Surgery EOP tips

Surgery will be pretty new to all semester 6 students, so don't be worried if you feel like you're totally lost at the start of the posting - it takes a bit of time of getting used to it.

Surgical problems are usually quite direct - if there is abdominal pain, there is most probably something wrong in the abdominal region. So naturally, your DD will not start from porphyria, Acute Gasteroentritis, or pseudomembranous colitis (all these are medical problems)

your diagnoses will be related to the surface anatomy.

there are some high-yield illnesses you should know very well, which are;

• appendicitis
• Hepatitis-related oesophagal varices
• Peptic Ulcer Disease
• gall bladder system diseases
• pancreatitis
• Colon Cancer
• Hernias
• skin infections (carbuncles, furuncles, cellulitis etc)

you won't see conditions which may be found in other departments, like fractures (for orthopedics), bed-sores (for rehab). - in the interest of your patient assessment while you're a medical student though.

Surgical problems are interesting because they often have interesting Physical findings. there are lots of things you can do to ellicit a sign from an appendicitis patient - for instance.
To make things more challenging, most of those commonly encountered surgical problems have certain criterias for diagnosis. If you want to become above the rest (which, I wasn't! haha), you may memorize those criterias and base your clerking upon that once you have the suspicion. (a good e.g. can be found here - Appendicitis Dx and preop RX )

You will be spending a little more time on finding out why the patient deserves to have the illness in the first place, how it could have been prevented, how the disease may progress, how the patient could be treated surgically (because in the end, surgeons like to talk about cutting)

try to diagnose patient in 5 dimentions - Aetiological, Anatomical, Pathological, Functional and Social.

e.g. patient has a Oesophagal varices rupture secondary to alcohol-induced Liver cirrhosis (Aetiology, Anatomy and pathology), which is causing him to have severe anemia (functional)  

Surgical posting is where you develop your physical examination skills. we learn how to examine patients without becoming the ultimate torture machine, and without being an awkward robot.