内容简介
《美国住院医师必读系列:外科住院医师病例分析与讨论(英文版)》为美国住院医师必读系列书,深受美国医学院校高年资医学生和住院医师的欢迎。
《美国住院医师必读系列:外科住院医师病例分析与讨论(英文版)》从临床病例入手,通过问题解答、病例复习、专题讨论、诊断与治疗、记忆要点、理解问题、推荐阅读等环节,提供住院医师“真正需要” 的知识和场景,培养临床思维,拓展知识面,提高住院医师的岗位胜任力。
《美国住院医师必读系列:外科住院医师病例分析与讨论(英文版)》既可作为住院医师规范化培训和PBL教学参考用书,也可作为双语教学和留学生教学用书;同时,其原汁原味的英语和美国医院场景,更是学习医学专业英语的好教材。
内页插图
目录
Contributors
Acknowledgments
I. Introduction
1. Welcome (Brian C George, MD, Alden H. Harken, MD, and
Debra A. DaRosa, PhD)
2. How to Read this Book (Brian C. George, MD,
Alden H. Harken, MD, and Debra A. DaRosa, PhD)
3. General Advice (Brian C. George, MD and AIden H. Harken, MD)
4. A 28-year-old Female Incoming Surgery Resident
(Amanda V. Hayman, MD, MPt-I)
5. How to Write a Note——Fast! (Teresa S. Kim, MD)
II. Handling Patients in the [D
6. Admissions (Anthony Visioni, MD and
Roy Phitayakom, MD, MHPE (IVIEd))
7. A 56-year-old Female Status Post Motor Vehicle Accident
(Ashley Hardy, MD and Marie Crandall, MD, MPI-I)
8. A 40-year-old Female With Abdominal Pain
(Aisha Shaheen, MD, MHA and Marie Crandall, MD, MPI-I)
9. A 42-year-old Man With Severe Right Upper Quadrant Pain
(Brian C. George, MD)
10. A 23-year-old Student With Periumbilical Pain That Has Migrated
to Her RLQ (Brian C. George, MD and AIden H. Harken, MD)
11. A 65-year-old Female in Severe Abdominal Pain
(Aisha Shaheen, MD, MHA and Marie Crandall, MD, MPH)
12. A Patient in the ER With a Blood Pressure of 60/- and a
Heart Rate of 140 (Alden H. Harken, MD and Brian C. George, MD)
13. A 67-year-old Man With Mental Status Changes and a Suspected
Diverticular Abscess (Alexander T. Hawkins, MD, MPH)
14. A 57-year-old Man With a Chief Complaint of Nausea and Vomiting
(Alexander T. Hawkins, MD, MPH)
15. A 65-year-old Man Status Post Surgery With a HCT of 24%
(Alden H. Harken, MD and Brian C. George, MD)
16. A 70-year-old Man With "Bad Blood" (Emily Miraflor, MD,
Louise Y. Yeung, MD, Brian C. George, MD, and Alden H. Harken, MD)
17. A 37-year-old Man With a Painful Bulge Over His Left Forearm
(Eric N. Feins, MD)
18. Three Patients All Present With Issues Related to
Laboratory Tests (Abigail K. Tarbox, MD and Mamta Swaroop, MD, FACS)
19. A 73-year-old Man With Acute Right Lower Extremity Pain
(Joel T. Adler, MD and Virendra L Patel, MD, MPH)
20. A 36-year-old Woman Status Post Motor Vehicle Accident While
Intoxicated (Shamim H. Nejad, MD and Nadia Ouijije, MD)
21. A 50-year-old Man Presenting With Extensive Bums
(Jeremy Goverman, MD, FACS and Shawn P. Fagan, MD, FACS)
22. A 56-year-old Man 6 Days Status Post Colectomy With New Pelvic
Discomfort (Michael F. McGee, MD and Brian C. George, MD)
III. Handling Inpatients
23. A 75-year-old Man With Postoperative Pain (Ezra N. Teitelbaum, MD)
24. A 72-year-old Man With Acute Confusion Postoperatively
(Shamim H. Nejad, MD and Justin B. Smith, MD)
25. You (the Intern) Are Asked to Read a Chest X-ray
(Alexander T. Hawkins, MD, MPH and Amy Robin Deipolyi, MD, PhD)
26. A 6S-year-old Woman in Respiratory Distress
(Alden H. Harken, MD and Brian C George, MD)
27. A Patient Who Is Postoperative Day 2 With New-onset Chest Pain
(Alden H. Harken, MD and Brian C George, MD)
28. A 6S-year-old Woman With a New-onset Cardiac Arrhythmia
(Alden H. Harken, MD)
29. A 60-year-old Man in the PACU With New-onset PVCs
(Alden H. Harken, MD)
30. A 65-year-old Man With Bradycardia (Alden H. Harken, MD and
Brian C George, MD)
31. A 6S-year-old Man With a Pacemaker Who Needs Surgery
(Alden H. Harken, MD and Brian C George, MD)
32. A Patient With Pulseless Electrical Activity
(Alden H. Harken, MD and Brian C George, MD)
33. A 55-year-old Man Who May Require Perioperative 13-blockade
(Alden H. Harken, MD and Brian C George, MD)
34. A 65-year-old Man Who Is in Respiratory
Distress 3 Days Postoperatively (Jahan Mohebali, MD)
35. A 68-year-old Man With Postoperative Hypotension
(Allan B. Peetz, MD and Marie Crandall, MD, MPI-I)
36. A 57-year-old Man Who Is Postoperative With a
Blood Pressure of 210/95 (Eric N. Feins, MD)
37. A 65-year-old Female Who Is 4 Days Postoperative With
Nausea, Vomiting, and a Distended Abdomen
(Ashley Hardy, MD and Marie Crandall, MD, MPH)
38. A 30-year-old Woman With Postoperative Nausea and Vomiting
(Abigail K. Tarbox, MD and Mamta Swaroop, MD, FACS)
39. A 79-year-old Man, Postoperative Day 3,
Who has Not had a Bowel Movement in 4 Days
(Anne-Marie Boiler, MD and Joel M. Stembach, MD, MBA)
40. A 70-year-old Postoperative Colectomy Patient Who Is Not Putting
Out Much Urine (Brian C. George, MD and AIden H. Harken, MD)
41. A 55-year-old Male With Postoperative Urinary Retention
(Selma Marie Siddiqui, MD and Marie Crandall, MD, MPt-I)
42. A 52-year-old Female Who Is Dehydrated Postoperative Day #1
(Aisha Shaheen, MD, MHA and Marie Crandall, MD, MPH)
43. A 68-year-old Woman With Electrolyte Abnormalities
(Molly A. Wasserman, MD and Mamta Swaroop, MD, FACS)
44. A 58-year-old Man With a Postoperative Fever (Jahan Mohebali, MD)
45. A 42-year-old Woman 4 Hours Postoperative With a Fever and
Extreme Pain (Michael W. Wandling, MD and
Mamta Swaroop, MD, FACS)
46. A 35-year-old Man With Crohn Disease
Who Needs Postoperative Orders (Roy Phitayakom, MD, MHPE (MEd))
47. A 65-year-old Man With Diabetes Needing
Postoperative Orders (Roy Phitayakorn, MD, MHPE (IVIEd))
48. A 65-year-old Female Presenting for Preoperative Evaluation
Uahan Mohebali, MD)
49. A 33-year-old Woman Who Needs Postoperative Orders for DVT
Prophylaxis (Brian C. George, MD and AIden H. Harken, MD)
50. A 78-year-old Woman and a 62-year-old Man With Drains
(Michael F. McGee, MD and Brian C. George, MD)
51. A 58-year-old Woman Who had a Drain Pulled by the Resident in Error
(Peter Angelos, MD, PhD, FACS and Debra A. DaRosa, PhD)
52. A Resident Who Is Unsure About How to Remove a Chest Tube
(Peter Angelos, MD, PhD, FACS and Debra A. DaRosa, PhD)
53. A Surgical Intern in a Moral Dilemma
(Peter Angelos, MD, PhD, FACS and Debra A. DaRosa, PhD)
54. A 35-year-old Man Who Is Disruptive on the Floor
(Xavier Jimenez, MD and Shamim H. Nejad, MD)
IV. Handling Patients in Clinic
55. Ambulatory Care and the Surgery Intern (John Maa, MD, FACS)
56. A 55-year-old Man Who Was Struck by a Beer Truck and Needs a
CT Scan (Haytham M.A. Kaafarani, MD, MPH, Brian C George, MD,
and Hasan B. Alam, MD)
57. A 60-year-old Man With Postoperative Wound Complications
(Michael W. Wandling, MD and Mamta Swaroop, MD, FACS)
58. A 35-year-old Woman Who Needs a Lipoma Removed in Clinic
(Roy Phitayakorn, MD, MHPE (MEd))
59. A 52-year-old Woman With a Suspected Congenital Coagulopathy
(Jahan Mohebali, MD)
Bibliography
Index
前言/序言
《普通外科住院医师病例分析与讨论》(英文版)—— 夯实临床技能,淬炼手术智慧 作为一名胸怀大志的外科住院医师,你是否渴望在浩瀚的医学知识海洋中精准导航,在复杂多变的临床实践中沉着应对?是否在无数个夜晚,对着厚重的教科书和海量的文献感到力不从心,期盼着一位经验丰富、循循善诱的导师,能够为你拨开迷雾,指点迷津?《普通外科住院医师病例分析与讨论》(英文版)正是为此而生,它将是你临床学习和成长道路上不可或缺的伙伴,是你迈向卓越外科医生的坚实阶梯。 本书并非泛泛而谈的理论总结,而是以真实、典型、极具挑战性的外科病例为载体,深度剖析每一个病例的诊断、鉴别诊断、治疗决策、手术技巧、术后管理以及并发症处理。每一章都仿佛一次身临其境的临床查房,你将跟随资深外科教授和主治医师的脚步,共同经历从患者入院到康复出院的全过程。本书旨在培养你批判性思维能力、解决复杂问题的能力,以及在压力下做出明智临床决策的能力,这些都是成为一名优秀外科医生所必需的核心素养。 深度解析,案例驱动: 本书最大的亮点在于其“病例驱动”的学习模式。不同于枯燥的理论讲解,本书聚焦于普通外科领域中最常见、最棘手、最有代表性的病例。从腹部急症、消化道肿瘤、疝气、胆道疾病、甲状腺疾病,到乳腺疾病、血管外科常见病,再到创伤外科的处理,本书几乎涵盖了普通外科的各个细分领域。每一个病例的呈现都详尽入微,包括: 详细的病史采集与体格检查要点: 强调从患者的主诉中提取关键信息,以及体格检查中不容忽视的体征。 精准的影像学与实验室检查解读: 引导你如何有效利用CT、MRI、超声、内镜、病理等检查结果,进行准确的诊断。 严谨的鉴别诊断思维: 面对相似的临床表现,本书教你如何层层剥离,排除其他可能性,最终锁定最可能的原因。 科学的治疗方案制定: 无论是保守治疗、微创手术还是开放手术,本书都提供了不同治疗策略的优劣势分析,以及循证医学证据的支持。 精湛的手术技巧讲解: 对于手术部分,本书会深入剖析关键步骤、解剖标志、注意事项以及潜在的风险。这并非简单的流程罗列,而是包含经验性的提示和技巧,让你对术野有更清晰的认识。 周密细致的术后管理: 术后的观察、镇痛、抗感染、并发症预防与处理,每一个环节都至关重要,本书将为你提供详细的指导。 并发症的识别与应对: 术后并发症是外科医生面临的严峻挑战,本书将列举常见并发症,并提供有效的识别方法和处理策略,帮助你未雨绸缪。 专家视角,思维启迪: 本书的价值远不止于病例的复盘,更在于其提供的“专家视角”和“思维启迪”。每一位作者都是经验丰富的临床专家,他们在分析病例时,不仅仅是在陈述事实,更是在传授一种思考方式、一种临床智慧。 “Why”与“How”的深度探讨: 本书不会止步于“怎么做”,而是深入探讨“为什么这样做”。例如,为什么选择某种影像学检查?为什么选择某种手术方式?为什么会出现这种并发症?通过对“Why”的追问,你能真正理解临床决策背后的逻辑。 循证医学的应用: 书中的讨论始终以最新的循证医学证据为基础,引导你养成查阅文献、评估证据、并将证据应用于临床的良好习惯。 经验性智慧的传承: 除了严谨的科学理论,本书也融入了资深外科医生在长期临床实践中积累的宝贵经验。这些经验往往是教科书上难以找到的,却能帮助你少走弯路,提高效率,避免不必要的风险。 对“不确定性”的处理: 外科临床充满不确定性,本書教會你如何在信息不完全或存在争议的情况下,做出最合理、最安全的决策。 精选案例,涵盖广泛: 本书精选的病例库,涵盖了普通外科领域中的高频病种和疑难杂症,确保了其普适性和指导意义。例如: 腹部急症: 急性阑尾炎的鉴别诊断与手术时机,急性肠梗阻的原因、分型及处理,消化道穿孔的急救与修补,急性胰腺炎的阶梯治疗等。 消化道肿瘤: 胃癌、结直肠癌、食管癌的早期诊断、分期、手术方式选择(包括微创和开放)、术后辅助治疗以及复发监测。 疝气: 腹股沟疝、股疝、腹壁疝的分类、手术指征、不同修复方式的适应症与优缺点。 胆道疾病: 急性胆囊炎、胆总管结石、胆道梗阻的诊断与处理,腹腔镜胆囊切除术的关键技术与并发症预防。 甲状腺与甲状旁腺疾病: 甲状腺结节的良恶性鉴别,甲状腺癌的手术适应症、术式选择、术后管理及复发风险。 乳腺疾病: 乳腺肿块的鉴别诊断、活检方式、保乳手术与全切除术的适应症,以及乳腺癌的综合治疗。 血管外科: 腹主动脉瘤、下肢动脉闭塞症、颈动脉狭窄的评估与治疗选择。 创伤外科: 多发伤的救治原则、损伤控制性手术、腹腔脏器损伤的处理、胸部创伤的急救。 学习价值,多维提升: 通过研读《普通外科住院医师病例分析与讨论》(英文版),你将获得多方面的能力提升: 临床思维的系统化: 建立起一套完整的临床问题解决流程,从病史采集到随访,环环相扣,逻辑清晰。 鉴别诊断能力的强化: 能够快速、准确地在众多可能性中找到真正的病因。 手术技能的提升: 虽非手术图谱,但对关键步骤的深入讲解,能帮助你形成清晰的手术预想。 术后管理水平的提高: 能够预见并有效应对术后可能出现的各种问题,保障患者安全。 沟通与协作能力的培养: 理解团队协作的重要性,以及与患者及家属进行有效沟通的技巧。 终身学习的动力: 激发你对外科知识的持续探索欲望,培养独立学习和自我提升的能力。 目标读者: 本书是为所有初级和高级普通外科住院医师、医学院校高年级学生、以及希望巩固和更新普通外科知识的年轻主治医师量身定制的。无论你是刚刚踏入临床的新晋住院医师,还是在住院医师生涯中不断进取的“老兵”,本书都能为你提供宝贵的学习资源和临床指导。 总结: 《普通外科住院医师病例分析与讨论》(英文版)是一本兼具理论深度、临床实践指导意义和思维启发性的优秀外科读物。它以真实病例为“引子”,以专家智慧为“酱料”,为你烹饪出一道道精彩纷呈的临床知识盛宴。翻开本书,你将不再孤单地面对临床挑战,而是与一群经验丰富的导师同行,在不断的学习与实践中,磨砺医技,淬炼智慧,最终成长为一名值得信赖、技艺精湛的普通外科医生。这不仅仅是一本书,更是你外科医生职业生涯中一次重要的“投资”,一次成功的“蜕变”。