PGY 1
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Knowledge Objectives |
- Order and interpret basic laboratory tests and x-rays.
- Review, prioritize and order appropriate medications.
- Understand the nature of the informed consent.
- Be familiar with intraoperative monitoring and know the doses and complications of local anesthetics, neuromuscular blocking agents, barbiturates, reversing agents and gas anesthetics.
- Understand acid-base and fluid-electrolyte imbalance in health and disease. Make adjustments in fluid administration for comorbid conditions.
- Recognize and treat hypo-hyperkalemia, hypo- hypernatremia, hypo-hypercalcemia and hypo- hypermagnesemia.
- Know mediators of fever, differential diagnosis, evaluation and management of the febrile patient and initiate appropriate work-up and supportive treatment.
- Know normal skin and gastrointestinal flora and manifestations of organ system infections.
- Know antibiotic pharmacodynamics, pharmacokinetics and side effects and recognize drug-related complications.
- Know proper use and duration of antibiotic prophylaxis.
- Know selection principles of antibiotics for specific infections. Understand the development of antibiotic resistance.
- Know principles of universal precautions, prevention of nosocomial infections and diagnosis and prevention of AIDS and of opportunistic infections.
- Know classification of wound expectancy. Differentiate wound infection, seroma, and hematoma and initiate therapy.
- Recognize necrotizing fasciitis, detect crepitus. Identify wound dehiscence and evisceration. Know and apply tetanus immunization.
- Differentiate and describe types of shock and initiate therapy.
- Assess and manage the following complications:
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Altered mental status
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Fever
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Hypotension, hypovolemia, oliguria
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Pain
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Hypoxemia
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Nausea, distension, vomiting
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Bleeding from surgical site
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Atelectasis, aspiration, pneumonia, dyspnea
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Chest pain, CHF, pulmonary edema, myocardial infarction
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Phlebitis, DVT, pulmonary embolus
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Urinary retention
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Diabetic ketoacidosis
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Seizure, alcohol or drug withdrawal
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- Recognize and treat acute anaphylaxis.
- Manage a diabetic patient perioperatively.
- Know pathophysiology of common gastrointestinal diseases. Diagnose and manage ileus and bowel obstruction, inflammatory bowel disease, GI bleeding, colonic volvulus, diarrhea and appendicitis.
- Recognize gross and basic microscopic findings of surgical diseases. Understand the implications of positive margins and limitations of frozen section and biopsy technique.
- Recognize the immunocompromised patient.
- Know surgical implications of pregnancy.
- Differentiate stroke, TIA, non-cerebrovascular events.
- Know acute presentations of intoxication and acute management of an intoxicated patient.
- Appreciate and use cost-benefit analysis in decision making.
| Skills Objectives |
- Obtain a complete H&P including appropriate assessment and plan of therapy. Write a daily progress note with a synthesis of physical, laboratory and radiologic findings in a diagnostic and therapeutic plan. Obtain written consent.
- Obtain ATLS.
- Dictate discharge summary. Provide efficient discharge planning. Maintain a personal patient log.
- Interpret the anesthesia record. Position the patient. Insert arterial and central venous lines.
- Obtain ACLS. Be able to perform endotracheal intubation.
- Give appropriate fluid resuscitation, manage fluid postoperatively and correct fluid and electrolyte disturbances.
- Order and interpret appropriate imaging studies to detect source of sepsis.
- Know and apply principles of incision and drainage.
- Perform as first assistant by performing basic maneuvers (suture tie, hemostasis, traction and countertraction, using electrocautery safely.)
- Simple suture technique, wound care including debridement.
- Tube thoracostomy.
- Fine needle aspiration biopsy, core biopsy.
- Perform under supervision:
- Excision of benign skin and soft tissue lesions
- Incisional biopsy
- Breast biopsy
- Lymph node biopsy
- Open hernia repair
- Amputation
- Tracheostomy
- Banding of hemorrhoids and hemorrhoidectomy
- High ligation and vein stripping
- Insert central venous and pulmonary artery catheters and interpret hemodynamic data to treat patient.
- Recognize ischemia and arrhythmias on EGG.
- Develop critical reading skills; understand application of biostatistics and clinical study design.
- Discuss pertinent aspects of patient's condition with a consultant.
- Develop skills in patient and family communication. Accept responsibility and demonstrate reliability.
- Become well organized and efficient to maximize time management.