Surgery 5th year, 3rd & 4th lectures (Dr. Ahmed Al-Azzawi)
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The lecture has been given on Oct. 14th & 21st, 2010 by Dr. Ahmed Al-Azzawi.
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Abdominal compartment syndrome[1]
This document discusses abdominal compartment syndrome (ACS), an underrecognized cause of acute kidney injury. It defines ACS as multiple organ dysfunction caused by elevated intra-abdominal pressure. The document outlines various causes of increased intra-abdominal pressure and the physiologic manifestations of ACS, which can impact the cardiac, pulmonary, gastrointestinal, renal and neurological systems. Left untreated, ACS can lead to multi-system organ failure and death. Early detection of increased intra-abdominal pressure and treatment, including decompressive laparotomy if needed, are important to prevent complications of ACS.
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A simplified description of ascitic fluid analysis. Aim of the presentation is to give a very clear understanding about the analysis of ascities.
Presentation will help the medical residents diagnose the cause of fluid accumulation in abdomen and thus will guide to adopt the appropriate pathway to solve the issue.
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This document provides an overview of the management of hypertensive disorders in pregnancy. It discusses the differences between gestational hypertension and chronic hypertension, how to assess proteinuria, prevention strategies, recommendations for various stages of mild to severe hypertension during pregnancy and postpartum, which antihypertensive medications to use and avoid, risk factors for preeclampsia, and conclusions about early diagnosis and treatment improving outcomes for both mother and baby. The conclusions recommend labetolol and methyldopa as first-line drugs, watching high risk women closely for preeclampsia, using urine protein to creatinine ratio for proteinuria screening, and aspirin as the only proven primary prevention method.
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Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are acute complications of diabetes that result from insufficient insulin levels. DKA is characterized by high blood glucose, low pH and bicarbonate levels, and ketones in the blood or urine. HHS involves extremely high blood glucose without significant ketosis or acidosis. Treatment for DKA involves rehydration, insulin administration, and correcting electrolyte imbalances. Complications can include hypokalemia, hypoglycemia, and in rare cases cerebral edema in children. Proper patient education aims to prevent DKA episodes.
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This document summarizes the surgical management of lumbar disc herniation. It outlines the absolute and relative indications for surgery, as well as the optimal timing. The available surgical interventions are listed, along with their common complications and results. Cauda equina syndrome is the absolute indication for surgery and requires immediate treatment. Relative indications include failure of conservative treatments and severe, intractable radicular pain. Open discectomy is considered the gold standard, while microdiscectomy has shorter recovery times. Patient selection influences surgical outcomes.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
The origins of surgery can be traced back many centuries, with practitioners using various materials and techniques for closing wounds. Ancient methods included using ants or thorns to close wounds. In more modern times, catgut made from sheep intestine was used. Post-World War II, sutures were developed with needles attached to reduce tissue trauma. Sutures are classified based on material and absorbability, and appropriate suture selection depends on factors like the tissue and wound characteristics.
Surgery 6th year, Tutorial (Dr. Ali A. Nabi)
The document discusses the anatomy and examination of the knee joint. It details the two knee joints - the patellofemoral and tibiofemoral joints. It describes the ligaments that provide stability to the tibiofemoral joint, including the anterior cruciate ligament and posterior cruciate ligament. The document outlines how to examine a patient's knee through obtaining a history, assessing symptoms, performing physical signs and tests of stability. Common tests mentioned include the Lachman test, McMurray's test and apprehension test. Imaging options like x-rays, MRI and arthrography are also summarized.
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
This document discusses hydrocephalus, including its definition, causes, classification, presentation, diagnosis and treatment. Some key points:
- Hydrocephalus is an abnormal enlargement of the ventricles due to excessive CSF accumulation from disturbances in flow, absorption or secretion.
- It can be obstructive, caused by blockages, or communicating, caused by issues outside the ventricles or with CSF absorption.
- Common causes include tumors, infections, bleeding and congenital abnormalities.
- Treatment involves surgically inserting shunts to drain CSF from the brain to the abdomen, or performing third ventriculostomies to create openings and bypass blockages.
Surgery 6th year, Tutorial (Dr. Khalid Shokor Mahmood)
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against mental illness and improve symptoms.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
Lower GI hemorrhage can originate from the colon or small bowel. Common causes include bleeding diverticulosis, colonic angiodysplasia, and neoplasms. Evaluation involves laboratory tests, colonoscopy, video capsule endoscopy, or angiography to locate the bleeding site. Treatment options depend on the cause but may include endoscopic therapies, angiographic embolization, or surgery.
Surgery 6th year, Tutorial (Dr. Bakhtyar Rasul)
Developmental dysplasia of the hip is a condition where the hip joint is unstable or partially dislocated. It affects 1-50 out of every 1000 live births, with 60% being detected by 1 week of age and 90% by 8 weeks. The document discusses the anatomy, aetiology, pathology, clinical features, imaging, and different treatment approaches depending on if the patient is under 6 months, 6 months to 6 years, or above 6 years of age.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
This document summarizes the management of upper GI hemorrhage. It outlines the steps to take which include obtaining a complete history and physical exam, performing laboratory tests, considering radiological scans, stabilizing the patient, identifying the source of bleeding through endoscopy, and various pharmacological and endoscopic interventions depending on the underlying cause of bleeding such as PPIs, octreotide, angiography, embolization, surgery, or TIPS procedure. Refractory cases may require repeat endoscopy, angiography, embolization or surgery.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
- Gastrointestinal hemorrhage is a common medical problem, accounting for 1-2% of hospital admissions. The most common causes are peptic ulcer disease (50%), esophageal varices (10-20%), and gastritis (10-25%).
- Symptoms depend on the location of bleeding in the GI tract. Upper GI bleeding causes vomiting blood (hematemesis) or black tarry stools (melena), while lower GI bleeding causes maroon or red blood in stool (hematochezia).
- Common etiologies include peptic ulcers, esophageal/gastric varices, gastritis, Mallory-Weiss tears, watermelon stomach, and Die
Surgery 6th year, Tutorial (Dr. AbdulWahid)
The document discusses different types of drains used in medical procedures including closed and open drains. Closed drains have lower infection rates but limit mobility while open drains are softer and more comfortable. Examples of closed drains include pigtail catheters and urinary catheters while open drains include Penrose and corrugated drains. Potential problems with all drains include tissue trauma, erosion, herniation, leaks, bacterial infection, and fluid/electrolyte loss.
Surgery 6th year, Tutorial (Dr. Ahmed Al-Azzawi)
The document discusses various artery emergencies including acute arterial occlusion, abdominal aortic aneurysm, and peripheral vascular injuries. Acute arterial occlusion occurs when blood flow to the leg is suddenly blocked, requiring immediate medical care to restore flow and prevent tissue death and gangrene. Symptoms include severe leg pain and skin changes. Abdominal aortic aneurysms are localized dilations of the abdominal aorta, often below renal arteries, and may cause abdominal or back pain. Peripheral vascular injuries from trauma can damage arteries and require rapid treatment to prevent limb loss.
Surgery 6th year, Tutorial (Dr. Sarwar Noori)
The document discusses different treatment options for renal and ureteric stones, including conservative management, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL), ureteroscopy (URS), and open surgery. For renal stones less than 2cm, ESWL is recommended, while PCNL may be used for larger stones or when ESWL fails. URS is recommended for ureteric stones, with an 85-90% success rate in achieving a stone-free state. Complications, prevention strategies, and dietary and medication advice are also summarized.
Surgery 6th year, Tutorial (Dr. AbdulWahid)
This document discusses fluid and electrolyte balance and management. It covers the composition of body fluids, mechanisms that regulate fluid homeostasis, and types of parenteral fluid therapy including crystalloids like saline solutions and dextrose solutions, as well as colloid solutions. It provides guidelines on fluid replacement and maintenance requirements, and examples of intravenous fluid orders.
Surgery 6th year, Tutorial (Dr. Bakhtyar Baram)
This document discusses various types of orthopedic infections including acute and subacute hematogenous osteomyelitis, chronic osteomyelitis, purulent infectious arthritis, soft tissue infections, and postoperative, posttraumatic, and postarthroplasty infections. It covers the incidence, diagnosis, and treatment of these conditions. Key factors that can influence infections include patient factors like general health, immunology, and alcohol/medicine use as well as surgical factors such as preparation, sterilization, and operating theater. Diagnosis involves clinical examination, laboratory tests, imaging like x-rays, ultrasound, CT, and MRI scans. Treatment depends on the type and severity of infection but generally involves antibiotics, biopsy or aspiration, surgery
Surgery 6th year, Tutorial (Dr. Aso Omar)
The kidneys can be injured by blunt or penetrating trauma, requiring timely medical evaluation. The kidneys are normally protected by back muscles but can be damaged by severe impacts or objects piercing the skin. Blunt trauma may cause bruising while penetrating injuries like gunshots can enter elsewhere and travel to the kidneys. Most kidney injuries are minor but evaluation with imaging tests like ultrasound or CT scans helps classify the injury and guide management, which may include rest, antibiotics, surgery, or nephrectomy in more severe cases.
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