Students of Surgery: Recent Episodes
Martin Brand
An overview of surgical topics aimed at medical students coming to their clinical surgery rotations, as well as refreshers for early career medical doctors working in surgical departments. These podcasts provide core knowledge of topics, providing a platform to commence deeper learning.
In this episode Annemie Steyn and Nicollete Kock find out about commonly used tumour markers in general surgery. From CEA, CA19-9 to AFP, calcitonin, and chromogranin Prof Brand gives a broad overview of when and how we should use these tumour markers.
In this episode we discuss the basics of obstructive (or surgical) jaundice with Dr Hendri Pretorius. The presentation theory, red flags and investigations. For an approacch to a patint with obstructive jaundice listen to the podcast linked below from the What's wrong with that patient? series. An approach to a patient with obstructive jaundice
In this episode we discuss with Dr Sherwyn Morrison abdominal aortic aneurysms, from risk factors to types, their presentation and an overview of management.
In this episode Bryce Svensson interviews Prof Brand to find out what are 'routine blood tests' used in general surgery. Specifically they talk about the full blood count, urea and electrolytes, C-reactive protein and procalcitonin. Their indications and interpretation.
In this podcast we will cover the basics of melanomas which all general practcioners should know about with Mayuri Ramnarain.
Liver metastases are very common. With modern liver resection techniques and chemotherapy agents we are able to offer these patients treatment that may significantly lengthen their overall survival. In thjis podcast we dicuss metastatic liver lesions with Dr Hendri Pretorius.
The normal blood pressure in the portal venous circulation is 3-5mmHg, portal hypertension is diagnosed once the pressure is greater than 6mm Hg. Varices start developing with a pressure greater than 8mmHg, and may bleed with pressures greater than 12mmHg. In this podcast we discuss portal hypertension with Dr Hendri Pretorius including with a clinical case scenario and the management thereof.
In this episode Dr Hendri Pretorius tells us about primary liver cancers, focusing on hepatocellular cancer.
In this podcast we discuss the types and pathogenesis of gallstones as well as their complications with Dr Hendri Pretorius.
In this podcast we discuss the indications of x-rays, eFAST, CT scans, contrast studies and other investigations. Attached to the podcast is a PDF with links to additional resources. Additional material Radiology in the trauma resuscitation room.pdf — PDF (31.1 KB)
Using ATLS principles, trauma surgeon Dr Barbaro Monzon, discusses the approach to a trauma patient in the emergency room. The primary, secondary and tertiary surveys are dealt with. Attached to the podcast is a summary sheet which includes links to useful free online claculators ect.. Additional content Approach to Trauma Patient podcast.pdf — PDF (54.8 KB)
We discuss informed consent, who can give consent and various ethical principles with Mr Jerry Mayaba, an attorney specialising in medicolegal litigation with MacRoberts Attorneys. Attached to the podcast are various HPCSA published douments relevant to consent and ethical medical practice. The Children's Act explained.pdf — PDF (812.8 KB) · HPCSA Ethical guidelines for good practice in the health care professions.pdf — PDF (6.3 MB)
In this podcast we discuss HPCSA internship training requirements with Mr Jerry Mayaba, attorney for MacRobert's Attorney's, and what is required for an intern doctor to be successfully signed off as an independent practicioner. Attached to the podcast are various HPCSA published documents relevant to Internship. HPCSA Core Competancies for Internship.pdf — PDF (386.5 KB) · HPCSA Guidelines for Internship Training.pdf — PDF (1.2 MB)
Join Martin Brand as he interviews electricity guru, Professor Ryan Blumenthal, Forensic pathologist at the University of Pretoria. Professor Blumenthal has a deep interest in electricity and how it casues trauma, from your kitchen kettle to high voltage power lines, many of the myths of electricity are debunked in this episode.
In this episode Professor Martin Brand interviews Professor Ryan Blumenthal, senior specialist forensic pathologist and associate professor at the University of Pretoria’s Department of Forensic Medicine. His chief field of interest is the pathology of trauma of lightning. His book 'Autopsy - Life in the trenches with a forensic pathologist from Africa' (Jonathan Ball Publishers) launched August 2020 and became a non-fiction best-seller in South Africa and his eight-part documentary “Lightning Pathologist” aired 9 November 2020 to 20 November 2020, and was viewed by over 2.2 million people.
In this podcast Professor Blumenthal explains how ligntning causes injuries and dispels several myths of this not uncommon cause of trauma in South Africa.
Oesophageal cancer is not an uncommon cause of dysphagia or odonophagia in a general surgery practice. In this podcast we give an overview of the two most common types of oesophageal cancer, their presentation, investigation and management. Oesophageal cancer podcast overview.pdf — PDF (88.4 KB)
An overview of surgical topics aimed at medical students coming to their clinical surgery rotations, as well as refreshers for early career medical doctors working in surgical departments. These podcasts provide core knowledge of topics, providing a platform to commence deeper learning. Optimising neonatal transfer. AC Fenton et al. 2004 · Transfer of the neonate lecture notes.pdf — PDF (41.1 KB)
Colorectal cancer and it's complications will be a common condition managed by anyone treating surgical emergencies as well as working in general surgery departments. In this podcast we discuss these cancers, their presentations and the management thereof. Colorectal cancer lecture notes.pdf — PDF (168.2 KB)
There are cancers rarely seen in the general population, but are common in HIV positive patients, such as Kaposi sarcoma and non-Hodgkins lymphoma. In this podcast we give an overview of the more common HIV associated malignancies that a general surgeon may be faced with.
The most common indication for spleen surgery is trauma. In the absence of trauma, spleen surgery is relatively rare and seldomly required. When indicated it may be curative and lifesaving. In this podcast we discuss elective, non-trauma general surgical aspects of the spleen. The spleen lecture notes.pdf — PDF (128.2 KB)
Having a systematic reproducible routine of assessing a surgical ward patient during your daily ward rounds is essential, ensuring that they are improving, picking up signs early that something may be going wrong. In this podcast we discuss how to go about this essential component of your clinical practice. Approach to a ward patient .pdf — PDF (51.1 KB)
In this podcast we discuss causes and the management of bowel obstruction once the baby is older than 28 days of age.
Constipation and faecal incontinence is common and has a good prognosis if treated appropriately. An assessment of a child with constipation is primarily through a careful history and clinical examination and rarely abdominal x-rays are required to determine the cause of the constipation. Constipation and Fecal incontinence in Children.pdf — PDF (100.6 KB)
Anorectal malformation does not only refer to an imperforate anus, but is a spectrum of abnormalities of rectum/ anus possible. It is also associated with other congenital abnormalities known by the mnenomonic 'VACTERL'. Anorectal malformation .pdf — PDF (59.2 KB)
Even a small amount of blood appears large and can be alarming for parents and doctor. It is usually self-limiting and seldom life threatening. A careful history and physical examination is important to determine the most likely cause and severity of the bleed. Gastro-intestinal bleeding in children.pdf — PDF (92.6 KB)
Acute pancreatitis is an acute inflammatory disease of the pancreas which is reversible. There are several causes, the most common of which are gallstones and alcohol ingestion. In this podcast we discuss the causes of acute pancreatitis, it's severity staging and management thereof. Acute pancreatitis .pdf — PDF (640.5 KB)
There are three common infective liver lesions: pyogenic abscess, hydatid disease and amoebic abscesses. In this podcats they are differentiated by their clinical presentation, diagnostic features and management. Infected liver lesions podcast overview.pdf — PDF (29.2 KB)
Benign liver lesions are common. The diagnosis is made by imaging and not by biopsy. However if the diagnosis is unclear after adequate imaging (U/S and CT and MRI with contrast) then the decision to do a biopsy should be made by a HPB surgeon. The biopsy would then be in the form of an excision as this is the safest. Benign liver lesions lecture notes.pdf — PDF (89.3 KB)
A neck mass is a lump or swelling in the neck. Most common are enlarged lymph nodes which may or may not be pathological. In this podcast we discuss an approach to diagnosising neck masses.
An acute abdomen is a painful process, of acute onset, and is characterized by progressively worsening pain and gasto-intestinal symptoms. In many cases the causative condition requires surgical intervention to avoid complications and death. Podcast Acute Abdomen .pdf — PDF (96.5 KB)
Sarcomas are rare cancerrs which originate in tissues that connect, support and surround other body structures, these include muscle, fat, blood vessels, nerves, tendons and joint linings.
There is an 8-10% lifetime risk for all women. The most significant risk factors are female sex and increased age. The most common type of breast cancer is ductal carcinoma. Breast Cancer .pdf — PDF (72.7 KB)
Benign breast disease can be classified under the term Abberations in Normal Development and Involution of the breast (ANDI). Benign breast disease .pdf — PDF (56.7 KB)
An elarged thyroid glans is called a thyroid goiter, and has several causes and treatment plans.
Defects in the diaphargm are most commonly either Bochdalek or Morgagni hernias, each with it's own unique presentation, assocaitions and complications. Congenital diaphragm hernia podcast outline.pdf — PDF (29.2 KB)
Definition: Aganglionosis of distal colon and rectum Hirschsprung's disease .pdf — PDF (93.4 KB)
Most common causes inlcude gastro-intestinal atresias, and conditions such as meconium ileum.
Physiological jaundice occurs in first week of life and is very common Pathological jaundice presents on day 1 of life, is prolonged (lasts after 14 days of life). Neonatal Surgical Jaundice notes.pdf — PDF (57.5 KB)
Dysphagia describes the difficulty in swallowing liquids and/or solids from the mouth to the stomach. It is usually called a symptom of an underlying pathology. Dysphagia may be progressive in nature, meaning the difficulty in swallowing is initially only for solids and progressively becomes worse ending with an inability to swallow liquids and saliva. An approach to dysphagia.pdf — PDF (55.0 KB)
Reflux of gastric juices from stomach into esophagus occasional occurs in normal human beings. When this reflux increases in frequency and volume causing troublesome symptoms and/or damage to esophageal mucosa it is then regarded as pathological and called gastroesophageal reflux disease (GERD). Gastroesophageal reflux disease overview.pdf — PDF (88.6 KB)
Chronic venous hypertension caused by reflux, obstruction or calf muscle pump failure commonly results in a spectrum of clinical manifestations and is major cause of morbidity and increased health care costs. Clinical signs range from small, superficial telangiectasia through to large chronic debilitating venous ulcers.
Diseases of the carotid artery may be asymptomatic or symptomatic. When symptomatic, patients may present with a transient ischemic attack (TIA) or a cerebrovascular accident (CVA).
Basal and squamous skin cancers are the most common skin cancers that are not melanomas.
Chronic pancreatitis is an irreversible fibro-inflammatory disease of the pancreas which commonly presents with abdominal pain, exocrine and or endocrine dysfunction.
Obstructive jaundice occurs as a result of a bile duct blockage resulting in bile not being able to flow from the liver into the duodenum. Following an adequate history and clinical examination a patient should have an abdominal ultrasound and biochemical tests. Following this a differential diagnosis can be developed and further management planned.