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NMS Surgery Casebook

Edition: 3
9781975112387
ISBN/ISSN:
9781975112387
Publication Date:
November 15, 2021
2021-11-15
9781975112387
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Ideal as a stand-alone review or as a perfect companion to NMS Surgery, Seventh Edition, this leading casebook for the ...
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  • Ideal as a stand-alone review or as a perfect companion to NMS Surgery, Seventh Edition, this leading casebook for the surgical rotation presents a series of surgical cases that begin with a clinical scenario and progress step by step through the decision-making process of patient management. Concise and portable, NSM Surgery Casebook, Third Edition fits in a lab coat pocket—ideal for review on the wards.

    ​Retaining the structured subject review, practice questions for the USMLE Step 2 exam, and focus on helping students work through clinical cases with a unique “what next” approach to decision making, this third edition offers a new full-color design, new study aids, and key updates throughout.
    • A unique, case-based surgical review, with case variations, teaches effective surgical approach and allows students to practice real-world clinical decision making and prepare for exams.
    • New and updated cases reflect modern surgical practice.
    • Revised Cutting to the Chase feature at the beginning of each chapter presents a high-yield overview of important concepts.
    • New Critical Surgical Associations from NMS Surgery cover associations and important sequences in a highly visual way.
    • All-new radiographic images are easier to read and interpret.
    • Easy-to-spot Digging Deep boxes provide high-yield information in an easily accessible way.
    • An extensive illustration program provides opportunities to make patient management decisions based on visual cues.
  • Edition
    3
    ISBN/ISSN
    9781975112387
    Product Format
    Paperback Book
    Trim Size
    6 x 9
    Pages
    512
    Series
    National Medical Series for Independent Study
    Edition
    3
    Publication Date
    November 15, 2021
  • Bruce Jarrell M.D.
    Stephen M. Kavic MD
    Eric D. Strauch MD
  • Preface vi
    Contributors vii
    Part I: Foundations
    1 Preoperative Care ............................ 1
    Bruce E. Jarrell, Molly Buzdon, Eric D. Strauch
    Preoperative Care Principles 2
    Case 1.1: Routine Surgery in a Healthy Patient 2
    Case 1.2: Common Risk Factors Associated with Routine
    Surgery 8
    Case 1.3: Common Problems in a Patient Waiting to Enter
    the Operating Room 10
    Case 1.4: Surgery in a Patient with Pulmonary Symptoms 11
    Case 1.5: Urgent Surgery in a Patient with Severe, Acute Pulmonary
    Function Problems 12
    Case 1.6: Cardiac and Neurologic Risk Associated with Surgery for
    Peripheral Vascular Disease 14
    Case 1.7: Surgery in a Patient with Liver Failure 19
    Case 1.8: Surgery in a Patient with Chronic Kidney Problems 23
    Case 1.9: Surgery in a Patient with Cardiac Valvular Disease 24
    Case 1.10: Endocarditis Prophylaxis in a Surgical Patient with
    Valvular Heart Disease 25
    Case 1.11: Surgery in a Patient with Cardiomyopathy 26
    2 Postoperative Care .......................... 27
    Bruce E. Jarrell, Molly Buzdon, Eric D. Strauch
    Postoperative Care Principles 28
    Case 2.1: Postoperative Fluid and Electrolyte Management 29
    Case 2.2: Postoperative Acute Renal Failure 31
    Case 2.3: Postoperative Fever 33
    Case 2.4: High Fever in the Immediate Postoperative Period 35
    ContentsCase 2.5: Postoperative Cardiopulmonary Problems 35
    Case 2.6: Management of a Small Bowel Fistula 37
    3 Wound Healing .................................... 38
    Bruce E. Jarrell, Eric D. Strauch
    Principles of Wound Healing 38
    Case 3.1: Wound Management and Complications 39
    Case 3.2: Wound Infection 42
    Case 3.3: Wound Classification Based on Risk of Subsequent Infection 44
    Part II: Specific Disorders
    4 Thoracic and Cardiothoracic Disorders ............... 49
    Bruce E. Jarrell, Eric D. Strauch
    Lung Disease 50
    Case 4.1: Asymptomatic Abnormality Seen on Chest Radiography 51
    Case 4.2: Symptomatic Abnormality Seen on Chest Radiography 55
    Case 4.3: Symptomatic Abnormality Located in the Hilum on Chest
    Radiography 57
    Case 4.4: Lung Mass with Possible Metastases 60
    Case 4.5: Symptomatic Superior Sulcus Tumor 61
    Case 4.6: Hemoptysis and Atelectasis in a Y oung Patient 63
    Case 4.7: New-Onset Pleural Effusion without Heart Failure 64
    Case 4.8: Sudden Chest Pain and Shortness of Breath in a
    Y oung Patient 67
    Cardiac Disease 72
    Case 4.9: Pleural-Based Chest Pain, Fever, and Pleural Effusion 72
    Case 4.10: Progressively Increasing Substernal Chest Pain 73
    Case 4.11: Mitral Valve Disease that Requires Surgery 77
    Case 4.12: Aortic Valve Disease that Requires Surgery 78
    Case 4.13: Congestive Heart Failure with Normal
    Coronary Arteries 80
    Esophageal Disease 81
    Case 4.14: Recurrent Regurgitation of Undigested Food 81
    Case 4.15: Dysphagia with Weight Loss 83
    Case 4.16: Dysphagia with Esophageal Defect 84
    Case 4.17: Severe Dysphagia with Coughing 90
    Mediastinal Masses 92
    Case 4.18: Muscular Weakness and a Mediastinal Mass 925 Vascular Disorders ................................ 95
    Bruce E. Jarrell, Molly Buzdon, Marshall Benjamin, Eric D. Strauch
    Peripheral Arterial Disease 96
    Case 5.1: Brief Neurologic Event 97
    Case 5.2: Other Transient Neurologic Events 102
    Case 5.3: Asymptomatic Carotid Bruit 103
    Case 5.4: Acute Vascular Event in the Leg 104
    Case 5.5: Claudication 108
    Case 5.6: Claudication and Absence of a Femoral Pulse 112
    Case 5.7: Toe Ulceration in Peripheral Vascular Disease 113
    Case 5.8: Aortoiliac Occlusive Disease 116
    Case 5.9: Cardiac Risk in Major Vascular Reconstruction 119
    Case 5.10: Pulsatile Mass in the Abdomen 121
    Case 5.11: Ruptured Abdominal Aortic Aneurysm 124
    Case 5.12: Complications of Abdominal Aortic Replacement 126
    Case 5.13: Chronic Postprandial Abdominal Pain and Weight Loss 128
    Case 5.14: Tearing Chest and Back Pain 130
    Venous Disease 131
    Case 5.15: Postoperative Leg Swelling 132
    Case 5.16: Prevention of Deep Venous Thrombosis 133
    Case 5.17: Postoperative Shortness of Breath 136
    Case 5.18: Confounding Findings in Pulmonary Embolism 137
    Case 5.19: Recurrent Pulmonary Embolism on Anticoagulation
    Therapy 138
    Case 5.20: Gastrointestinal Bleeding as a Complication of Anticoagulation
    Therapy 138
    Case 5.21: Severe Deep Venous Thrombosis 140
    6 Upper Gastrointestinal Tract Disorders ............... 141
    Bruce E. Jarrell, John L. Flowers, Molly Buzdon, Eric D. Strauch
    Case 6.1: Acute Epigastric Pain 144
    Case 6.2: Acute Epigastric Pain with Regurgitation and Coughing 145
    Case 6.3: Acute Epigastric Pain with Hiatal Hernia 148
    Case 6.4: Acute Epigastric Pain with Pyloric Channel Ulcer 150
    Case 6.5: Acute Epigastric Pain with Gastric Ulcer 153
    Case 6.6: Acute Epigastric Pain with Early Gastric Cancer 156
    Case 6.7: Acute Epigastric Pain with a Rigid Abdomen 158
    Case 6.8: Upper Gastrointestinal Bleeding 161
    Case 6.9: Upper Gastrointestinal Bleeding with Esophageal Varices 168
    Case 6.10: Acute Epigastric Pain with Gastric Lymphoma 1707 Pancreatic and Hepatic Disorders ................... 172
    Bruce E. Jarrell, Eric D. Strauch
    Common Pancreaticobiliary Disorders 173
    Case 7.1: Asymptomatic Gallstones 173
    Case 7.2: Right Upper Quadrant Pain 174
    Case 7.3: Right Upper Quadrant Pain with Gallstones and Signs of
    Infection 177
    Case 7.4: Right Upper Quadrant Pain with Gallstones and Jaundice 178
    Case 7.5: Right Upper Quadrant Pain in Pregnancy 179
    Case 7.6: Right Upper Quadrant Pain with Cholelithiasis and Elevated
    Amylase 179
    Case 7.7: Right Upper Quadrant Pain with High Fever 180
    Case 7.8: Right Upper Quadrant Pain in an Extremely Ill Older Adult 183
    Case 7.9: Right Upper Quadrant Pain, Fever, and Jaundice 184
    Case 7.10: Complications of Laparoscopic Cholecystectomy 186
    Case 7.11: Painless Jaundice 188
    Case 7.12: Painless Jaundice due to Obstruction at the Common Bile Duct
    Bifurcation 193
    Case 7.13: Other Biliary Tract Cancers 196
    Case 7.14: Acute Epigastric Pain with High Serum Amylase and Lipase 197
    Case 7.15: Acute Epigastric Pain in Severely Ill Patient 198
    Case 7.16: Acute Epigastric Pain with Continued Pain 201
    Common Hepatic Disorders 204
    Case 7.17: Hepatic Mass 205
    Case 7.18: Fever and Pain in the Right Upper Quadrant 210
    8 Lower Gastrointestinal Disorders ................... 213
    Bruce E. Jarrell, Molly Buzdon, Eric D. Strauch
    Small Intestinal Disorders 214
    Case 8.1: Crampy Abdominal Pain 214
    Case 8.2: Crampy Abdominal Pain with Partial Improvement 221
    Case 8.3: Crampy Abdominal Pain with Signs of Small Bowel
    Obstruction 222
    Case 8.4: Injury to the Bowel during Lysis of Adhesions 223
    Case 8.5: Crampy Abdominal Pain following Pneumonia 224
    Case 8.6: Abdominal Pain in an Older Adult 224
    Case 8.7: Abdominal Pain with Suspected Mesenteric Ischemia 226
    Inflammatory Bowel Disease 229
    Case 8.8: Crampy Abdominal Pain in Patient with Crohn Disease 230
    Case 8.9: Perianal Disease in a Patient with Crohn Disease 232Case 8.10: Management of Crohn Colitis 233
    Case 8.11: Complications of Long-Standing Ulcerative Colitis 233
    Case 8.12: Complications of Acute Colitis 235
    Disorders of the Colon 237
    Case 8.13: Right Lower Quadrant Pain 237
    Case 8.14: Right Lower Quadrant Pain with Dysuria and Increased
    WBCs 238
    Case 8.15: Worsening Right Lower Quadrant Pain 243
    Case 8.16: Right Lower Quadrant Pain with Mass on Appendix 244
    Case 8.17: Complications of a Ruptured Appendix 245
    Malignant Disorders of the Colon, Rectum, and Anus 247
    Case 8.18: Screening for Colorectal Cancer 247
    Case 8.19: Heme-Positive Stool 248
    Case 8.20: Heme-Positive Stool in Patient with Polyp 250
    Case 8.21: Heme-Positive Stool with Fatigue and Weight Loss 253
    Case 8.22: Heme-Positive Stool with Suspected Colon Cancer 256
    Case 8.23: Operative Findings in Colon Cancer 257
    Case 8.24: Complications of Postoperative Colectomy 258
    Case 8.25: Heme-Positive Stool in Patient with Rectal Adenocarcinoma 259
    Case 8.26: Heme-Positive Stool in Patient with Rectal Cancer 262
    Case 8.27: Metastasis in Colorectal Cancer 267
    Case 8.28: Heme-Positive Stool with a Hard Lesion 268
    Lower Abdominal Pain 269
    Case 8.29: Left Lower Quadrant Pain and Fever 270
    Case 8.30: Recurrence of Left Lower Quadrant Pain 272
    Case 8.31: Left Lower Quadrant Pain in a Deteriorating Patient 273
    Case 8.32: History of Left Lower Quadrant Pain with Sensation
    of Voided Air 274
    Lower Gastrointestinal Bleeding 275
    Case 8.33: Massive Lower Gastrointestinal Bleeding 275
    Case 8.34: Persistent Bleeding with a Massive Lower Gastrointestinal
    Bleed 279
    Other Benign Lower Gastrointestinal Tract Disorders 282
    Case 8.35: Syndromes of Acute Colonic Dilation and Obstruction 282
    Case 8.36: Rectal Prolapse 286
    Case 8.37: Perianal Problems 287
    Case 8.38: Persistent Perianal Drainage 288
    Case 8.39: Severe Anal Pain with Perianal Mass 289
    Case 8.40: Need for Colostomy 2899 Endocrine Disorders .............................. 291
    Bruce E. Jarrell, W . Bradford Carter, Eric D. Strauch
    Endocrine Disorders 291
    Case 9.1: Thyroid Nodule Found on Examination 292
    Case 9.2: Symptomatic Hypercalcemia 299
    Case 9.3: Medical Management of Acute Hypercalcemia 303
    Case 9.4: Secondary Hyperparathyroidism 305
    Case 9.5: Hyperparathyroidism and Severe Hypertension in the Same
    Patient 305
    Case 9.6: Acute Development of a Tender Neck Mass 306
    Case 9.7: History of Hyperparathyroidism and Intractable Duodenal
    Ulcers 308
    Case 9.8: Medullary Carcinoma of the Thyroid 311
    Case 9.9: Incidentally Discovered Adrenal Mass 311
    10 Skin and Soft Tissue Disorders and Hernias .......... 313
    Bruce E. Jarrell, Eric D. Strauch
    Malignant Melanoma 313
    Case 10.1: Evaluation of a Skin Lesion 313
    Case 10.2: Diagnosis of Malignant Melanoma in a Skin Lesion 315
    Case 10.3: Malignant Melanoma with a Palpable Lymph Node 323
    Case 10.4: Malignant Melanoma with Distant Metastasis 323
    Case 10.5: Malignant Melanoma on the Cheek 324
    Case 10.6: Malignant Melanomas in Other Areas 325
    Case 10.7: Small Bowel Obstruction and History
    of Malignant Melanoma 326
    Sarcoma 326
    Case 10.8: Sarcoma of the Lower Extremity 326
    Case 10.9: Metastatic Sarcoma to the Lung 331
    Hernias and Related Conditions 332
    Case 10.10: Pain in the Groin 332
    Case 10.11: Inguinal Hernia 335
    Case 10.12: Additional Hernia-Related Problems 342
    Case 10.13: Ventral Hernia 343
    11 Breast Disorders ................................. 345
    Julia H. Terhune, Bruce E. Jarrell, Emily Bellavance, Michelle
    Townsend Day, Katherine Tkaczuk, Eric D. Strauch
    Case 11.1: Screening for Breast Cancer 346
    Case 11.2: Evaluation of a Mammographic Abnormality 349Case 11.3: Evaluation of Mammographic Microcalcifications 350
    Case 11.4: Biopsy Results in Lesions Visible on Mammography 352
    Case 11.5: Palpable Breast Mass 355
    Case 11.6: “Lumpy” Breasts 356
    Case 11.7: Breast Mass in a Y oung Woman 357
    Case 11.8: Nipple Discharge 357
    Case 11.9: Staging and Prognosis in Infiltrating Ductal Carcinoma 359
    Case 11.10: Select Clinical Factors that Affect Prognosis 360
    Case 11.11: Nipple Lesion 362
    Case 11.12: Surgical Management of Breast Cancer 363
    Case 11.13: Treatment Options for Stage I and II Breast Cancer 366
    Case 11.14: Breast Reconstruction 368
    Case 11.15: Medical Management of Breast Cancer 369
    Case 11.16: Treatment of Stage III and IV Breast Cancer 370
    Case 11.17: Breast Mass with Cellulitis and Edema 371
    Case 11.18: Events that Occur Later in Patients with Breast Cancer 372
    Case 11.19: Breast Problems in Pregnancy and the Peripartum Period 373
    Case 11.20: Breast Cancer in Patients of Advanced Age and Decreased
    Function 374
    Case 11.21: Breast Mass in a Man 375
    Case 11.22: Gynecomastia 375
    Part III: Special Issues
    12 Trauma, Burns, and Sepsis ......................... 377
    Bruce E. Jarrell, Thomas Scalea, Molly Buzdon
    Case 12.1: Primary and Secondary Assessment of Injuries 378
    Case 12.2: Initial Airway Management 378
    Case 12.3: Initial Pulmonary Management 380
    Case 12.4: Pneumothorax in a Patient with Hypotension 385
    Case 12.5: Hypotension and Neck Vein Distention
    with Normal Breath Sounds 386
    Case 12.6: Hypotension with Normal Breath Sounds
    and No Neck Vein Distention 387
    Case 12.7: Initial Cervical Spine Management 390
    Case 12.8: Initial Assessment of Thoracic Injury 393
    Case 12.9: Indistinct or Widened Mediastinum 396
    Case 12.10: Initial Abdominal Assessment Based on the Mechanism
    of Injury 397
    Case 12.11: Initial Assessment of Abdominal Injury 401
    Case 12.12: Abdominal Injuries Visible on CT Scan 406
    Case 12.13: Operative Findings with Abdominal Trauma 413
    Case 12.14: Initial Neurologic Injury Assessment and Management 415Case 12.15: Other Neurologic Problems 416
    Case 12.16: Continuing Hemorrhage 418
    Case 12.17: Postoperative Problems in Trauma Patients 419
    Case 12.18: Traumatic Arteriovenous Fistula 423
    Case 12.19: Continuing Pulmonary Problems 425
    Case 12.20: Respiratory Distress 426
    Case 12.21: Stab Wound to the Neck 428
    Case 12.22: Other Injuries to the Neck 430
    Case 12.23: B ur n 431
    Case 12.24: Total Parenteral Nutrition 437
    13 Pediatric Surgical Disorders ........................ 442
    Clint D. Cappiello, Eric D. Strauch, Bruce E. Jarrell
    Case 13.1: Acute Respiratory Distress 443
    Case 13.2: Respiratory Distress with Oral Intake 445
    Case 13.3: Bilious Emesis 448
    Case 13.4: Imperforate Anus 456
    Case 13.5: Vomiting in a 2-Week-Old Infant 457
    Case 13.6: Abdominal Wall Defects 459
    Case 13.7: Abdominal Pain in a 7-Month-Old Child 463
    Index 465
    • A unique, case-based surgical review, with case variations, teaches effective surgical approach and allows students to practice real-world clinical decision making and prepare for exams.
    • New and updated cases reflect modern surgical practice.
    • Revised Cutting to the Chase feature at the beginning of each chapter presents a high-yield overview of important concepts.
    • New Critical Surgical Associations from NMS Surgery cover associations and important sequences in a highly visual way.
    • All-new radiographic images are easier to read and interpret.
    • Easy-to-spot Digging Deep boxes provide high-yield information in an easily accessible way.
    • An extensive illustration program provides opportunities to make patient management decisions based on visual cues.
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NMS Surgery Casebook

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