Pocket Pimped: General Surgery

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Pocket Pimped: General Surgery

Pocket Pimped: General Surgery is a book of the 1,500 most commonly asked questions in general surger

18/02/2023

PRESIDENTS DAY SALE! 🇺🇸

25% off all Pocket Pimped & Pocket Passed books!

Orthopedic Surgery
General Surgery
Internal Medicine
Emergency Medicine
Obstetrics & Gynecology

Preparation is everything, get ready to absolutely crush your rotations and pimp questions with the secrets of Pocket Pimped. 🏆

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Sale ends midnight 02/21/23.

16/01/2023

👀 What's the diagnosis? ⬇️ Scroll down to check out some of the most common questions you'll get asked after seeing a patient with this condition on your general surgery rotation!

Small Bowel Obstruction (SBO)

❓What are the three most common causes of SBO?
✅Most common: Adhesions from prior surgery
✅Second: Malignant tumor
✅Third: Hernia

❓What are the most common symptoms of a SBO?
✅Colicky abdominal pain, nausea, vomiting, distention, inability to pass stool or flatus.

❓Why are patients with SBOs at risk for dehydration?
✅Water and electrolytes accumulate in the dilated small bowel resulting in third spacing, which results in intravascular volume loss and dehydration.

❓What metabolic abnormalities are expected with frequent vomiting secondary to a SBO?
✅Hypochloremic hypokalemic metabolic alkalosis - due to loss of hydrochloric acid from the stomach. Lost H+ is replaced via the gastric H/K pump, resulting in hypokalemia.

❓What type of X-ray should be ordered to evaluate a SBO and what findings are consistent with obstruction?
✅Upright and supine abdominal x-rays. Air fluid levels on upright radiographs.

How would you have done if asked these questions on rotation?

💪 These are just some of the 1500 questions in "Pocket Pimped: General Surgery", a book designed to help you succeed on rotations and know the exact questions and answers you'll get asked!

Use the link in our profile now for 15% off. Applied automatically at checkout. 📚

06/01/2023

Let's talk FLUIDS!

What are some examples of crystalloid solutions? Colloid solutions?
Crystalloids - Normal saline (NS), Lactated Ringers (LR), Plasmalyte
Colloids - Albumin, Blood products (ie platelets, cryoprecipitate, RBCs, etc)

What are the mEq of Na and Cl in each of the 3 crystalloids listed above?
NS - Na: 154, Cl: 154
LR - Na: 130, Cl: 109
Plasmalyte - Na: 140, Cl: 98

What are the respective pHs of NS, LR and plasmalyte?
NS: 5.5
LR: 6.5
Plasmalyte: 7.4 (most physiologic)

What is the difference between resuscitative fluids and maintenance fluids?
Resuscitative fluids are used for patients who are intravascularly depleted from a biologic or metabolic process
Maintenance fluids are used in patients who are intravascularly replete, but are unable to take in oral fluids to maintain euvolemic status

Now that you have the basics down, let's kick it up a notch with more questions straight from Pocket Pimped: General Surgery....

What physiologic derangement occurs with administration of too much NS?

What is typically used for maintenance fluid in surgical patients? Why?

30/10/2022

Happy Halloween

21/10/2022

Cases involving axillary dissection can be very intimidating to study for, but we got you covered. 💪

Here are some of our favorite questions, straight out of "Pocket Pimped: General Surgery" we KNOW you'll be asked! 📖

#264. What are the 3 anatomic levels of axillary lymph nodes in relation to the pectoralis minor muscle?
▶️ Level I: lateral
▶️ Level II: posterior
▶️ Level III: medial (easiest to see when the pec. minor muscle is divided)

#265. What is a synonym for the interpectoral lymph nodes located between the pec. minor and major muscles?
▶️ Rotter’s nodes

268. What are the borders of the axilla?
▶️ Superior: axillary vein
▶️ Anterior: pectoralis muscle
▶️ Medial: serratus anterior muscle
▶️ Posterolaterally: latissimus dorsi

269. What 3 major motor nerves are commonly encountered during an axillary dissection? What do they innervate?
1️⃣ Long thoracic nerve: serratus anterior muscle
2️⃣ Thoracodorsal nerve: latissimus dorsi muscle
3️⃣ Medial pectoral nerve: pectoralis minor and major (partial) muscles

270. What is the primary sensory nerve encountered during an axillary dissection?
▶️ Intercostobrachial nerve

271. What pathology results from injury to the long thoracic nerve?
▶️ Winged scapula

16/09/2022

🗣Airway management is a crucial part of surgical training and is covered in the trauma section of "Pocket Pimped: General Surgery", a pocket sized book of all the questions/answers you WILL be asked on rotations! Here are just a few questions from that section 📖

#1103. What is a definitive airway?
▶️Cuffed endotracheal tube below the vocal cords - orotracheal tubes, nasotracheal tubes, surgical
airway (i.e. cricothyroidotomy or tracheostomy)

#1104. What GCS score is an indication to intubate?
▶️< 8 (Remember: less than eight, intubate)

#1105. What are the superior and inferior surface landmarks for cricothyroidotomy?
▶️Superior - Thyroid cartilage
▶️Inferior - Cricoid cartilage

#1106. Should the incision be made vertically or horizontally, why?
▶️Vertically - avoids anterior jugular veins

#1107. When should a cricothyroidotomy be converted to a tracheostomy?
▶️Within 48 hours

It's never too late to start crushing your rotations and exams! 💯

13/09/2022

Some humor for Monday!

07/08/2022

One topic that lends itself to ALOT of questions is hernia surgery. Here, we ask only a few questions related to this topic (for a full list of must know questions be sure to check out your Pocket Pimped: General Surgery book).

1️⃣What are the options for repair of an inguinal hernia?
➡️Open vs. laparoscopic
➡️Open repair options:
⏩⏩Tension free (mesh): Lichtenstein plug and patch
⏩⏩Primary tissue repair: Bassini, Cooper’s ligament repair, McVay repair, Shouldice
2️⃣What is a Bassini repair? Shouldice repair?
➡️Bassini: suture repair of an inguinal hernia where the transverse abdominus aponeurosis is sutured to the inguinal ligament
➡️Shouldice: suture repair of an inguinal hernia where the hernia is repaired in multiple layers

3️⃣What is a McVay repair? When is this repair utilized?
➡️Primary tissue repair where Cooper’s ligament is sutured to the transverse abdominus aponeurosis
➡️Utilized in the repair of a femoral hernia

4️⃣What is the difference between a TAPP and a TEP hernia repair?
➡️TAPP: trans-abdominal, pre-peritoneal approach
➡️TEP: totally extra-peritoneal approach
➡️Main difference is the way in which the pre-peritoneal space is accessed
⏩⏩TAPP: pre-peritoneal space is accessed laparoscopically by opening from inside the abdominal cavity
⏩⏩TEP: abdominal cavity is never entered; a balloon dissector is used to create a space within the pre-peritoneal cavity

5️⃣What are the indications for mesh placement in repairing an umbilical hernia?
➡️

04/08/2022

Let’s review some general knowledge of circulation! Here are some must know facts related to this topic

1️⃣What is Beck’s triad (associated with cardiac tamponade)?
☑️Hypotension, muffled heart sounds, JVD

2️⃣What is Kussmaul’s sign?
☑️JVD with inspiration

3️⃣What is pulsus paradoxus?
☑️Decrease in SBP >10 mmHg during inspiration

4️⃣What minimum systolic BP is required to have a palpable radial pulse? Carotid/femoral?
☑️Radial: 80 mmHg
☑️Carotid/femoral: 60 mmHg

5️⃣What are the landmarks for femoral central venous access?
☑️1 cm below the inguinal ligament
☑️Medial to the femoral artery

6️⃣What is the orientation from lateral to medial of the femoral artery, vein, nerve and lymphatics?
☑️Nerve ➡️ Artery ➡️ Vein ➡️ Lymphatics
‼️Remember: “NAVeL”

7️⃣What is Poiseuille’s law and why is this important for vascular access in trauma patients?
☑️Flow rate is proportional to (radius)4 of the cannula and inversely proportional to cannula length
☑️Short, large-caliber catheters are preferred for rapid infusion

8️⃣Where are acceptable intraosseous access sites?
☑️Proximal humerus, distal femur, proximal tibia (most common), distal tibia

29/07/2022

It is our biggest sale ever on the Pocket Pimped Series. Don’t miss out on this huge discount. Sale ends 8/7/22

13/07/2022

Let’s review something’s about the appendix! While on your rotation, the appendix is one of the most commonly asked anatomic structures. Here are some must know appendix general anatomy questions you may be asked!

1️⃣What is the function of the appendix?
✅Immunologic organ, secretes immunoglobulins (IgA)

2️⃣Is the appendix foregut, midgut, or hindgut?
✅Midgut

3️⃣How is the appendix located? What is the most common location? Other locations?
✅Follow the convergence of the taeniae to the tip of the cecum
✅Most common location: retrocecal
✅Other locations: (counter clock-wise) subcecal, pelvic, pre-ileal, post-ileal

4️⃣What is the blood supply to the appendix?
✅Appendiceal artery

5️⃣Name the blood supply to the appendix starting at the aorta.
✅SMA ➡️ ileocolic artery ➡️ appendiceal artery

6️⃣What is the normal length of the appendix? Diameter?
✅Length: ~9 cm
✅Diameter:

11/07/2022

Knowledge bombs 💣

Make sure you’re ready for your General Surgery rotation!

📖 PocketPimped.com

Now available as flashcards for your mobile device as well! 📱

08/07/2022

Test your knowledge!

Are you ready for rotations?

📕 “Pocket Pimped: General Surgery” is a collection of the 1500 questions you’ll get asked on rotations. No fluff, just the questions you’ll be asked and the answers they want to hear.

Study smarter! 💡

04/07/2022

Happy Independence Day!

30/06/2022

🚨 F.A.S.T Exam 🚨

Focused Assessment with Sonography for Trauma (FAST) is a rapid bedside test used identify free fluid in trauma patients.

The typical FAST exam consists of 4 views.
1️⃣ RUQ- Perihepatic and Hepatorenal spaces
2️⃣ LUQ- Perisplenic and Splenorenal spaces
3️⃣ Pelvis and Pouch of Douglas
4️⃣ Pericardium

You just know normal anatomy and physiology before you can identify abnormal.
⏩ SWIPE to check out some normal images from a FAST exam. Make sure you know what anatomic regions visible in each portion of the exam!

🗓 July 1st and the start of a new academic year is almost here - make sure you’re prepared!

“Pocket Pimped: General Surgery” for all of the most know questions and answers for your rotations. No fluff, just the need to know info to help you stand out! 🏆

📎 POCKETPIMPED.COM

20/06/2022

July is almost here, are you READY? 📖

19/06/2022

Happy Father’s Day to all those you are fathers during medical school, residency, fellowship, and/or while practicing. It is a tough journey by itself and those who are fathers during these times are further tested (but also greatly rewarded)!

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