Indications, key steps, and complications of common general surgery procedures like appendectomy, cholecystectomy, and hernia repair.
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- What is the most common indication for appendectomy?
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Acute appendicitis
- Where does the pain of acute appendicitis classically begin?
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The periumbilical region
- Where does appendicitis pain classically migrate to over several hours?
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The right lower quadrant
- What is McBurney's point?
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A point one-third of the way from the anterior superior iliac spine to the umbilicus, the classic site of maximal tenderness in appendicitis
- What is Rovsing's sign?
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Palpation of the left lower quadrant causes pain in the right lower quadrant
- What imaging study is preferred for suspected appendicitis in a pregnant patient?
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Ultrasound
- On CT, what appendiceal diameter suggests appendicitis?
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Greater than 6 mm
- What is the standard surgical approach for uncomplicated appendicitis today?
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Laparoscopic appendectomy
- What is a major complication of a ruptured (perforated) appendix?
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Peritonitis or intra-abdominal abscess
- Why do perforated appendicitis cases have higher rates of surgical site infection?
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Contamination of the wound by spilled infected material during surgery
- What is the most common indication for cholecystectomy?
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Symptomatic cholelithiasis (biliary colic)
- What is Murphy's sign?
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Inspiratory arrest during palpation of the right upper quadrant
- What are the three components of Charcot's triad?
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Right upper quadrant pain, fever, and jaundice
- What two additional findings, added to Charcot's triad, make up Reynold's pentad?
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Altered mental status and hypotension
- What is the first-line imaging study for suspected gallstones?
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Right upper quadrant ultrasound