Surgery Shelf Prep!

Your postoperative patient suddenly becomes confused, agitated, or unusually sleepy. Is it dementia, medication effect, withdrawal, or postoperative delirium? In this episode, Chris and Mars break down how to recognize postoperative delirium, including the often-missed hypoactive form, and review the high-yield Confusion Assessment Method features. You’ll learn the major reversible triggers, the m...

A postoperative patient suddenly develops a heart rate of one forty with an irregularly irregular rhythm. What comes first: rate control, cardioversion, or anticoagulation? In this episode, Chris and Mars break down postoperative atrial fibrillation from a Surgery Shelf perspective. Learn the major postoperative triggers, how to recognize atrial fibrillation on an electrocardiogram, why hemodynami...

Postoperative myocardial infarction does not always present with crushing chest pain. In fact, many perioperative myocardial injuries are clinically silent. In this episode, Chris and Mars break down type one versus type two myocardial infarction, postoperative oxygen supply-demand mismatch, electrocardiogram and troponin interpretation, myocardial injury after noncardiac surgery, and why selected...

A hospitalized postoperative patient develops fever, purulent secretions, worsening oxygenation, and a new infiltrate. Is it hospital-acquired pneumonia or ventilator-associated pneumonia—and how broad should your antibiotics be? In this episode, Chris and Mars break down the high-yield differences between HAP and VAP, common pathogens including methicillin-resistant Staphylococcus aureus and Pseu...

A postoperative patient aspirates and suddenly becomes hypoxemic. Do they need antibiotics? Not necessarily. In this episode, Chris and Mars break down aspiration pneumonitis versus aspiration pneumonia. Learn how to separate chemical lung injury from bacterial infection using timing, aspiration history, clinical trajectory, and dependent Chest X Ray findings. We cover why fever and leukocytosis d...

Postoperative hypoxemia on day one? Don’t immediately call it pneumonia—and definitely don’t blame every early postoperative fever on atelectasis. In this episode, Chris and Mars break down postoperative atelectasis: why anesthesia, pain, splinting, immobility, and retained secretions cause alveolar collapse; the classic Chest X ray findings of volume loss; and the high-yield differences between a...

Your postoperative patient has not urinated in six hours. Is the bladder full—or are the kidneys simply not making urine? That distinction is the key to getting postoperative urinary retention questions right on the Surgery Shelf. In this episode, Chris and Mars review the classic presentation of postoperative urinary retention, major risk factors including spinal anesthesia, opioids, anticholiner...

Intra-abdominal abscesses can be easy to miss—especially when the skin incision looks completely normal. On the Surgery Shelf, the key is recognizing the postoperative pattern, knowing when to image, and understanding when drainage or surgery is the next best step. In this episode, Chris and Mars break down the classic presentation of intra-abdominal abscess, the role of C T imaging, and the core...

Surgical site infections are a Surgery Shelf favorite because one postoperative wound can test timing, diagnosis, source control, prevention, and even the need for emergency surgery. In this episode, Chris and Mars break down how to recognize superficial, deep, and organ-space infections—and how management changes with each one. You’ll review the classic postoperative timing of wound infections, d...

A postoperative incision suddenly starts draining pink fluid—or worse, bowel appears through the wound. Knowing the difference between superficial wound separation, fascial dehiscence, and evisceration can turn a tricky shelf question into an easy point. In this episode of Surgery Shelf Prep, Chris and Mars break down wound dehiscence and evisceration, including the classic postoperative timing, m...

Postoperative Hemorrhage Postoperative bleeding can be obvious—or remain hidden until the patient begins to deteriorate. In this episode, Chris and Mars review how to recognize postoperative hemorrhage, why an initially normal hemoglobin can be misleading, and how to distinguish focal surgical bleeding from a systemic coagulopathy. You’ll also learn: The earliest signs of hemorrhagic shock Immedia...

An anastomotic leak may not announce itself with dramatic peritonitis. Sometimes persistent tachycardia is the only early clue—and missing it can be catastrophic. In this episode, Chris and Mars break down how anastomotic leaks present, why they commonly appear during the first postoperative week, and how to distinguish a dangerous leak from routine postoperative ileus. You’ll learn: Why unexplain...

Postoperative Fever: Timing, Differential, and Workup Postoperative fever may represent a normal inflammatory response—or the first sign of a life-threatening complication. In this episode of Surgery Shelf Prep, Chris and Mars review how fever timing guides the differential without replacing careful clinical assessment. Learn how to: Apply the classic five W’s Distinguish early inflammatory fever...

Primary sclerosing cholangitis can look quiet at first, but it carries major shelf-level consequences. If you see a young man with cholestatic labs, pruritus, and ulcerative colitis, this is the diagnosis you need to catch. In this episode of Surgery Shelf Prep, we break down the classic presentation of primary sclerosing cholangitis, why Magnetic Resonance Cholangiopancreatography is the key test...

Pyogenic liver abscess can look subtle at first, but on the shelf it is a big-time diagnosis. Fever, right upper quadrant pain, leukocytosis, and a rim-enhancing liver lesion should make you think fast. In this episode of Surgery Shelf Prep, we break down pyogenic liver abscess in a clear, high-yield way. You will learn the classic presentation, the major routes of infection to the liver, the most...

Abnormal liver function tests can feel like a mess—until you learn the pattern. In this episode of Surgery Shelf Prep, we break down how to approach elevated liver labs the way the shelf wants: fast, organized, and high-yield. Chris and Mars walk through the three major liver injury patterns: cholestatic, hepatocellular, and mixed. You’ll learn how to use the lab pattern to narrow the differential...

Complications of cirrhosis can show up in a lot of different shelf-style ways, and this episode helps you organize them fast. In this high-yield review, Chris and Mars walk through the major complications every medical student needs to know: ascites, spontaneous bacterial peritonitis, esophageal varices, hepatic encephalopathy, hepatorenal syndrome, and hepatocellular carcinoma. They break down th...

Cirrhosis can look slow and chronic on the surface, but on shelf questions it shows up with big consequences fast. If you do not recognize the clues behind ascites, varices, encephalopathy, and spontaneous bacterial peritonitis, this topic can absolutely trip you up. In this episode of Surgery Shelf Prep, Chris and Mars break down cirrhosis in a clear, high-yield way for the surgery shelf exam. Th...

GERD is one of those shelf topics that seems simple, but the exam loves to test the complications, alarm symptoms, and when surgery becomes the answer. In this episode of Surgery Shelf Prep!, Chris and Mars break down the classic presentation of gastroesophageal reflux disease, including heartburn, regurgitation, and symptoms that get worse at night or when lying down. They walk through the pathop...

Groin bulge on the shelf? Don’t get trapped by the anatomy. In this episode of Surgery Shelf Prep!, Chris and Mars break down inguinal hernias in a fast, high-yield way that helps you separate indirect from direct, recognize the classic exam clues, and know when a hernia becomes an emergency. You’ll learn how to use the inguinal ligament and inferior epigastric vessels to classify hernias, why ind...

Hiatal hernias are a classic Surgery Shelf topic because the exam loves the distinction between sliding and paraesophageal hernias. In this episode, Chris and Mars break down the anatomy, the classic symptom patterns, and the key test-taking question: who has reflux and who needs surgery. They cover the high-yield differences between sliding hiatal hernias, which are common and usually cause GERD...

Achalasia can be tricky, and it is absolutely fair game for the Surgery Shelf. In this episode of Surgery Shelf Prep!, Chris and Mars break down the classic presentation of progressive dysphagia to both solids and liquids, regurgitation of undigested food, chest pain, and weight loss. They walk through the key pathophysiology of failed lower esophageal sphincter relaxation and loss of distal esoph...

In this episode of Surgery Shelf Prep , Chris and Mars break down esophageal perforation, a rare but life-threatening emergency classically seen after forceful vomiting or esophageal instrumentation. They review the classic presentation of sudden severe chest pain, dyspnea, and subcutaneous emphysema, explain why mediastinal contamination can rapidly lead to sepsis, and walk through the high-yield...

Pancreatic cancer can look subtle at first, but on the shelf it is a major diagnosis you cannot miss. Painless jaundice, weight loss, dark urine, pale stools, back pain, and Trousseau syndrome should all make you think pancreatic ductal adenocarcinoma fast. In this episode of Surgery Shelf Prep, Chris and Mars walk through the classic presentations of pancreatic head versus body and tail tumors, t...

Burning epigastric pain, meal-related symptoms, and sudden complications like bleeding or perforation make peptic ulcer disease a classic Surgery Shelf topic. In this episode, Chris and Mars break down the two major causes, Helicobacter pylori and nonsteroidal anti-inflammatory drugs, then walk through the key differences between gastric and duodenal ulcers, how to diagnose them, and when to use e...