By Latha Stead, S. Matthew Stead, Matthew Kaufman, Nitin Mishra
The student-to-student, step by step advisor to surgical procedure clerkship success
There isn't any greater solution to ace the surgical procedure clerkship examination and provoke at the wards than First relief for the surgical procedure Clerkship. thoroughly up to date all through, the second one variation incorporates a consultant to excelling within the clerkship, a high-yield evaluate of middle fabric, universal examination and "pimp" questions, and a piece of "classifieds" together with scholarship opportunities.
* particular what-to-study and what you must-know recommendation from clerkship veterans is helping you ace the surgical procedure clerkship examination and galvanize at the wards * Frequently-tested high-yield evidence and mnemonics maximize your learn time * “Exam Tips” strengthen strategies you must recognize on examination day * “Ward Tips” organize you for universal “pimp” questions * “Classifieds” spotlight extracurricular possibilities and scholarships
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Additional resources for First Aid for the Surgery Clerkship (First Aid Series)
Severe decrease in SVR). They include septic shock, neurogenic shock, and anaphylactic shock. These patients will have warm skin from vasodilation. 5 cc/kg/hr. Infection that causes vessels to dilate and leak, causing hypotension refractory to fluid recuscitation. Lab/Physical Findings Ⅲ Ⅲ Ⅲ Fever, tachypnea Metabolic acidosis, hyperglycemia Positive blood cultures (often negative, however, particularly if drawn after antibiotics are started) Treatment Critical Care Gram-negative bacteria are notorious for causing septic shock.
What is the significance of the wedge pressure? It reflects the left ventricular pressure, which will be increased with left ventricular failure. 60 PRESSORS A group of vasoactive drugs that are the final line of defense in treating shock EFFECTS AND SIDE EFFECTS Generally, pressors are used to increase CO or SVR. All of them have important side effects that can limit their use. These side effects are easily predicted based on the drug’s action. For example, in addition to stimulating β1 receptors, dobutamine stimulates β2 (which causes vasodilation).
Thiazides) SIGNS AND SYMPTOMS Ⅲ Ⅲ Ⅲ Ⅲ Fatigue, weakness, anorexia, weight loss, nausea, vomiting Somnambulism, stupor, coma Severe headache, pain in the back and extremities, thirst, polydipsia, polyuria Death TREATMENT Ⅲ Ⅲ Ⅲ Vigorous volume repletion with salt solution—dilutes Ca and increases urinary Ca excretion: Ⅲ May be augmented with furosemide. Definitive treatment of acute hypercalcemic crisis in patients with hyperparathyroidism is immediate surgery. Treat underlying cause. I N D I C AT I O N S F O R N U T R I T I O N A L S U P P O R T Enteral Ⅲ Gut works Ⅲ Oral intake not possible—altered mental state, ventilator, oral/pharyngeal/esophageal disorders Ⅲ Oral intake not sufficient for metabolic requirements—anorexia, sepsis, severe trauma/burns Ⅲ Presence of malnutrition and wasting 52 Parenteral (TPN) Ⅲ Enteral feeding not possible—GI obstruction, ileus Ⅲ Enteral intake not sufficient for metabolic requirements—chronic diarrhea/emesis, malabsorption, fistulas, chemotherapy, irradiation therapy Ⅲ Risk of aspiration Ⅲ Adjunctive support necessary for managing disease—pancreatitis, hepatic failure, renal failure, chylothorax Ⅲ Presence of malnutrition and wasting Malnutrition and Wasting KWASHIORKOR (PROTEIN MALNUTRITION) Ⅲ Ⅲ HIGH-YIELD FACTS Ⅲ Ⅲ Ⅲ Adequate fat reserves with significant protein deficits Slight or no weight loss Low visceral proteins (albumin, prealbumin, transferrin) Edema often present Seen in acutely stressed patients MARASMUS (PROTEIN–CALORIE MALNUTRITION) Ⅲ Ⅲ Ⅲ Weight loss with fat and muscle wasting Visceral proteins normal or slightly low Seen in chronic malnutrition NUTRIENT REQUIREMENTS Ⅲ Ⅲ Harris–Benedict equation—used to estimate basal energy expenditure.
First Aid for the Surgery Clerkship (First Aid Series) by Latha Stead, S. Matthew Stead, Matthew Kaufman, Nitin Mishra