Fistulas that not heal due to

 FRIENDS

Foreign bodies
Radiation
Infection/Inflammation
Epithelialization

Neoplasms
Distal obstruction
Short fistulas

Hyperkalaemia causes

7 A‘s

• Artifact
• Aldosterone antagonist
• Addison’s disease
• Acidosis
• ACE inhibitors
• Angiotensin receptor blocker
• Anti-inflammatory

Treatment (if >7mmol/L) is 10mL of 10% calcium gluconate IV over 1 minute; to stabilise the action potential of the cell membrane

Plain X - Ray Abdomen in Gall Bladder Diseases

An easy was to remember findings is - 
1. Gas 
2. Opacity 
3. Gas in Opacity 

1. Gas - 
- Outside Gall Bladder (Perforation of Gall Bladder) 
- In Wall of Gall Bladder (Emphysematous Cholecystitis) 
- Within Gallbladder lumen (also Known as Pneumobilia) 
(seen in Cholecystenteric fistula, Post ERCP) 

2. Opacity - 
- Outside Gall Bladder (Gallstone ileus) 
- In Wall of Gall bladder (Calcified Gallbladder) 
- In lumen (Limey bile, Gall Stones, Calcification in Tumor) 

3. Gas in Opacity - Mercedez Benz Sign / Seagull's Sign 

Sarcomas in which Lymphatic Metastasis is seen -

click here
MORE SURGERY MNEMONICS
 RACE For MS
 R: Rhabdomyosarcoma
 A: Angiosarcoma
 C: Clear cell sarcoma
 E: Epithelial cell sarcoma 
For: Fibrosarcoma 

M: Malignant fibrous histiocytoma
 S: Synovial cell sarcoma 

Diverticulitis complications

Please Fix His Arse SOon!

• Perforation (leading to peritonitis)
• Fistulae (colovaginal, colovesicle)
• Haemorrhage (large haemorrhage)
• Abscess (swinging fever)
• Strictures / Obstruction (large bowel)

MORE SURGERY MNEMONICS

Lower GI bleed causes

MORE SURGERY MNEMONICS

H-DRAIN

• Haemorrhoids
• Diverticular disease
• Radiation colitis
• Angiodysplasia
• Infection / Inflammatory Bowel Disease / Ischaemia
• Neoplasm (cancer)

CHAND

• Colitis (radiation, ischaemia, infection, IBD (UC>CD)
• Haemorrhoids/fissures
• Angiodysplasia
• Neoplastic
• Diverticular disease

Upper GI endoscopy indications

How Gastroenterology Doctors Visualise Inside The Duodenum

• Haematemesis
• Gastric biopsy (?cancer)
• Dyspepsia
• Vomiting, persistent
• Iron-deficiency anaemia
• Therapeutic e.g. banding, sclerotherapy, stent, laser therapy
• Duodenal biopsy

Ulcerative colitis treatment options

SAACS

• Steroids – oral prednisolone or IV hydrocortisone if severe
• 5-Aminosalicyclic acid (5-ASA) e.g. mesalazine, sulfasalazine
• Azathioprine (immunosuppressant)
• Cyclosporin (immunosuppressant)
• Surgery if perforation, cancer or poor response to medical therapy

Ulcerative colitis (UC) complications

How To Perform Gi Colonoscopy

• Haemorrhage
• Toxic megacolon
• Perforation / Pseudopolyps
• Gallstones / Gangrene
• Colorectal carcinoma (if extensive and lasting >10 years)

Ulcerative colitis (UC) features

ULCERS IN ABDomen

• Ulcers (mucosal and submucosal)
• Large intestine involved (rectum always involved)
• Clubbing of fingers
• Extra-intestinal manifestations (e.g. Erythema nodosum)
• Remnants of old ulcers (pseudopolyps)
• Stools bloody

• Inflamed, red granular mucosa/submucosa
• Neutrophil invasion

• Abscesses in crypts
• Biochemical markers of inflammation e.g. ESR raised
• Diarrhoea (esp. in pancolitis)

Jaundice causes

Medical causes

Medical Doctors Aren’t Very Happy

• Malignancy -  lymphoma, hepatocellular carcinoma
• Drugs – oral contraceptive pill, IVDA, overdose
• Alcohol – liver disease, cirrhosis, acute alcoholic hepatitis
• Viruses – hepatitis A, B, C, EBV, CMV
• Haematological – haemolytic anaemia

Surgical causes

Surgeons ARe Not Much better

• Stones – painful jaundice
• Antibiotics/Anaesthetic effect
• Reabsorption of haematoma
• Nodal obstruction – painful or painless
• Malignancy of pancreatic head

Aneurysm typical causes

ATTIC

• Atheroma
• Trauma
• Takayasu’s aortitis (inflammation)
• Infection e.g. mycotic aneurysm in endocarditis, syphilis
• Connective tissue disorders e.g. Marfan’s syndrome, Ehlers-Danlos

Salter-Harris clafficiation of paediatric fractures

SALTR

• Slipped / Straight across
• Above
• Lower
• Through
• Rammed (crushed)

Chronic pancreatitis causes

PACE

• Pancreas divisum (congenital)
• Autoimmune
• Cystic fibrosis
• Ethanol, chronic abuse

Acute pancreatitis complications

Early - GRASS

• Glucose elevated
• Renal failure
• ARDS
• Sepsis
• Shock

Late – NAP

• Necrosis of pancreas
• Abscess
• Pseudocyst

Describing an ulcer

BBEDDS

• Basics – site, size, shape
• Base – colour (red, pink, white, black)
• Edge:
• Flat, sloping (venous)
• Punched-out (arterial/neuropathic); arterial = pain, neuropathic = no pain
• Undermined (pressure sores)
• Rolled edge (basal cell carcinoma)
• Everted edge (squamous cell carcinoma)
• Depth – measure height (mm)
• Discharge – serous (clear), blood, purulent
• Surroundings – skin changes, colour, scars

Lump examination

She Cuts The Fish PERfectly!

• Site, Size, Surface (skin)
• Colour, Contour (border), Consistency (firm/soft)
• Temperature, Tenderness, Trans-illuminable
• Fluctuance (fluid-filled), Fixity
• Pulsatile (aneurysm)
• Expansile
• Reducible (hernia)

Basic Signs & Symptoms

Chills & Rigors
 CAMP
Cholangitis, Abscess, Malaria / Meningitis, Pylonephritis / Pneumonia

Itch, Non-dermatological causes of
 DULL JAM
DM, Uraemia, Lymphoma, Leukaemia
Jaundice, Anaemia, Myxoedema

Non-pitting lower limb oedema
 MI CHAM
Milroys, infection (filariasis), Congenital, Hypothyroid, Allergy, Malignancy

Shock
 HEN SCAM
Hypovolaemia, Endocrine (adrenal, thyroid), Neuropathic (autonomic)
Spinal cord injury/ Sepsis, Cardiac, anapyhlaxis/ anaesthesia, anti HPT, Massive PE

Complications of undescended testis :

TESTIS

Torsion
Epididymo orchitis
Sterility
Trauma
Inguinal hernia
Seminoma

Drugs stopped/modified before surgery..

SEMLA 6,4,3,2,1 wk before respectivly
SEMLA
S-Smoking
E-Estrogen
M-MAO-A inhibitor
L-Lithium
A-Aspirin