Ortho Oracle - orthopaedic operative atlas

Antibiotic Prophylaxis

– See:       – Antibiotic Menu       – Osteomyelitis – Perioperative Prophylactic Antibiotics:     – the main question we need to ask is what are we trying to accomplish?     – obviously we want a strategy that prevents the infection of MRSA, MSSA, staph epi, and anaerobic infections;     – giving ancef alone, … Read more

Amputation Menu

– Amputations in the Diabetic Patient – Above the Knee Amputation: – AKA prosthetics – Basic Science: – Below Knee Amputation: – amputation following fractures of the tibia – pediatric BKA: – BKA prosthetics – prosthetic feet – Foot and Ankle Amputation – Syme’s Amputation – Transmetatarsal Amputation – Chopart Amputations – Pediatric Amputations – … Read more

Amphotericin B/Fungizone

for severe systemic fungal infections; dose: 0.25mg/kg IV over 6hrs initially (infusion .1mg/ml); gradually increase dose as tolerated up to 1-1.5mg/kg/24hrIV over 6hr; note hypersensitivity, caution with nephrotoxic/antineoplastic agents; monitor blood, liver, and renal function, discontinue therapy if BUN >40mg/dl, Creatinine >3.0mg/dl, or if liver function test abnormalities are noted; should be delivered via Central … Read more

Amikacin/Amikin

    – See:       – aminoglycosides – for short term Rx of serious infections from Gm Neg aerobes and penicillinase producing Staph; – Adult: 15 mg/kg/24hr divided over q8-12 hours;  – with clearance < 50 ml/min. give dose over 12-18hr;  – w/ clearance < 30 give dose over 24-36 hr; – Peds: … Read more

Aminoglycosides

– Specific Agents:     – Neomycin     – Gentamicin     – Tobramycin     – Amikacin     – Netilmicin – Discussion:     – indicated for serious Gm Neg infections caused by suseptable pseudomonas, proteus, e. coli, klebsiella, enterobacter sp., serratia, and gm neg sepsis;     – tobramycin is more … Read more

ALGORITHM for PAROXYSMAL SVT

– See: – Tachycardia, Assessment – Discussion – VT vs SVT UNSTABLE STABLE | | Synchronous Cardioversion 75-100 J Vagal Maneuvers | | Synchronous Cardioversion 200 J Verapamil, 5 mg IV | | Synchronous Cardioversion 360 J Verapamil, 10 mg IV | (in 15-20 min) Correct Underlying Abnormalities | | Cardioversion, Digoxin, B Blocker Pharmological … Read more

Alcohol Withdrawl

  – Discussion: –  onset- usually a few hours to 10 days after last drink (Usually 6-48 hr); – early symptoms: tend to be mild; – nausea, vomiting, anorexia, insomnia, diaphoresis, agitation, tachycardia, HTN, if seizures occur, – common abstinence syndrome, occurring at 6-8 hr, is the earliest withdrawl syndrome and is often present when the … Read more

Absent Thumb

Discussion total absence of the thumb may be an isolated anomaly, but it is often associated with some other congenital malformation; absent thumb may be inherited as autosomal dominant or may be sporadic; absent thumb is frequently observed in Holt-Oram syndrome, Fanconi’s anemia, and ring D chromosome abnormalities; absent radius is almost always associated with … Read more

Gout

(see also: Therapeutic Principles & Anti-Gout Meds Discussion gout refers to articular dz of MSU deposits (tophi) in soft tissues. it is caused by deposition of monosodium urate crystals in poorly perfused tissues, as well as bursae, ligaments, articular cartilage, and synovial membranes; on average, a family history of gout can be obtained in less … Read more