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Case Files Surgery. BREAST MASS: - radiation therapy is indicated for pt
with stage I dz tx with breast conservation therapy - this ...
... they are the people who book the appointments and edit files for things ... also help
the customers tell their friends about the surgery in case their friends ...
... In this case study the issues will be ... Greek which forbade general practitioners from
surgery, abortion, euthanasia ... access to their patient’s files in order to ...
... In either case, advanced directives are an extremely ... directives (wills) in their
medical files for reviewing by the ... on an incapacitated female (surgery on the ...
... Even veterinarians who do not perform surgery must retain information on ... In the case
of the AEC of CNY, AVImark is ... Storing the files of all of the patients who ...
Submitted by amerchea on November 3, 2006
Category: Science
Words: 4305 | Pages: 18
Views: 191
Popularity Rank: 52,233
Average Member Grade: N/A (Add a Comment / Grade this Paper)
BREAST MASS:
- radiation therapy is indicated for pt with stage I dz tx with breast conservation therapy
- this reduces the rate of recurrence from 30% to 9%
- post-menopausal or non-lactating women with red/tender breasts should be assumed to have breast cancer until proven otherwise
- tamoxifen therapy assoc with uterine cancer
- systemic therapy is given when widespread mets is dx or when pt is high risk for distant mets
GERD:
- if hoarseness and wheezing, suggests pharyngeal reflux with silent aspiration
- if dysphagia and/or weight loss think malignancy
- do endoscopy to evaluate for esophagitis, 24-hour pH monitoring can quantify severity
- H2 blockers may provide sx’atic relief, PPIs are superior for decr acid production
- ~50% of pts with GERD develop complications such as peptic strictures, Barrett’s esophagus, and extraesophageal complications
- when LES is abnormally located, as in hiatal hernia, anti-reflux mechanism may be compromised at the GE junct
- std workup prior to surgery = endoscopy, 24-hour pH, barium esophagography (evaluates for gastric outlet obstruction – fundoplication is contraindicated)
- pts with esophagitis or significant sx PPI therapy
- std surgery = Nissen fundoplication
- diagnostic endoscopy when pts have long-standing GERD and when sx’s are refractory to medical tx
- pts with GERD may develop pulmonary and laryngeal sx
- adenocarcinoma of esophagus is a complication of barrett’s (from longstanding GERD)
- surgery is indicated if persistent sx’s while taking max PPI dose, can’t tolerate PPIs, does not wish lifelong medications
ESOPHAGEAL PERFORATION:
- spontaneous esophageal perf = Boerhaave syndr; most are iatrogenic and in distal 1/3 of esophagus
- typically, have acute onset chest pain after an episode of vomiting; also may have shoulder...
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