1. Surgery
    2. 1. Pain
    2. Swelling
    3. Ulcer, Sinus, Fistula
    4. Peripheral Vascular Disease
    5. Venous Disease
    6. Neck
    7. Thyroid
    8. Chest
    9. Breast
    10. Acute abdomen
    11. Chronic abdomen
    12. Abdominal lump
    13. Renal case
    14. Prostate
    15. Hernia
    16. Hydrocele
    17. Operative procedure
    18. Post-operative case
    19. X-ray
    20. Surgical instrument
    21. Specimens
  2. Medicine
    3. 22. Scheme of case taking
    23. Arterial pulse
    24. Respiration
    25. Blood pressure
    26. Temperature
    27. Anaemia
    28. Jaundice
    29. Cyanosis
    30. Clubbing
    31. Lymph node examination
    32. Oedema
    33. Dehydration
    34. General Examination of a Patient
    35. Respiratory System
    36. Cardiovascular System
    37. Abdominal system
    38. Genitourinary system
    39. Nervous system
    40. Chest X-ray
    41. ECG
  3. Paediatrics
    4. 42. New born history taking
    43. New born examination
    44. New born discussion
    45. History taking of child
    46. Examination of child
    47. Anthropometry
    48. Malnutrition
    49. Alimentary system
    50. Respiratory system
    51. Cardiovascular system
    52. Nervous system
    53. Genitourinary system
    54. Haemopoietic system
    55. Instruments and Ward procedures
  4. Obstetrics and Gynaecology
    5. 56. Anatomy of Female Genital System
    57. Fetal Skull and Maternal Pelvis
    58. Normal labour
    59. History taking of Obstetric case
    60. Postnatal case
    61. Examples of OBS case
    62. Case of Eclampsia
    63. Case of Puerperium
    64. Case of LSCS
    65. Haemorrhage in Early pregnancy
    66. Ectopic pregnancy
    67. Gestational Trophoblastic diseases
    68. Case of Postdated pregnancy
    69. Case of multiple pregnancy
    70. Pregnancy in Rhesus negative woman
    71. Gynaecological cases
    72. Case of Fibroid
    73. Case of Prolapse
    74. A case of ovarian tumour
    75. Pelvic infections
    76. Abnormal uterine bleeding (AUB)
    77. Infertility
    78. Contraception
    79. Drugs in Obs and Gynae
    80. Instruments in Gynae and Obs
    81. Specimens of Gynae and Obs
    82. Operative obstetrics and Gynae
    83. Induction of Labour and Partograph
Surgery
1. Pain
DEFINITION
Pain is an unpleasant sensory or emotional experience associated with actual or potential tissue damage or described in terms of damage.
TENDERNESS
Pain which occurs in response to a stimulus given by somebody.
  1. Pain --> Symptom
  2. Tenderness --> Sign
CLASSIFICATION 1
Based on Aetiopathogenesis
Physiological
Acute response to injury
Inflammatory/ Nociceptive
Inflammatory mediators secondary to ongoing disease process.
Neuropathic
Injury to or dysfunction of CNS or PNS.
Psychosomatic
Based on Duration
Acute
Chronic
CLASSIFICATION 2
Superficial pain
  1. Sharp
  2. Pain
Segmental pain
  1. Irritation of sensory nerve trunk or root.
  2. Located in particular dermatome of the body supplied by the affected sensory nerve trunk or root.
Deep pain
Psychogenic pain
Arises from brain
HISTORY
Note
  1. Site
  2. Onset and Progression
  3. Character/ Nature
  4. Radiation, Referred, Shifting of pain
  5. Associated symptoms
  6. Timing
  7. Exacerbating and Relieving factor
  8. Severity
Site
▢ Right hypochondrium: Gall bladder or Liver pathology
▢ Right iliac fossa (McBurney's point): Acute appendicitis
Onset and Progression
Onset
▢ Insidious onset:
  1. Chronic nature of disease
  2. Chronic pancreatitis
  3. Chronic peptic ulcer
▢ Sudden (recent) onset:
  1. Acute nature of disease
  2. Acute pancreatitis
  3. Acute appendicitis
  4. Rupture of aneurysm
Progression
Character/ Nature
▢ Vague (dull aching) pain:
▢ Colicky pain:
▢ Burnign pain:
▢ Throbbing pain:
▢ Scalding pain:
▢ Pin and needles sensation:
▢ Shooting pain:
▢ Stabbing pain:
Radiation, Referred, Shifting of pain
Radiation of pain
Referred pain
Shifting or migration of pain
Associated symptoms
▢ Colicky pain: Associated with sweating, vomiting and clammy extremities.
▢ Ureteric colic: Hematuria
▢ Biliary colic: Jaundice
▢ Acute pyelonephritis: Rigor and
Timing
Exacerbating and Relieving factor
Severity