Medical Malpractice Insurance for orthopaedic surgeons

Proprionobacter acnes

Discussion:    – see anaerobic joint infections    – slow growing, typically aerotolerant anaerobic gram positive bacterium;    – found in skin pores and the gut.    – may colonize the axilla (esp in males)    – positive cultures may be seen patients having revision shoulder arthroplasty performed for pain, stiffness, and component loosening    – … Read more

PROPYLTHIOURACIL: PTU/PROPACIL

– for hyperthyroidism; Inhibits production T3 and T4;  – Adult Dosing: – 100mg PO q8hr (up to 1,200mg/day for control);  – after pt is euthyroid (6-8 weeks), taper dose by 1/3 every 4-6 weeks to a maintainance dose of 50-150 mg/24hr;  – inhibits production and conversion of T3 and T4

Prostacyclin

– Action:     – powerful vasodilator and inhibits platelet aggregation thru activation of adenylate cyclase, which leads to an increase in intracellular cyclic adenosine monophosphate;     – prostacyclin and thromboxane A(sub 2) are formed from arachidonic acid, w/ endoperoxides & prostaglandins G2 and H2 as           intermediates;     – variety of drugs with diverse mechanisms … Read more

Prosthetic Feet

– See: Foot Selection for AKA Prosthesis: – Discussion:     – excessive heel softness: causes knee hyper-extension;     – excessive heel stiffness: knee tends to hyper-flex at heel strike; – Types of Prosthetic Feet:     – SACH foot:     – single axis foot:           – used since … Read more

Propanolol/Inderal

– See: Class II Agents – Discussion:      – nonselecive beta blocker;      – for PSVT & for VF / VT w/o pulse after standard Rx fails: – Dose:       – 1.0 mg IV q5min to total dose of 0.1 mg/kg;       – HTN: 40mg PO bid initially, then … Read more

Proliferative Myositis

– Discussion:     – benign condition usually occuring in adults, but sometimes in children;     – may present as a rapidly growing mass, in the shoulder, thigh, and chest; – Histology:     – should not show mitotic figures; – Diff Dx:     – rhabdomyosarcoma     – myositis ossificans – Treatment: … Read more

Promethazine/Phenergan

– for N/V/motion sickness, potentiates narcotics; – adult: 12.5-25mg PO,PR,IM,IV bid/qid; (reduce dose w/ IV and slowly) – drowsiness common; compatable with morphine and meperidine; – motion sickness: 0.5 mg/kg/dose q12hr PO prn; – N/V: 0.25-0.5 mg/kg/dose q4-6hr IM or PR prn; – is a phenothiazine derivative that possesses antihistaminic, sedative, anti-motion sickness, antiemetic and anticholinergic … Read more