SUBSCRIBE TO OUR DAILY RSS FEED!
Facebook
Date posted: April 4, 2012

Dr Sreeja S     

Intervals, Durations etc.

Abdomen

  • Interval appendicectomy – two months after acute attack
  • Appendicular mass resolves within three days or else it forms appendicular abscess by 5 to 10 days.
  • Appendicular mass is to be operated immediately after it resolves.
  • Cholecystectomy for acute cholecystits is preferably done after 8 to 10 weeks.
  • Colostomy matures after two months and it can be closed thereafter.
  • In carcinoma pancreas, death usually occurs in six months after obstructive jaundice.
  • Chronic intestinal ischaemia—Pain in abdomen occurs in 30 minutes after food intake.
  • Return of intestinal motility after operation occurs after 16 hours.
  • Duodenal blow out occurs on 4th postoperative day of gastrectomy.
  • Stoma should be open after polyagastrectomy by 3rd day.
  • Stoma should be open after Billroth 1 operation in five days.
  • Postoperative obstruction by fibrinous adhesions occurs in three to six postoperative days, m) Postoperative obstruction by fibrous adhesions—anytime,
  • Splenectomy in hereditary spherocytosis done best at 7 years (if asymptomatic),
  • Schistosomiasis (Egyptian splenomegaly)—Survival after ascites only 6 to 12 months,
  • Obstructive appendicitis—Gangrene occurs in 12-18 hours.
  • Choledochal cysts are seldom seen before six months of age.
  • Acute pancreatitis—Pseudopancreatic cyst may form at the end of 2nd week. Abscess after 3rd week.

General

  • Wound tensile strength approaches that of normal tissue by six months but 100% normal after 2 year only.
  • Primary suture of wound—within six hours.
  • Crushed and devitalised wounds. Delayed primary suture in 4 to 6 days after injury.
  • Embolectomy is to be done within 10 hours.
  • Graft rejection – Inflammation appears by 4th day (first set response). Sloughs appear by 10th day. If again grafted from same donor (second set response) sloughs by 6th day.
  • After starting treatment with stilbesterol, for prostatic carcinoma histological changes in 48 hr. Symptoms improve in 2 weeks and prostate smaller in size by 3 to 4 weeks. ;
  • In thyrotoxicosis
    • Treatment with carbimazole, symptoms relieved after 7 to 14 days.
    • Treatment with I131 in 8 to 12 weeks, patient becomes asymptomatic.
    • Repeat the dose after 12 weeks if necessary. -1 Antithyroid drugs can be given 48 hr after I’31.
  • Postoperative thyroid insufficiency manifests in 2 to 3 days after thyroidectomy.
  • Response to iodine in thyrotoxicosis is seen in 24 hours (quickest acting).
  • Parathyroid tetany manifests on 2nd or 3rd postoperative day after thyroidectomy.
  • Pregnancy is contraindicated for 3 years after operation for breast carcinoma.
  • In haemorrhage, physiologically fluid loss is replaced immediately.
  • Stored blood for transfusion, platelets live for 3 days.
  • RBC are suitable for transfusion for 3 weeks after collection.
  • RBC become functional in the body 3 days after transfusion.
  • Phenindione and dicumarol start acting after 36—48 hr.
  • Prothrombin estimation not valid within 6 hr after heparin.

Paediatric Surgery

  • Cleft lip operated at 3 months of age.
  • Cleft palate operated at 1V2 to 2 years.
  • Exomphalos major operated within few hours.
  • Surgery for sacrococcygeal teratoma—soon after birth
  • Orchipexy for undescended testes—2 years (essentially before puberty)
  • Operation for Hirschprung’s disease—after the child gains 8 kg weight and is well thriving
  • Hirschsprung’s disease, symptoms appear in 3 days after birth
  • Congenital hypertrophic pyloric stenosis—symptoms appear at 3 to 6 weeks of age
  • Ectopia vesicae—Diversion of urine best done at 4 to 6 weeks.
  • Operation for patent vitellointestinal duct at 6 months of age
  • Neonatal tetanus occurs within 5-15 days. Usually around 8th day. So called 8th dayisease.
  • Operation for ASD—first decade
  • Operation for PDA—before the child goes to school
  • Fallot’s tetralogy in infancy—palliative correction
  • Posterior fontanelle closes at the age of 4 months.
  • Anterior fontanelle closes at the age of 9-18 months,
  • Newborn passes urine usually within 24 hours,
  • Newborn passes meconium usually within 12 hours,
  • Witch’s milk appears on 3rd day; disappears in 3 weeks,
  • Alpha-fetoprotein disappears in a few weeks after birth.

Neurosurgery

  • Reaction of degeneration occurs in 3 weeks after nerve injury.
  • Irreversible changes at motor end plates after denervation seen after 18 months.
  • Meningitis after head injury develops in 3-5 days.
  • Extradural haemorrhage usally presents before 18 hours after injury.
  • In head injury, prophylactic anticonvulsants are given forj6 weeks.
  • In post-traumatic epilepsy, or after major head injury, antiepilepties are given for 3 years.
  • Idiopathic epilepsy is rare before 6 years and after 30 years, h)   Spinal concussion—Recovery occurs in 24-48 hours.
  • Spinal injury—Mass reflex appears at 3-6 weeks.

Orthopaedics

  • Menisci injury heals in 6 weeks.
  • X-ray signs in osteomyelitis seen in 2-3 weeks.
  • Angular deformities of limbs (genu valgum or varus) and in-toeing spontaneously correct by 6 weeks. If necessary, correction done after 6 weeks
  • In-toeing in girls for cosmetic purpose—operation at about 11 years of age.
  • Earliest X-ray sign in myositis ossificans is a cloud of new bone by 4-6 weeks after injury

Medicine

  • Pulmonary infarction signs detectable in X-ray in 12 hours.
  • X-ray positive for pneumonia 12-18 hours after symptoms appear.
  • Vitamin C stores last for 21/2 to 3 months.
  • B12 stores last for 3 years.
  • Thiamine stores last for few weeks.
  • Drug induced hepatitis occurs within 2 weeks after drug intake.
  • Recovery of vision in multiple sclerosis occurs usually 4-6 weeks after attack.
  • Post streptococcal glomerulonephritis—1 to 3 weeks after streptococcal infection. Post
  • streptococcal rheumatic fever 2-3 weeks after sore throat,
  • After myocardial infarction, leukocytosis peaks on 1st day, fever peaks on 3rd or 4th day
  • Dressier’s syndrome – few weeks or months after myocardial infarction; recovers in a fewdays.
  • Myocardial infarction surgical repair lesions after 6 weeks.
  • Time to reach normal counts in CML with busulphan: 12-18 weeks,
  • Idiopathic thrombocytopenic purpura remits in young in 2-3 weeks,
  • Rose-Waaler test in rheumatoid arthritis positive after 18 months,
  • Reiter’s disease—1-3 weeks after sexual intercourse or dysentery.

Gynaecology and Obstetrics

  • Myomectomy—6 months after caesarian.
  • Time for Huhner’s test or Sim’s test—2 hours after and within 16 hours of intercourse.
  • Fistulas develop 10 days after ureteral ligation or interfering with its blood supply.
  • In prolonged labour, the urinary fistulae develop usually on 5th day.
  • Forceps etc., instrumentation—the urinary fistulas develop immediately. 

Download the complete articles: www.similima.com/pdf/surgery-notes-study-materials.pdf

Comments

One Response so far.

  1. Dr,R,S Prasad says:

    Eventhugh very late I had the chance visit your site.wich is most useful to whoever wants to improve or refresh their knowledge.in short quicktime.My hearty congrats to those who took the pain & effort for the betterment of it & also the mastermind.

1. Comments will be moderated. Please use a genuine email ID and provide your name, to   avoid rejection.
2. Comments that are abusive, personal, incendiary or irrelevant cannot be published.
3. Please write complete sentences. Do not type comments in all capital letters, or in all   lower case letters, or using abbreviated text. (example: u cannot substitute for you, d is not   'the', n is not 'and')


*

Comment moderation is enabled. Your comment may take some time to appear.