Simini Boards Cast

Simini Podcasts
  • 5.0 (2)
  • EDUCATION

  The Simini Boards-Cast is the go-to audio study tool for small animal surgery residents prepping for board exams.  Each episode simplifies high-yield surgical content from trusted sources  — built to help you pass faster and with less stress.  🎧 Audio-based learning for passive study ✂️ Practical relevance for surgical application 🧠 Flashcard-style recaps + board-style questions 📈 Designed with resident + program director input  Whether you're commuting, walking the dog, or post-op, turn that time into surgical mastery.  Subscribe now and get board-ready — fast. 

  1. 4D AGO

    Chapter 93 - Part E: Successful Colectomy, Failed Patient: The Colon Physiology Trap

    In this BoardsCast episode, we finish Tobias Chapter 93 — Colon by confronting the scenario that haunts surgeons: successful colectomy. failed patient. Margins were clean. The anastomosis looked perfect. No leak on the table. And then 36 hours later, the patient is hypotensive, septic, and crashing — because colon surgery doesn’t fail in the abdomen. It fails in physiology. This episode builds the framework the boards want you to recognize instantly: post-colectomy survival is driven by three killing forces — fluid shifts, bacteria, and motility — all colliding in the days 3–5 danger window when colonic wounds are at their weakest.  You’ll learn: Why the colon is a hostile environment: extreme bacterial density + segmental terminal blood supply (vasa recta) with no collateral “insurance.” The three killing forces after colectomy: fluid loss/third spacing, bacterial endotoxin, and ileus-driven distension/tension Why the days 3–5 window is deadly: collagen breakdown outpaces synthesis (lag phase), and wound strength is dramatically reduced early Why “cleaning the colon” can backfire: mechanical prep can turn solid stool into a leaking slurry The 5 predictable post-colectomy killers: masked hypovolemia, unrecognized septic peritonitis, progressive ileus, low albumin/protein, and inadequate analgesia (pain → vasoconstriction → ischemia) The board-pattern red flag: hypotension + abdominal pain at ~48 hours = assume leak/septic peritonitis (don’t wait for fever; don’t trust drains) This episode closes Chapter 93 with the shift that saves patients: don’t just close the colon — stabilize the biology. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    14 min

  2. 4D AGO

    Chapter 93 - Part D: Foreign Bodies, Linear Tension & Colonic Obstruction

    In this BoardsCast episode, we continue Tobias Chapter 93 — Colon by confronting the most common (and most lethal) trap in abdominal surgery: “It’s just constipated.” “It’s just a foreign body.” “Let’s wait until morning.” That “stable obstruction” is often a ticking time bomb — because colonic obstruction is not a plumbing issue. It’s a pressure-driven vascular emergency happening inside an organ packed with bacteria.  This episode builds the mental model the boards want you to recognize instantly: the colon becomes a closed-loop pressure chamber, venous outflow fails first, mucosa becomes ischemic, and bacteria translocate before you ever see a perforation.  You’ll learn: Why colonic obstruction is a vascular problem first, not “stool stuck in a tube” The normal function of colon (storage + dehydration) — and why obstruction turns that into a pressure amplifier The blood supply failure sequence: venous collapse → congestion/edema → arterial shutdown → necrosisWhy the colon crashes patients early: bacterial burden + barrier failure → translocation + endotoxemia (before a visible hole exists) Why linear foreign bodies are worse: pleating + tension that saws into the mesenteric border, especially in fixed colonic segments The healing trap: the colon gets weaker for 3–4 days (collagen lysis > synthesis), and collagen formation stops if tissue oxygen is too low The surgical rule: don’t trust gray colon — preserving questionable tissue is riskier than resection, and omentum should be used every time This episode teaches the shift that saves lives: time is not neutral in colonic obstruction — time is destructive. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    17 min

  3. 4D AGO

    Chapter 93 - Part C: Colonic Anastomosis: Why This Leak Is Worse Than the Last One

    In this BoardsCast episode, we continue Tobias Chapter 93 — Colon by confronting the nightmare scenario that feels like a betrayal: You’ve repaired small intestinal leaks before. You’ve done a hundred resections. And then you treat the colon the same way… and the patient crashes. Because a colonic anastomosis is not “plumbing.” It is a pressure-sealed septic barrier sitting in a hostile environment — and if it fails, it doesn’t smolder like small bowel. It detonates. This episode builds the failure model the boards want you to say out loud: the colon is a high-pressure storage organ with low perfusion reserve, a healing curve that gets weaker at 48 hours, and bacteria that actively accelerate collagen breakdown during the most vulnerable window.  You’ll learn: Why the colon is mechanically different: storage organ = higher luminal pressure and solid contents that don’t “flow away” The 4 requirements your anastomosis must meet from minute one: pressure-tight seal, preserve marginal blood supply, contain massive bacterial load, and heal in a hypovascular field Why colonic blood supply has no gray zone: short, irregular, terminal vessels = “alive or dead” The lag phase reality: at ~48 hours, colonic wound strength drops to ~30% of normal because collagen lysis exceeds productionWhy colonic bacteria aren’t just “dirtier” — they actively induce collagenase and speed repair breakdown The “make it reach” fallacy: tension kills perfusion, and if tissue oxygen drops too low, repair mechanisms stop The lethal triad the boards expect: tension + perfusion compromise + bacterial loadThe overbuild strategy: zero tension, wide perfusion margins (cut until it bleeds), submucosa bites, monofilament synthetic (never gut), and omentalization as insuranceThis episode teaches the shift that prevents disaster: you didn’t lose the patient because you forgot how to suture — you lost them because you treated the colon like small intestine. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    17 min

  4. 4D AGO

    Chapter 93 - Part B: Megacolon Is a Neurologic Problem, Not a Stool Problem

    In this BoardsCast episode, we continue Tobias Chapter 93 — Colon by deleting the most dangerous mental model in constipation medicine: megacolon is not a plumbing problem. If you treat it like a clog—more laxatives, more enemas, more fiber—you can waste critical time while the colon is literally losing the ability to contract. This episode reframes megacolon correctly: a neuromuscular failure where the “container” is broken, not just the “content.”  You’ll learn: Why treating megacolon like a stool problem is dangerous (symptom treatment while the organ fails) The difference between constipation vs obstipation — and why obstipation implies loss of function The colon’s three jobs (storage, absorption, propulsion) — and which one dies in megacolon The progression from hypertrophic to dilated megacolon (compensation → irreversible failure) The failure loop: distension → reduced contractility → more distension → “dead organ” The board-critical timeline: changes are usually considered irreversible after ~6 months of dilation Primary (idiopathic) vs secondary megacolon (pelvic fractures, neurologic causes like Manx syndrome) Why cisapride, lactulose, and fiber can fail—or worsen the loop—in true megacolon Why subtotal colectomy works: removing a nonfunctional reservoir (not “unclogging”) + the ICJ tradeoff This episode teaches the shift the boards expect: stop fighting the poop—start evaluating propulsion. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    14 min

  5. 4D AGO

    Chapter 93 - Part A: The Colon Isn’t Just Dirtier — It’s Less Forgiving

    In this BoardsCast episode, we begin Tobias Chapter 93 — Colon by dismantling the most dangerous assumption in large bowel surgery: “I’ll just close it like small intestine.” That mindset is how you get the nightmare outcome: the suture is still tied, the pattern was “perfect,” and the patient crashes two days later with septic peritonitis — because colonic surgery is not primarily a suturing problem. It’s a vascular and bacterial problem. This episode rebuilds the mental model for why the colon fails: it’s a high-pressure storage tank with a segmental, low-reserve blood supply, and a bacterial population that actively dissolves collagen during the first critical post-op days.  You’ll learn: Why the colon is mechanically different: storage + pressure vs small intestine flow pipe Why microscopic leaks become catastrophic in the colon (solidifying feces + gas + constant wall stress) Why the “pink trap” is real: deep layers can be ischemic while serosa still looks viable How segmental blood supply and short terminal vessels create a razor-thin margin for tensionWhy colonic wounds get weaker before they get stronger: 3–4 day lag phase + bacterial collagenaseWhy the boards’ answer is a triad: reduced perfusion reserve + bacterial load/collagen lysis + tension-related ischemiaThe technical non-negotiables: submucosa is the holding layer, monofilament synthetic (avoid gut), no bowel prep, and omentum as insuranceThis episode teaches you the shift that prevents the “perfect closure, dead patient” scenario: the colon isn’t just dirtier — it’s less forgiving. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    16 min

  6. FEB 10

    Chapter 92 - Part E: Successful Anastomosis, Dead Dog: The Small Intestine Failure Pattern

    In this BoardsCast episode, we finish Tobias Chapter 92 — Small Intestine by locking in the most brutal (and most common) postoperative pattern in GI surgery: successful anastomosis. dead dog. The leak test was dry. The closure looked perfect.  And the patient still dies 48 hours later — because technical success can be meaningless if the tissue and the patient physiology are already failing. This final episode of Chapter 92 builds the board-level failure framework: small intestine surgery is a physiologic stress test, and outcomes are often decided before you cut. You’ll learn: Why “watertight on the table” doesn’t predict what happens over the next 48 hoursThe three pre-op conditions that drive this failure pattern: shock/hypoperfusion, endotoxemia/translocation, and hypoproteinemia/anemia → edemaWhy edema makes bowel “sewable today, leaking tomorrow” (and why it can loosen staples/closure later)The 3–5 day danger window: lag phase + collagen breakdown → microleak → septic collapseWhy x-rays are unreliable after GI surgery — and what actually triggers action: ultrasound + fluid samplingThe “smoking gun” for septic peritonitis: intracellular bacteria on abdominal fluid cytologyTechnical traps that still matter: submucosa is the strength layer, and staplers can fail in edematous bowel when swelling resolvesWhy reinforcement doesn’t replace physiology: you can’t “patch” your way out of systemic failureThis episode closes Chapter 92 with the shift that saves patients: don’t just evaluate the anastomosis — evaluate the patient’s ability to heal it. 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    18 min

  7. FEB 10

    Chapter 92 - Part D: Foreign Bodies, Linear Traps, and the Bowel You Shouldn’t Save

    In this BoardsCast episode, we continue Tobias Chapter 92 - Small Intestine by confronting one of the most lethal instincts in GI surgery: “Save as much bowel as you can.” With linear foreign bodies, that instinct is the trap. Because a linear foreign body isn’t a simple obstruction — it’s a tension-driven injury pattern that creates diffuse damage, especially along the mesenteric border where the blood supply enters the bowel. And the inside injury is often worse than what your eyes show you on the serosa. This episode rebuilds the decision-making framework the boards want you to recognize instantly: preservation does not equal safety. You’ll learn: Why linear foreign bodies are mechanically different than “normal” obstructions (anchor + tension + pleating)The classic anchor points: base of tongue (cats) and pylorus (dogs)The “accordion” mechanism — and why the string saws along the mesenteric border (the blood-supply side)The diagnostic pattern: teardrop/triangular gas + bunched bowel (not normal tubular gas)Why “it looks pink / it has peristalsis” is an unreliable viability test in linear FB casesThe board trap: multiple enterotomies + bruised bowel → septic peritonitis at 48 hours (decision error, not suture error)The two non-negotiable rules: release the anchor first, resect doubt, and preserve certaintyThis episode teaches you how to stop thinking “how do I save bowel?” and start thinking “what bowel will still be alive tomorrow?” 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    16 min

  8. FEB 10

    Chapter 92 - Part C: Anastomosis Isn’t Closure: Tension, Diameter, and the Leak You Built

    In this BoardsCast episode, we continue Tobias Chapter 92 - Small Intestine by dismantling the most dangerous misconception in GI surgery: An anastomosis is not “closure.” It’s engineering — a dynamic, load-bearing junction inside a pressurized hydraulic system.  Because here’s the nightmare: the sutures hold, the knots are perfect, the leak test is dry… and 36 hours later the abdomen is full of septic fluid. Not because you “missed something” — but because the failure was designed on the table. This episode shifts your mental model from “edges touch = success” to load transfer, perfusion, flow dynamics, and healing biology—the real determinants of whether the anastomosis survives the first 3–5 days.  You’ll learn: Why the “closure trap” is false security—and why no leak on the table proves almost nothing about what happens later The orthopedic analogy that changes everything: anastomosis as a load-sharing bridge (not a watertight seal) Why the bowel gets weaker on days 3–5 (collagenase + lag phase) even if your surgery looked perfect The #1 engineered failure: tension you pretended was acceptable—and how inadequate mobilization creates vascular strangulation How diameter mismatch creates turbulence, pressure spikes, and focal strain—and the fixes: spacing, angling, and spatulationWhy twisting geometry and mesenteric alignment can “ring out” blood supply and build a kink into the repair Why edema is a silent killer, why “opposed not crushed” is non-negotiable, and when staplers fail on swollen bowel The board-relevant diagnostic clue for early leaks: abdominal fluid glucose delta to catch septic peritonitis before collapse This episode teaches you how to stop thinking “I didn’t see a leak” and start thinking “did I build a junction that survives force + inflammation + enzymatic breakdown?” 🎁 Simini Bonus Claim your free sample of Simini Protect Lavage (just cover shipping): https://www.simini.com/getstarted1620808454519 Listen On: Spotify | Apple Podcasts | Amazon Music

    17 min
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out of 5
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About

  The Simini Boards-Cast is the go-to audio study tool for small animal surgery residents prepping for board exams.  Each episode simplifies high-yield surgical content from trusted sources  — built to help you pass faster and with less stress.  🎧 Audio-based learning for passive study ✂️ Practical relevance for surgical application 🧠 Flashcard-style recaps + board-style questions 📈 Designed with resident + program director input  Whether you're commuting, walking the dog, or post-op, turn that time into surgical mastery.  Subscribe now and get board-ready — fast. 

Information

  • Creator
    Simini Podcasts
  • Years Active
    2025 - 2026
  • Episodes
    103
  • Rating
    Clean
  • Copyright
    © 2026 Simini Boards Cast
  • Show Website
    Simini Boards Cast