First Incision

This week's episode covers everything you need to know about cutaneous squamous cell carcinoma.

- presentation
- risk factors
- premalignant lesions
- histopathology
- workup and when to stage
- grading
- TNM staging
- poor prognostic markers
- management including topical treatments, surgery, radiotherapy, systemic treatments and nodal treatment

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022

This week's episode covers the topic of Merkel Cell Carcinoma - a favourite question in the exam.  We have added the discussion we had with Dr Julie Howle onto the end of this episode. Dr Howle a surgical oncologist from Westmead Hospital who has an interest in these rare cancers.

We cover:
- background
- risk factors
- pathogenesis
- presentation
- diagnosis
- staging
- histopathology
- and management 

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022

This week's episode welcomes our guest Dr Julie Howle who is a surgical oncologist from Westmead Hospital in Sydney.

We cover a wide range of topics related to management of melanoma including:
- precursor lesions
- whether ulceration relates to the clinical or histopathological diagnosis of ulceration
- when to perform systemic staging for melanoma
- management of in-transit and satellite lesions including whether you need do a sentinel lymph node biopsy if these are present
- sentinel lymph node biopsy
- the role of isolated limb infusion and perfusion in the era of effective systemic therapies
- a brief overview of targeted therapies and immunotherapy
- how to perform an inguinal lymph node dissection

Julie also talks to us about her incredible triathlon achievements and balancing life in surgery and as an athlete. 

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022

This week's episode continues on from last week to discuss the management of Melanoma

This episode covers:
- wide local excision and the surgical margin
- lymph node biopsy and when to perform it, as well as a summary of the MSLT 1 and MSLT2 trials
- the role of lymphadenectomy
- the role of radiotherapy in melanoma
- systemic therapy including the targeted therapies (BRAF and MEK inhibitors), and immunotherapies (Anti-PD1, Anti-PD-L1, and CTLA-4)
- when to give adjuvant treatment
- management of in-transit and satellite lesions and some information about isolated limb perfusion and infusion
- follow-up post a diagnosis of melanoma 

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022

This week's episode introduces us to the topic of melanoma

We cover:
- Risk factors
- Precursor lesions
- Histopathology and important histopathological features related to poor prognosis
- Melanoma types and their appearance including superficial spreading, nodular, lentigo maligna melanoma, acral lentiginous, and desmoplastic
- Workup including excisional biopsy and when to stage patients
- Staging with AJCC 8th edition TNM staging classification
- When to perform sentinel lymph node biopsy and lymph node dissection

Keep an eye out for next week's episode where we talk about management of melanoma!

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022

This week's episode introduces us to the topic of 'skin'. I know it seems weird that I would do an episode just on this but bear with me! The topics covered include:
- the function of the skin as an organ
- histopathology of the layers of the skin
- Fitzpatrick skin types
- history and examination of a skin lesions
- principles and pathophysiology of flaps and grafts
- topical treatments for skins cancers
Everything we need before taking a deep dive into skin cancers in the coming weeks!

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022

This week's episode covers the useful topics of topical haemostatic agents and anticoagulants.

We discuss principles of haemostasis, the coagulation cascade, how topical haemostatic agents work, the different classes and when to use them.
We also cover anticoagulants, the different types, how they work, when to stop them before surgery and how to reverse them if you need to quickly!

Great high yield topics for the exam.

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022

This week's episode is co-hosted by Ben Finlay.
We cover a wide range of topics including:

Burns
- initial resuscitation including the parkland formula
- assessment of depth and extent of burns (rule of nines
- burns management
- frostbite

Blast injuries
- pathophysiology
- management

Extremity compartment syndrome and how to perform fasciotomy

The blast injury talk Ben mentioned was from the recent GSA trainees day and is accessible for general surgical trainees through the GSA website. Go to 'educational webcasts', '2021 Virtual: Trauma and Critical Care', and the Session 5 talk is by Kyle Bender on Blast Injuries.

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022

This week's trauma episode is presented with our guest host Ben Finlay.

We cover hollow viscus injuries including:
- gastric
- duodenal
- small bowel
- colonic, and
- rectal injuries

We also cover pelvic trauma including:
- pelvic fractures and the Young and Burgess classification
- pelvic bleeding management including how to perform preperitoneal pelvic packing
- bladder injuries, and
- ureteric injuries including how to do a retrograde urethrogram

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022

This week's episode welcomes back Ben Finlay to help present abdominal trauma.

We go through:
- trauma laparotomy
- liver trauma
- splenic trauma
- pancreatic trauma
- renal trauma
- and retroperitoneal haematomas and what to do with them!
Special mentions include how to do right and left medial visceral rotations, and some operative decision making that will be super high yield for the exam.

The ANZAST (Australian and New Zealand Association for the Surgery of Trauma) has some great recordings from their grand rounds available on trauma topics which we found useful for study: https://anzast.org/anzast-trauma-grand-rounds/

Disclaimer
The information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.
This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.
The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.
To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. 
To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.
The information contained in this podcast has not been independently verified.

© Amanda Nikolic 2022