Surgical Clerkship: Week 3

Surgical Clerkship - Syllabus (PDF)

Online Modules: Ethics and Nutrition:
These were created so that you could learn on your own time and at your own pace. They should be taken seriously, even though there is no grade associated with them. Faculty and residents expect you to be familiar with these concepts as you care for your patients

• The Nutrition Module is very thorough (long). Take your time with it, take notes. Although much of the detail will not be required for you to know at this time, it is an excellent module designed by Stanford and is a valuable resource.
• Make sure you take the quizzes after each module
• The Ethics Module is undergoing an overhaul. The content available on the LSU webpage, however, is still very relevant and important.
• http://www.medschool.lsuhsc.edu/medical_education/undergraduate/JrSrResources.asp

Suggested textbooks:

• Cope’s Early Diagnosis of the Acute Abdomen

  • Cope’s book will be checked out to students on a first-come-first-serve basis and must returned the Thursday before your General Surgery ends.
  • If not returned by the end of the General Surgery rotation you will receive an INCOMPLETE.
  • Cope’s is an extremely well-written book on the basics of an abdominal exam. It’s like a private rotation with a master surgeon. It’s essential reading for students interested in a career in surgery. You will not be quizzed, but if you read it, it will be obvious.

• General Surgery Essentials by Peter Lawrence, 4th Ed.)

  • A great reference for students, useful when studying for USMLE steps 1, 2 & 3

Other Recommendations:

• NMS Case Files in General Surgery

  • A student favorite, a good study guide

• Surgical Recall

  • Standard ammo in a student’s pocket, good daily pocket review
  • Advanced Surgical Recall (written for junior surgical residents, or students gunning for a surgical career)

• Pre-Test for General Surgery

  • By all accounts a difficult read, but if you expect to do very well on the shelf, you should be running at this speed

• Kaplan Review for General Surgery

  • Contains the famous Pestana review, a favorite for high-yield facts. A good review, not a great reference

• Mont Reid Handbook

  • A great pocket-reference with extensive content in bullet form if you like that sort of thing

• The Washington University Handbook

  • Like the Mont Reid but more paragraphs than bullets, if you prefer this sort of thing

Core Topics for Attending Student Sessions

Place emphasis on diagnosis/workup/management. Less on actual surgeries.

• Trauma care

  • Initial approach to trauma patient (ABC’s)

  • Approach to a blunt trauma patient with decreased level of consciousness.

    • GCS (calculating, intubation indication)
    • SDH/EDH/ICH/SAH
    • Concept of secondary injury and management of ICP

  • Approach to a blunt trauma patient with spine fracture and neurological deficit.

    • Evaluation of spine fractures
    • SCI dx and management (considerations – DVT/respiratory compromise/decubs/neurogenic bowel/bladder)
    • Neurogenic shock

  • Approach to patient with penetrating trauma to the neck.

    • Zones of the neck
  • Approach to trauma patient with decreased breath sounds (PTx)

  • Approach to blunt trauma patient with widened mediastinum

    • Blunt aortic injury (very basic, suspect w/ widened mediastinum, dx with cta)
    • Pericardial tamponade

  • Approach to a blunt trauma patient with abdominal pain (both normotensive, then hypotensive). Now switch it to penetrating trauma.

    • How to evaluate the abdomen – exam/DPL/CT
    • Op vs. non-op management of solid organ injuries
    • Abdominal compartment syndrome?

  • Approach to patient with a pelvic fracture (both stable and unstable hemodynamics)

    • Pelvic fx’s and bleeding – Role of IR, pelvic binder

  • Approach to patient with penetrating trauma to extremity. Now blunt trauma with decreased pulses.

    • Blood loss associated with long bone fractures
    • Diagnosing vascular injuries and some common injury patterns associated w/ vascular injury
  • Drowning

  • Approach to a burned patient. First in outside fire, then trapped in car.

    • Rule of 9’s
    • Parkland formula – importance of fluids
    • Inhalational injury – signs of and how to dx
    • Escarotomies / fasciotomies
    • Electrical injury

  • Approach to patient who was found down in January and is hypothermic, now frostbite only.

    • Rewarming
    • Cardiac effects of hypothermia

  • Approach to patient who was involved in a building collapse and crushed.

    • Rhabdomyolysis

  • Approach to a patient with facial trauma

    • Recognize need to crich/intubate/etc.

Source:
https://www.medschool.lsuhsc.edu/surgery/docs/Surgical%20Clerkship%20Survivial%20Guide%209th%20Ed.pdf
Captured on May 1, 2021