ASA classification
ASA I A normal healthy patient
ASA II A patient with mild systemic disease
ASA III A patient with severe systemic disease
ASA IV A patient with severe systemic disease that is a constant threat to life
ASA V A moribund patient who is not expected to survive without the operation
ASA VI A declared brain-dead patient whose organs are to be removed for donor purposes
the gold standard for confirming cerebrospinal fluid leakage
Beta-2 transferrin testing
The most common cause of large bowel obstruction is
malignancy
with the second most common being sigmoid volvulus
What’s the diagnosis and common lesion associated with this injury?
Dx: Anterior luxation of the shoulder
Lesion: Axilary nerve injury
Axillary nerve injury typically presents with
numbness over the lateral aspect of the upper arm in a ‘regimental badge’ distribution.
AAA Follow-up
- 25 - 29 mm: ultrasound every five years
- 30 - 39 mm: ultrasound every three years (appropriate in this case)
- 40 - 49 mm (men) or 40 – 44 mm (women): annual ultrasound
- ≥50 mm (men) or ≥45 mm (women): ultrasound every six months.
- ≥55 mm (men) or ≥50 mm (women): most surgeons would consider offering surgical repair;
note that the threshold for elective repair in women is lower due to higher rupture risk at smaller diameters.
Indications for surgical management of AAA are as follows:
- Size >55 mm
- Growth in size of >10 mm/year
- Symptomatic AAA
The cornerstone of initial management in acute pancreatitis.
Early fluid resuscitation
low-risk prostate cancers in patients with good life expectancy (≥10 years) management
Surgical intervention - Radical prostatectomy
Thyroid cancers usually appear on thyroid scintigraphy as:
a ‘cold nodule’ as they are often nonfunctioning / nonsecreting.
patient’s symptoms of knee pain after exertion or prolonged sitting, aggravation of pain during tonic contraction of quadriceps (ie, extending knee against resistance), and normal physical findings are consistent with the diagnosis of
patellofemoral pain syndrome (PPS).
An acute, painful knee joint in the absence of trauma should be assumed to be due to …
septic arthritis until proven otherwise
why should Colonoscopy be performed after an episode of acute complicated diverticulitis
after four to six weeks to exclude underlying colorectal cancer.
Brain tumor presenting with
- a short history of progressive neurological deficits and features of raised intracranial pressure.
- CT findings: irregular ring enhancement with central necrosis and significant mass effect.
- Occupational exposure to synthetic rubber manufacturing is a risk factor
Glioblastoma
The mechanism of injury—falling on an outstretched hand—and the location of tenderness just distal to the radial styloid at the base of the thumb are classic for
scaphoid injury.
first step in the management of osteoarthritis
Muscle strengthening via land based exercises
- Wrist drop
- Inability to extend fingers
- Sensory loss: dorsum of hand (first web space)
Radial nerve injury
For triple negative, or ER/PR/HER2 negative breast cancers as well as HER2 positive tumours, which neoadjuvant is recommended prior to surgical management?
chemotherapy
monoclonal antibody used for patients with HER2 positive breast cancer
Trastuzumab, or herceptin,
IF pain in the lateral aspect of the knee during running or biking + worse downhill or with longer strides + pain occurs when the fully flexed knee is extended and pressure is applied to the lateral femoral epicondyle at 30 degrees of flexion
Iliotibial band syndrome
The tenderness over the pubic tubercle, acute onset after sporting activity, and absence of a palpable hernia support this diagnosis
inguinal disruption (previously called sportsman’s hernia)
Splenic trauma classification: American Association for the Surgery of Trauma (AAST)
Splenic trauma with a haemodynamically unstable patient, MANAGEMENT
Surgical management is indicated (splenectomy).
All splenic trauma Grade IV and V, with a haemodynamically stable patient, MANAGEMENT
splenic artery embolisation (SAE)
