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Case 13-2010 — NEJM
Results were normal for the hematocrit; the erythrocyte sedimentation rate; plasma levels of electrolytes, glucose, total protein, albumin, bilirubin, and calcium; tests of liver function; and urinalysis. .... The presence of a solitary mass might be indicative of a ganglioneuroma because of its benign nature. The differential diagnosis also should include other lesions that occupy the retroperitoneal space, such as schwannomas or neurofibromas, as well as a ...
weingarten's syndrome
the etiology remains controversial, but some evidence of calcium deposition in the sweat glands is present. o o subepidermal calcified nodule: these lesions usually develop in early childhood and are typically solitary, though multiple ...
mci screening test questions | medical students exam Blog
A couple, with a family history of beta thalassemia major in a distant relative, has come for counselling. The husband has HbA2 of 4.8% and the wife has HbA2 of 2.3%. The risk of having a child with beta thalassemia major is: ..... D. Nd : YAG laser. Ans. C Q 216. What is the most appropriate operation for a solitary nodule in one lobe of thyroid: A. Lobectomy B. Hemithyroidectomy. C. Nodule removal. D. Partial lobectomy with 1 cm margin around nodule. ...
Solitary Pulmonary Nodule
80 SOLITARY PULMONARY NODULE
Jamie M. Brown M.D., Marvin Pomerantz M.D.
1. What is a solitary pulmonary nodule?
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A solitary pulmonary nodule or “coin lesion” is < 3 cm and is discrete on chest radiograph. It is usually surrounded by lung parenchyma.
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should an infectious solitary pulmonary nodule be removed,Urinary Calculus Disease
94 URINARY CALCULUS DISEASE
Bretat B. Abernathy M.D.
1. What are the most common types of urinary stones found in North America?
Show answer
* Calcium stones (calcium oxalate, calcium phosphate, or mixed calcium stones): 70%.
* Struvite or magnesium ammonium phosphate stones, often associated with infection: 20%.
* Uric acid stones (radiolucent): 5%
* Cystine stones, often with a genetic association: 5% Read more
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irest stent, abernathy wordpress calculus 3, calcium mixed stones eswl treatment, calculus disease, can urosepsis cause intractable vomiting, cystine stones radiolucent radiopaque, how long should i rest after stone blasting and stent, indication of urological disorders urinary calculus, should stone in distal ureter be removed, steinstrasse ct scan,Thyroid Nodules & Cancer
59 THYROID NODULES AND CANCER
Robert C. McIntyre Jr., M.D.
1. What is the prevalence of thyroid nodules and cancer?
Show answer
Thyroid nodules increase throughout life. Nodules are four times more common in females than in males, and 50% of 50-year-old women have a palpable nodule. After exposure to radiation, nodules develop at approximately 2% annually, reaching a peak at 25 years. Nodules are 10 times more frequent in glands examined by ultrasound, at surgery, or at autopsy. Fewer than 50% of thyroid nodules that appear solitary on physical examination are truly solitary.
Each year in the United States, there are approximately 15,000 new cases and 1000 deaths due to thyroid cancer. Up to 35% of thyroid glands examined at autopsy contain occult papillary cancer (< 1.0 cm).
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57 HYPERPARATHYROIDISM
Robert C. McIntyre Jr., M.D.
1. What is the prevalence of hyperparathyroidism (HPT)?
Show answer
There are approximately 100,000 new cases of HPT annually in the United States. Primary HPT occurs in 1 in 500 women and in 1 in 2000 men older than 40 years. Approximately 10% of patients with primary HPT are referred for surgery.
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Renal Cell Carcinoma
95 RENAL CELL CARCINOMA
Brett B. Abernathy M.D.
1. How common is renal cell carcinoma?
Show answer
In the United States, 30,000 new cases of renal cell carcinoma are predicted for 2004 and 2005, about 3% of all adult malignancies.
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Evaluation & Treatment Of Cardiac Dysrhythmias
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 rhythm. But these are the same purists who use the word iatrogenic to mean “caused by a physician,” when, of course, the only thing that can truly be “iatrogenic” is a physician’s parents.
Parental Nutrition
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 (lipid 20% solution delivers 2 kcal/mL), vitamins, minerals, trace elements, fluid, and sometimes insulin through an intravenous (IV) infusion. Acid-base status may be influenced by the amount of chloride and acetate used in providing sodium and potassium. The concentrations of calcium and phosphorus are limited to avoid precipitation of a calcium phosphate salt.
What Does Postoperative Fever Mean?
10 WHAT DOES POSTOPERATIVE FEVER MEAN?
Alden H. Harken M.D.
1. What is a fever?
Show answer Normal core temperature varies between 36°C and 38°C. Because we hibernate a little at night, we are cool (36°C) just before rising in the morning; after revving our engines all day, we are hot at night (38°C). A fever is a pathologic state reflecting a systemic inflammatory process. The core temperature is > 38°C but rarely > 40°C.
Cardiopulmonary Resuscitation
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 disease are the most common causes. VF is becoming less common.
2. What is the predominant determinant of successful cardiopulmonary resuscitation (CPR)?
Show answer
Time to restoration of spontaneous circulation, which itself is a function of the time to effective chest compression and time to defibrillation of VF. The chance of a good outcome decreases by 10% per minute. Successful outcomes are more likely if CPR is initiated promptly and if preexisting hypothermia is present.
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Mitral Stenosis
75 MITRAL STENOSIS
David A. Fullerton M.D., Glenn J.R. Whitman M.D.
1. What causes mitral stenosis?
Show answer
Rheumatic fever.
2. Which gender most commonly gets mitral stenosis?
Show answer
Women by a ratio of 3:2.
3. What are the physical findings of mitral stenosis?
Show answer
On ascultation, an opening snap and a diastolic murmer are heard best at the apex.
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Aortic Valvular Disease
77 AORTIC VALVULAR DISEASE
Christopher D. Raeburn M.D., Alden H. Harken M.D.
1. What are the most common causes of aortic stenosis?
g> Show answer
Rheumatic heart disease is now a rare cause of aortic stenosis, so the most common causes are now congenital anomalies and calcific (degenerative) disease.
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Pediatric Urology
99 PEDIATRIC UROLOGY
Kirstan K. Meldrum M.D., Mark P. Cain M.D.
1. A healthy 3-year-old girl develops a urinary tract infection (UTI). How should she be evaluated?
Show answer
After treatment of the infection, the patient should undergo a urinary tract evaluation (this recommendation stands even in a little girl after only one UTI). Evaluation includes a renal-bladder sonogram and voiding cystourethrogram (VCUG). Approximately 50% of children younger than age 12 years who present with a UTI are found to have abnormalities of the genitourinary tract. The most common abnormalities identified are vesicoureteral reflux, obstructive uropathies, and neurogenic bladder.
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93 THE SURGICAL APPROACH TO INFERTILITY
Randall B. Meacham M.D., Alex J. Vanni
1. How common a problem is infertility?
Show answer
Infertility is the inability to establish a pregnancy during 1 year of well-timed intercourse. This affects 15% of all couples in the United States. In 50% of such couples, the woman is responsible; in 30% of couples, a male factor prevents pregnancy; and in 20% of couples, it is a combination of both.
Breast Masses
61 BREAST MASSES
Christina A. Finlayson M.D.
1. What are the three parts of breast screening that assist in the early diagnosis of breast cancer?
Show answer
Breast self-examination (BSE) should begin at age 20 years and should be performed monthly. The breast is usually easiest to examine on the days immediately after the menstrual cycle. BSE can be frustrating to patients, particularly when they have fibrocystic changes, because they are not certain what they are feeling or supposed to feel. The BSE technique should be taught early and reinforced regularly. Women who regularly perform BSE present with tumors 1 cm or smaller more frequently than women who do not perform BSE. BSE has yet to translate into a survival benefit, however. Some women are spooked by repetitive false-positive findings. These women need to rely on their physicians to perform a breast examination once a year.
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Coronary Artery Disease
74 CORONARY ARTERY DISEASE
Joseph C. Cleveland Jr., M.D.
1. What is angina, and what causes it?
Show answer
Angina pectoris reflects myocardial ischemia. Patients often describe the sensation as pressure, choking, or tightness. Angina is typically produced by an imbalance between myocardial oxygen supply and myocardial oxygen demand. The classic presentation is a man (male-to-female ratio = 4:1) out shoveling snow on a cold night after a big meal after having a fight with his wife.
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Abernathy’s Surgical Secrets, Updated Edition (Book w / Student Consult)
Author / s: Harken Alden H., Abernathy Charles, Moore Ernest Eugene
Year: 2004
Pages: 473
Publishers: Elsevier Mosby; 5th Bk & Acc edition
ISBN: 0323034160
