Five clinical questions. Every day. See where you rank.

Surgery Shelf Prep

Intra-Abdominal Abscess

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 CT imaging, and the core treatment principle of antibiotics plus source control. You’ll learn when percutaneous drainage is preferred, when operative management is necessary, and how hemodynamic instability changes the entire plan. We also review one of the most practical postoperative concepts: what your drain output is telling you. Clear fluid? Check creatinine for urine. Milky output? Check triglycerides for chyle. Pancreatic concern? Check amylase. Bilious drainage? Check bilirubin. Feculent output? Think bowel leak or fistula. Plus, we cover persistent fever after drainage, clogged or malpositioned drains, loculated collections, and key surgery shelf-exam traps that can change management.

Medicine Shelf Prep

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy is an inherited myocardial disease characterized by unexplained left ventricular hypertrophy, impaired diastolic filling, and sometimes dynamic left ventricular outflow tract obstruction. In this episode, Chris and Mars review the classic genetics and asymmetric septal hypertrophy of HCM, systolic anterior motion of the mitral valve, why the murmur gets louder with standing and Valsalva, exertional dyspnea, angina, syncope, and sudden cardiac death, echocardiography and cardiac MRI findings, beta blockers as first-line treatment for symptomatic obstructive HCM, medications and volume changes that can worsen outflow obstruction, sudden-death risk assessment and implantable cardioverter-defibrillator indications, and atrial fibrillation, anticoagulation, exercise, genetics, and family screening. Episode pearl: In obstructive HCM, a smaller left ventricular cavity means more obstruction—which explains both the murmur maneuvers and many of the treatment decisions.

Surgery Shelf Prep

Surgical Site Infection

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, dangerous early clues for necrotizing infection, when to open and drain a wound, when systemic antibiotics are needed, and when an intra-abdominal collection requires percutaneous or operative source control. We also cover the prevention details worth knowing for the shelf: perioperative temperature goals, glucose control, chlorhexidine-alcohol versus povidone-iodine skin preparation, clipping instead of shaving, appropriate prophylactic antibiotics, and the four surgical wound classes—clean, clean-contaminated, contaminated, and dirty-infected.