Arriving at a Surgical Diagnosis

Pramod Shrikrishna Bapat MS Consultant General Surgeon, Shree Harneshwar Clinic, Talegaon (Dabhade), Pune, Maharashtra, India  

Section 1: General Surgery
General principles of case-taking
History-taking
Selected common symptoms in clinical practice
General examination
Locoregional examination
Respiratory system examination 
Pelvic examination [‘PS/E’, ‘PV/E’, ‘DRE’ and anoscopy (Proctoscopy)]
Examination of the pregnant patient
Diagnosis
Guidelines on documentation of clinical notes
Sudden loss of consciousness (Sudden unresponsiveness) / cardiorespiratory arrest
Shock
Infections / infestations
Skeletal muscles in the body amenable to physical examination (Applied anatomy) 
Swelling—basic concepts
Chronic lymph node swelling 
Chronic bone swelling
Chronic vascular swelling
Chronic circumscribed swelling in the region of the head and face
Chronic swelling of the jaw
Chronic circumscribed swelling in the neck
Goiter and thyroid cancer
A reducible (/irreducible) swelling in the groin 
A non-reducible swelling in the groin
Scrotal swelling / scrotal pain
Impalpable testicle / intermittently palpable testicle / empty scrotum
Chronic swelling in the back
Chronic swelling in the perineum, and gluteal region
Swellings / bulges related to vulva / vagina /urethra
Disorders of the female breast
Disorders of the male breast
Disorders of the chest wall
Chronic pain in abdomen
Acute pain in abdomen
Lump in abdomen
Distension of abdomen
Jaundice
Portal hypertension
Difficulty in swallowing i.e. dysphagia, and other symptoms of (chronic) esophageal disorder
Vomiting of blood—hematemesis
Anorectal pain, bleeding per rectum, and other manifestations of anorectal disorder 
Ulcer 
Sinus / fistula
(Recurrent attacks of) Discharge from the umbilicus
Limb pain
Limb ischemia—acute and chronic peripheral arterial occlusive disease
Limb gangrene
Amputation stump
Tortuous veins in the limbs—varicose veins / chronic venous insufficiency
Limb edema
Oral cavity / orofacial pain
Temporomandibular joint 
Backache


 





Section 2: Urogenital Case
Urogenital Case


 





Section 3: Neurosurgery
Intracranial space-occupying lesion


Headache



Head injury



 





Section 4: Trauma (Essentially Soft Tissue)
Acute mechanical trauma—general principles
Head injury
Facial (Maxillofacial) injury
Injury to the neck
Chest injury
Esophageal injury


Perforation
Corrosive injury
Ingested foreign body
Abdominal trauma
Urogenital trauma
Injury to anorectum, perineum, buttock
Spinal trauma
Hand injury
Vascular injury
Burn injury: Thermal, chemical, electrical





 





Section 5: Pediatric Surgery
History-taking in a child
Surgical examination of the child 
Respiratory distress in the newborn
Acute abdominal disorders
Colic (Colicky pain in abdomen)
Neonatal intestinal obstruction
Recurrent pain in abdomen
Vomiting in the neonate 
Non-bile-stained vomiting in infancy
GI bleeding
Jaundice / cholelithiasis / portal hypertension
Discharge from the umbilicus
Anorectal malformation
Urinary tract infection (UTI) / urinary stones
Disorders of the lower urinary tract
Acute scrotum
Disorders of the external genitalia
Acute pain in the limb
Disorders of the mouth
Swellings / lesions in the face
Swelling in the neck / notes on selected swellings
Torticollis (Wry neck)
Disorders of the breast 
A big head / hydrocephalus / assessing a VP shunt 
Spinal dysraphism—spina bifida 
Foreign bodies