Resident Readiness General Surgery (82 page)

Insulin

diabetic, type 1,
277
–279

diabetic, type 2,
278
–279

exogenous basal/prandial,
279

hypoglycemia/hyperglycemia,
278

lispro/aspart,
278

nutritional requirement,
277

    components,
278
f

pump,
277

types of,
277

Insulin therapy, lack of,
280

International normalized ratio (INR),
351

Internships,
7
,
21

Interventional radiology (IR),
78
,
293

Intra-abdominal abscess (IAA),
133
,
134
,
262

adjunctive treatment for,
135

etiologic classification,
134

in post colectomy,
133
–136

Intracellular electrolyte shifts,
258

Intravenous unfractionated heparin (IVUH),
285

IOM report,
297

Ischemia,
34

reperfusion injury,
118

Ischemic bowel,
64

Isoproterenol,
178

Isotonic solutions,
251

J

Jackson-Pratt (JP) drain,
293

Jaw-dropping experimental design,
190

Jitters

case of,
7

taking care of health,
10
–11

teamwork,
10

time management and efficiency,
9

trenches, simple rules from,
8
–9

K

Korsakoff psychosis,
126

KUB

reading and using,
213
–217

L

Lab abnormalities,
110

Labetalol,
208

Laboratory tests,
107
–112

LABS 101,
107
–111

tips to,
111

β-Lactam,
65

Lactated Ringer’s (LR) solution,
247
,
270

Laparoscopic appendectomy,
201

Laparoscopic cholecystectomy,
265

Laparoscopic right colectomy,
186

Laparotomy,
201

Large gastric bubble,
216

Leaking triple A,
167

Left ventricular end-diastolic volume (LVEDV),
187

Leiden deficiency, factor V,
286
–287

Leukocyte esterase,
111

Leukocytes,
110

Leukocytosis,
133
,
332
,
334

Levetiracetam,
121

Lidocaine,
346

Limb ischemia, acute

in acute right lower extremity pain,
113
–119

cause of,
113

common causes of,
117
t

Limb-threatening ischemia,
116

Lipoma, removal,
341

field block technique,
345
,
345
f

local anesthetics, classes,
341
–345

    epinephrine,
341
–342

    pain, minimization,
343
,
344

    risk of,
343

mechanism of action,
343
,
344
,
346

picture of,
342
f

useful technique,
344
–345

Liver abscess, liver fluid collection suspicious for,
327
f

Local anesthetics, classes,
341
–345

agent,
342
t

anxiety, medications for,
343

bicarbonate,
343

buffering,
343

bupivacaine,
341
,
342

epinephrine,
341
–342

esters,
341

field block technique,
345
,
345
f

lidocaine,
341
,
342

lipoma, picture of,
342
f

needle, small,
343

pain, minimization,
343
,
344

problems,
343

risk of,
343

wound pretreatment,
344

Lorazepam, for acute confusion postoperatively,
149

Lower leg, fascial compartments of,
119
f

Low-molecular-weight heparin (LMWH),
285

Low-risk procedures,
93

LR, composition of,
248

Lung, pneumoperitoneum,
330

LUQ,
214

Lysis catheter,
118

M

Magnesium-containing medications, elimination,
258

Maladaptive expressions,
308

Maladaptive traits,
307
,
309

Malignant tumors,
84

Massive fluid resuscitation,
131

Massive inflammatory response,
77

Mean arterial pressure (MAP),
201

Mean corpuscular volume (MCV),
121

Mechanical obstruction,
84

Mechanical valve, in mitral position,
287

Meckel diverticulum,
59

Medical errors,
297
–299

coping mechanisms,
299

disclosure of,
298
,
300

mistakes, disclosing,
298
–299

research,
300

risk management office,
298

Medical records,
37

Medication administration record (MAR),
142

Medication reconciliation,
36

Medicine’s
To Error is Human
report,
297

Menorrhagia, platelet disorder,
349
t

Mental status, altered

acute confusion postoperatively,
150
–153

high-risk causes of,
150
t

Mentor,
17

Mesoappendix,
59

Metformin,
279

Methicillin-resistant
Staphylococcus aureus
(MRSA),
80
,
101
,
104

Metoclopramide,
219

Metoprolol,
37
,
190
,
205

Mood dysregulation,
311
,
312

Morality, surgical intern,
305
–306

Morphine,
144

Motor vehicle accidents,
39
–46,
121
–128

alcohol withdrawal,
121
–127

tips to,
44
–45,
127

trauma primary survey,
39
–44

Motor vehicle crash (MVC).
See
Motor vehicle accident

Mucosal bleeding, platelet disorder,
349
t

Multiorgan dysfunction syndrome (MODS),
77

Murphy sign,
47
,
51
,
52

Myocardial infarction, acute,
166

Myocardial ischemia,
173
,
195

evidence of,
92

Myriad data,
26

N

Narcotic pain medication,
207

Narcotics,
202

administration of,
222

Nasogastric tube,
254

Nasogastric tube (NGT),
86

Nasopharynx, anatomy of,
86
,
87
f

Nausea,
213
–218

Nausea and vomiting

complaint of,
83
–89

small bowel obstruction,
83
–88

tips to,
88

Necrotizing soft tissue infection (NSTIs),
267
–270

diagnosis of,
268
–269

features characteristic of,
268

hallmarks of,
268

physical exam findings of,
268
f

radiographic evidence of,
269
f

tips to,
270

treatment of,
269
–270

Negative inspiratory force (NIF),
163

Neurologic disorders,
242

Neurotransmitter systems,
122

NG tube,
87
,
221

Nitrates,
111

Nitroglycerin,
209

Nociceptive nerves, irritation of,
47

Nonhemorrhagic hypovolemia,
203

Normal saline (NS),
247

Normothermia,
333

Note writing,
21
–30

acute event specifics,
28
–29

admission note specifics,
26
–27

communicate pertinent data,
21

consult note specifics,
27

daily progress,
27
–28

general approach to,
21
–26

postoperative check specifics,
28

preparation of,
28

procedure note specifics,
29
–30

purpose of,
21

sample template

    admission/consult H+P,
23
f
,
26

    brief operative note,
25
f

    procedure note,
24
f

    SOAP note,
24
f
,
26

system developement,
21

NSAID, acetaminophen,
144

O

Ohm’s law,
71
,
74

Ondansetron,
222

Online medical records,
25

Operating room,
185

Operative notes,
29

Opioids,
143
,
145

side effect of,
143

Opioid schedule,
143

Oral pain medications,
144

Oral pain regimen,
144

Orders, for admissions,
36
–37

Osmotic laxatives, for constipation,
230

Outsourcing,
14

Ovarian cyst,
59
,
60

Oxygen-carrying capacity,
95