Surgery Shelf Prep!

Primary sclerosing cholangitis can look quiet at first, but it carries major shelf-level consequences. If you see a young man with cholestatic labs, pruritus, and ulcerative colitis, this is the diagnosis you need to catch.

In this episode of Surgery Shelf Prep, we break down the classic presentation of primary sclerosing cholangitis, why Magnetic Resonance Cholangiopancreatography is the key test, and how to separate it from primary biliary cholangitis, autoimmune hepatitis, and other causes of jaundice. We also cover the highest-yield complications, including ascending cholangitis, cholangiocarcinoma, cirrhosis, fat-soluble vitamin deficiency, and the increased colon cancer risk seen...

Pyogenic liver abscess can look subtle at first, but on the shelf it is a big-time diagnosis. Fever, right upper quadrant pain, leukocytosis, and a rim-enhancing liver lesion should make you think fast.

In this episode of Surgery Shelf Prep, we break down pyogenic liver abscess in a clear, high-yield way. You will learn the classic presentation, the major routes of infection to the liver, the most important organisms, how to separate pyogenic abscess from amebic liver abscess, and when management requires antibiotics alone versus percutaneous drainage.

We also cover: How biliary disease, portal spread...

Abnormal liver function tests can feel like a mess—until you learn the pattern. In this episode of Surgery Shelf Prep, we break down how to approach elevated liver labs the way the shelf wants: fast, organized, and high-yield.

Chris and Mars walk through the three major liver injury patterns: cholestatic, hepatocellular, and mixed. You’ll learn how to use the lab pattern to narrow the differential, when to order a Right upper quadrant ultrasound first, how to spot dangerous causes like ascending cholangitis or acute liver failure, and how to avoid common traps like isolated bilirubin or i...

Complications of cirrhosis can show up in a lot of different shelf-style ways, and this episode helps you organize them fast. In this high-yield review, Chris and Mars walk through the major complications every medical student needs to know: ascites, spontaneous bacterial peritonitis, esophageal varices, hepatic encephalopathy, hepatorenal syndrome, and hepatocellular carcinoma.

They break down the classic presentations, the core pathophysiology, and the next-step management that shows up on exam questions, including paracentesis, ascitic neutrophil thresholds, octreotide, lactulose, rifaximin, TIPS, and liver cancer surveillance. Perfect for a quick but focused Surgery Shelf review.

Cirrhosis can look slow and chronic on the surface, but on shelf questions it shows up with big consequences fast. If you do not recognize the clues behind ascites, varices, encephalopathy, and spontaneous bacterial peritonitis, this topic can absolutely trip you up.

In this episode of Surgery Shelf Prep, Chris and Mars break down cirrhosis in a clear, high-yield way for the surgery shelf exam. They walk through the classic presentation, the pathophysiology behind portal hypertension and liver failure, and the major complications you need to know cold, including ascites, esophageal varices, hepatic encephalopathy, and hepatorenal syndrome.<...

GERD is one of those shelf topics that seems simple, but the exam loves to test the complications, alarm symptoms, and when surgery becomes the answer.

In this episode of Surgery Shelf Prep!, Chris and Mars break down the classic presentation of gastroesophageal reflux disease, including heartburn, regurgitation, and symptoms that get worse at night or when lying down. They walk through the pathophysiology of lower esophageal sphincter dysfunction, the stepwise treatment approach from antacids to proton pump inhibitors, and the high-yield indications for endoscopy.

You will also review major complications like esophagitis, peptic stricture...

Groin bulge on the shelf? Don’t get trapped by the anatomy. In this episode of Surgery Shelf Prep!, Chris and Mars break down inguinal hernias in a fast, high-yield way that helps you separate indirect from direct, recognize the classic exam clues, and know when a hernia becomes an emergency.

You’ll learn how to use the inguinal ligament and inferior epigastric vessels to classify hernias, why indirect hernias can track into the scrotum, how direct hernias push through Hesselbach triangle, and which findings suggest incarceration or strangulation. This episode also reviews the key differential diagnoses, when...

Hiatal hernias are a classic Surgery Shelf topic because the exam loves the distinction between sliding and paraesophageal hernias. In this episode, Chris and Mars break down the anatomy, the classic symptom patterns, and the key test-taking question: who has reflux and who needs surgery.

They cover the high-yield differences between sliding hiatal hernias, which are common and usually cause GERD symptoms, and paraesophageal hernias, which are less common but more dangerous because of risks like volvulus, incarceration, strangulation, bleeding, and respiratory compromise. The episode also reviews diagnosis with barium swallow and endoscopy, plus when to manage...

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: