General Surgery

General Surgery — 30-Min Notes

ABC of trauma: Airway, Breathing, Circulation — primary survey.
Shock types: Hypovolemic → hemorrhage, Cardiogenic → heart failure, Septic → infection.
High-yield: ATLS protocol → rapid assessment, fluid resuscitation, control bleeding
Tip: FAST ultrasound detects free fluid in abdomen in trauma.
Fractures: Open vs closed; manage open fractures with antibiotics and tetanus prophylaxis.

Appendicitis: RLQ pain, tenderness at McBurney’s point, leukocytosis; appendectomy definitive.
Cholelithiasis: Gallstones → may cause biliary colic or cholecystitis; treat symptomatic cases surgically.
Hernias: Inguinal → direct vs indirect; Umbilical, Incisional; surgery indicated if symptomatic or complicated.
High-yield: Perforated peptic ulcer → sudden severe abdominal pain, free air under diaphragm
Tip: Pre-op optimization includes correcting dehydration, electrolytes, and coagulopathy.

Thyroid: Goiter → multinodular or diffuse; Hyperthyroidism → surgery if toxic or large obstructive goiter.
Parathyroid: Hyperparathyroidism → hypercalcemia; surgery indicated for symptomatic cases.
Breast: Fibroadenoma → benign; carcinoma → mass, skin changes, axillary nodes.
High-yield: Thyroid carcinoma → papillary most common, good prognosis
Tip: FNAC guides diagnosis for thyroid and breast lesions.

Liver: Hepatic abscess → fever, right upper quadrant pain; may require drainage.
Pancreas: Acute pancreatitis → epigastric pain radiating to back; Ranson criteria for severity.
Gallbladder: Acute cholecystitis → Murphy’s sign positive; laparoscopic cholecystectomy treatment of choice.
High-yield: Obstructive jaundice → assess for stones or malignancy; LFTs and imaging important
Tip: ERCP can be both diagnostic and therapeutic in biliary obstruction.

Aneurysms: Abdominal aortic aneurysm → pulsatile abdominal mass; risk of rupture if >5.5 cm.
Peripheral arterial disease: Claudication → relieved by rest; angioplasty or bypass for severe cases.
Varicose veins: Superficial venous incompetence; managed conservatively or surgically if symptomatic.
High-yield: Acute limb ischemia → 6 P’s: Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia
Tip: Anticoagulation immediately in arterial thrombosis; vascular surgery emergency.

Colorectal cancer: Adenocarcinoma most common; screening with colonoscopy over 50 yrs.
Gastric cancer: Adenocarcinoma; presents with weight loss, anemia, early satiety.
High-yield: Breast cancer: BRCA mutation, TNM staging guides surgery
Tip: Early detection significantly improves prognosis; surgery + chemo/radiotherapy standard treatment.
Skin tumors: Basal cell carcinoma → locally aggressive; squamous cell carcinoma → potential for metastasis.

Appendectomy, Cholecystectomy, Herniorrhaphy — basic procedures every dental surgeon should know.
Exploratory laparotomy — for acute abdomen with unclear etiology.
High-yield: Emergency surgery → perforation, obstruction, strangulated hernia, trauma
Tip: Pre-op assessment → vitals, comorbidities, anesthesia fitness, labs, imaging.
Post-op care → prevent infection, DVT prophylaxis, monitor vitals and bleeding.

ATLS → Airway, Breathing, Circulation; FAST for trauma assessment
Appendicitis → RLQ pain, McBurney’s point tenderness
Cholecystitis → RUQ pain, Murphy’s sign
Perforated ulcer → free air under diaphragm, emergency surgery
Thyroid carcinoma → papillary most common, good prognosis
Abdominal aortic aneurysm → risk of rupture >5.5 cm
Acute limb ischemia → 6 P’s: Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Poikilothermia
Colorectal cancer → adenocarcinoma, colonoscopy for screening
Emergency surgery indications → obstruction, perforation, strangulation, trauma

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