First Incision

This week's episode kicks off the endocrine content with the thyroid. In this episode we cover:
- Physiology of thyroid hormone and iodine metabolism
- Hyper and hypothyroidism
- Interpreting thyroid function tests 
- Thyroiditis, covering: hashimoto's subacute, reidel's, postpartum, radiation and amiodarone thyroiditis
- Thyrotoxicosis, covering: grave’s disease including thyroid eye disease, the toxic multinodular goitre, toxic adenoma/toxic solitary nodule, and amiodarone thyroiditis

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 podcast.
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 2021

Hi everyone!
It's time to change tack and tackle the endocrine module from our curriculum.
I have a feeling this will be a wild, feedback-cycle kind of ride, so let's ease ourselves into it with the anatomy and embryology of our favourite endocrine organs: the thyroid, parathyroids and adrenal glands.

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 podcast.
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 2021

This week's episode covers chronic liver failure:
- the causes
- pathophysiology of what actually happens when the liver fails
- diagnosis of chronic liver disease and cirrhosis
- portal hypertension diagnosis and management
- grading classification systems (Child-Pugh-Turcott and MELD scoring)
- the perioperative management of a patient with chronic liver disease

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 podcast.
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 2021

This week's episode covers liver infections, including pyogenic liver abscesses, hydatid cysts, amoebic abscesses and other rarer types of liver infections.
We discuss the pathophysiology, lifecycle of the hydatid parasite, microbiology, diagnosis and treatment of these infections.

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 podcast.
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 2021

This week's episode covers chronic pancreatitis
- what is it
- risk factors
- pathophysiology of it's aetiology and complications
- how it presents
- diagnosis
- imaging findings
- complications
- 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 podcast.
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 2021

This episode covers acute pancreatitis.
- risk factors
- aetiology
- pathophysiology (a beloved question in the exam)
- workup
- severity classification (including the apache score, modified glasgow critiera, ranson's criteria, IAP/APA guidelines, and revised Atlanta classification)
- radiological classification (revised Atlanta) and radiological severity classification systems
- management of pancreatitis
--- including acute management which addresses fluid resuscitation, nutrition, ERCP, as well as when to do the lap chole.
--- and management of complications including how to do a cystgastrostomy, how to manage pancreatic necrosis, and more!

Pancreatitis is a favourite question in the exam so this is a high yield episode!

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 podcast.
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 2021

This episode covers pancreatic cancer. Topics discussed include:
- risk factors
- familial pancreatic cancer syndromes
- pathophysiology
- presentation
- workup
- staging
- and treatment including chemotherapy, radiotherapy, surgery and palliative approaches

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 podcast.
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 2021

This episode delves into liver metastases and liver surgery. We discuss both colorectal and non-colorectal liver metastases

For colorectal liver metastases we cover:
- epidemiology
- how they are diagnosed and how to work them up
- medical treatment including chemotherapy both neoadjuvantly and adjuvantly
- the decision making on who to operate on, and the treatment sequence when considering the colorectal primary
- other liver targeted treatments

We talk about liver surgery including:
- preoperative considerations such as the future liver remnant quality and quantity to prevent postoperative liver failure
- how to improve the future liver remnant
- what is postoperative liver failure
- postoperative surveillance
Principles of liver surgery:
- liver mobilisation
- inflow control
- outflow control
- low CVP
- parenchymal dissection

For non-colorectal liver metastases we have a quick summary at the end of the episode about which ones would be considered for surgery.

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 2021

This week's operative episode covers laparoscopic cholecystectomy, and some of the intraoperative pitfalls they might throw your way in the exam.

Topics covered, how to avoid them, and how to deal with them if they happen include every way your day can go from bad to worse when doing a laparoscopic cholecystectomy:
- bleeding (hepatic artery, portal vein, middle hepatic vein)
- anatomical variations
- ureteric catheter not flushing
- the 'difficult' gallbladder'
- the dreaded bile duct injury
- common bile duct stones and how to do a transcystic laparoscopic bile duct exploration, open choledochotomy and laparoscopic choledochotomy and exploration

Here's to hoping you avoid these intraoperative issues, but at least you will be prepared if they do happen!

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 2021