| Preface |
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| Contributors |
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vii | |
| Part I Foundations |
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1 | (26) |
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Preoperative Care Principles |
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2 | (26) |
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Case 1.1 Routine Surgery in a Healthy Patient |
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2 | (6) |
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Case 1.2 Common Risk Factors Associated with Routine Surgery |
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8 | (2) |
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Case 1.3 Common Problems in a Patient Waiting to Enter the Operating Room |
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10 | (1) |
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Case 1.4 Surgery in a Patient with Pulmonary Symptoms |
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11 | (1) |
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Case 1.5 Urgent Surgery in a Patient with Severe, Acute Pulmonary Function Problems |
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12 | (2) |
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Case 1.6 Cardiac and Neurologic Risk Associated with Surgery for Peripheral Vascular Disease |
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14 | (5) |
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Case 1.7 Surgery in a Patient with Liver Failure |
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19 | (4) |
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Case 1.8 Surgery in a Patient with Chronic Kidney Problems |
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23 | (1) |
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Case 1.9 Surgery in a Patient with Cardiac Valvular Disease |
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24 | (1) |
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Case 1.10 Endocarditis Prophylaxis in a Surgical Patient with Valvular Heart Disease |
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25 | (1) |
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Case 1.11 Surgery in a Patient with Cardiomyopathy |
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26 | (1) |
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27 | (11) |
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Postoperative Care Principles |
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28 | (10) |
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Case 2.1 Postoperative Fluid and Electrolyte Management |
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29 | (2) |
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Case 2.2 Postoperative Acute Renal Failure |
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31 | (2) |
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Case 2.3 Postoperative Fever |
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33 | (2) |
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Case 2.4 High Fever in the Immediate Postoperative Period |
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35 | (1) |
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Case 2.5 Postoperative Cardiopulmonary Problems |
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35 | (2) |
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Case 2.6 Management of a Small Bowel Fistula |
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37 | (1) |
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38 | (11) |
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Principles of Wound Healing |
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38 | (12) |
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Case 3.1 Wound Management and Complications |
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39 | (3) |
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42 | (2) |
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Case 3.3 Wound Classification Based on Risk of Subsequent Infection |
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44 | (5) |
| Part II Specific Disorders |
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4 Thoracic and Cardiothoracic Disorders |
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49 | (46) |
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50 | (22) |
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Case 4.1 Asymptomatic Abnormality Seen on Chest Radiography |
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51 | (4) |
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Case 4.2 Symptomatic Abnormality Seen on Chest Radiography |
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55 | (2) |
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Case 4.3 Symptomatic Abnormality Located in the Hilum on Chest Radiography |
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57 | (3) |
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Case 4.4 Lung Mass with Possible Metastases |
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60 | (1) |
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Case 4.5 Symptomatic Superior Sulcus Tumor |
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61 | (2) |
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Case 4.6 Hemoptysis and Atelectasis in a Young Patient |
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63 | (1) |
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Case 4.7 New-Onset Pleural Effusion without Heart Failure |
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64 | (3) |
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Case 4.8 Sudden Chest Pain and Shortness of Breath in a Young Patient |
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67 | (5) |
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72 | (9) |
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Case 4.9 Pleural-Based Chest Pain, Fever, and Pleural Effusion |
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72 | (1) |
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Case 4.10 Progressively Increasing Substernal Chest Pain |
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73 | (4) |
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Case 4.11 Mitral Valve Disease that Requires Surgery |
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77 | (1) |
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Case 4.12 Aortic Valve Disease that Requires Surgery |
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78 | (2) |
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Case 4.13 Congestive Heart Failure with Normal Coronary Arteries |
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80 | (1) |
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81 | (11) |
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Case 4.14 Recurrent Regurgitation of Undigested Food |
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81 | (2) |
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Case 4.15 Dysphagia with Weight Loss |
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83 | (1) |
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Case 4.16 Dysphagia with Esophageal Defect |
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84 | (6) |
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Case 4.17 Severe Dysphagia with Coughing |
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90 | (2) |
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92 | (4) |
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Case 4.18 Muscular Weakness and a Mediastinal Mass |
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92 | (3) |
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95 | (46) |
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Peripheral Arterial Disease |
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96 | (35) |
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Case 5.1 Brief Neurologic Event |
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97 | (5) |
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Case 5.2 Other Transient Neurologic Events |
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102 | (1) |
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Case 5.3 Asymptomatic Carotid Bruit |
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103 | (1) |
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Case 5.4 Acute Vascular Event in the Leg |
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104 | (4) |
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108 | (4) |
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Case 5.6 Claudication and Absence of a Femoral Pulse |
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112 | (1) |
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Case 5.7 Toe Ulceration in Peripheral Vascular Disease |
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113 | (3) |
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Case 5.8 Aortoiliac Occlusive Disease |
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116 | (3) |
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Case 5.9 Cardiac Risk in Major Vascular Reconstruction |
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119 | (2) |
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Case 5.10 Pulsatile Mass in the Abdomen |
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121 | (3) |
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Case 5.11 Ruptured Abdominal Aortic Aneurysm |
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124 | (2) |
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Case 5.12 Complications of Abdominal Aortic Replacement |
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126 | (2) |
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Case 5.13 Chronic Postprandial Abdominal Pain and Weight Loss |
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128 | (2) |
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Case 5.14 Tearing Chest and Back Pain |
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130 | (1) |
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131 | (13) |
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Case 5.15 Postoperative Leg Swelling |
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132 | (1) |
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Case 5.16 Prevention of Deep Venous Thrombosis |
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133 | (3) |
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Case 5.17 Postoperative Shortness of Breath |
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136 | (1) |
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Case 5.18 Confounding Findings in Pulmonary Embolism |
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137 | (1) |
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Case 5.19 Recurrent Pulmonary Embolism on Anticoagulation Therapy |
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138 | (1) |
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Case 5.20 Gastrointestinal Bleeding as a Complication of Anticoagulation Therapy |
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138 | (2) |
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Case 5.21 Severe Deep Venous Thrombosis |
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140 | (1) |
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6 Upper Gastrointestinal Tract Disorders |
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141 | (31) |
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Case 6.1 Acute Epigastric Pain |
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144 | (1) |
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Case 6.2 Acute Epigastric Pain with Regurgitation and Coughing |
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145 | (3) |
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Case 6.3 Acute Epigastric Pain with Hiatal Hernia |
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148 | (2) |
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Case 6.4 Acute Epigastric Pain with Pyloric Channel Ulcer |
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150 | (3) |
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Case 6.5 Acute Epigastric Pain with Gastric Ulcer |
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153 | (3) |
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Case 6.6 Acute Epigastric Pain with Early Gastric Cancer |
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156 | (2) |
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Case 6.7 Acute Epigastric Pain with a Rigid Abdomen |
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158 | (3) |
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Case 6.8 Upper Gastrointestinal Bleeding |
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161 | (7) |
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Case 6.9 Upper Gastrointestinal Bleeding with Esophageal Varices |
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168 | (2) |
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Case 6.10 Acute Epigastric Pain with Gastric Lymphoma |
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170 | (2) |
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7 Pancreatic and Hepatic Disorders |
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172 | (41) |
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Common Pancreaticobiliary Disorders |
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173 | (31) |
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Case 7.1 Asymptomatic Gallstones |
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173 | (1) |
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Case 7.2 Right Upper Quadrant Pain |
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174 | (3) |
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Case 7.3 Right Upper Quadrant Pain with Gallstones and Signs of Infection |
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177 | (1) |
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Case 7.4 Right Upper Quadrant Pain with Gallstones and Jaundice |
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178 | (1) |
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Case 7.5 Right Upper Quadrant Pain in Pregnancy |
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179 | (1) |
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Case 7.6 Right Upper Quadrant Pain with Cholelithiasis and Elevated Amylase |
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179 | (1) |
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Case 7.7 Right Upper Quadrant Pain with High Fever |
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180 | (3) |
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Case 7.8 Right Upper Quadrant Pain in an Extremely Ill Older Adult |
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183 | (1) |
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Case 7.9 Right Upper Quadrant Pain, Fever, and Jaundice |
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184 | (2) |
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Case 7.10 Complications of Laparoscopic Cholecystectomy |
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186 | (2) |
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Case 7.11 Painless Jaundice |
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188 | (5) |
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Case 7.12 Painless Jaundice due to Obstruction at the Common Bile Duct Bifurcation |
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193 | (3) |
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Case 7.13 Other Biliary Tract Cancers |
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196 | (1) |
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Case 7.14 Acute Epigastric Pain with High Serum Amylase and Lipase |
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197 | (1) |
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Case 7.15 Acute Epigastric Pain in Severely Ill Patient |
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198 | (3) |
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Case 7.16 Acute Epigastric Pain with Continued Pain |
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201 | (3) |
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204 | (10) |
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205 | (5) |
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Case 7.18 Fever and Pain in the Right Upper Quadrant |
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210 | (3) |
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8 Lower Gastrointestinal Disorders |
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213 | (78) |
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Small Intestinal Disorders |
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214 | (15) |
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Case 8.1 Crampy Abdominal Pain |
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214 | (7) |
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Case 8.2 Crampy Abdominal Pain with Partial Improvement |
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221 | (1) |
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Case 8.3 Crampy Abdominal Pain with Signs of Small Bowel Obstruction |
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222 | (1) |
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Case 8.4 Injury to the Bowel during Lysis of Adhesions |
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223 | (1) |
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Case 8.5 Crampy Abdominal Pain following Pneumonia |
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224 | (1) |
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Case 8.6 Abdominal Pain in an Older Adult |
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224 | (2) |
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Case 8.7 Abdominal Pain with Suspected Mesenteric Ischemia |
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226 | (3) |
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Inflammatory Bowel Disease |
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229 | (8) |
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Case 8.8 Crampy Abdominal Pain in Patient with Crohn Disease |
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230 | (2) |
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Case 8.9 Perianal Disease in a Patient with Crohn Disease |
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232 | (1) |
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Case 8.10 Management of Crohn Colitis |
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233 | (1) |
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Case 8.11 Complications of Long-Standing Ulcerative Colitis |
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233 | (2) |
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Case 8.12 Complications of Acute Colitis |
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235 | (2) |
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237 | (10) |
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Case 8.13 Right Lower Quadrant Pain |
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237 | (1) |
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Case 8.14 Right Lower Quadrant Pain with Dysuria and Increased WBCs |
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238 | (5) |
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Case 8.15 Worsening Right Lower Quadrant Pain |
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243 | (1) |
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Case 8.16 Right Lower Quadrant Pain with Mass on Appendix |
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244 | (1) |
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Case 8.17 Complications of a Ruptured Appendix |
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245 | (2) |
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Malignant Disorders of the Colon, Rectum, and Anus |
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247 | (22) |
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Case 8.18 Screening for Colorectal Cancer |
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247 | (1) |
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Case 8.19 Heme-Positive Stool |
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248 | (2) |
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Case 8.20 Heme-Positive Stool in Patient with Polyp |
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250 | (3) |
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Case 8.21 Heme-Positive Stool with Fatigue and Weight Loss |
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253 | (3) |
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Case 8.22 Heme-Positive Stool with Suspected Colon Cancer |
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256 | (1) |
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Case 8.23 Operative Findings in Colon Cancer |
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257 | (1) |
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Case 8.24 Complications of Postoperative Colectomy |
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258 | (1) |
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Case 8.25 Heme-Positive Stool in Patient with Rectal Adenocarcinoma |
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259 | (3) |
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Case 8.26 Heme-Positive Stool in Patient with Rectal Cancer |
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262 | (5) |
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Case 8.27 Metastasis in Colorectal Cancer |
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267 | (1) |
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Case 8.28 Heme-Positive Stool with a Hard Lesion |
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268 | (1) |
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269 | (6) |
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Case 8.29 Left Lower Quadrant Pain and Fever |
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270 | (2) |
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Case 8.30 Recurrence of Left Lower Quadrant Pain |
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272 | (1) |
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Case 8.31 Left Lower Quadrant Pain in a Deteriorating Patient |
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273 | (1) |
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Case 8.32 History of Left Lower Quadrant Pain with Sensation of Voided Air |
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274 | (1) |
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Lower Gastrointestinal Bleeding |
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275 | (7) |
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Case 8.33 Massive Lower Gastrointestinal Bleeding |
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275 | (4) |
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Case 8.34 Persistent Bleeding with a Massive Lower Gastrointestinal Bleed |
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279 | (3) |
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Other Benign Lower Gastrointestinal Tract Disorders |
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282 | (9) |
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Case 8.35 Syndromes of Acute Colonic Dilation and Obstruction |
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282 | (4) |
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Case 8.36 Rectal Prolapse |
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286 | (1) |
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Case 8.37 Perianal Problems |
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287 | (1) |
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Case 8.38 Persistent Perianal Drainage |
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288 | (1) |
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Case 8.39 Severe Anal Pain with Perianal Mass |
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289 | (1) |
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Case 8.40 Need for Colostomy |
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289 | (2) |
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291 | (22) |
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291 | (22) |
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Case 9.1 Thyroid Nodule Found on Examination |
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292 | (7) |
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Case 9.2 Symptomatic Hypercalcemia |
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299 | (4) |
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Case 9.3 Medical Management of Acute Hypercalcemia |
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303 | (2) |
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Case 9.4 Secondary Hyperparathyroidism |
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305 | (1) |
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Case 9.5 Hyperparathyroidism and Severe Hypertension in the Same Patient |
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305 | (1) |
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Case 9.6 Acute Development of a Tender Neck Mass |
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306 | (2) |
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Case 9.7 History of Hyperparathyroidism and Intractable Duodenal Ulcers |
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308 | (3) |
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Case 9.8 Medullary Carcinoma of the Thyroid |
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311 | (1) |
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Case 9.9 Incidentally Discovered Adrenal Mass |
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311 | (2) |
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10 Skin and Soft Tissue Disorders and Hernias |
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313 | (32) |
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313 | (13) |
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Case 10.1 Evaluation of a Skin Lesion |
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313 | (2) |
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Case 10.2 Diagnosis of Malignant Melanoma in a Skin Lesion |
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315 | (8) |
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Case 10.3 Malignant Melanoma with a Palpable Lymph Node |
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323 | (1) |
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Case 10.4 Malignant Melanoma with Distant Metastasis |
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323 | (1) |
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Case 10.5 Malignant Melanoma on the Cheek |
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324 | (1) |
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Case 10.6 Malignant Melanomas in Other Areas |
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325 | (1) |
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Case 10.7 Small Bowel Obstruction and History of Malignant Melanoma |
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326 | (1) |
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326 | (6) |
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Case 10.8 Sarcoma of the Lower Extremity |
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326 | (5) |
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Case 10.9 Metastatic Sarcoma to the Lung |
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331 | (1) |
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Hernias and Related Conditions |
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332 | (14) |
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Case 10.10 Pain in the Groin |
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332 | (3) |
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Case 10.11 Inguinal Hernia |
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335 | (7) |
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Case 10.12 Additional Hernia-Related Problems |
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342 | (1) |
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Case 10.13 Ventral Hernia |
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343 | (2) |
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345 | (32) |
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Case 11.1 Screening for Breast Cancer |
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346 | (3) |
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Case 11.2 Evaluation of a Mammographic Abnormality |
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349 | (1) |
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Case 11.3 Evaluation of Mammographic Microcalcifications |
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350 | (2) |
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Case 11.4 Biopsy Results in Lesions Visible on Mammography |
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352 | (3) |
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Case 11.5 Palpable Breast Mass |
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355 | (1) |
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Case 11.6 "Lumpy" Breasts |
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356 | (1) |
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Case 11.7 Breast Mass in a Young Woman |
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357 | (1) |
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Case 11.8 Nipple Discharge |
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357 | (2) |
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Case 11.9 Staging and Prognosis in Infiltrating Ductal Carcinoma |
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359 | (1) |
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Case 11.10 Select Clinical Factors that Affect Prognosis |
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360 | (2) |
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362 | (1) |
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Case 11.12 Surgical Management of Breast Cancer |
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363 | (3) |
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Case 11.13 Treatment Options for Stage I and II Breast Cancer |
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366 | (2) |
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Case 11.14 Breast Reconstruction |
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368 | (1) |
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Case 11.15 Medical Management of Breast Cancer |
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369 | (1) |
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Case 11.16 Treatment of Stage III and IV Breast Cancer |
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370 | (1) |
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Case 11.17 Breast Mass with Cellulitis and Edema |
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371 | (1) |
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Case 11.18 Events that Occur Later in Patients with Breast Cancer |
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372 | (1) |
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Case 11.19 Breast Problems in Pregnancy and the Peripartum Period |
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373 | (1) |
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Case 11.20 Breast Cancer in Patients of Advanced Age and Decreased Function |
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374 | (1) |
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Case 11.21 Breast Mass in a Man |
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375 | (1) |
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375 | (2) |
| Part III Special Issues |
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12 Trauma, Burns, and Sepsis |
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377 | (65) |
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Case 12.1 Primary and Secondary Assessment of Injuries |
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378 | (1) |
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Case 12.2 Initial Airway Management |
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378 | (2) |
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Case 12.3 Initial Pulmonary Management |
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380 | (5) |
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Case 12.4 Pneumothorax in a Patient with Hypotension |
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385 | (1) |
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Case 12.5 Hypotension and Neck Vein Distention with Normal Breath Sounds |
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386 | (1) |
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Case 12.6 Hypotension with Normal Breath Sounds and No Neck Vein Distention |
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387 | (3) |
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Case 12.7 Initial Cervical Spine Management |
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390 | (3) |
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Case 12.8 Initial Assessment of Thoracic Injury |
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393 | (3) |
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Case 12.9 Indistinct or Widened Mediastinum |
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396 | (1) |
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Case 12.10 Initial Abdominal Assessment Based on the Mechanism of Injury |
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397 | (4) |
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Case 12.11 Initial Assessment of Abdominal Injury |
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401 | (5) |
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Case 12.12 Abdominal Injuries Visible on CT Scan |
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406 | (7) |
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Case 12.13 Operative Findings with Abdominal Trauma |
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413 | (2) |
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Case 12.14 Initial Neurologic Injury Assessment and Management |
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415 | (1) |
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Case 12.15 Other Neurologic Problems |
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416 | (2) |
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Case 12.16 Continuing Hemorrhage |
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418 | (1) |
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Case 12.17 Postoperative Problems in Trauma Patients |
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419 | (4) |
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Case 12.18 Traumatic Arteriovenous Fistula |
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423 | (2) |
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Case 12.19 Continuing Pulmonary Problems |
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425 | (1) |
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Case 12.20 Respiratory Distress |
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426 | (2) |
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Case 12.21 Stab Wound to the Neck |
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428 | (2) |
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Case 12.22 Other Injuries to the Neck |
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430 | (1) |
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431 | (6) |
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Case 12.24 Total Parenteral Nutrition |
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437 | (5) |
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13 Pediatric Surgical Disorders |
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442 | (23) |
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Case 13.1 Acute Respiratory Distress |
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443 | (2) |
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Case 13.2 Respiratory Distress with Oral Intake |
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445 | (3) |
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448 | (8) |
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Case 13.4 Imperforate Anus |
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456 | (1) |
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Case 13.5 Vomiting in a 2-Week-Old Infant |
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457 | (2) |
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Case 13.6 Abdominal Wall Defects |
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459 | (4) |
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Case 13.7 Abdominal Pain in a 7-Month-Old Child |
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463 | (2) |
| Index |
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465 | |
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