Divine Intervention Episode 24 Comprehensive 3rd Year Surgery Shelf Review

[@MrGreed2000]

Divine Intervention + Emma Rahmani are key for all shelf exams. Thanks for taking the time to make these reviews. They are an excellent resource!

[@d0h4]

4:09: anti-inflammatory drugs are avoided in post-infarction pericarditis, they're given acetaminophen

[@MultiDarkstar21]

- NSAIDs (except aspirin) and corticosteroids are typically avoided due to impairment of collagen deposition and increased risk of post-MI complications like ventricular wall rupture (versus Dressler syndrome

[@joshuaemina8224]

Correct

[@joshdolsen5242]

Correct me if I am mistaken. Shiny skin/ hairless skin is seen with PAD. Venous stasis will likely also have accompanying stasis dermatitis which presents with hyperpigmentation and thickening of the skin.

[@seeker296]

Venous stasis causes shiny (edematous) discolored skin as well. For pad focus on signs of ischemia like changes in sensation or coldness

[@williamj9604]

I really really appreciate all your effort. Thank you. 1:16:98, 1:17:10, 1:17:44, 1:20:00 , 1:42:55 ,1:51:49, 1:54:00~ breast HY,hernia~~ to the end / Q28~33,+ all the MSK, neuro // diverticulosis Dx : barium enema or CT, Thumbprinting sign on XR of Acute bowel infarction , Burn pts ->PPI ppx for stress ulcer

[@chinasa_]

Helpful review. Thank you! @15:40 please correct me if I’m wrong. I think shiny skin with loss of hair is arterial insufficiency while skin discoloration is venous insufficiency.

[@ColorMeAshx]

This is correct

[@londynjacobs9443]

2:01 for septic thrombophlebitis treatment is the excision of the vein.

[@MrMagicsfan]

this is true. NBME 7

[@elizabethdiaz6906]

March 2021 Lung cancer screening recommendation: "The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery."

[@maurohenriqueanghinoniboni664]

Your poadcasts have been a game changer for me, God bless you!

[@chidiakusobi6581]

This review was so fantastic! The highest of high yields, thank you!

[@robsemco7120]

If anybody is having trouble with the audio, switch your computer settings from mono to stereo. It fixed the problem for me.

[@abdallaahmed6630]

im using a phone, what should I do?

[@fearlessverses]

Bluetooth or wired headphones ​@@abdallaahmed6630

[@hobo603]

Another absolutely legendary review. Just amazing

[@chelsycalhoun4422]

I appreciate all the work you put into this!

[@varunnurav6912]

1:50:00- Aortic dissection unstable pt trans-esophageal not transthoracic : UWORLD POINT...if I'm wrong please correct me. Your videos are very helpful Mr. Divine Thank you.

[@divineinterventionpodcasts]

You're right. It's a TEE, not TTE.

[@garycaputo4359]

Also, the 5 Ps are for acute limb ischemia, not compartment syndrome (around 1:24:15)

[@boogman5747]

6 P's rather- and although yes, they ARE for neurovascular assessment of limb ischemia in an acute setting, you will find in the literature that they are not clinically reliable and may manifest only in the late stages of a compartment syndrome- so in effect, most ortho's refer to them as such; i guess one could say they are essentially interchangeable in this context. Divine know's what he's doing :p

[@marymwangi7379]

My understanding is that the 5 Ps are also found in compartment syndrome because it leads to the same physiology as acute limb ischemia. The high pressures hinder 1st the venous then arterial perfusion of the limb so the symptoms are the same.

[@Sameer-yq1nv]

Errata at 1:18:12 -- patients on NBME are more likely to present with inury after tackle during a football game rather than a basketball game

[@HankFuller333]

lmfaoo

[@AdelAliakbar]

God bless you ; correction ; HUS due to endothelial injury by toxins of E-coli or shigella leading to wide spread thrombi formation TTP = deficiency of ADAMTS-13😇

[@michellewiciak2613]

Around minute 8 mark, he talks about IE and S. gallolyticus being a part of step viridans. S. gallolyticus is actually associated with colon cancer/hepatobiliary disease as a heads up! Don't know if someone mentioned this or he corrected himself. He did not mention S. sanguinis as a part of step viridans group and I have seen this come up a bit

[@vishavsehdev8341]

They are not going to have Gastrograffin on the exam because its brand name, its gonna be described as water-soluble

[@ApurvaPopat]

1:17:16 Also, its not gastrograffin enema, its gastrograffin (water-soluble) swallow

[@greensky01]

Thank you very much for this detailed review; it was extremely helpful.

[@robertgordon2031]

Is the audio jacked up for anyone else?

[@eliannasanchez1331]

Thank you so much for sharing your knowledge. God bless.

[@rachelcarrasquillo283]

I didn't think dantrolene is a typical calcium channel blocker. It is a ryanodine receptor antagonist.

[@garycaputo4359]

HTN is the biggest risk factor for CAD, as well as stroke. Smoking is the biggest modifiable risk factor.

[@goleafsgosinghshady]

HTN is biggest risk factor for stroke and Aortic Dissection. Smoking and HTN are both modifiable risks for CAD/Atherosclerosis. If they give you an option between smoking and HTN re: biggest risk factor for CAD; pick smoking.

[@emekaemmanuel5258]

Pick smoking. Both hypertension and smoking are modifiable.

[@mohamedmed64]

just sooo clear and concise. very good work. Thanks a lot

[@IJtwoeight]

Even a toaster has a GCS of 3 😂😂

[@rachelcarrasquillo283]

I also thought to diagnose diverticulosis you want to do a colonoscopy

[@laurenrowe7234]

septic thrombophlebitis I believe is treated with vein excision and antibiotics, not heparin as stated.

[@rosiesaikaly1178]

He was joking about the heparin

[@iamimperfect5443]

Q31:USG abd for both preg lady and children to dx acute appendicitis

[@viflet-will]

Is the audio messed up or all of my devices speakers are not working?😢😢

[@whereredroseblooms]

Is the audio weird for people ?

[@rachelcarrasquillo283]

I thought the 6 P's refer to acute limb ischemia.

[@danielveragrandez7254]

correct me if am wrong but s gallolyticus is bovis not with viridians, with virid is mitis mutans y sanguinis

[@LilReadingMunky]

you're right.

[@Jay_Islander]

Is there a podcast version of this????

[@serellamadole]

Amazing review!

[@kfi098]

Anyone else having an issue with the audio on mobile?? Sounds super muted and sped up no matter what I do

[@whereredroseblooms]

same here

[@kfi098]

@@whereredroseblooms works fine on desktop :/

[@afshannizami5339]

same here

[@danieldonascimentoaraujo3221]

53:00 h Peripheral N.

[@rajshri19y]

@46:00,50:00, 57:56, 1:05:00, 1:48:00, 1:51:41

[@PepsiT98]

Chukwu gozie gi for these reviews mehnn!

[@edugwuagbo6828]

100% agree. lmao

[@ajkovic914]

Can't hear the voice ? What's wrong plz

[@nabeelafatima1417]

The biggest rf for cad is dm according to mehlman and smoking is second.?

[@darkh_choco1ate]

Thank you for the reviews!! Are your slides downloadable anywhere?? Would love to have the physical stuff to follow along with the video!! TIA!!

[@marymwangi7379]

Yes check the archives for episode 24 on his website. The slides are there

[@Juju10985]

great review thanks a lot 😊

[@amangoyal1999]

At @ 1:05:30 what does he mean by waiting for a new what?

[@bircanboga9154]

The king

[@rachelcarrasquillo283]

Why would a neuroblastoma have a posterior mediastinal mass?

[@preethi7751]

Posterior mediastinum comprises of neuro stuff (like spinal cord)

[@rachelcarrasquillo283]

Why would a postsurgical patient with a long history of crohn's that is hypotensive have adrenal insuffiency?

[@rachelcarrasquillo283]

did you mean cushings?

[@MrSandChess]

Patient’s who have chronic steroid use and undergo surgery are at risk of an adrenal crisis from the adrenal insufficiency caused by the steroid use. They are unable to amount an adequate response to stress and thus have hypotension, hyperkalemia, hyponatremia, and hypoglycemia. Stress in general is a precipitating factor for adrenal crisis in these patients but that also applies for the post-op period and GI illnesses. I hope that helped.

[@aky19832001]

Sorry alot of the information wasn't on my surgical shelf. I'd say...10%

[@Mizzbah95]

Anyone else having problem with audio?

[@evelynbell6336]

Yeah. Can't hear anything except some static.

[@lovelyangelmon]

@@evelynbell6336 try to adjust the balance between left and right sound.

[@taylorwilliams2830]

@@lovelyangelmon you are a LIFE saver a year later. that fixed my issue thank you!!

[@mojustus1783]

Thanks G

[@yaya1653]

its not working cant hear :( do you have this available somewhere else?

[@gettygets872]

I know, had the same problem. Check out his website.

[@gettygets872]

@@user-ko4uc9nz9w , thank you ! I listened to his KZbin lectures without headphones and never had a problem until now. I took your advice, used headphones and it worked.

[@The_Admiral5]

20:29

[@MultiRock38]

Is gastrogaffin *enema* the dx of choice for Boerhaave? I would think a gastrogaffin esophagogram would be more appropriate. kzbin.info/www/bejne/jKmWaoRrj6hqjLM

[@jackjohnson4586]

This is correct, he just misspoke. I know this is old, but for anyone studying, the key is just not to use barium as it can irritate the mediastinum

[@harvey2733]

I wish I knew this for my step 2 ck...well, question 8 can also be paralytic ileus? failure of bowel movement after surgery? can anyone please clear this doubt. thanks.

[@yashpawate1306]

Yes I was thinking the sams as well. I think the difference is Dull abd pain vs fullness like he said in this question.

[@elizabethbhagwandass4811]

No sound. Just squishy sound

[@bfurl69]

same on my android and iphone. works on my PC though. wth?

[@chakradharyarlagadda338]

doesnt shiny legs mean peripheral artery disease 11::01

[@yaya1653]

there is something wrong with the noise. I cant hear it and tried different phones.

[@JustAPairofLegs]

This isnt slayer

[@elizabethzollos858]

L

[@atlantic7949]

Dude spends 50% of the time advertising his upcoming seminars/lectures and tutoring session the he actually teaches in his podcast. I listened a bit then gave up cos he plays too much being repetitive. He sells his content more than teaching and then dives into religious stuff. There is an avenue for everything. Instead of teaching he’s talking about Bible life lessons. The Bible you wrote? C’mon man.

[@damilolaadegbenro]

It is his platform, he can choose to discuss anything (religious or not). And you have to option to listen to him or not. SIMPLE