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Anorectal Disease. Pilonidal Sinus Disease
PILONIDAL SINUS DISEASE
29. What is the most common clinical presentation of a pilonidal sinus?
Show answer
Pain and swelling in the sacrococcygeal region, which typically are associated with a (sometimes several) chronic draining sinus tract.
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pilonidal sinus and anorectal pain,Congenital Cysts & Sinuses Of The Neck
88 CONGENITAL CYSTS AND SINUSES OF THE NECK
Frederick M. Karrer M.D., Denis D. Bensard M.D.
1. What are branchial cleft anomalies?
Show answer
Cysts, sinuses, and fistulas that result from incomplete obliteration of the first, second, or third branchial clefts, and are present in early fetal development.
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CAROTID DISEASE
70 CAROTID DISEASE
Rao Gutta M.D., B. Timothy Baxter M.D.
1. What diseases affect the carotid arteries?
Show answer
Atherosclerosis is by far the most common (accounting for 90% of lesions in the Western world). The carotid also can be affected by fibromuscular dysplasia, inflammatory arteriopathies (e.g., Takayasu’s arteritis), extrinsic compression (e.g., neoplasm), and trauma.
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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.
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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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.
Lung Transplantation
92 LUNG TRANSPLANTATION
Daniel R. Meldrum M.D., Azad Raiesdana M.D., Jeffrey A. Breall M.D., John W. Brown M.D.
1. What are the general types of lung transplants?
Show answer
Single, double (bilateral), and heart-lung.
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Trauma To The Colon & Rectum. Rectal Trauma
RECTAL TRAUMA
9. How do rectal injuries occur?
Show answer
Similar to colon injuries, most rectal injuries result from penetrating trauma. Blunt pelvic fractures should be assessed with a strong suspicion for rectal (and urethral) injury.
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colon rectal trauma, rectal injuries, trauma of the colon, colon trauma and antibiotics, demetriades d penetrating colon injuries requiring resection: diversion or primary anastomosis? an aast prospective multicenter study, principles of rectal trauma, recovery time for rectal trauma, rectal trauma, rectum trauma, suspection rectal injury, thorough examination in rectal trauma, trauma colorectal, trauma de recto extraperitoneal, trauma to the colon,Surgical Infectious Disease
15 SURGICAL INFECTIOUS DISEASE
Glenn W. Geelhoed M.D., M.P.H., DTMH
1. Have modern antibiotic developments controlled many, if not most, of the problems of surgical infection?
Show answer
No. In seriously ill surgical patients in intensive care unit (ICU) settings, the problems of sepsis have increased and remain among the principal causes of death in ICU patients, especially those with multiple organ failure and impairments of host defense. Antibiotic treatment may change the biographical sketch of the flora associated with patients’ deaths but cannot overcome the multiple causes of failing host resistance to infection that accompany barrier breeches to microbial invasion and the inflammatory and immunologic responses to the “usual suspects.”
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Hyperthyroidism
58 HYPERTHYROIDISM
Robert C. McIntyre Jr., M.D.
1. What are the symptoms and signs of hyperthyroidism? Show answer
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General:
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Heat intolerance, perspiration, flushing, tremor, sleep disturbance
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Psychological:
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Nervousness, emotional lability, anxiety, aggressiveness, delusions
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Cardiovascular:
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alpitations, tachycardia, supraventricular dysrhythmias
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Respiratory:
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Breathlessness, hoarseness
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Gastrointestinal:
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Increased appetite, weight loss, increased frequency of bowel movements
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Reproductive:
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Gynecomastia, irregular menses
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Bone:
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Osteoporosis
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Other:
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Ophthalmopathy, dermopathy
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2. What causes hyperthyroidism?
Incoming search terms
dexamethasone guideline hypertyroid,Nutritional Assessment & Enteral Nutrition. Enteral Nutrition
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 score < 8), major torso trauma, major trauma to the pelvis and long bones, or major chest trauma benefit from enteral nutrition. Approximately 85% of postoperative patients (even those undergoing gastrointestinal [GI] surgery) tolerate early enteral feeding (within 24 hours).
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How to Think About Shock?
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
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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
