Click here Today we covered some key areas in surgery for the acem exam. Mesenteric ischemia The 4 key patterns of presentation include embolic - AF or ventricular aneurysm related - 50% of all MI thrombosis low flow states venous thrombosis each of these have a specific risk factor profile which are distinct recognising aetiology, sensitive or specific findings on clinical assessment, and diagnosis on CTA is important, as well as severity grading or assessment of complications such as infarction and organ failure is key. Management options of laparotomy for bowel resection or embolectomy vs angiography for clot retrieval or local papaverine is considered Pancreatitis
diagnostic criteria - 2 of 3 - lipase Elevation, clinical features, imaging findings classification -oedematous vs necrotic severity assessment - based on organ failure prognostic scores : be ale to compare and contrast - BISAP - renal function, effusion, gcs, sirs, 60 yo ransons, apache, sirs, have some knowledge of imaging of the pancreas Toxic megacolon was covered in detail, reviewing the 2 common presentations from IBD or clostridium difficile. Imaging diagnosis of tvs colon > 6 cm and diagnostic criteria including systemic illness and anaemia, wcc elevation, sirs the treatment options varied with underlying cause associations of metabolic alkalosis, hypokalaemia, dysmotility agents Clostridial infecting and predictors or risk factors for clostridial such as antibiotic use, COPD, hospital admission were discussed in detail. Lastly we covered MCQ golden rules: read the question assess if you have the knowledge in an area, or not your gut feeling is only good if you have reviewed the area concerned always study the topic highlighted in the mcq know why an option is correct and why incorrect good resources for MCQ: de Alwis Emergency medicine mcq Dunn mcq's / Tintinalli mcq's emcee practice
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