Resident Readiness: General Surgery

Resident Readiness General Surgery......Page 3
Copyright Page......Page 4
Dedication......Page 6
CONTENTS......Page 7
Contributors......Page 10
Acknowledgments......Page 18
I. Introduction......Page 19
1. Welcome......Page 20
2. How to Read this Book......Page 22
3. General Advice......Page 23
4. A 28-year-old Female Incoming Surgery Resident......Page 28
5. How to Write a Note—Fast!......Page 34
II. Handling Patients in the ED......Page 43
6. Admissions......Page 44
7. A 56-year-old Female Status Post Motor Vehicle Accident......Page 49
8. A 40-year-old Female With Abdominal Pain......Page 56
9. A 42-year-old Man With Severe Right Upper Quadrant Pain......Page 59
10. A 23-year-old Student With Periumbilical Pain That Has Migrated to Her RLQ......Page 64
11. A 65-year-old Female in Severe Abdominal Pain......Page 68
12. A Patient in the ER With a Blood Pressure of 60/– and a Heart Rate of 140......Page 72
13. A 67-year-old Man With Mental Status Changes and a Suspected Diverticular Abscess......Page 78
14. A 57-year-old Man With a Chief Complaint of Nausea and Vomiting......Page 83
15. A 65-year-old Man Status Post Surgery With a HCT of 24%......Page 90
16. A 70-year-old Man With “Bad Blood”......Page 93
17. A 37-year-old Man With a Painful Bulge Over His Left Forearm......Page 97
18. Three Patients All Present With Issues Related to Laboratory Tests......Page 101
19. A 73-year-old Man With Acute Right Lower Extremity Pain......Page 106
20. A 36-year-old Woman Status Post Motor Vehicle Accident While Intoxicated......Page 114
21. A 50-year-old Man Presenting With Extensive Burns......Page 121
22. A 56-year-old Man 6 Days Status Post Colectomy With New Pelvic Discomfort......Page 126
III. Handling Inpatients......Page 131
23. A 75-year-old Man With Postoperative Pain......Page 132
24. A 72-year-old Man With Acute Confusion Postoperatively......Page 139
25. You (the Intern) Are Asked to Read a Chest X-ray......Page 145
26. A 65-year-old Woman in Respiratory Distress......Page 151
27. A Patient Who Is Postoperative Day 2 With New-onset Chest Pain......Page 154
28. A 65-year-old Woman With a New-onset Cardiac Arrhythmia......Page 157
29. A 60-year-old Man in the PACU With New-onset PVCs......Page 160
30. A 65-year-old Man With Bradycardia......Page 164
31. A 65-year-old Man With a Pacemaker Who Needs Surgery......Page 167
32. A Patient With Pulseless Electrical Activity......Page 169
33. A 55-year-old Man Who May Require Perioperative β-blockade......Page 173
34. A 65-year-old Man Who Is in Respiratory Distress 3 Days Postoperatively......Page 176
35. A 68-year-old Man With Postoperative Hypotension......Page 182
36. A 57-year-old Man Who Is Postoperative With a Blood Pressure of 210/95......Page 185
37. A 65-year-old Female Who Is 4 Days Postoperative With Nausea, Vomiting, and a Distended Abdomen......Page 192
38. A 30-year-old Woman With Postoperative Nausea and Vomiting......Page 198
39. A 79-year-old Man, Postoperative Day 3, Who has Not had a Bowel Movement in 4 Days......Page 203
40. A 70-year-old Postoperative Colectomy Patient Who Is Not Putting Out Much Urine......Page 213
41. A 55-year-old Male With Postoperative Urinary Retention......Page 217
42. A 52-year-old Female Who Is Dehydrated Postoperative Day #1......Page 221
43. A 68-year-old Woman With Electrolyte Abnormalities......Page 226
44. A 58-year-old Man With a Postoperative Fever......Page 233
45. A 42-year-old Woman 4 Hours Postoperative With a Fever and Extreme Pain......Page 238
46. A 35-year-old Man With Crohn Disease Who Needs Postoperative Orders......Page 243
47. A 65-year-old Man With Diabetes Needing Postoperative Orders......Page 247
48. A 65-year-old Female Presenting for Preoperative Evaluation......Page 251
49. A 33-year-old Woman Who Needs Postoperative Orders for DVT Prophylaxis......Page 257
50. A 78-year-old Woman and a 62-year-old Man With Drains......Page 260
51. A 58-year-old Woman Who had a Drain Pulled by the Resident in Error......Page 263
52. A Resident Who Is Unsure About How to Remove a Chest Tube......Page 266
53. A Surgical Intern in a Moral Dilemma......Page 269
54. A 35-year-old Man Who Is Disruptive on the Floor......Page 271
IV. Handling Patients in Clinic......Page 277
55. Ambulatory Care and the Surgery Intern......Page 278
56. A 55-year-old Man Who Was Struck by a Beer Truck and Needs a CT Scan......Page 282
57. A 60-year-old Man With Postoperative Wound Complications......Page 291
58. A 35-year-old Woman Who Needs a Lipoma Removed in Clinic......Page 299
59. A 52-year-old Woman With a Suspected Congenital Coagulopathy......Page 305
Bibliography......Page 313
Index......Page 314