Ngoo had a busy night, just came back from Termeloh posting in full throttle. He presented a case of a man with worsening chronic left medial maleolus ulcer. ABSI right leg was 0.62 and left leg 0.7.
Q - "Why do you think its venous ulcer?" - Mr Hanafiah
A - "the location of the ulcer is at the medial aspect where the long saphenous runs...." - Ngoo
Q - "How do you treat venous ulcer?" - Mr Hanafiah
A - "Dressing, graduated compression stocking...." - Ngoo
Q - "Why is it call graduated compression stocking?" - Prof Razman
Q - "Does ABSI matter before starting patient on compression stocking?" - Mr Hanafiah
Case 2:
74 year old bed bound after a stroke two days ago presented with obstructive jaundice. Per abdomen no mass palpable. CT scan showed mass at head of pancreas with necrotic centre.
Q - "How does pancreatic mets to the brain look like?" - Prof Ismail
everybody looked puzzled and turn their faces away from Prof.
A - "I also don't know the answer, I just know how to throw question only" - Prof Ismail....... ha.....ha.......ha
Q - "Why do CT scan?" - Prof Ismail
A - "The answer for a surgeon is to know resectability" - Prof Ismail
Q - "What are the resectability criteria in pancreatic head of tumour?" - Mr Hanafiah
A - "encasement of portal veins, liver metastasis, size does not matter for head of pancreas......" - Ngoo
"If there is present of only one liver mets, it won't change the management. i.e. palliative stenting" - Prof Razman
Q - "Which stent is better for palliative case?" - Mr Azim
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