Surgery A Competency-Based Companion

1 How to Study This Book

Barry D. Mann MD

2 Medical Knowledge: The Foundation of Patient Care

Sandra Fine MBA and Thomas G. McCarter MD

3 Practice-Based Learning and Improvement

Mary Ann Hopkins MPhil, MD

Susan Kaiser MD, PhD and Leo A. Gordon MD

4 Interpersonal and Communication Skills

Jane Ruddell Esq, Stephanie R. Landmesser RN, CNOR, MSN, Daria Arcaro BA, Nicholas P. Lang MD, and Pamela A. Rowland PhD

5 Professionalism in Surgery

Joel C. Rosenfeld MD, MEd and Linda L. Blank

6 Systems-Based Practice

Stephen E. Gordon MBA, John R. Clarke MD, Stephen K. Klasko MD, MBA, Linnea S. Hauge PhD, and Barry D. Mann MD

7 How to Succeed on the Surgical Clerkship: Thoughts on Expectations, Feedback, and Stress

Kimberly D. Schenarts PhD and Paul J. Schenarts MD

8 The Resident as Teacher: Facilitating Student Success: Thoughts on Expectations, Feedback, and Stress

Paul J. Schenarts MD and Kimberly D. Schenarts PhD

9 The Art of Oral Presentation

Paul J. Schenarts MD and Mary Ann Hopkins MPhil, MD

Appendix 1: ACGME General Competencies

Appendix 2: Competency Assessment Forms

10 Radiology Tools for Abdominal Diagnosis

Anton Mahne MD, Andrew J. Curtin MD, and Harry G. Zegel MD

11 Right Lower Quadrant Pain in a 28-Year-Old Female (Case 1)

Barry D. Mann MD and Michael Belden MD

12 Right Upper Quadrant Pain in a 44-Year-Old Female (Case 2)

Joseph F. Golob MD and Christopher P. Brandt MD

13 Epigastric Pain in a 47-Year-Old Male (Case 3)

R. Matthew Walsh MD

14 Left Lower Quadrant Pain in a 67-Year-Old Male (Case 4)

Rebecca S. Evangelista MD

15 Groin Mass in a 68-Year-Old Male (Case 5)

Ryan S. Hoffman MD and Jonathan Gefen MD

16 Abdominal Pain and Diarrhea in a 43-Year-Old Female (Case 6)

Roy Phitayakorn MD, MHPE, Brett C. Gilbert DO, and Christopher P. Brandt MD

17 Free Air in a 72-Year-Old Female (Case 7)

Karen J. Brasel MD, MPH

18 Abdominal Pain and Distention in a 63-Year-Old Man (Case 8)

Marjie L. Persons MD, Adeline M. Deladisma MD, MPH, and John D. Mellinger MD

19 Abdominal Pain and Hypotension in a 79-Year-Old Female (Case 9)

Jeffrey A. Claridge MD

Professors Pearls: Abdominal Pain

Bruce E. Stabile MD

20 Abnormal Screening Mammogram in a 48-Year-Old Female (Case 10)

Paula M. Termuhlen MD

21 Breast Mass in a 44-Year-Old Female (Case 11)

Roxane Weighall DO, Jennifer L. Sabol MD, and Ari D. Brooks MD

22 Teaching Visual: Breast Pathology

Ari D. Brooks MD and Paula M. Termuhlen MD

23 Pigmented Skin Lesion in a 58-Year-Old Female (Case 12)

James G. Bittner IV MD and D. Scott Lind MD

24 Dysphagia in a 62-Year-Old Male (Case 13)

Paul Vesco MD

25 Thyroid Nodule in a 48-Year-Old Woman (Case 14)

Mira Milas MD, Deebeanne M. Tavani DO, PhD, and Paula M. Termuhlen MD

26 Hypercalcemia in a 56-Year-Old Female (Case 15)

Walter E. Pofahl II MD and Rita El-Hajj MD

27 Lateral Neck Mass in a 67-Year-Old Male (Case 16)

James R. Ouellette DO, Veeraiah Siripurapu MD, and Bradford Davison Smith, Jr. MD

28 35-Year-Old Male with an Expanding Lump in the Thigh (Case 17)

Robin M. Ciocca DO and Ned Z. Carp MD

29 63-Year-Old Female with Jaundice (Case 18)

J. David Schmidt MD, James R. Ouellette DO, and Giancarlo Mercogliano MD, MBA

30 Teaching Visual: Anatomic Relationships of the Pancreatic Head

Barry D. Mann MD, Meredith N. Osterman MD, and Paula M. Termuhlen MD

31 Splenomegaly in a 40-Year-Old Female (Case 19)

Matthew I. Goldblatt MD and Clifford H. Pemberton MD

Professors Pearls: Surgical Oncology

Ari D. Brooks MD

32 Vascular Tools

Lino F. Miele MD, MS and Alexander Uribe MD

33 Teaching Visual: Peripheral Vascular Reconstruction

Thomas G. Lynch MD

34 Peripheral Arterial Disease (Case 20)

Thomas G. Lynch MD

35 Arterial Aneurysms (Case 21)

G. Matthew Longo MD

36 Cerebrovascular Disease (Case 22)

Iraklis I. Pipinos MD

37 Leg Swelling (Case 23)

Jason M. Johanning MD

Professors Pearls: Vascular Surgery

Thomas G. Lynch MD

38 Radiology Tools in the Diagnosis of GI Hemorrhage

John F. Schilling MD and Anton Mahne MD

39 Upper GI Bleeding in a 58-Year-Old Male (Case 24)

Veeraiah Siripurapu MD and Robert B. Noone, Jr. MD

40 Lower GI Bleeding in a 71-Year-Old Male (Case 25)

Gregg Guilfoyle DO and Robert B. Noone, Jr. MD

41 Anorectal Pain in a 45-Year-Old Male (Case 26)

Catherine M. Schermer MD and W. Randall Russell MD

Professors Pearls: GI Bleeding

John H. Marks MD

42 Chest Pain (Case 27)

Peter F. Lalor MD

43 Shortness of Breath (Case 28)

Steve B. Behrens MD, Omar Yusef Kudsi MD, and Catherine L. Kuntz MD, MSCE

44 Postoperative Fever (Case 29)

Charles Shieh MD, Julia Bulatova MD, and Mary Ann Hopkins MPhil, MD

45 Low Urine Output (Case 30)

Gregory Peck DO, Umber Burhan MD, and Robert L. Benz MD

46 Postoperative Wound Complications (Case 31)

Gabriel Del Corral MD, Larry Jonas MD, and Leo A. Gordon MD

Professors Pearls: Postoperative Care

Leo A. Gordon MD

47 Introduction to the Trauma Patient: Using the Primary and Secondary Surveys

Amy J. Goldberg MD

48 Trauma Radiology Tools

Jonathan R. Hiatt MD and Michael Zucker MD

49 Head Trauma (Case 32)

Michael W. Weaver MD and Darric E. Baty MD

50 Penetrating Neck Injury (Case 33)

Abhijit S. Pathak MD and Christine T. Trankiem MD

51 Penetrating Chest Injury (Case 34)

Amy J. Goldberg MD and Justin B. Hurie MD

52 Blunt Chest Trauma (Case 35)

Jeffry L. Kashuk MD and Benjamin J. Rogoway MD

53 Penetrating Abdominal Injury (Case 36)

Mark J. Seamon MD and Brian P. Smith MD

54 Blunt Abdominal Trauma (Case 37)

Kevin M. Bradley MD and Carlos R. Medina MD

55 Pelvic Fracture (Case 38)

Saqib Rehman MD

Professors Pearls: Trauma

Jonathan R. Hiatt MD

56 Teaching Visual: The Roux-en-Y Limb

Barry D. Mann MD

57 Gastric Bypass (Case 39)

Lisa R. Weisfelner MD and Andres E. Castellanos MD

58 Coronary Revascularization (Case 40)

Sharon Ben-Or MD and Francis D. Ferdinand MD

59 Teaching Visual: Coronary Bypass

Sharon Ben-Or MD and Francis P. Sutter DO

60 Mediastinal Mass in a 61-Year-Old Male (Case 41)

Douglas E. Paull MD

61 Solitary Pulmonary Nodule in a 58-Year-Old Male (Case 42)

Dennis F. Zagrodnik II MD

Professors Pearls: Cardiothoracic Surgery

Scott M. Goldman MD

62 Persistent Jaundice in a 1-Month-Old Infant (Case 43)

David A. Rogers MD, MHPE

63 Newborn Baby with a Large Abdominal Wall Defect (Case 44)

Dan Poenaru MD, MHPE

64 Newborn Infant with Labored Breathing and Hypoxemia (Case 45)

Andreas H. Meier MD

65 Vomiting in an Infant (Case 46)

Celeste M. Hollands MD

66 3-Year-Old Female with a 12-Hour Onset of Abdominal Pain, Vomiting, and Fever of 38.5°C (Case 47)

Ruth D. Mayforth MD, PhD

67 4-Year-Old Boy with a Groin Mass (Case 48)

Barbara J. Pettit MD

68 2-Year-Old Boy with Gastrointestinal Bleeding (Case 49)

Donald R. Cooney MD

69 Abdominal Mass in a 4-Month-Old Infant (Case 50)

Douglas Katz MD

In Memoriam: Philip J. Wolfson MD

Professors Pearls: Pediatric Surgery

Philip J. Wolfson MD

70 Liver Transplant Evaluation (Case 51)

Hilary A. Sanfey MB, BCh

71 Kidney Transplant Evaluation (Case 52)

Nicole D. Figueredo MD, James Lim MD, and Francisco Badosa MD

72 Cardiac Transplant Evaluation (Case 53)

Jaromir Kohout MD and Louis Samuels MD

Professors Pearls: Transplantation

Hilary A. Sanfey MB, BCh and Louis Samuels MD

73 Introduction to Surgical Critical Care

Thomas A. Santora MD

74 Fluid and Electrolyte Disorders

Jennifer L. Denne MD

75 Acid-Base Balance

Thomas J. Meyer MD

76 Mechanical Ventilation

Rashna F. Ginwalla MD, Leah Lande MD, John Mullarkey RRT,and Thomas A. Santora MD

77 Shock: Principles of Management

Thomas A. Santora MD and Dipin Gupta MD

78 Coagulation and Transfusion

Rohit A. Patel MD and Kevin M. Bradley MD

79 Infections in the Critically Ill: Principles and Management

Christina M. Rose PharmD, BCPS and Aditi Madabhushi MD

80 Nutrition Support in the ICU

Sharon Del Bono RD, CNSD, LDN and Julia M. Toto MD

81 Multiple System Organ Failure

Mark J. Seamon MD and Abhijit S. Pathak MD

Critical Care Exercises: Integrating the Management of the Critical Care Patient

Thomas A. Santora MD, Miren A. Schinco MD, and Lewis J. Kaplan MD

82 The Iraq Experiences: Do Competencies Apply in the War Zone?

Paul J. Schenarts MD

83 Potential Conflict between Patient Care and Systems-Based Practice Competencies

Donald M. Jacobs MD

84 Bloodless Care Medicine: The Intersection of Religion and the Competencies

Philip Craig Wry MD

85 A Patients Perspective

Linnea S. Hauge PhD

86 On CABGs and Competencies

Barry D. Mann MD

87 Business Challenges to Our Professionalism

Robert E. Booth, Jr. MD

Surgical Procedures

BREAST

Operation 1 Breast Biopsy

Operation 2 Partial Mastectomy (Lumpectomy)

Operation 3 Sentinel Lymph Node Biopsy (SLNB)

Operation 4 Axillary Node Dissection

Operation 5 Total (Simple) Mastectomy

NECK

Operation 6 Thyroidectomy

Operation 7 Parathyroidectomy

Operation 8 Tracheostomy

GENERAL

Operation 9 Open Inguinal Hernia Repair

Operation 10 Laparoscopic Inguinal Hernia Repair

Operation 11 Laparoscopic Ventral Hernia Repair

Operation 12 Splenectomy

GASTROINTESTINAL

Operation 13 Gastrectomy

Operation 14 Laparoscopic Gastric Bypass

Operation 15 Laparoscopic Adjustable Gastric Band

Operation 16 Laparoscopic Fundoplication

Operation 17 Graham Patch for Perforated Ulcer

Operation 18 Oversew of Bleeding Duodenal Ulcer (Vagotomy and Pyloroplasty)

Operation 19 Small Bowel Resection

Operation 20 Right Colectomy

Operation 21 Left Colectomy and Low Anterior Resection

Operation 22 Laparoscopic Colectomy

Operation 23 Colostomy and Ileostomy

Operation 24 Open Appendectomy

Operation 25 Laparoscopic Appendectomy

Operation 26 Hemorrhoidectomy

HEPATOBILIARY

Operation 27 Laparoscopic Cholecystectomy

Operation 28 Common Bile Duct Exploration

Operation 29 Hepatic Lobectomy

Operation 30 Whipple Procedure (Pancreaticoduodenectomy)

Operation 31 Distal Pancreatectomy

THORACIC

Operation 32 Pulmonary Lobectomy

VASCULAR

Operation 33 Endovascular Aneurysm Repair (EVAR)

Operation 34 Carotid Endarterectomy

Operation 35 Femoral-Popliteal Bypass Grafting

Operation 36 Dialysis Access Procedures

Operation 37 Insertion of Portacath