FISTULA IN ANO     usually associated with anorectal abscess; could indicate IBD  an inflammatory tract with internal os at ...

HEMORRHOIDS   Etiology   anal cushions, vascular and connective tissue complexes, become engorged forming hemorrhoids proposed ...

ACUTE CHOLANGITIS Mechanism: obstruction of common bile duct leading to biliary stasis, bacterial overgrowth, suppuratio...

Approach to the Critically Ill Surgical Patient ABC, I’M FINE   A - air way B -breathing C - circulation I - IV: two...

steps in physical exam 1) general observation: patient position (i.e. lying still vs. writhing) 2)vitals: postural changes, fe...

SPECIFIC "SIGNS" ON PHYSICAL EXAMINATION   Blumberg's sign (rebound tenderness): constant, held pressure with sudden ...

CHOLEDOCHOLITHIASIS stones in common bile duct   Signs and symptoms 50% asymptomatic tenderness in RUQ or epigastriu...

ACALCULOUS CHOLECYSTITIS   acute or chronic cholecystitis in the absence of stones usually diabetic, immunosuppressed or po...

  BILIARY COLIC (or CHRONIC CHOLECYSTITIS)   many patients with acute cholecystitis have a history of episodic biliary colic ...

    Pathogenesis   imbalance of cholesterol and its solubilizing agents, bile salts and lecithin concentrations if hepa...

Adjuvant Therapy – Chemotherapy Indications sub-groups of stage I at high risk of recurrence lymphatic invasi...

Pathology Non-invasive Ductal carcinoma in situ risk of development of infiltrating ductal carcinoma in same breast excisi...

Epidemiology   most common cancer in women (excluding skin) second leading cause of cancer mortality in women most...

Common causes of breast symptoms     FIBROCYSTIC DISEASE   benign breast condition consisting of fibrous and  cystic cha...

  ACUTE PANCREATITIS   (see Gastroenterology Notes )   usually no surgical management in uncomplicated acute pancreatitis  ...