By Manoj Ramachandran; Marc A Gladman

This ebook of over one hundred forty situations is designed for applicants getting ready for all surgical examinations, no matter if at undergraduate, postgraduate or go out exam point. it's going to demystify and simplify the medical evaluation of surgical circumstances and gives useful recommendation on how you can be successful. The textual content contains best advice, acronyms and up to date summaries of present perform according to the authors' own event of surgical examinations.

    • Cases are graded by way of most likely visual appeal within the examinations.
    • Top counsel emphasize particular matters which reason confusion.
    • The textual content offers recommendation at the the best option time to complete an examination.
    • Examples of the typical methods and props that arise within the skill-based exam layout are included.
    • This absolutely revised moment variation is now in color and contains images of key manoeuvres played in the course of particular surgical exam routines
    • Includes a brand new part on conversation skills
    • A new co-author in educational surgical procedure joins the project.

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C) What are the features of Graves’ disease? • Commoner in females (9 : 1) • Results from polyclonal immunoglobulins against thyroid-stimulating hormone receptor which bind and stimulate the receptor – these antibodies are found in 90% of patients • Hyperthyroidism with goitre • Thyroid eye disease (see Case 8) • Thyroid acropachy • Pretibial myxoedema • Normochromic normocytic anaemia, raised erythrocyte sedimentation rate and hypercalcaemia can also occur • Associated with other autoimmune conditions such as Type 1 diabetes and pernicious anaemia.

QUESTIONS (a) What are the causes of a diffusely enlarged thyroid gland? • Simple colloid goitre • Graves’ disease • Thyroiditis (Hashimoto’s, de Quervain’s or Riedel’s, see Case 8). (b) What do you know about simple colloid goitres? • Commonest form of thyroid abnormality • Secondary to hyperplasia of the gland to meet physiological demand for thyroxine • Secondary to defective production of thyroid hormone • Causes are as follows: • Iodine deficiency (commonest cause worldwide) • Increased physiological demand – puberty, pregnancy and lactation (commonest cause in the UK) • Goitrogens (less common) – uncooked cabbage, lithium and anti-thyroid drugs • Defects of thyroid hormone production (rare).

Naevus sebaceous. (c) What treatment options are available for BCC? 5 cm margin (maximum) • Tumours not raised above the skin: wider margin of excision, particularly if at inner canthus of eye, nasolabial fold, nasal floor and ear – frozen section may be necessary to ensure adequate excision • Other approaches: radiotherapy and Mohs’ surgery (see Case 14). 33 34 Superficial lesions ADVANCED QUESTIONS (a) What do you know about the histology of BCC? On microscopy, BCCs have many patterns but the most common features are islands and nests of basaloid cells in the dermis (like those seen in the basal cell layer of the epidermis).

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