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4. Proficiency-based simulation training on central venous
catheter insertion has been successful in improving
which of the following outcomes?
A. Iatrogenic pneumothoraces
B. Misplaced central venous catheters
C. Catheter-related bloodstream infections
D. Failure of catheter insertion
CHAPTER 53
5. A surgical instructor wishes to evaluate the effects of a
simulation-based training program to reduce bile duct
injuries during laparoscopic cholecystectomy. Which of
the following would be the most feasible, relevant learner
metric in assessing the success of this training?
A. Perceptions about the training
B. Knowledge about bile duct injuries
Skills and Simulation
C. Skills transfer to the clinical environment
D. Institutional incidence of bile duct injuries
Answer: C
Proficiency-based simulation training on central venous catheter insertion is one of the best examples of evidence for improved
patient outcomes with simulation. Multiple studies have
demonstrated reductions in the incidence of catheter-related
bloodstream infections. (See Schwartz 11th ed., pp. 2178–2179.)
Answer: C
While ideally, simulation training should lead to improved
patient outcomes, the incidence of bile duct injury with laparoscopic cholecystectomy is uncommon. Large, unrealistic
sample sizes would be necessary to demonstrate a clinically
relevant difference. In evaluating the effectiveness of educational intervention efforts, the Kirkpatrick four-level scale is
often used. The four levels are: Reaction, learning, behavioral
change, and institutional impact. Since institutional impact
cannot be assessed in this example, the next highest level
would be behavioral change—did the knowledge, skills, and
attitudes acquired during simulation transfer to the clinical
environment? (See Schwartz 11th ed., p. 2178.)
CHAPTER 54
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Web-Based Education and
Implications of Social Media
1. Which of the following terms describes computermediated platforms that are used for creating and sharing information, ideas, and other content?
A. Websites
B. Social media
C. Simulators
D. Applications
2. Which of the following is not a barrier to the more widespread adoption of web-based educational strategies?
A. Lack of data for superior effectiveness
B. Up-front costs for development
C. Surgeon uptake of the technology
D. Ability to have asynchronous learning
3. Which of the following is not a social media strategy
for disseminating information about peer-reviewed
publications?
A. Visual abstracts
B. Online journal clubs
C. Conference live-tweeting
D. Journal postings
Answer: B
Social media is a term describing websites and web-based
applications that enable users to share ideas, information, and
content through virtual networking. Commonly used social
media platforms include Facebook, Twitter, and YouTube.
(See Schwartz 11th ed., pp. 2187–2189.)
Answer: D
Web-based education and coaching allow for asynchronous
learning whereby students and instructors do not have to
be on the same schedule. Additionally, web-based education allows for access to educational materials regardless of
time of day or night. However, barriers include lack of highquality studies demonstrating that web-based education is
superior to traditional educational interventions. Additionally, the high up-front costs for development and need for
technical expertise are also barriers. Lastly, lack of surgeons’
uptake of the technology is a barrier. (See Schwartz 11th ed.,
pp. 2187–2188.)
Answer: C
Conference live-tweeting describes the posting of social
media posts on Twitter about an event while it is ongoing.
Usually, peer review and publication lag behind conference proceedings. Visual abstracts are graphical summaries
of the main results of journal articles. They may be created
by the author or the journal, and they typically accompany
social media posts referencing the peer-reviewed publication.
Online journal clubs are similar to in-person journal clubs
that discuss peer-reviewed publications. Social media-based
journal clubs, however, allow asynchronous discussions
across multiple time zones and geographic locations. Journals
often post links to the abstract and/or peer-reviewed publication on social media in order to draw attention to the article.
These posts can be accompanied by a visual abstract. (See
Schwartz 11th ed., pp. 2190–2192.)
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4. Which of the following increases the quality and accuracy of web-based educational materials for patients?
A. Crowdsourcing
B. Peer review
C. Physician author
D. Number of viewers
CHAPTER 54
5. Which of the following uses of social media does not
Web-Based Education and Implications of Social Media
require patient consent?
A. Case report of a patient with an unusual complication
B. Email between physician and established patient
C. Online journal club about a published randomized
trial
D. Posting of a photo that does not have the patient’s
face
Answer: B
One of the potential pitfalls associated with web-based education is inaccuracy in information in web-based educational materials. High-quality online resources should have
peer-reviewed content or verifiable mechanisms for quality
control of information. Crowdsourcing describes the process
whereby information is gathered by enlisting the assistance of
a large number of participants. Crowdsourcing often involves
the general public or a loosely defined group of individuals.
Physician authorship is not necessarily associated with
increased accuracy of the online content. Number of viewers of the web-based content does not guarantee quality or
accuracy. (See Schwartz 11th ed., pp. 2190–2193.)
Answer: C
Another potential pitfall of web-based education is ethical
considerations surrounding patient confidentiality and privacy. Appropriate safeguards must be taken to guard against
violation of patient confidentiality and privacy. Although
patients must consent to participate in a randomized trial,
discussion of an already published and peer-reviewed randomized trial does not require additional patient consent.
Case reports, whether published in a journal or posted on
social media, require patient consent. Emails or other electronic communications should only be used by physicians in
an established patient–physician relationship and with patient
consent. Photos should not be posted that have any details that
would result in the patient being identifiable. (See Schwartz
11th ed., pp. 2190–2193.)
Note: Page numbers followed by italic f or t denote figures or tables, respectively.
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INDEX
A
A-A index, 55
AAA. See Abdominal aortic
aneurysms
AAH. See Atypical adenomatous
hyperplasia
ABCDE initialism, for melanoma, 130
Abdomen, blunt trauma to, 60, 60f
Abdominal aortic aneurysms,
191–192, 368
Abdominal compartment syndrome,
69, 103, 112–113
Abdominal hemorrhage, 50
Abdominal hernias, 270
Abdominal rectopexy, 250
Abdominal wall
anterior, 307
desmoid tumors of, 308
malignancy of, 307
Abdominal wall hernia, 307
ABI. See Ankle brachial index
Abscess
anorectal, 253
breast, 140
cellulitis without, 129
hepatic, 41–42
lung, surgical drainage of, 152, 152t
perianal, 253
pyogenic, 41, 272, 272f
subphrenic, 51
Abstracts, visual, 389
Abundance mentality model, of
conflict resolution, 4
Accessory spleen, 300
Accommodation response, 241
ACDF. See Anterior cervical
discectomy and fusion
Acetaminophen, 269
Achalasia, 212, 221
Acidic chemical burns, 134
Acidosis
alkalosis versus, 17
metabolic. See Metabolic
acidosis
Acral lentiginous melanoma,
130–131
Acrochordons, 136
ACTH. See Adrenocorticotropin
hormone
Actinic keratoses, 136
Activated protein C, 22
Acupuncture, 379
Acute cholecystitis, 279–280, 283f,
283–284
Acute hypercalcemia, 18
Acute limb ischemia, 194
Acute liver failure, 269
Acute lung injury
description of, 100
transfusion-related, 25–27
Acute myeloid leukemia, 303
Acute myocardial infarction, 33
Acute pancreatitis, 42, 290
Acute prostatitis, 338
Acute renal failure, 18
Acute respiratory distress syndrome,
32, 36, 100–101, 101t
ADAM S13, 24
Adenocarcinoma
in Barrett mucosa, 214f–215f
duodenal, 238
gallbladder, 280
lung, 148–149, 150f
metastatic Barrett esophagus and,
208–209
rectal, 256
Adenomas, liver, 275, 275f
Adenomatous polyposis coli, 154
Adenosine diphosphate, 21
ADH. See Antidiuretic hormone;
Atypical ductal hyperplasia
Adjustable gastric banding, 233
ADP. See Adenosine diphosphate
Adrenal glands, 8
Adrenal incidentaloma, 328
Adrenal insufficiency, 8–9
Adrenal mass, 327
Adrenalectomy, laparoscopic, 328
Adrenocorticotropin hormone, 8
Adventitial cystic disease, of popliteal
artery, 196
Aerobic bacteria, 41
AF. See Atrial fibrillation
African Americans, 5
AG. See Anion gap
AI. See Aortic insufficiency
AIHA. See Autoimmune hemolytic
anemia
Air enema, 335
Air leak, 59
Airway pressure, 111
Airways
interventions for, 57–58
mucus production in, 147
AJCC. See American Joint
Committee on Cancer
Albumin, 268
anion gap affected by, 16
fluid resuscitation uses of, 14
serum calcium and, 15
Aldosterone, 17
ALF. See Acute liver failure
ALH. See Atypical lobular hyperplasia
ALI. See Acute lung injury
Alkaline chemical burns, 134
Alkalosis
acidosis versus, 17
metabolic, 17
potassium change associated
with, 15
Allen test, 107
Allergy, antibiotics, 45
Allografts, kidney, 91–92, 92f
Allotransplant, 87
Alpha angle, 28
Alvimopan, 101, 378
Ambulatory surgery, 385–386
Ambulatory surgery centers, 385–386
Amelanotic lesions, 130
American Joint Committee
on Cancer
description of, 248
sarcoma staging, 312
American Society of
Anesthesiologists physical
status classification
system, 363
Amino acids
branched-chain, 9
gastrin secretion inhibition by, 223
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Amino acids (Cont.):
INDEX
questions regarding, 8
in wound healing, 79
Aminoacyl-tRNA synthetases, 120
AML. See Acute myeloid leukemia
AMOs. See Assistant medical officers
Amoxicillin/clavulanate, for human
bites, 134
Amsterdam I criteria, 247–248
Amsterdam II criteria, 247–248
Anal canal, 241
Anastomoses
arterial, 92f
Damus-Kaye-Stansel, 160
end-to-end, 244, 245f
end-to-side, 244, 245f
intestinal, 244–245
questions regarding, 244–245
side-to-side, 244, 245f
venous, 92f, 93
wound healing, 75
Anastomotic pseudoaneurysms, 183
Anemia
autoimmune hemolytic, 298–300
wound healing and, 78
Anesthesia
American Society of
Anesthesiologists physical
status classification system, 363
epidural, 101
fasting before, 364, 366
general, 245, 363, 366
malignant hyperthermia after, 363
regional, 245
saddle, 350
Aneurysms
aortic. See Aortic aneurysms
aortic arch, 185
ascending thoracic, 184
endovascular repair of, 184, 192
left ventricular, 176
mycotic, 182–183
splenic, 304
splenic artery, 304
Angina pectoris, 171, 171t
Angiography
computed tomography. See
Computed tomography
angiography
hepatic hemorrhage controlled
using, 61
indications for, 50
Anion gap
equation for calculating, 14
metabolic acidosis with, 13–14, 17
normal, 13–14, 16
Ankle brachial index, 352
Ankylosing spondylitis, 246
Anomalous coronary artery
patterns, 170
Anorectal abscess, 253
Anorectal lymphatic drainage, 241
Anorectal melanoma, 250
Anosmia, 347
Anterior abdominal wall, 307
Anterior cerebral artery, 112
Anterior cervical discectomy and
fusion, 349, 350f
Anterior mediastinal mass, 155
Anterior mediastinal tumors, 155
Anthrax
inhalational, 44
treatment of, 44
Antibiotic prophylaxis
for colectomy, 246
for human bites, 133–135
for inguinal hernias, 316
for overwhelming postsplenectomy
infection, 306
for surgical infections, 38–39, 45, 102
Antibiotics
allergy to, 45
diverticulitis treated with, 247
lymphedema treated with, 206
methicillin-resistant Staphylococcus
aureus treated with, 129
perioperative treatment with, 45
postappendectomy, 261
primary microbial peritonitis
treated with, 41
pyogenic liver abscess treated
with, 272
uncomplicated diverticulitis
treated with, 247
Anticoagulation, in elderly, 367
Antidiuretic hormone
as mesenteric vasoconstrictor, 31
sodium depletion caused by
secretion of, 13
Antigen-presenting cells, 87
Antigens, 125
Antireflux, 214, 216–217, 217f
Antithrombin, 205
Antithrombin III, 22
Antithrombotic therapy, for deep
vein thrombosis, 202
Antrectomy, 227f–228f, 227–228, 231
Anus
imperforate, 336
questions regarding, 241–257
Aorta
chemoreceptors in, 30
coarctation of the, 159, 163–164
diameter of, 183
Aortic aneurysms
abdominal, 191–192, 368
ascending, 183–184
distal, 183
false, 181
thoracic, 181
true, 181
Aortic arch
aneurysms of, 185
bovine, 182
Aortic arch receptor, 30
Aortic dissection, 184, 185f, 186–187
Aortic insufficiency, 175
Aortic stenosis
age-related, 175
congenital, 163
Aortic valve
replacement of, 175
stenosis of, 158–159
Aortoiliac occlusive disease, 193–194
APC. See Activated protein C;
Adenomatous polyposis coli
APCs. See Antigen-presenting cells
Apocrine sweat glands, 133
Apoptosis
of cancer cells, 84, 122
pathways of, 122f
Appendectomy, laparoscopic, 259–261
Appendiceal carcinoid tumors, 260
Appendicitis, 259–262, 260t, 262f, 367
Appendix, 259–262
ARDS. See Acute respiratory distress
syndrome
Arginine, 79
Arginine vasopressin, 33
Arrhythmia
in laparoscopy, 115
questions regarding, 176
Arterial anastomosis, 92f
Arterial disease
computed tomography
angiography of, 189
vascular stents for, 189–190
Arterial lines, 107–108
Arterial pH, 17–18
Arterial switch operation, 161
Arthritis
inflammatory bowel disease
and, 246
management of, 353
ASA physical status classification
system. See American Society
of Anesthesiologists physical
status classification system
Asbestos exposure, 156
Ascending aortic aneurysms, 183–184
Ascending aortic dissection, 187
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Ascending thoracic aneurysms, 184
ASCs. See Ambulatory surgery centers
ASD. See Atrial septal defects
Aspergillosis, 153
Aspergillus sp., 153
Aspiration pneumonia, 153
Aspirin, 23
Asplenia, 298
Assistant medical officers, 373
Astrocytoma, 348
Atherosclerotic aortoiliac occlusive
disease, 193–194
AT-III. See Antithrombin III
Atresia
biliary, 333
esophageal, 330, 331f
Atrial fibrillation, 174, 176
Atrial septal defects, 157f, 157–158
Atrophic gastritis, 229
Atypical adenomatous hyperplasia, 148
Atypical ductal hyperplasia, 137
Atypical lobular hyperplasia, 137
AUG, 120
Authoritative leader, 4
Autoimmune hemolytic anemia,
298–300
Automobile accidents, 50, 59
Autophagy, 9
Autotransplant, 87
Axillary lymph nodes, 137
Axillary vein, 198
Axonotmesis, 77
AZA. See Azathioprine
Azathioprine, 88, 89t
B
Back pain, 352
Balloon valvotomy, 158–159
Balloon-expandable stents, 189
Bare coronary stent placement, 364
Bariatric surgery
gastric stasis after, 224
questions regarding, 233–234
Barium esophagogram
of H-type tracheoesophageal
fistula, 331f
of vascular rings, 168f
Barium swallow, for eosinophilic
esophagitis, 220
Baroreceptors, 30
Barotrauma, 112
Barrett esophagus, 208–209
Barrett mucosa, 214f–215f
Basal cell carcinoma, 129, 135
Basal energy expenditure, 11, 11t
Base deficit, 36
Basic fibroblast growth factor, 124
Battle’s sign, 346
Baxter formula, 68
B-cell–mediated rejection, 95
BE. See Barrett esophagus
Beck’s triad, 49, 55
Beclin I gene, 84
BEE. See Basal energy expenditure
Belsey fundoplication, 221
Benign calcifications,
in hamartomas, 148
Benign prostatic hyperplasia, 339
Betel nut chewing, 144
Bevacizumab, 149
bFGF. See Basic fibroblast growth
factor
Bicarbonate
chemoreceptor sensitivity to
levels of, 30
metabolic acidosis with anion gap
caused by loss of, 13, 17
Bidirectional Glenn procedure,
160, 160f
Bifunctional RNAi technology, 125
Bifunctional short hairpin, 125
Bile acids
description of, 236, 268
reabsorption of, 283
Bile ducts
cancer/carcinoma of, 246, 276
common, 279
stricture of, 282
Bile leak, 102
Bile salts, 268
Biliary atresia, 333
Biliary cancer, 281
Biliary injury, 282
Biliary scintigraphy, 283
Biliary stricture, 282
Bilious emesis, 330
Billroth I gastroduodenostomy,
227, 227f
Billroth II gastroduodenostomy,
227, 228f
Biloma, after laparoscopic
cholecystectomy, 102
Biologic mesh, for abdominal wall
hernia repair, 307
Biomarkers, cancer, 85
Biomedical ethics, 369
Biopsy
fine needle aspiration, of thyroid
nodules, 324
primitive neuroectodermal tumor
diagnosis, 154
sentinel lymph node
for breast cancer, 139
for melanoma, 132
Biosynthetic heart valves, 367
Bipolar electrosurgery, 116
Birbeck granules, 133
bi-shRNA. See Bifunctional short
hairpin
Bites, human, 133–134
Bladder cancer, 337
Bladder pressure, 112t
Blastocysts, 124
Blastomyces dermatitidis, 90
Blood loss, 26, 32–33
Blood pressure
intra-arterial monitoring
system for, 106
pregnancy-related changes, 62
Blood transfusion
complications of, 26
description of, 25
diseases not transmitted by, 27
indications for, 25–26
Blood urea nitrogen, 18
“Blooming artifact,” 189
Blotting, 124
Blunt trauma
to abdomen, 60, 60f
duodenal hematoma from, 53
to liver, 50
to pancreas, 53
transcriptomic response to, 10
BMI. See Body mass index
Body mass index, 233
Bone healing, 77
Bone marrow suppression, 88
Bottleneck, 5
Bougie, 234
Bovine aortic arch, 182
Bowel preparation, 246
BPH. See Benign prostatic hyperplasia
Brachiocephalic veins, 198
Bradycardia, 115
Brain
herniation of, 345, 345f
malignant tumors of, 348
traumatic injury of. See Traumatic
brain injury
Brain stem compression, 346
Branched-chain amino acids, 9
BRCA1, 140
BRCA2, 140
Breast
abscess of, 140
anatomy of, 139
blood supply to, 139
Cooper suspension
ligaments of, 139
hormonal effects on, 139
infection of, 140
INDEX
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Breast (Cont.):
INDEX
pregnancy-related changes in, 137
sarcoma of, 312
Breast cancer
BRCA1/BRCA2, 140
distal carcinoma in situ,
137–138
estrogen exposure and, 137
lobular carcinoma in situ, 137
lymph node metastasis of, 139
mastectomy for, 140–141
in pregnancy, 139
radiation therapy for, 140
risk factors for, 137, 140
sentinel lymph node
biopsy for, 139
staging of, 137
treatment of, 140–141
Breast lesions, 137
Bronchioles, 147
Bronchoscopy, 59, 167f
Brush border membrane, 236
BUN. See Blood urea nitrogen
Burch procedure, 343
Burn(s)
caloric needs in, 69
caustic, 134
chemical, 134
complications of, 70
cyanide toxicity from, 66
depth classification of, 67
electrical, 67
eschar, 69
escharotomies for, 68
first-degree, 66, 68
fluid resuscitation for, 68
full-thickness, 67–68
heterotopic ossification
associated with, 70
initial evaluation of, 65
Lactated Ringer solution for, 68
Lund and Browder chart for, 66
massive resuscitation of, 69
nutritional requirements, 69
partial-thickness, 67–68
resuscitation of, 69
“rule of nines” for, 65, 66f
second-degree, 67
smoke inhalation injuries, 66
superficial, 66
third-degree, 67
thoracic compartment syndrome
caused by, 68
total body surface area
calculations, 65–66, 66f
zone of coagulation for, 67, 129
zone of hyperemia, 67, 129
Burn disasters, 71
Burn wounds
excision of, 70
silver sulfadiazine for, neutropenia
caused by, 68–69
surgical treatment of, 70
C
CA-125, 342
Calcifications, in hamartomas, 148
Calcineurin inhibitors, 88, 89t
Calcium
hyperkalemia treated with, 15
serum levels of, 15
Calcium chloride, 15
Calcium gluconate, 15
Callus formation, 77
Canadian Cardiovascular Society
angina classification,
171, 171t
Cancer. See also Carcinoma;
Tumor(s)
biomarkers of, 85
bladder, 337
breast. See Breast cancer
chemoprevention of, 84
chemotherapy agents for, 84
in chronic wounds, 80
colorectal, 123, 247–249
conservative resections in, 85
dormancy of, 84
epithelial ovarian, 342
esophageal, 210, 221
gallbladder, 276, 280
gastric, 229
hallmarks of, 83
head and neck, 143
hereditary, 83
hereditary nonpolyposis colorectal
cancer, 247–248
immune-based therapies for, 85
invasion, 84
laryngeal, 144
lip, 143
in low- and middle-income
countries, 373
lung. See Lung cancer
management of, 85
metastasis of, 84–85
ovarian, 342
pancreatic, 123
papillary thyroid, 281, 324
prostate, 338
rectal. See Rectal cancer
in situ, 84
splenectomy and, 299
testicular, 337, 339
tumorigenic transformation of
cells in, 83
vaginal, 343
Cancer cells
apoptosis of, 84
metastasis by, 84
transforming growth factor-ß
resistance by, 123
tumorigenic transformation of, 83
Cancer genes, 124
Candida albicans, 41
Capnography, 111
Caput medusae, 270
Carbohydrate
digestion of, 236
preoperative supplementation
of, 377
Carbon monoxide diffusion
capacity, 152
Carbonic acid, 17
Carcinoid tumors, 230, 260
Carcinoma. See also Cancer; Tumor(s)
basal cell, 129, 135
bile duct, 246
hepatocellular, 276–277
neuroendocrine, 148
renal cell, 337, 339
squamous cell. See Squamous cell
carcinoma
vulvar, 342
Cardiac myxomas, 179
Cardiac output, 108, 366
Cardiac tamponade, 35, 49
Cardiac transplantation, 95
Cardiac tumors, 179–180
Cardiogenic shock, 29, 34,
55–56, 56f
Cardiopulmonary bypass
coagulation during, 25
Cox-Maze IV procedure,
177, 177f
deleterious effects of, 173
Cardiopulmonary resuscitation, 363
Cardiovascular disease, renal
failure and, 91
Caroli disease, 285
Carotid bodies, 30
Carotid body tumors, 191
Carotid endarterectomy, 190–191
Carpal tunnel syndrome, 357
Cas9, 125
Case fatality rates, 375f
Case reports, 390
Case series, 382
Case-control study, 382
Caspases, 84
Catecholamines, for septic shock, 33
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Catheter(s)
indwelling intravascular, 43, 46–47
pulmonary artery, 109, 109f
thrombosis and, 107
Catheter-based contrast
aortography, 184
Catheter-directed thrombolysis, 201
Catheter-related bloodstream
infection, 108
Cauda equina syndrome, 350
Cause of death
medical errors as, 97
in pediatric patients, 333
Caustic injury, 134
CCK. See Cholecystokinin
CD117, 249
CD4+ T cells
cytokines produced by, 9
helper T cells, 10
CD8+ T cells, 9
CDC. See Centers for Disease
Control and Prevention
CDH. See Congenital diaphragmatic
hernia
Cecal volvulus, 250–251
Cell(s)
apoptosis of, 84, 122
physiologic alterations of,
in cancer, 83
tumorigenic transformation of, 83
Cell cycle, 83, 121f, 121–122
Cell-free mitochondrial DNA, 8
Cell-surface receptors, 122–123
Cellulitis, 129
Centers for Disease Control and
Prevention, 100
Centers of Medicare and Medicaid
Services, 385
Central line infections, 100
Central transtentorial herniation, 345f
Central venous pressure, 55,
106–107, 178
Cephalic vein, 198
Cerebellar stroke, 346f
Cerebral perfusion pressure, 53, 112
Cerebrospinal fluid leak/leakage, 144,
346–347
Cerebrovascular accident, 190
Cervical disc herniation, 349, 349t
Cervical esophagus, 207, 213
Cervical radiculopathy, 349
Cesarean delivery, 341
Chagas’ disease, 27
Charcot triad, 284
Chemical burns, 134
Chemoprevention, of cancer, 84
Chemoreceptors, 30
Chemotherapy
adjuvant, for colorectal cancer,
248–249
agents used in, 84
hairy cell leukemia treated
with, 302
hepatocellular carcinoma treated
with, 277
Chenodeoxycholic acid, 268
Chernobyl disaster, 324
Chest injury, penetrating, 53
Chest wall tumors, 154
Children. See Pediatric patients
Child-Turcotte-Pugh score, 274, 274t
Chin lift, 58
Chinese medicine, traditional, 379
Chlamydia trachomatis, 343
Chloroquine, 84
Cholangiocarcinoma, 276, 281,
286–287
Cholecystectomy
indications for, 286
laparoscopic
acute cholecystitis treated with, 284
anesthesia for, 364
biloma after, 102
safety concerns for, 117
Cholecystitis, acute, 279–280, 283f,
283–284
Cholecystokinin, 279
Choledochal cysts, 281, 285, 286f, 335
Cholestasis, 103
Cholic acid, 268
Chondromas, 154
Chondrosarcoma, 154
Chronic allograft nephropathy, 93
Chronic bacterial prostatitis, 338
Chronic liver disease, 270
Chronic lymphedema, 311
Chronic lymphocytic leukemia, 297
Chronic myelogenous leukemia, 303
Chronic pancreatitis, 290f–291f,
290–292, 292t
Chronic venous insufficiency, 198, 199f
Chvostek sign, 16
Chylothorax, 156
Cingulate gyrus, 345f
Cirrhosis, 270–271, 276, 280
CKI. See Cyclin-dependent kinase
inhibitors
Claudication, 196
Clean wound, 39, 40t
Clean/contaminated wound,
39–40, 40t
CLL. See Chronic lymphocytic
leukemia
Clopidogrel, 22–23
Closed brain injury, 347
Closed loop obstruction, 236
Clostridium difficile, 259
Clostridium perfringens, 80
Clot
formation of, 21
propagation of, 22
Clotting factors, 268
congenital deficiency of, 22
in intrinsic and extrinsic
pathways, 21
CML. See Chronic myelogenous
leukemia
CMS. See Centers of Medicare and
Medicaid Services
CMV. See Cytomegalovirus
COA. See Coarctation of the aorta
Coaching, 3
Coagulation
in cardiopulmonary bypass, 25
extrinsic pathway of, 21
intrinsic pathway of, 21
Coagulation cascade, 22
Coagulopathy, trauma-induced, 23
Coarctation of the aorta, 159, 163–164
Codon, 120
Coercive style, of leadership, 4
Colectomy
bowel preparation for, 246
left, 244
right, 243
sigmoid, 244, 250
subtotal, 244
total, 244
transverse, 244
Collagen
in inguinal hernias, 315, 316t
synthesis of, steroid effects on, 78
in wound healing, 74, 76t
Collagen disorders, 315
Collagenase, 74, 76t
Colloid osmotic pressure, 16
Colloid resuscitation, 30
Colocolic anastomosis, 245f
Colon
hepatic flexure of, 54
laparoscopic resection of, 378
layers of, 256
leiomyoma of, 249
leiomyosarcoma of, 249
minimally invasive
resection of, 243
penetrating injuries to, 54
questions regarding, 241–257
resection of, 243–244
Colonic pseudo-obstruction, 251
Colonoscopy, 252
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Colorectal cancer
INDEX
adjuvant chemotherapy for,
248–249
description of, 123
in elderly, 367
hepatic metastasis of, 277
hereditary nonpolyposis, 247–248
lymph node metastasis of, 248–249
resection of, 348, 367
staging of, 248
TNM staging of, 248
Colostomy, 54, 256
Colostrum, 137
Columnar epithelium, 208–209
Command-and-control
leadership, 3–5
Common bile duct
arterial supply to, 279
lateral injury to, 281
Common carotid artery, 145, 145f
Communication
errors in, 4
in leadership, 3–4
Community-acquired
pneumonia, 44
Compartment syndrome
abdominal, 69, 103, 112–113
definition of, 351
description of, 51
Compensated shock, 35
Complement cascade, 32
Complicated diverticulitis, 247
Computed tomography
adenomas on, 275f
adrenal incidentaloma on, 328
appendicitis on, 262, 262f
cerebellar stroke on, 346f
cerebrospinal fluid leakage
findings, 346
hernia recurrence evaluations, 319
inferior vena cava filters on, 203f
liver lesions on, 268, 275f
lung cancer diagnosis using, 148
magnetic resonance imaging
versus, 269
mediastinal lymph node staging
with, 151
mesenteric vein thrombosis on, 206
pheochromocytomas on, 327
pyogenic liver abscess on, 272f
urolithiasis on, 338
Computed tomography angiogram
of arterial disease, 189
of coarctation of the aorta, 164f
of double aortic arch, 167f
of extremities, 55
of neck, 52
of pulmonary artery slings, 167f
of total anomalous pulmonary
venous connection repair, 166f
Concussion, 347
Conference live-tweeting, 389
Conflict resolution, 3t, 4
Congenital diaphragmatic hernia, 329
Congenital factor XIII deficiency, 22
Congenital heart disease
aortic stenosis, 163
aortic valve stenosis, 158–159
arterial switch operation for, 161
atrial septal defects, 157f, 157–158
bidirectional Glenn procedure for,
160, 160f
double aortic arch, 167f
double-outlet right ventricle, 170
Ebstein’s anomaly, 169f
hypoplastic left heart syndrome,
160–161, 169
management of, 163
patent ductus arteriosus, 162–163
pulmonary artery slings, 166,
167f–168f
tetralogy of Fallot, 161, 170
total anomalous pulmonary
venous connection, 159, 159f,
165–166, 166f
transposition of the great vessels, 161
tricuspid atresia, 168
truncus arteriosus, 165
ventricular septal defect, 161–162
Wolff-Parkinson-White syndrome
associated with, 169f, 169–170
Congenital inguinal hernias,
314–315, 315f
Congenital nevi, 136
Conn’s syndrome, 327
Consent, informed, 369–370
Constructive pericarditis, 178
Contaminated wound, 40, 40t
Continence, 241–242
Contusions
pancreatic, 53
pulmonary, 58, 63
Cooper’s ligament
of breast, 139
of inguinal region, 317
Corona radiata sign, 148
Coronary artery bypass, 173
Corticosteroids
arthritis treated with, 353
immunosuppression uses of, 89t, 90
side effects of, 89t
wound healing affected by, 78
Corticotropin-releasing hormone, 8
Cortisol, 8
Cox-Maze IV procedure, 177, 177f
CPB. See Cardiopulmonary bypass
CPP. See Cerebral perfusion pressure
CPR. See Cardiopulmonary
resuscitation
C-reactive protein, 7
CRH. See Corticotropin-releasing
hormone
Cricoid cartilage, 146, 146f
Cricopharyngeal muscle, 207
Cricopharyngeal sphincter, 212
Cricothyroidotomy, 56
CRISPR, 125
CRISPR-associated genes, 125
Critically ill patients
hyperglycemia in, 33
insulin resistance in, 33
metabolism in, 11
treatment of, 33–34
Crohn’s disease
description of, 237
rectovaginal fistulas caused by, 254
steatorrhea in, 268
Crossmatching, 25
Cross-sectional study, 382
Crowdsourcing, 390
CRP. See C-reactive protein
Cruveilhier-Baumgarten murmur, 270
CT. See Computed tomography
CTA. See Computed tomography
angiogram
CTS. See Carpal tunnel syndrome
Cubital tunnel syndrome, 358
Cushing ulcers, 349
Cushing’s disease, 327
Cushing’s syndrome, 327
Cutaneous melanoma, 130, 132
CVD. See Cardiovascular disease
CVI. See Chronic venous insufficiency
CVP. See Central venous pressure
Cyanide poisoning, 66
Cyanide toxicity, 66
Cyclin D1, 154
Cyclin-dependent kinase
inhibitors, 121
Cyclins, 121
Cyclophilin, 88
Cyclosporin, 88, 89t, 90
Cyst(s)
choledochal, 281, 285,
286f, 335
dermoid, 135
ganglion, 360
splenic, 303–304
thyroglossal duct, 323, 330
Cystic neoplasms, pancreatic, 295f
Cytochrome c, 122
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Cytokines
autophagy regulation of, 9
CD4+ T cell production of, 9
proinflammatory, 9
shock-related elevations of, 32
Th1, 9
Cytomegalovirus, 90
D
Dabigatran, 24
Dacron patch aortoplasty, for
coarctation of the aorta, 164
DALY. See Disability-adjusted life year
Damage control resuscitation, 26
Damage-associated molecular
patterns, 7–8, 10, 29, 37
DAMPs. See Damage-associated
molecular patterns
Damus-Kaye-Stansel anastomosis, 160
DCD. See Donation after cardiac death
DCIS. See Distal carcinoma in situ
DCP3, 374, 374t
DCR. See Damage control resuscitation
Death
cardiac, organ donation after, 91
causes of, 97
medical errors as cause of, 97
Decompressive laparotomy, 69
Deep vein thrombosis, 200–202,
202t, 366
Defecation, 241
Delirium, postoperative, 365–366
Democratic leadership style, 3–4
Dermatitis, 294
Dermoid cysts, 135
DES. See Diffuse esophageal spasm
Desarda repair, of inguinal hernias,
318, 318f
Desmoid tumors
of abdominal wall, 308
description of, 154
Desufflation, 115
Diabetes mellitus
dermatitis and, 294
pancreatic endocrine tumors
associated with, 294
questions regarding, 78, 123–124
Roux-en-Y gastric bypass
effects on, 234
wound healing affected by, 78
Diagnostic peritoneal lavage,
59–60, 60t
Diaphragm, penetrating trauma to, 59
Diaphragmatic hernia, 218, 329
DIC. See Disseminated intravascular
coagulation
Difficult airway algorithm, 364
Diffuse alveolar damage, 32
Diffuse axonal injury, 347
Diffuse esophageal spasm, 212
Digestion, carbohydrate, 236
Digit amputation, 356
Direct Coombs test, 298
Direct oral anticoagulants, 24
Direct thrombin inhibitors, 24, 205
Dirty wound, 40, 40t
Disability-adjusted life year, 374
Disasters, 71
Dislocation
knee, 352
shoulder, 352
Disseminated intravascular
coagulation, 23
Distal aortic aneurysms, 183
Distal carcinoma in situ, 137–138
Distal ischemia, 107
Distal pancreatectomy, 54
Distant flaps, 361
Diversity, in surgery, 5
Diverticulectomy, 220
Diverticulitis, 247
Diverticulopexy, 220
Diverticulum
Meckel, 235, 335
Zenker’s, 220
DKS anastomosis. See Damus-Kaye-
Stansel anastomosis
DLCO. See Carbon monoxide
diffusion capacity
DNA
eukaryotic, 119
replication of, 121–122
in RNA synthesis, 120
DO2. See Oxygen delivery
DOACs. See Direct oral anticoagulants
Dobutamine, 34
Dobutamine-stress
echocardiography, 172
Donation after cardiac death, 91
Donation by non–heart-beating
donors, 91
Donebedian model of measuring
quality, 98
Dopamine, 34
Dor fundoplication, 221
Dormancy, 84
D O RV. See Double-outlet right
ventricle
Double aortic arch, 167f
“Double bubble” sign, 333, 334f
Double-outlet right ventricle, 170
DPL. See Diagnostic peritoneal
lavage
Drug metabolism, 268
DTIs. See Direct thrombin inhibitors
Dumping syndrome, 231
Duodenum
adenocarcinoma of, 238
gastrinoma of, 294
hematoma of, 53
obstruction of, 333, 334f
ulcers of, 226–227
Duplex ultrasonography, for venous
thromboembolism, 204, 204f
Durable power of attorney for health
care, 370
DVT. See Deep vein thrombosis
Dysphagia, 210
E
EA. See Esophageal atresia
Ebstein’s anomaly, 169f
EBV. See Epstein-Barr virus
E-cadherin gene, 229
Eccrine sweat glands, 133
Echinococcal antigens, 273
Echocardiography
dobutamine-stress, 172
transesophageal, 172–173
transthoracic, 172–173
Edmonton protocol, 94
EDP. See End-diastolic pressure
EDS. See Ehler-Danlos syndrome
EDV. See End-diastolic volume
EE. See Eosinophilic esophagitis
eFAST. See Extended focused
abdominal sonography
for trauma
EGD. See
Esophagogastroduodenoscopy
EGFR. See Estimated glomerular
filtration rate
Ehler-Danlos syndrome, 75,
182, 315
Elderly
abdominal aortic
aneurysms in, 368
anticoagulation in, 367
appendicitis in, 367
cardiac function in, 366
colon cancer resection in, 367
deep venous thrombosis
prophylaxis in, 366
falls in, 367
frailty in, 365
heart valve replacement in, 367
medications in, 366
necrotizing fasciitis in, 80
nutritional status in, 366
preoperative assessment and
counseling in, 365
INDEX
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