First Aid for the Surgery Clerkship

561 Pages·2009·9.39 MB·English

FIRST AID FOR

THE®
Surgery
Clerkship
Second Edition
SERIES EDITORS:
MATTHEW S. KAUFMAN, MD S. MATTHEW STEAD, MD, PhD
Attending Physician and Co-investigator Epilepsy Research Fellow
Chronic Lymphocytic Leukemia Research and Treatment Program Department of Neurology
Department of Hematology-Oncology Mayo Clinic and Mayo School of Graduate Medical
North Shore–Long Island Jewish Health System Education
Manhasset and New Hyde Park, New York Rochester, Minnesota
LATHA G. STEAD, MD, FACEP
Professor and Chair, Department of Emergency Medicine
University of Rochester
Rochester, New York
VOLUME EDITOR:
NITIN MISHRA, MBBS, MS, MRCS (UK)

Resident in General Surgery
North Shore–Long Island Jewish Health System
Manhasset and New Hyde Park, New York
New York / Chicago / San Francisco / Lisbon / London / Madrid / Mexico City
Milan / New Delhi / San Juan / Seoul / Singapore / Sydney / Toronto
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ISBN: 978-0-07-164308-5
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DEDICATION
My work in the book is dedicated to my grandmother, Frances Jacobson.
—Matthew S. Kaufman, MD
My work in this book is dedicated to my parents, Mr. Rajeshwar Mishra and
Mrs. Indu Mishra.
—Nitin Mishra, MBBS, MS, MRCS (UK)
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CONTENTS
Contributors vii
Introduction ix
How to Contribute xi
SECTION I: HOW TO SUCCEED IN THE SURGERY CLERKSHIP 1
SECTION II: HIGH-YIELD FACTS FOR THE SURGERY CLERKSHIP 15
The Surgical Patient 17
Wounds 25
Acute Abdomen 35
Trauma 43
Critical Care 63
Fluids, Electrolytes, and Nutrition 75
The Esophagus 97
The Stomach 113
Small Bowel 133
Colon, Rectum, and Anal Canal 155
The Appendix 181
Hernia and Abdominal Wall Problems 189
The Hepatobiliary System 201
The Pancreas 229
The Endocrine System 243
v
The Spleen 273
The Breast 279
Burns 297
SECTION III: HIGH-YIELD FACTS FOR SURGICAL ELECTIVES 307
Anesthesia 309
Vascular Surgery 315
Pediatric Surgery 335
Ear, Nose, and Throat Surgery 353
Neurosurgery 395
Cardiothoracic Surgery 419
Transplant 439
The Genitourinary System 453
Orthopedics 469
The Hand 487
SECTION IV: CLASSIFIED: AWARDS AND OPPORTUNITIES 503
Index 519
About the Authors 546
vi
CONTRIBUTORS
MUHAMMAD AFTAB, MB, BS, MD ARIELLE GLUECK, MD
Resident in General Surgery Resident in Pediatrics
North Shore–Long Island Jewish Health System Children’s Hospital at Montefi ore
Manhasset and New Hyde Park, New York Albert Einstein College of Medicine
Cardiothoracic Surgery Bronx, New York
Acute Abdomen
MALATHY APPASAMY, MD
Resident in General Surgery EDWIN GULKO
North Shore–Long Island Jewish Health System Medical Student
Manhasset and New Hyde Park, New York Class of 2009
Orthopedics Albert Einstein College of Medicine
Bronx, New York
MICHAEL P. AST, MD Neurosurgery
Resident in Orthopedic Surgery
North Shore–Long Island Jewish Health System ANUNAYA R. JAIN, MBBS, MCEM (UK)
Manhasset and New Hyde Park, New York Research Fellow
The Hand Instructor of Emergency Medicine
Department of Emergency Medicine
LUKAS R. AUSTIN-PAGE Mayo Clinic College of Medicine
Rochester, Minnesota
Medical Student
Section IV: Classifi ed
Class of 2010
Albert Einstein College of Medicine
Bronx, New York VIJAY KAMATH, MBBS
The Pancreas
Resident in General Surgery
North Shore–Long Island Jewish Health System
NETANEL BERKO, MD Manhasset and New Hyde Park, New York
Intern The Breast
Department of Medicine
New York Medical College JONATHAN D. KAYE, MD
Sound Shore Medical Center of Westchester
Fellow in Pediatric Urologic Surgery
New Rochelle, New York
Emory University School of Medicine
The Surgical Patient
Children’s Healthcare of Atlanta
Atlanta, Georgia
RONEN ELEFANT, MS, MD
The Genitourinary System
Resident in General Surgery
Montefi ore Medical Center ASHLEY KEILER-GREEN, MD
Albert Einstein College of Medicine Program
Bronx, New York Resident in Emergency Medicine
Fluids, Electrolytes, and Nutrition University of New Mexico
Albuquerque, New Mexico
The Hepatobiliary System
TOVA C. FISCHER
Medical Student
SILVIA KURTOVIC, MD
Class of 2009
Albert Einstein College of Medicine Resident in General Surgery
Bronx, New York Cedars-Sinai Medical Center
The Esophagus; Ear, Nose, and Throat Surgery Los Angeles, California
Critical Care
REBECCA PARVER GAMSS
CHARLES F. LANZILLO III, MD
Medical Student
Class of 2009 Resident in Ophthalmology
Albert Einstein College of Medicine University of Colorado
Bronx, New York Denver, Colorado
The Spleen Wounds
vii
JONATHAN MAZUREK, MD CASEY SEIDEMAN
Resident in Internal Medicine Medical Student
Beth Israel Medical Center Class of 2009
New York, New York Albert Einstein College of Medicine
Small Bowel Bronx, New York
The Genitourinary System; Colon, Rectum, and Anal Canal
NITIN MISHRA, MBBS, MS, MRCS (UK)
ANAND SHAH, MD, MPH
Resident in General Surgery
North Shore–Long Island Jewish Health System Resident in Radiology
Manhasset and New Hyde Park, New York Hospital of the University of Pennsylvania
Trauma; Transplant Philadelphia, Pennsylvania
Vascular Surgery
SNEHA MISHRA, MBBS
EDAN SHAPIRO
Resident in Internal Medicine
Wyckoff Heights Medical Center Medical Student
Brooklyn, New York Class of 2009
Burns; Anesthesia Albert Einstein College of Medicine
Bronx, New York
SAMUEL T. OSTROWER, MD The Endocrine System
Fellow in Pediatric Otolaryngology
GRACE L. YU, MD
Children’s Hospital Boston
Boston, Massachusetts Resident in Plastic and Reconstructive Surgery
Ear, Nose, and Throat Surgery University of Southern California
Los Angeles, California
TAMAR RUBINSTEIN The Stomach
Medical Student
LISA ZUCKERWISE
Class of 2009
Albert Einstein College of Medicine Medical Student
Bronx, New York Class of 2009
Pediatric Surgery Albert Einstein College of Medicine
Bronx, New York
DAVUT SAVASER, MD The Appendix
Resident in Emergency Medicine
University of California–San Diego
San Diego, California
Hernia and Abdominal Wall Problems
viii
INTRODUCTION
This book is designed in the tradition of the First Aid series of books. It is for-
matted in the same way as the other books in the series. You will fi nd that,
apart from preparing you for success on the clerkship exam, this resource will
also help guide you in the clinical diagnosis and treatment of common surgi-
cal conditions.
The content of the book is based on the objectives for medical students as de-
termined by the Association for Surgical Education (ASE). Each chapter con-
tains the major topics central to the practice of general surgery and has been
specifi cally designed for the medical student. The book is divided into general
surgery, which contains topics that comprise the core of the surgery rotation,
and subspecialty surgery, which may be of interest but is generally considered
less high yield for the clerkship. Knowledge of a subspecialty topic may be
useful if observing a related surgery or if requesting a letter from a surgeon in
that fi eld.
The content of the text is organized in the format similar to other texts in the
First Aid series. Topics are listed with bold headings, and the “body” of the
topic provides essential information. The outside margins contain mnemon-
ics, diagrams, summary or warning statements, and tips. Tips are categorized
into Exam Tip , Ward Tip , and OR tip .
ix