GENERAL SURGERY

Intermittent Episodes of Sweating, Palpitations, and Hypertension

May 13, 2017 by in GENERAL SURGERY Comments Off on Intermittent Episodes of Sweating, Palpitations, and Hypertension

Diagnosis History and physical Comments Pheochromocytoma Episodic hyperadrenergic symptoms (5 P’s): pressure (hypertension), pain (headache), perspiration, palpitation, pallor Associated with MEN 2, neurofibromatosis-1, and von Hippel-Lindau disease (VHL) Carcinoid syndrome…

read more

Chest and Back Pain

May 13, 2017 by in GENERAL SURGERY Comments Off on Chest and Back Pain

Fig. 7.1 Chest radiograph on admission showing widening of the upper mediastinum Diagnosis What is the Differential Diagnosis? Condition History and physical Aortic dissection Sudden onset of tearing chest pain…

read more

Postoperative Decreased Urine Output

May 13, 2017 by in GENERAL SURGERY Comments Off on Postoperative Decreased Urine Output

Type Causes Pathophysiology Prerenal Hypovolemia (postsurgical bleeding, dehydration), decreased cardiac output (heart failure) Inadequate perfusion of a normal functioning kidney Intrinsic/ renal Acute tubular necrosis (ATN) (e.g., renal artery occlusion;…

read more

Fatigue, Constipation, and Depressed Mood

May 13, 2017 by in GENERAL SURGERY Comments Off on Fatigue, Constipation, and Depressed Mood

Etiology Lab findings Comment Calcium supplementation None  Hyperparathyroidism ↑ or high-normal PTH Primary hyperparathyroidism is the most common outpatient cause of hypercalcemia Hyperthyroidism ↓ TSH Hyperthyroidism: increased bone reabsorption Immobility…

read more

Postoperative Bleeding

May 13, 2017 by in GENERAL SURGERY Comments Off on Postoperative Bleeding

Condition Comments Surgical bleeding Bleeding from a major artery or vein that was missed during surgery must be ruled out first, especially in the immediate postoperative period Medications Inquire about…

read more

Infant with Nonbilious Emesis

May 13, 2017 by in GENERAL SURGERY Comments Off on Infant with Nonbilious Emesis

Diseases managed medically Diseases managed surgically Acute gastroenteritis Antral web Gastroesophageal reflux disease Enteric duplication cyst Metabolic disorders (congenital adrenal hyperplasia, electrolyte imbalance, glycogen storage disease) Gastroesophageal reflux disease Pylorospasm…

read more

New Onset of Painless Jaundice

May 13, 2017 by in GENERAL SURGERY Comments Off on New Onset of Painless Jaundice

Condition Comments Prehepatic (hemolytic) Hemolytic anemia Pallor, fatigue, shortness of breath Gilbert’s syndrome Benign condition triggered by overexertion, dehydration, menstruation, concurrent illness; decreased activity of the enzyme UDP-glucuronyl transferase Hepatic…

read more

Right Upper Quadrant Pain, Fever, Nausea, and Vomiting

May 13, 2017 by in GENERAL SURGERY Comments Off on Right Upper Quadrant Pain, Fever, Nausea, and Vomiting

Disease Pathophysiology Acute calculous cholecystitis Obstruction of cystic duct by gallstone Choledocholithiasis Common bile duct (CBD) obstruction by gallstone Gallstone pancreatitis Transient obstruction of the distal CBD (and pancreatic duct)…

read more

Stab Wound to the Chest

May 13, 2017 by in GENERAL SURGERY Comments Off on Stab Wound to the Chest

Lethal six Characteristics Airway obstruction Laryngeal trauma, foreign body aspiration, stridor, expanding neck hematoma, and gurgling Tension pneumothorax Hemodynamic instability, tracheal shift away from injury, one-way valve in injured lung…

read more
Get Clinical Tree app for offline access