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…

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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…

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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…

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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…

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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)…

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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…

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Progressively Hoarse Voice

May 13, 2017 by in GENERAL SURGERY Comments Off on Progressively Hoarse Voice

Diagnosis History and Physical Viral laryngitis Acute onset of fever, sore throat, cough, and/or other symptoms consistent with upper respiratory tract infection Vocal cord paralysis Breathy voice, most commonly idiopathic…

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New Palpable Mass in Right Breast

May 13, 2017 by in GENERAL SURGERY Comments Off on New Palpable Mass in Right Breast

Condition History and physical Features Fibrocystic change Vague irregularity of breast tissue (lumpy breast), often in upper quadrants, cysts have a blue-dome appearance on exam Most common breast mass in…

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