F85C905B3DC

Examination of Peripheral Vascular Disease
http://www.youtube.com/watch?v=PA8MQOosZ4A

Examination of Varicose Veins
http://www.youtube.com/watch?v=gZK9YBmprCQ

و دا ازاى تكتب شيت الجراحه مشروح بكذا طريقه بالعربى و بالانجليزى .. فيه مختصر و فيه بالتفصيل فيه بالالون و فيه من غير الوان .. علشان محدش يبقى نفسه فى حاجه :)

http://www.mediafire.com/?vh4sl12hl9w77n3





 Oral Questions of GENERAL SURGERY

((((( دى معظم الأسئلة اللى اتسألناها فى امتحان الراوند ... مجمعة بواسطة د.هدى ))))))
==============================================================
⊱ Dr. GAMAL⊰
**************
Q1. DD between 1ry & 2ry hydrocele ?
Q2. DD between submandibular dlands & lymph nodes ?
Q3. How to detect 2ry hydrocele ?
- By ” pinching test “ idea -> separate parietal and visceral
Q4. DD between ranula & dermoid cyst?
˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•
⊱ Dr. RAGAB ⊰
**************
# Solitary toxic thyroid nodule #
Q1. What’s the diagnostic test & it’s idea ? -> vermer test & T3 depression
Q2. What’s the ttt ? -> Surgical lobectomy + isthmusectomy
. why ? -> autonomus
. why we remove isthmus ? -> same embryological origin

# Thyroglossal fistula #
Q1. What’s pathogenesis , name of operation done , it’s idea ?
Q2. What’s congenital anomalies from false fusion of branchial arches ? -> branchial cyst

لا إلـًّﮧ إلا اللـًّﮧ مـכـمد رسـول اللـًّﮧ ... لا إلـًّﮧ إلا اللـًّﮧ مـכـمد رسـول اللـًّﮧ
# Varicocele #
Q1. Why left varicocele is more common ?
- أهم حاجه عايزها as left testis is more oblong and lower in position
Q2. What’s the most preferred operation & it’s idea ?
- Palomo & retro peritoneal approach for shifting venous blood to vesical veins
˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•
⊱ DR. HAMDY ⊰
****************
Q1. What’s internal ring test ?
Q2. Complications of nodular goiter ?
Q3. Ttt of Simple nodular goiter ?
Q4. What do you know about lipoma & it’s consistency ?
˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•
⊱ DR. EMAD ⊰
**************
Q1. Definition of hernia , external abdominal hernia ?
Q2. What’s content of hernia ?
Q3. Why reduction of omentocele is easy at 1st then difficult and the reverse with enterocele ?
Q4. DD of solitary thyroid nodule & how to differentiate between them by investigation ?
Q5. How to take biopsy ?
- from wall
˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•
⊱ DR. ASHRAF WAGDY ⊰
**********************
Q1. Definition of hernia ?
Q2. What’s external abdominal hernia & abdominal hernia ?
Q3. What’s complications of hernia ?
Q4. CASE … boy & girl 3 years old with inguinal hernia you will do surgery to one of them only … WHO & WHY ?
- Boy bcoz complication more serous
˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•˙•٠•
⊱ DR. AHMED 3TYA ⊰
********************
# Thyroid #
Q1. How to diagnose it clinically ?
Q2. Other swelling move up and down with deglutination & why move ?
Q3. etiology of thyroglossal cyat & clinical diagnosis ?
Q4. Other swellings move with tongue protrusion ?
Q5. What’s pathological types of thyroid ?
- simple & toxic & malig & infl & autoimmune
Q6. DD bet. 1ry & 2ry toxic goiter ?
Q7. Why CVS manifestation r more common with 2ry toxic goiter ?
- dt old age
# Breast #
Q1. Skin manifestations of cancer breast ?
Q2. What’s possible nipple discharge ?
Q3. DD bet. Paget’s disease and eczema ?
Q4. What’s fibroadenosis ?

‎(((((( دى تجميعة لأسئلة د. رجب اللى قالها فى محاضراته باجابتها ... مجمعة بواسطة د.مروة ))))))
==========================================================================
Q1. Shifting tenderness ?
- In acute non specific mesenteric lymphadenitis -> when pt. move the site of pain changed

Q2. Rare causes of toxic goiter ? سؤال د. رجب و د. ناصر
1- Thyrotoxicosis factitia
2- Jod-besedow throtoxicosis
3- Hashitoxicosis (early)
4- Neonatal thryrotoxicosis
5- Functioning follicular carcinoma
6- Stroma ovarii
7- T3 throtoxicosis

Q3. Enumerate types of follicular adenoma ?
1- Embryonal adenoma
2- Fetal adenoma
3- Simple adenoma
4- Macrofollicular adenoma
5- Hurthel cell adenoma

Q4. Types of conistipation ?
1- Absolute conistipation , ----- , -------
2- Glandular conistipation دى اللى الدكتور عايزها
by lugal’s iodine -> immediate stop release of thyroxine
سبـــــــــحان الله وبحمــــــدة ,,, سبــــــــــــحان الله العظيــــــــــم
Q5. Prognosis of encephaloid carcinoma of breast cancer is gOOd , why ?
- Dt lymphocytic infiltration indicate good immunity

Q6. Worest breast cancer ?
- Lactational ( mastitis ) carcinomatosa dt rapid proliferation

Q7. Character of lobular carcinoma of breast ?
- Mirror image ( multi focal & multi centric )

Q8. Types of TNM staging ?
1- Clinical staging -> by clinical examination
2- Operative -> can‘t palpated clinically
3- Histopathological TNM -> enlarged LN without metastasis

Q9. Clinical clombia classification of brest cancer ? سؤال د. رجب و د. ناصر
A- 1) Noskin edema , 2) no nodules , 3) no ulcer , 4) not fix to chest wall , 5) no enlarged LN
B- 1) , 2) , 3) , 4) -> NO , 5) Enlarged LN ( mobile & < 2.5 cm )
C- One of 5 grave breast signs OR enlarged LN ( fixed & > 2.5 cm )
D- Two or more of grave breast signs OR upper limb lymphedema OR cancer encurisae OR distant metastasis

Q10. French staging ?
- Acc. to Biological Virulence (ability of cells for invasion & proliferationlocally or distant metastasis ) of malignant cells

Q11. Reigemen of chemotherapy in ttt of lymphoma ?
HL -> M=mastine , O=onchoveine , P=predinsolone , P= procarbazine
NHL -> C=cyclophosphamide , V=vincristine , P=prednisolone

Q12. Ileo-femoral vein thrombosis ?
1- Phlegmasia alba dollens -> swollen painfull white limb
2- Phlegmasia cerulae dollens -> swollen painful bluish limb

Q13. 1ry lymphedema (cong. ) ?
1- Lymphedema conginita -> aplasia of lymphatics , manifest since birth
2- Lymphedema pre-cox -> hypoplasia < at puberty
3- Lymphedema tarda -> distal hyperplasia + proximal hypoplasia < manifest at age of 35y

Q14. Technique of lymphangiography (now obsolete) ?
- Inject patent blue dye in 1st web of Lower limb then canulation of obvious lymphatics & inject lipidol slowly ( 1ml / 10 min.) -> X-Ray show ( a / hypo / hyperplasia )
- Dye found in LN after 24h & last for 1y , SO used in follow up of lymphoma

Q15. Cattell’s operation ?
- 5 layers repair


((((( دى أسئلة شفوى قالهالنا د. حسام فى مراجعة الراوند ))))
===================================
# Breast #
Q1. Causes of nipple retraction ??
- cong & acq.
Q2. Abnormal nipple discharge ? ((( N.B >>> normal : MILK with LACTATION )))
Q3. DD of breast mass ??
Q4. DD of breast fistula ? -> milk fistula & T.B sinus & actinomycosis
Q5. Risk factor of breast canc. ??
Q6- Pre-malignant breast canc. ??
Q7. Screening tests for breast cancer ??
1- Breast self examination “start at 20y & post menstrual at 1st week after it “
2- Physician examination “annual”
3- Mammography “ > 40y “
Q8. TRIPLE test & what’s meaning of specificity and sensitivity ? سؤال د. أبو بكر
1- Clinical examination
2- Mammography “ sensitivity = 60 % after age of 35y & accuracy = 90% with expert hand “
3- Biopsy “ fine needle “ sensitivity = 90% “
- Specificity = TN ”true –ve” / TN + FP ”false +ve”
- Sensitivity = TP “ true +ve “ / TP + FN “false –ve “

# hernia #
Q1. Other swellings give expansile impulse with cough ?
“ any intra-cavitary connection “

Q2. Types of hernia NOT give impulse with cough ?
1- Fatty hernia of linea alba
2- Strangulated
3- Long standing omentocele with adhesions
4- Obstructive “weak”
Q3. Anatomical sites ? -> common & rare
Q4. Why groin is common site of herniation ?
1- Ms. are apenonerotic
2- Presence of opening
3- Passage of spermatic cord
4- Presence of reminant of fetal life
Q5. Residule hernia after reduction ?
1- Sliding hernia
2- Pantallon hernia
3- Swellings ass. With hernia : hydrocele of hernia sac & lipoma of cord
Q6 types of irreducability ?
1- True : with sac
2- False : fatty hernia “ no sac “
3- Partial : para umbilical , sliding


Ʒ•*´¨`*• DR. GAMAL REVISION •*´¨`*•Ƹ̶͍͎͈̐̑Ӝ̶͍͎͈͍͎͈̐̑̐̑Ʒ

•••••••••••••••••••••••••••••••••••••••••••••••

1>>> SWELLING ………p 11
- How to diff. bet. Cystic & solid mass??

”*°•.˜”*°•.•°*”˜.•° *”

2>>> ULCERS
- How to diff. bet. Rodent & epithelioma ?? …. P 28 (( COMPLETE ))
- How to differentiate bet. Ranula & sublingual ?? … 41 (( COMPLETE ))

”*°•.˜”*°•.•°*”˜.•° *”
3>>> How to diff. Bet. Submand. Lymph node & gland swelling ?? …. 46

”*°•.˜”*°•.•°*”˜.•° *”

4>>> thyroidd gland …. P 50
- Diff . bet. 1ry & 2ry toxic goiter ?? (( oral dr.gamal ))
- Malignant & Toxic manifestations ??

”*°•.˜”*°•.•°*”˜.•° *”

5>>> lymphadenopathy …. P 64
- Causes of lymphadenopathy ?? VIIIIIIIIIIIp
- Anatomical site = groups
- clinical staging of hodgkin’s lymphoma

”*°•.˜”*°•.•°*”˜.•° *”

6>>> Breast … p 87
- Skon manifestation of breast cancer ?? VIIIIIIIIIIp
- DD of chronic breast masses & diff. bet. Them by shape and surface ??
- How to palpate a breast mass ?? (( Complete ))

”*°•.˜”*°•.•°*”˜.•° *”

-7>>> abdominal examination ….. p 110
- How to know by inspection that patient has increase intra abdominal pr. ??
ANSWER ::: 3,4,8 items of inspection , umbilicus is flat
- Diff. bet. Physiological & ptosed & shrunken liver ??
- Methods of spleen palpation ??
- DD between splenic swelling & lt renal swelling ?? VIIIIIIIP
- How to examine ascites ??

”*°•.˜”*°•.•°*”˜.•° *”

8>>> jaundice …. P 154
- Types & causes of jaundice & abdominal examination to diff. bet. Them ?? VIIIP

”*°•.˜”*°•.•°*”˜.•° *”

9>>> Hernia …. P 171
- Diff. bet. Inguinal & femoral ??
- Diff. bet. Direct & indirect Inguinal h . ?? VIIIIIIIIIIP
- Diff. bet. Complete & incomplete oblique hernia ??
- Content oh hernia ??

”*°•.˜”*°•.•°*”˜.•° *”

10>>> scrotal swelling ….p 178
- Diff. bet. 1ry & 2ry hydrocele ?? (( oral dr.gamal ))
- Diff. bet. 1ry & 2ry varicocele ?? (( oral dr. gamal ))
- Scrotal- neck test ?? VIIIIIIIIIIIP

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