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Pancreatitis: treatment

MACHINES:
Monitor vital signs
Analgesia/ Antibiotics
Calcium gluconate (if deemed necessary)
H2 receptor antagonist
IV access/ IV fluids
Nil by mouth
Empty gastric contents
Surgery if required/ Senior review
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---Sushant Varma Junior Doctor

Appendicitis: Alvarado's scoring system for diagnosis

MANTRELS:
Migratory pain (1)
Anorexia (1)
Nausea (1)
Tenderness (2)
Rebound tenderness (1)
Elevated temperature (1)
Leucocytosis (2)
Shift to left (1)
· Score 3-4 = no appendicitis. Score 5-6 = doubtful. Score 7 or more = appendicitis is confirmed.
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---Angel and Dipendra Kathmandu Medical College, KTM, Nepal

Post operative order list check-up

FLAVOR:
Fluids
Laboratories
Activity
Vital signs
Oral allowances
Rx [medications]
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---Manuel S. Mendizabal, MD Mercy Hospital of Miami

Child-Pugh classification

"Pour Another Beer At Eleven":
PT
Albumin
Bilirubin
Ascites
Encephalopathy
·Scoring (each is either 1, 2 or 3 points):
PT (greater than 12 sec.): 1-3 or 4-6 or >6.
Albumin: >3.5 or 2.8-3.5 or less than 2.8
Bilirubin: less than 2 or 2-3 or >3.
Ascities: none or slight or moderate
Encephalopathy: none or 1-2 (subjective) or 3-4 (subjective)
· Interpretation:
Class A: 5-6 points (candidate for surgical liver resection).
Class B: 7-9 points (consider chemoembolization or RFA).
Class C: 10-15 points (consider options in B or no therapy).
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---Michael Sawyer, MD Dept. of Surgery, Univ. of Hawaii and Kaiser Permanente Medical Center, Honolulu, Hawaii

Hernias of Abdominal Wall

Think of the abdomen as a bucket, or PAIL that contains the viscera. These are the four groups of hernias:
Pelvic hernias: obturator, perineal, sciatic
Anterior hernias: epigastric, incisional, Spigelian, supravesical, umbilical
Inguinal hernias: indirect, direct, femoral
Lumbar hernias: inferior lumbar triangle (Petit), superior lumbar triangle (Grynfelt)
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---Michael Sawyer, MD Dept. of Surgery, Univ. of Hawaii and Kaiser Permanente Medical Center, Honolulu, Hawaii

Hernias: abdominal wall: pelvic

The end products of metabolism that are released through the pelvis, are "Pee Or Stool":
Perineal hernia
Obturator hernia
Sciatic hernia
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---Michael Sawyer, MD Dept. of Surgery, Univ. of Hawaii and Kaiser Permanente Medical Center, Honolulu, Hawaii

Hernias: abdominal wall: lumbar triangles (with eponyms)

PIGS:
Petit aka Inferior lumbar triangle
Grynfelt aka Superior lumbar triangle
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---Michael Sawyer, MD Dept. of Surgery, Univ. of Hawaii and Kaiser Permanente Medical Center, Honolulu, Hawaii

TPN indications

"MISIPPI Burning":
Major visceral injury
IBD
Sepsis
Ileus
Post-op
Paralysis
Intestinal fistula
Burns
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---Brendan O'Daly University College Dublin

Surgical discharge checklist

FLAG COUP:
Lucid
Ambulatory
GP letter sent
CVS checked (BP, pulse
Operation site OK
Urinating OK
Prescription
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---Anonymous Contributor