Resident Readiness General Surgery (83 page)

P

Pacemaker,
181
–183

electrocautery and,
181
–182

Pain,
113

abdominal (
See
Abdominal pain)

chest (
See
Chest pain)

medications,
146

periumbilical (
See
Periumbilical pain)

quadrant (
See
Quadrant pain)

somatic,
47

visceral,
47

Paralysis,
116

Parenteral antibiotics,
104

Parietal peritoneum, inflammation of,
64

Parietal peritoneum rub,
58

Parkland formula,
129
,
130

Paroxysmal atrial fibrillation,
281

Partial thromboplastin time (PTT),
107
,
110
,
347

prolongation,
351

Pathogenic bacteria,
101

Patient-controlled analgesia (PCA) pump,
142
,
143

Patient management,
109

Patient-specific factors,
263

Pelvic abscesses,
134

Pelvic inflammatory disease (PID),
58

Perceptual disturbances,
151

Percocet,
144

Percutaneous image-guided drainage techniques, development of,
136

Pericardial space,
187

Pericardial tamponade,
188

Peri-incisional erythema,
332

Perioperative β-blockade,
189
–191

Perioperative ischemic evaluation (POISE) trial,
189

Peripheral vascular disease, measure of,
116

Peritoneal inflammation,
48

Peritonitis,
63

physical exam finding of,
33

Periumbilical pain,
57
–61.
See also
Pain

diagnosis of,
57

history of,
57

RLQ pain,
57
–60

tips to,
60

Personality disorder

diagnoses,
309
t

splitting treatment,
310

Personality disorders,
309

Person-to-person communication,
36

Pheochromocytomas,
8

Phosphate binders, administration of,
259

Physical activity,
14

Physiological stress.

hydrocortisone, dose of,
274

Piperacillin–tazobactam,
104

Platelet adhesion,
350
f

Platelet aggregation,
350
f

Platelet disorder,
349
,
349
t
,
351

Plavix,
281
,
282
,
283

antiplatelet medications,
317

hernia repair,
281
–283

Pneumonia,
157
,
167

Pneumoperitoneum, lung,
330

Pneumothorax,
167
,
186

Postanesthesia care unit (PACU),
165
,
169
,
261

Post colectomy

intra-abdominal abscess,
133
–136

with pelvic discomfort,
133
–138

tips to,
136
–137

Posteroanterior (PA) chest x-ray,
157
f

Postoperative check specifics,
28

essentials of,
28

purpose of,
28

Postoperative colectomy,
235
–239

postoperative oliguria,
235
–237

tips to,
238

Postoperative heart failure

etiologies of,
197

treatment,
198

Postoperative hypertension

algorithm for approach,
208
f

Postoperative hypotension,
201
–204

tips to,
203

Postoperative ileus,
221
f

Postoperative nausea and vomiting (PONV),
219
–223,
220

tips to,
222

treatment of,
220

Postoperative oliguria,
235
–237

causes of,
235
,
236
t

furosemide (Lasix), use of,
235

invasive indicators,
235

Postoperative pain,
141
–147

management,
141
–146

tips to,
146

Postoperative patient,
21

Postoperative pelvic abscess

CT reconstructions of,
136
f

Postoperative pelvic fluid collection

axial CT of,
134
f

Postoperative recovery room,
205

Postoperative urinary retention (POUR),
241
–245

etiologies of,
242

risk factors of,
242

signs of,
241

tips to,
244

Posttransfusion purpura,
97

Predictive value,
107

calculations of,
108
t

disease prevalence effects on,
108
t

specificity and sensitivity,
107

Prednisone, Crohn disease,
275
–276

Premature ventricular contractions (PVCs),
174

with postanesthesia care unit (PACU),
173
–176

tips to,
175

ventricular tachydysrhythmias,
173
–175

Preoperative evaluation

paroxysmal atrial fibrillation,
281

patient’s hernia repair,
281
,
282

Procedure note specifics,
29
–30

essentials of,
29
–30

purpose of,
29

Procrastination,
15

Profunda femoris artery,
114

Prolonged postoperative ileus,
134

Promethazine,
219

Prothrombin time (PT),
351

Protocol-based methods,
126
Pseudomonas aeruginosa
,
101

Psychiatry consultation service,
127

Psychiatry, difficult patients management,
308

Psychotic disorders,
308
,
311
,
312

Pulmonary capillary wedge pressure (PCWP),
70

Pulmonary embolism,
166

Pulse examination,
116
t

Pulseless electrical activity (PEA),
185
–188

causes of,
186
t
,
188

Pulse oximetry,
193

Purkinje fibers,
174

Q

QRS complex,
181

QTc prolonging medications,
153

Quadrant pain,
51
–55.
See also
Pain

right upper quadrant (RUQ) pain,
51
–54

severe right upper,
51

tips to,
54

Quetiapine,
152

“Quick-look” paddles,
170

R

Rectal cancer,
290
–291

Red blood cells,
95

transfusions, in HCT,
91
–93

Reflex tachycardia,
208
,
209

Reflux esophagitis,
167

Renin–angiotensin–aldosterone axis,
255

Resident–patient relationship,
305
–306

Respiratory alkalosis,
161

Respiratory distress,
161
–163,
193
–199

acute postoperative heart failure,
193
–197

case analysis,
161
–162

tips to,
197
–198

Resuscitation,
88

Resuscitation volumes approach,
130

Revascularization,
117

Rhythm strip,
169
f
,
173
f
,
174

Right lower extremity pain, acute,
113
–120

acute limb ischemia,
113
–119

tips to,
119
–120

Right upper quadrant (RUQ) abdominal pain,
72

Right upper quadrant (RUQ) pain,
51
–54

differential for,
51

tenderness in,
51

RLQ

differential for,
60

phlegmon,
59

RN, procedural,
291

Rome III criteria,
225

4-2-1 rule

for maintenance fluid requirements,
249
,
250
f

Rule of 9’s,
130
,
131

S

Saline
versus
Albumin Fluid Evaluation (SAFE) study,
249

Sample template

admission/consult H+P,
23
f
,
26

brief operative note,
25
f

procedure note,
24
f

SOAP note,
24
f
,
26

Scut work, in admissions,
33

Seizures, previous history of,
127

Sepsis,
77
–80

definition of,
78

relationship SIRS,
78
,
79
f

Serotonin antagonists,
220

Shock,
69
–74

augment cardiac performance,
71

cardiogenic,
72
–73

classification of,
71
t

hypovolemic,
72

peripheral vascular collapse,
71
,
73
–74

volume status,
70

Signal-to-noise ratio,
3

Single-agent therapy,
65

Sinus rhythm,
175

Skype,
17

Sleep budget,
11

Small bowel obstruction,
214
f

cause of,
84

dilated loops, supine KUBs with,
85
f

functional,
83

mechanical,
83
–84

nausea and vomiting in,
83
–88

radiograph of,
221
f

SOAP system,
29