What's Inside the Document

1. Chemotherapy in Surgery

• Full classification of agents (alkylating, antimetabolites, antitumour antibiotics, plant alkaloids, hormonal, targeted)
• Neoadjuvant vs. adjuvant chemotherapy with clear comparison table
• Regimens for specific cancers (colorectal, breast, gastric, GIST, osteosarcoma, ovarian, etc.)
• HIPEC (hyperthermic intraperitoneal chemotherapy) - indications and drugs
• Side effects with their surgical implications (myelosuppression, wound healing impairment, cardiotoxicity, nephrotoxicity)

2. Antibiotics in Surgery

• CDC Wound Classification (Clean to Dirty) with SSI rates
• Prophylaxis principles: timing (within 60 min), spectrum, duration (max 24h), and re-dosing
• Regimens by operation type in a detailed table
• Therapeutic antibiotics for common surgical infections (peritonitis, necrotizing fasciitis, C. diff, biliary sepsis, gas gangrene)
• Mechanism of action for each antibiotic class
• Resistance patterns (MRSA, ESBL, CRE)

3. Obstructive Uropathy

• Classification (level, onset, intrinsic/extrinsic), aetiology
• Detailed pathophysiology including post-obstructive diuresis
• Clinical features, investigations (USS, NCCT KUB as gold standard, MAG-3 scan)
• Management by cause (calculi, BPH, UPJ obstruction, PUV, malignant obstruction)
• Emergency management of the infected obstructed kidney

4. Intestinal Obstruction

• Mechanical vs. paralytic ileus comparison table
• Causes (80% rule: Hernias - Adhesions - Intussusception - Volvulus)
• Pathophysiology: third-spacing, strangulation, closed-loop obstruction
• Cardinal features of SBO vs. LBO
• Investigations (AXR findings, CT gold standard, Gastrografin)
• Conservative vs. surgical management; operations by cause

5. Wounds in Surgery

• Classification by mechanism (incised, lacerated, puncture, avulsion, burns, GSW)
• Phases of wound healing (Haemostasis, Proliferative, Remodelling) with key cells
• Primary, secondary, and tertiary intention
• Local and systemic factors affecting healing
• Complications (haematoma, seroma, SSI, dehiscence, incisional hernia, keloid, contracture)
• Dressings guide (hydrocolloid, foam, alginate, silver, NPWT/VAC)

6. Tracheostomy

• Indications (3 categories: upper airway obstruction, prolonged ventilation, neurological)
• Contraindications (all relative)
• Types: surgical open, PDT (Ciaglia), cricothyroidotomy, mini-tracheostomy
• Surgical anatomy (2nd-4th rings, innominate artery, RLN)
• Tube types (cuffed, uncuffed, fenestrated, double-lumen)
• Complications (early: haemorrhage, displacement; late: stenosis, TEF, tracheo-innominate fistula)
• Daily care and decannulation criteria

7. Resuscitation in Surgery

• ABCDE approach with actions at each step
• Haemorrhagic shock classification (Class I-IV: blood loss, HR, BP, GCS, urine output)
• Fluid resuscitation: permissive hypotension, crystalloids vs. colloids, blood products
• Massive Transfusion Protocol (MTP): 1:1:1 ratio, TXA (CRASH-2 Trial)
• Cardiac arrest ALS: shockable (VF/pVT) vs. non-shockable (PEA/Asystole), 4Hs and 4Ts
• Sepsis (Sepsis-3 definitions) and Hour-1 Bundle (Surviving Sepsis Campaign)
• Special situations: burns (Parkland formula), head injury, paediatrics

Quick Revision Summary Table