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USMLE Step 2 CS - Vaginal Discharge This is just preview video. To get full access please visit our website : www.usmletutoring.com

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If you're pregnant, you're likely paying extra close attention to your body. If you happen to feel a cramp you may worry that it is a sign of a miscarriage. While the first trimester is the most common time for miscarriages, there are other reasons for cramps. Whether it signals a miscarriage depends on when it occurs, the severity of the cramping, and whether you're experiencing other symptoms alongside it.

In this video, Jenna talks about Braxton Hicks contractions and preparing for labor.

The first stage of labor is the longest and involves three phases: Early Labor Phase –The time of the onset of labor until the cervix is dilated to 3 cm. Active Labor Phase – Continues from 3 cm. until the cervix is dilated to 7 cm.

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They might not sound very life threatening, but a blood clot that develops in the deep veins of your leg, if left untreated and unable to dissolve of its own volition, may detach and travel to your lungs, causing a pulmonary embolism (or PE). In most cases, a leg blood clot will form due to lengthy periods of travel, for example if you remain immobile in cramped spaces—such as an airplane or bus—with few opportunities to stretch your legs or get up and walk around. Here are ten signs that you may have a dangerous blood clot in your leg

Mini-Laparoscopic Cholecystectomy with Intraoperative Cholangiogram for Symptomatic Cholelithiasis (Gallstones) - Extended
Authors: Brunt LM1, Singh R1, Yee A2
Published: September 26, 2017

AUTHOR INFORMATION
1 Department of Surgery, Washington University, St. Louis, Missouri
2 Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri

DISCLOSURE
No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.

ABSTRACT
Minimal invasive laparoscopic cholecystectomy is the typical surgical treatment for cholelithiasis (gallstones), where patients present with a history of upper abdominal pain and episodes of biliary colic. The classic technique for minimal invasive laparoscopic cholecystectomy involves four ports: one umbilicus port, two subcostal ports, and a single epigastric port. The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has instituted a six-step strategy to foster a universal culture of safety for cholecystectomy and minimize risk of bile duct injury. The technical steps are documented within the context of the surgical video for (1) achieving a critical view of safety for identification of the cystic duct and artery, (2) intraoperative time-out prior to management of the ductal structures, (3) recognizing the zone of significant risk of injury, and (4) routine intraoperative cholangiography for imaging of the biliary tree. In this case, the patient presented with symptomatic biliary colic due to a gallstone seen on the ultrasound in the gallbladder. The patient was managed a mini-laparoscopic cholecystectomy using 3mm ports for the epigastric and subcostal port sites with intraoperative fluoroscopic cholangiogram. Specifically, the senior author encountered a tight cystic duct preventing the insertion of the cholangiocatheter and the surgical video describes how the author managed the cystic duct for achieving a cholangiogram, in addition to the entire technical details of laparoscopic cholecystectomy.

The cat's stomach is a sac-like structure designed to store large volumes of food and continue the digestive process. The esophagus carries food to the stomach, where it enters via a valve-like structure called the cardiac sphincter. On the interior surface of the stomach is a series of folds called gastric folds. These folds function to help grind and digest food. The inner stomach lining secretes acids and enzymes to break down food. Once the initial stomach digestive process is complete, the partially digested food exits the stomach through the pyloric sphincter area and then enters the duodenum (first segment of the small intestine). Once eaten, most food leaves the stomach within twelve hours after entering.

Cholecystectomy means removal of the gallbladder. The most common reasons
your doctor might recommend a cholecystectomy are biliary colic, cholecystitis,
choledocolithiasis, or gallstone pancreatitis. Biliary colic, also known as symptomatic
cholelithiasis, is caused by gallstones, which are hardened deposits of bile. Gallstones are
common in the general population, and gallstones alone are not a reason for gallbladder
removal if they do not cause symptoms. However, sometimes gallstones can get caught at the
neck of the gallbladder, causing pain when the gallbladder contracts against them trying to
release its bile, especially after a fatty meal. With biliary colic, the pain typically resolves within
an hour or so. Occasionally, a stone or some other blockage may prevent the gallbladder from
emptying over a long period of time, causing an increase in pressure and trapped fluid within the
gallbladder. This can cause inflammation and infection of the gallbladder, which we call
cholecystitis. Choledocholithiasis is when there are one or more stones in the bile ducts, which
can cause back up of bile into the liver, and depending on the location of the stones, could
cause pancreatitis, which is inflammation of the pancreas. Other reasons for gallbladder
removal, though less common, are gallbladder polyps and cancer. All of these are reasons for
gallbladder removal.

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