Surgery Shelf Prep!

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 esophageal peristalsis, then connect it to the classic bird-beak finding on barium swallow and the gold-standard diagnosis with esophageal manometry.

The episode also covers the high-yield management pathway, including pneumatic dilation, Heller myotomy, POEM, and...

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 diagnosis with CT or esophagography showing contrast extravasation. The episode also covers urgent management with NPO status, IV broad-spectrum antibiotics, IV proton pump inhibitor, and emergent surgical consultation, plus key differentials like Mallory-Weiss tear, myocardial infarction, aortic dissection, and pneumothorax. Perfect for shelf review...

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, the key risk factors, and the high-yield diagnostic workup. They break down when to start with ultrasound, when computed tomography is the better next step, why carbohydrate antigen 19-9 is not a screening...

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 endoscopy.

They also cover the high-yield complications you cannot miss, including bleeding, perforation, gastric outlet obstruction, and malignancy risk, plus the core treatment plan with proton pump inhibitors and bismuth quadruple therapy.

Pancreatitis is a classic Surgery Shelf topic because the exam loves the presentation, the diagnosis criteria, and the management steps. In this episode, Chris and Mars break down acute versus chronic pancreatitis, the major causes like gallstones, alcohol, and hypertriglyceridemia, and the key diagnostic rule of needing two of three criteria for acute pancreatitis.

They also cover the high-yield treatment plan, including aggressive Lactated Ringer resuscitation, pain control, when to feed patients, when ERCP is actually indicated in gallstone pancreatitis, and the complications you cannot miss, like necrotizing pancreatitis, pseudocysts, organ failure, steatorrhea, and pancreatogenic diabetes.

Gastrointestinal bleeding is a must-know Surgery Shelf topic because the first step is always the same: decide if it is an upper bleed or a lower bleed, then determine how sick the patient is. In this episode, Chris and Mars break down the classic presentations of hematemesis, melena, and hematochezia, then walk through the most important causes like peptic ulcer disease, varices, diverticulosis, angiodysplasia, hemorrhoids, and anal fissures.

They also cover the high-yield workup and management, including initial stabilization, when to use upper endoscopy versus colonoscopy, when computed tomography angiography is the right next step, and the...

Crampy abdominal pain, vomiting, abdominal distension, and obstipation? That is classic Small Bowel Obstruction, and this is one of the most high-yield Surgery Shelf topics because the exam loves to test both recognition and urgency. In this episode, Chris and Mars walk through the textbook presentation, the most common causes like adhesions and hernias, and the key pathophysiology behind bowel dilation, third-spacing, ischemia, necrosis, and perforation.

They also break down the diagnosis step by step, including abdominal X ray findings, why computed tomography is the best test, and how to distinguish Small Bowel Obstruction from ileus. On...

Rectal prolapse looks obvious… until the shelf exam tries to trick you with hemorrhoids, mucosal prolapse, and the wrong operation.

In this episode of Surgery Shelf Prep, Chris and Mars break down rectal prolapse step-by-step: how to identify it fast using concentric versus radial folds, why adults need colonoscopy to rule out a lead point malignancy, and how to choose the right surgery based on patient frailty. We also hit emergency management of an incarcerated prolapse, plus high-yield procedures like abdominal rectopexy, Altemeier, and Delorme. Perfect for med students who want clean algorithms and fewer missed questions.

Hemorrhoids are common and easy points—but they’re a high-yield shelf exam trap, especially when the question is really testing anatomy, rectal bleeding workup, and when to escalate treatment.

In this episode of Surgery Shelf Prep, Chris and Mars break down internal versus external hemorrhoids using the dentate line, the classic “painless dripper” versus “painful blueberry” presentations, and the stepwise management from fiber and sitz baths to rubber band ligation and excisional hemorrhoidectomy. We also cover the seventy-two-hour rule for thrombosed external hemorrhoids, when rectal bleeding needs colonoscopy, and the key distractors like rectal varices and Crohn’s dise

Anal cancer is the classic “hemorrhoids” misdirection—and the shelf loves it. If you miss the risk factors, the lymph node drainage, or the treatment algorithm, you’ll bleed points fast.

In this episode of Surgery Shelf Prep, Chris and Mars break down the high-yield presentation, key risk factors like Human Papillomavirus and Human Immunodeficiency Virus, why the dentate line predicts inguinal node spread, and the must-know management pearl: first-line treatment is combined chemoradiation, not surgery. We also cover staging imaging, when salvage abdominoperineal resection is indicated, and the common distractors that try to trick you on exam day

Anorectal pain with fever is a surgery shelf trap you can’t afford to miss. If the skin looks normal but the digital rectal exam is exquisitely tender, think deep abscess—then move fast.

In this episode of Surgery Shelf Prep, Chris and Mars break down perianal versus perirectal abscesses, the cryptoglandular origin at the dentate line, when imaging is actually needed, and the non-negotiable management rule: pus must be drained. We also cover who needs antibiotics, how fistula-in-ano shows up after drainage, and the key distractors that love to steal points on exams.

Ogilvie Syndrome can fool you: the colon looks obstructed, the belly is huge, but there’s no mechanical blockage. In this episode of Surgery Shelf Prep, Chris and Mars break down Acute Colonic Pseudo-Obstruction with the exact shelf-style framework you need—classic patient scenarios, key imaging findings, critical cecal diameter cutoffs, and the stepwise treatment algorithm from conservative management to neostigmine, colonoscopic decompression, and when to rush to surgery. We also cover the most testable traps, including how to quickly distinguish Ogilvie from ileus, sigmoid volvulus, and toxic megacolon.

Colonic volvulus can go from “constipated and uncomfortable” to “ruptured and crashing” fast. If you cannot instantly tell sigmoid from cecal and know the next best step, the shelf will absolutely punish you.

In this episode, Chris and Mars walk through the two big volvulus patterns you must recognize: the elderly, constipated nursing home patient with sigmoid volvulus, and the younger patient with a mobile cecum and acute onset pain from cecal volvulus. You will learn how to use demographics, imaging, and clinical stability to jump straight to the correct management pathway without getting lost in low-yield details...

Rectal cancer is where anatomy, oncology, and surgical decision-making all collide. In this episode, learn when to order pelvic MRI, when to give neoadjuvant chemoradiation, and when to choose Low Anterior Resection versus Abdominoperineal Resection.

Listen as Chris and Mars walk you through rectal cancer from first symptom to definitive surgery, with a tight focus on staging, local control, and those “next best step” questions that separate a passing score from a surgery shelf master.

Colon cancer is one of the highest-yield topics on the Surgery Shelf and Step 2 Clinical Knowledge – and one of the easiest places to lose points on subtle traps. This episode walks you through exactly how exam writers expect you to think, so you can move faster and more confidently on test day.

In this episode, Chris and Mars break down colon cancer from the ground up: how it presents, how to work it up, when to operate, and how to avoid the sneaky pitfalls that separate pass from honors. You will finally lock in the difference between ri...

Ischemic colitis is one of the highest-yield gastrointestinal emergencies on the Surgery Shelf — and if you don’t know how to spot it fast, you’ll miss the diagnosis both on exams and in real life.

In this episode, Chris and Mars break down everything you need to recognize, diagnose, and manage ischemic colitis with complete confidence. From classic elderly patients with low-flow states to the watershed zones most vulnerable to hypoperfusion, this is the episode that turns a tricky vascular–GI crossover topic into an easy win.

A low-flow state doesn’t have to mean a low...

Diverticulitis is one of those “can’t-miss” shelf exam topics that shows up again and again — and this episode breaks it all down so you’ll never confuse uncomplicated inflammation with a life-threatening perforation.

Chris and Mars walk through classic patient presentations, imaging pitfalls, and management strategies — from outpatient antibiotics to emergent surgery. You’ll also learn how to master the Hinchey classification, spot a colovesical fistula, and avoid the biggest test traps that trip students up.

Perfect for med students prepping for the Surgery Shelf or Step 2, this episode delivers the pearls you need — fast, focused, a...

Familial Adenomatous Polyposis and Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer) — two hereditary colorectal cancer syndromes that look similar at first glance but couldn’t be more different when it comes to genetics, screening, and surgical management.

In this episode, Chris and Mars walk you through how to instantly spot the differences on exam questions and in real-life surgical decision-making. These syndromes love to show up on the Surgery Shelf and Step 2, and mastering them means knowing the genes, the patterns, and the procedures cold.

Hit play and lock this one in — it’s guaranteed to show up...

Ulcerative Colitis loves to test your nerves — and your shelf knowledge. Continuous inflammation, rectal involvement, and surgical decision-making make this topic a guaranteed favorite on the Surgery Shelf.

In this episode, Chris and Mars walk through everything you need to crush Ulcerative Colitis questions — from recognizing the hallmark presentation to knowing exactly when surgery becomes life-saving.

Don’t let UC trip you up. Hit play, review your shelf pearls, and get ready to dominate your next surgery block with Chris and Mars on Surgery Shelf Prep!

Crohn’s Disease doesn’t play fair — it’s chronic, sneaky, and full-thickness. From skip lesions to fistulas, this disease hits every level of the gut, and it’s a shelf favorite.

In this episode, Chris and Mars break down everything you need to crush Crohn’s questions on your Surgery Shelf exam. They cover classic presentations, key diagnostic clues, medical and surgical management, and the can’t-miss complications that show up again and again in question stems.

You’ll learn how to: ✅ Recognize high-yield findings like cobblestoning, skip lesions, and non-caseating granulomas ✅ Differentiate Crohn’s from ulcerative coli...

Peri-operative anticoagulation, simplified. Chris and Mars hit the must-know hold times, monitoring, and reversals for Unfractionated Heparin and Low Molecular Weight Heparin (including partial protamine), warfarin (four factor Prothrombin Complex Concentrate plus intravenous vitamin K), and the direct oral anticoagulants (andexanet for factor ten A inhibitors, idarucizumab for dabigatran). They also cover when to continue aspirin, how to pause P2Y12 agents around recent stents, and key neuraxial anesthesia timing red flags. Perfect quick refresher for pre-op huddles and shelf questions.

Bleeding disorders are a classic shelf trap—know how to tell them apart or risk losing easy points.

In this episode, Chris and Mars tackle three must-know causes of abnormal bleeding: Von Willebrand Disease, Hemophilia A, and Uremic Platelet Dysfunction. You’ll learn their hallmark presentations, the diagnostic clues that separate them, and the treatments that save patients and score points on test day.

We break down:

Phosphorus doesn’t always get the spotlight—but on test day, it’s a game changer. From energy metabolism to bone health, imbalances can wreck patients and trip you up on the shelf.

In this episode, Chris and Mars break down the most high-yield phosphorus scenarios you need to master: Refeeding Syndrome, DKA after insulin therapy, Hungry Bone Syndrome, antacid and binder use, Fanconi syndrome, CKD-related hyperphosphatemia, tumor lysis syndrome, and post-thyroidectomy hypoparathyroidism. You’ll learn the classic presentations, the underlying pathophysiology, and the treatment pearls that show up again and again.

We cover:

Magnesium derangements are sneaky but high-yield! In this episode, Chris and Mars break down hypomagnesemia and hypermagnesemia across classic scenarios you’ll see on the wards and on exams. Learn why magnesium is the key to fixing refractory hypokalemia and hypocalcemia, how alcohol, PPIs, and refeeding syndrome trigger dangerous lows, and why CKD patients with laxatives or OB patients on mag drips can tip into life-threatening highs. We cover exam-ready pearls like Torsades treatment, reflex monitoring, and safe bowel prep alternatives.

Perfect for med students prepping for the surgery shelf—don’t miss this one!

Calcium disorders can flip a patient’s physiology upside down — and your shelf score with it. From post-thyroidectomy hypocalcemia to malignancy-induced hypercalcemia, these electrolyte shifts demand quick recognition and targeted management.

In this episode, Chris and Mars break down everything you need to know about hypocalcemia and hypercalcemia for your surgery shelf. You’ll learn how to recognize key signs, connect them to the underlying physiology, and avoid the treatment traps that love to appear in exam vignettes.

We cover: ✅ Why ionized calcium is the only number you can truly trust ✅ The post-op red flags for hypopa...

Potassium disturbances can make or break your shelf exam performance—and your patient’s outcome. Whether it’s a sneaky NG tube–induced hypokalemia or a burn patient at risk for fatal hyperkalemia, knowing the patterns, EKG changes, and pitfalls is non-negotiable.

In this high-yield episode, Chris and Mars break down hypokalemia and hyperkalemia from the ground up, covering GI losses, Conn syndrome, hypomagnesemia, renal failure, trauma, adrenal insufficiency, pseudohyperkalemia, and tumor lysis syndrome. You’ll learn when to act fast, how to avoid common traps, and why magnesium is the unsung hero of potassium management.

We cover...

Electrolyte imbalances can make or break your management on the wards and in the OR. Sodium, the OG electrolyte, has a way of testing your knowledge under pressure—whether it’s hyponatremia in a trauma patient or hypernatremia in the ICU.

In this high-yield episode, Chris and Mars break down everything you need to know about sodium disorders for the surgery shelf exam. From differentiating Cerebral Salt Wasting from Syndrome of Inappropriate Antidiuretic Hormone to decoding Diabetes Insipidus, they cover the pathophysiology, diagnostic pearls, and life-saving treatment strategies—plus the critical correction rates you can’t afford to forge...

High-voltage shocks and lightning strikes are devastating—but the hidden muscle damage, lethal arrhythmias, and silent toxins offer a chance to make a difference in a patient's life.

In this high-yield episode, Chris and Mars break down the full spectrum of electrical and thermal trauma you need to know cold for test day. From the iceberg effect of high-voltage contact burns to the sneaky labial artery bleed in a toddler’s mouth, they cover recognition, work-up, management, and—most importantly—the classic traps. You’ll also learn the must-know formulas, drug mechanisms, and airway decisions to save lives.

Compartment pressure can rise fast—and a missed diagnosis means muscle death. Meanwhile, crushed muscle spills toxins into the bloodstream, and a long-bone fracture can shower fat into the lungs before anyone blinks.

In this episode, Chris and Mars unpack three orthopedic trauma syndromes every surgery clerk must spot instantly: Compartment Syndrome, Rhabdomyolysis, and Fat Embolism Syndrome. You’ll learn to recognize hallmark presentations, understand the pathophysiology that makes each condition dangerous, and nail the definitive management steps that keep patients alive and limbs intact.

We break down:

One yank of a toddler’s arm or a split-second dashboard hit can spell disaster for tiny nerves and big joints. Don’t let routine-looking fractures and dislocations blindside you on exam day—or in the trauma bay.

In this episode, Chris and Mars break down four classic musculoskeletal injuries that love to show up on the shelf: mid-shaft clavicle fractures with Erb palsy, Nursemaid’s Elbow, posterior hip dislocations, and anterior hip dislocations. You’ll learn how to spot the tell-tale limb positions, understand the underlying nerve jeopardy, and master the swift interventions that save function (and medico...

Nerve injuries love to hide behind broken bones—and if you miss them, the consequences can be devastating. Make sure a wrist-drop or badge-patch numbness never slips past you again.

In this upbeat episode, Chris and Mars dissect three fracture-related nerve injuries that show up again and again on the surgery shelf (and in real life): axillary nerve palsy with proximal humerus fractures, radial nerve palsy with mid-shaft humerus fractures, and ulnar nerve palsy with distal humerus or medial epicondyle fractures. You’ll hear classic presentations, learn the anatomic “why,” and lock in the key diagnostic steps and trea...

Pelvic trauma can wreck more than bones—it can shred urethras, pop bladders, and crank intra-abdominal pressure past the danger zone. Don’t let hidden hematuria, missed CT cystograms, or a tight fascial closure sink your patient—or your shelf score.

In this episode, Chris and Mars break down three abdominal trauma heavy-hitters you absolutely can’t miss on exam day:

Hidden abdominal injuries can fool even the sharpest trauma team. Don’t let seat-belt bruises, subtle CT findings, or delayed enzyme rises trip you up on exam day.

In this episode, Chris and Mars unravel three shelf-favorite abdominal trauma patterns that demand a high index of suspicion: Hollow Viscus tears, Duodenal and Pancreatic “handle-bar” injuries, and the Seat-Belt Sign paired with Chance fractures. You’ll learn the tell-tale presentations, key imaging pearls, and must-know operative decisions that separate pass from honors.

We cover: ✅ Why a “normal” early CT never clears a small-bowel perforation ✅ Mesenteric tears versus blow-out...

Abdominal trauma isn’t just shelf-worthy—it’s life-saving knowledge in the trauma bay. From subtle splenic bleeds to delayed bilomas, this episode breaks down everything you need to master solid organ injuries.

Chris and Mars walk you through the classic presentations, imaging pathways, and life-or-death decisions around spleen, liver, and kidney trauma. Whether it’s a FAST-positive patient crashing in the trauma bay or a sneaky Page kidney showing up days later, we’ve got your back.

We cover: ✅ Why left-sided rib fractures scream splenic injury ✅ The critical post-splenectomy vaccines and platelet traps ✅ How to catch and man...

Abdominal trauma isn’t just high-yield—it’s high-stakes. One missed diagnosis, one delayed move, and your patient’s outcome could spiral fast. That’s why mastering this topic is essential for the shelf—and for real-life emergencies.

In this episode, Chris and Mars break down abdominal trauma management like pros. From FAST algorithms to trauma laparotomy, you’ll learn how to quickly triage, resuscitate, and operate with confidence.

We cover: ✅ When to take a trauma patient straight to the OR—no detours ✅ What the FAST exam doesn’t tell you (and why that matters) ✅ How to recognize the let...

Sternal fractures aren’t just bruises—and a “crunchy” neck might mean a trip to the OR. Don’t miss these deadly thoracic trauma patterns that hide in plain sight.

In this high-octane episode of Surgery Shelf Prep, Chris and Mars break down three clutch thoracic trauma topics that are critical for your shelf exam and real-life resuscitations: Sternal Fracture, Traumatic Pneumomediastinum, and Resuscitative Thoracotomy.

You'll learn to: ✅ Recognize sternal fractures as more than just broken bones—watch out for underlying cardiac contusions and aortic injuries ✅ Catch the Macklin effect in traumatic pneumomediastinum—and rule out deadly trachea...

Blunt chest trauma can be sneaky—and deadly. Don’t let widened mediastinums, bowel sounds in the chest, or new right bundle branch blocks catch you off guard.

In this episode, Chris and Mars tackle three critical thoracic trauma topics that are absolute shelf favorites: Blunt Aortic Injury, Traumatic Diaphragmatic Rupture, and Cardiac Contusion. You’ll learn how to recognize key signs on chest X-ray, understand the pathophysiology behind these high-stakes injuries, and lock in life-saving management steps.

We break down: ✅ When to act fast on a widened mediastinum ✅ Why bowel sounds in the chest mean surge...

Chris and Mars are back to bring the heat with Part 2 of Thoracic Trauma on Surgery Shelf Prep! This episode covers three critical, life-threatening injuries including flail chest, pulmonary contusions, and cardiac tamponade. Understanding these high yield topics will help you ace your surgery shelf exam and shine on your surgery clerkship! Strap in and tune in your brain for this rocking thoracic trauma episode!

Chris and Mars are back to tackle thoracic trauma—starting with the three that will make or break your shelf exam and your real-life trauma responses. In this jam-packed episode of Surgery Shelf Prep, they break down:

✅ How to clinically recognize and manage Tension Pneumothorax ✅ The do’s and don’ts of treating an Open (Sucking) Pneumothorax. ✅ Identifying a Massive Hemothorax ✅ Shelf traps, treatment pitfalls.

Perfect for surgery clerkship students preparing for the surgery shelf exam!

Chris and Mars wrap up their spinal-cord-injury episodes with a review of some high-yield spinal cord injury diagnoses including the Jefferson Fracture, Hangman Fracture, Chance Fracture, and SCIWORA. Nail down these topics to shine on your clerkship rotations, the shelf exam, and in patient care. Rock it!