in the study of medicine, it's essential to initiate from the genesis of any condition to understand its full scope. when we consider the word "surreptitious," we often think of something done in secret. however, in a medical context, this could refer to conditions that are not immediately apparent or that patients may not readily disclose during a preadmission review. it's our duty as future medical professionals to pass over the initial surface information presented and delve deeper into our patient's history and symptoms to uncover these hidden factors. this approach helps us provide comprehensive care and builds a foundation of trust and transparency with our patients.