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9 PARENTERAL NUTRITION Margaret M. McQuiggan M.S., R.D., CNSD, Frederick A. Moore M.D. 1. What is parenteral nutrition? Show answer Parenteral nutrition is the provision of protein as amino acids (4 kcal/g), dextrose (3.4 kcal/g), and fat...

CONTROVERSIES 23. How fat is fat? Show answer Lean body mass is three times more metabolically active than adipose tissue. Multiple definitions of clinical obesity exist: > 120% ideal body weight (IBW), > 130% IBW, body mass index (BMI) >...

ENTERAL NUTRITION 10. When should enteral nutrition be considered? Show answer Always, but especially when a patient is unlikely to meet > 70% of nutritional needs by mouth. Patients who have sustained major head injury (Glasgow Coma Scale...

8 NUTRITIONAL ASSESSMENT AND ENTERAL NUTRITION Margaret M. McQuiggan M.S., R.D., CNSD, Frederick A. Moore M.D. NUTRITIONAL ASSESSMENT 1. What does a nutritional assessment include? Show answer 1. The medical and surgical history is...

7 FLUIDS, ELECTROLYTES, GATORADE, AND SWEAT Alden H. Harken M.D. 1. What is hypertonic saline? Show answer Normal saline is 0.9% sodium chloride. Hypertonic saline is 7.5% sodium chloride (eight times as concentrated as normal...

6 WHY GET ARTERIAL BLOOD GASES? Alden H. Harken M.D. 1. Is breathing really overrated? Show answer It may be. A Japanese yoga master survived just fine breathing once per minute for an hour (see reference 1)! 2. Mr. O'Flaherty has just...

5 WHAT IS PULMONARY INSUFFICIENCY? Alden H. Harken M.D. 1. What is pulmonary insufficiency? how answer The alveolar-capillary surface of the lung is the size of a singles tennis court. The purpose of the lung is to match alveolar ventilation...

4 HOW TO THINK ABOUT SHOCK Alden H. Harken M.D. 1. Define shock. Show answer Shock is: * Not just low blood pressure * Not just decreased peripheral perfusion * Not just limited systemic oxygen delivery Ultimately, shock is...

3 EVALUATION AND TREATMENT OF CARDIAC DYSRHYTHMIAS Alden H. Harken M.D. 1. Are cardiac dysrhythmias and cardiac arrhythmias the same? Show answer Yes. Some purists will tell you that an arrhythmia can be only the absence of a cardiac...

2 CARDIOPULMONARY RESUSCITATION Norman A. Paradis M.D., Alden H. Harken M.D. 1. Define sudden cardiac death. Sudden ventricular fibrillation (VF) or pulseless electrical activity (PEA). Acute coronary ischemia and preexisting cardiac...

Unlike medical rounds, where in order to "keep up" you need to "one up" by quoting a current (preferably yesterday's) journal article, in surgery, you can flourish by knowing the following references-but you need to know them cold. 1. Mangano DT,...

Surgery is a participatory, team, and contact sport. Present yourself to patients, residents, and attendings with enthusiasm (which covers a multitude of sins), punctuality (type A people do not like to wait), and cleanliness (you must look, act, and...