Help. Cover for Abernathy's Surgical Secrets Chapter 1 - Are you ready for your surgical rotation? .. Expert Consult™ eBook version included with download. euthanasia, initially for mentally ill and severely handicapped 'true' Germans during the 1 s, to the most obscene and grotesque distortions of medical. Abernathys surgical secrets 6e pdf. Abernathy's Surgical Secrets, 6e Alden H. Harken MD, Ernest E. Moore MD Publisher: Mosby Release.
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What causes ARDS?
Anything that increases lung dysfunction by promoting wet lung: 1. Heart failure backs up pulmonary intravascular Pc, forcing fluid into the pulmonary interstitium. Malnutrition and liver failure decrease plasma protein and therefore COP. Fluid is not sucked back out of the lung if the total protein and albumin are low. Sepsis may break down the capillary endothelial barrier K , permitting water and protein to leak into the lung.
Severe hypoxemia refractory to increased inspired oxygen concentration 2. Diffuse pulmonary infiltrates 4. Explain high-pressure versus low-pressure ARDS. Purists appropriately note that lung congestion resulting from high intravascular Pc hydrostatic pressure secondary to heart failure is really not primary respiratory distress syndrome.
A patient with pure mitral stenosis may have high-pressure lung congestion, whereas a malnourished patient may develop low-pressure lung congestion; neither of these is, strictly speaking, ARDS, although patients with ARDS frequently have components of both. What is a normal colloid oncotic pressure COP?
It is 22 mm Hg. How is COP calculated? Define low-pressure ARDS.
Low-pressure ARDS is a redundant term. The current concept involves a septic expression of neutrophil CD11 and CD18 adhesion receptors, which stick to pulmonary vascular endothelial intercellular adhesion molecules. Septic stimuli provoke the adherent neutrophils to release intravascular proteases and oxygen radicals. Resultant endovascular damage breaks down the K, permitting the lung leak-even at low Pc.
What is a Lasix sandwich? Many surgeons, when their backs are against the wall, give 25 g of albumin followed in 20 minutes by 20 mg of furosemide Lasix intravenously IV.
They reason that the albumin pulls fluid out of the water-logged lung and the Lasix promotes diuresis to rid the patient of extra water. This therapeutic concept probably works only in patients who are not very sick. The sicker the patient, the faster the infused albumin leaks and equilibrates across the damaged endovascular endothelial barrier. Little water is sucked out of the sick lung in preparation for diuresis. List the goals of therapy for ARDS. Reduce lung edema typically with a diuretic.
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Reduce oxygen toxicity inspired oxygen concentration 40 cm H 2O. Maintain systemic oxygen delivery arterial oxygen content cardiac output [CO].
What governs the distribution of lung perfusion? It is governed mostly by gravity.
The dependent portions of the lung always are better perfused. Discuss hypoxic pulmonary vasoconstriction HPV. Most students believe that after dedicating the entire second year of medical school to pheochromocytoma and hypoxic pulmonary vasoconstriction HPV , both entities may be safely forgotten. King later became a member of the junior choir in his church.
When the boys were six, they started school: King had to attend a school for African Americans, and the other boy went to one for whites public schools were among the facilities segregated by state law. King lost his friend because the child's father no longer wanted the boys to play together.
In his adolescent years, he initially felt resentment against whites due to the "racial humiliation" that he, his family, and his neighbors often had to endure in the segregated South. At the age of 13, he denied the bodily resurrection of Jesus during Sunday school. Washington High School. He became known for his public-speaking ability and was part of the school's debate team.
On the ride home to Atlanta by bus, he and his teacher were ordered by the driver to stand so that white passengers could sit down. King initially refused but complied after his teacher told him that he would be breaking the law if he did not submit. During this incident, King said that he was "the angriest I have ever been in my life.
At that time, many students had abandoned further studies to enlist in World War II. Due to this, Morehouse was eager to fill its classrooms.
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At the age of 15, King passed the exam and entered Morehouse. The summer before his last year at Morehouse, in , the year-old King chose to enter the ministry. He had concluded that the church offered the most assuring way to answer "an inner urge to serve humanity. In , King graduated at the age of 19 from Morehouse with a B. Proctor who went on to become well-known preachers in the black church. King became fond of the street because a classmate had an aunt who prepared collard greens for them, which they both relished.
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The daughter had been involved with a professor prior to her relationship with King. King planned to marry her, but friends advised against it, saying that an interracial marriage would provoke animosity from both blacks and whites, potentially damaging his chances of ever pastoring a church in the South. King tearfully told a friend that he could not endure his mother's pain over the marriage and broke the relationship off six months later.
He continued to have lingering feelings toward the woman he left; one friend was quoted as saying, "He never recovered. William Hunter Hester. Hester was an old friend of King's father, and was an important influence on King.
Powell asked fellow student Coretta Scott if she was interested in meeting a Southern friend studying divinity. Scott was not interested in dating preachers, but eventually agreed to allow Martin to telephone her based on Powell's description and vouching. On their first phone call, King told Scott "I am like Napoleon at Waterloo before your charms", to which she replied "You haven't even met me". They went out for dates in his green Chevy. After the second date, King was certain Scott possessed the qualities he sought in a wife.
She had been an activist at Antioch in undergrad, where Carol and Rod Serling were schoolmates. Convincing his dad would be another matter, as Coretta hailed from smalltown Marion, Alabama, was studying to be a performer, and Daddy King hoped his son would marry a daughter of Atlanta's prominent Dobbs family, particularly classical singer Mattiwilda Dobbs proving a musical career was not the real issue.
Also in Boston, King befriended a small cadre of local ministers his age, and sometimes guest pastored at their churches, including the Reverend Michael Haynes, associate pastor at Twelfth Baptist Church in Roxbury and younger brother of jazz drummer Roy Haynes. The young men often held bull sessions in their various apartments, discussing theology, sermon style, and social issues.
Decades later, an academic inquiry in October concluded that portions of his dissertation had been plagiarized and he had acted improperly.
However, "[d]espite its finding, the committee said that 'no thought should be given to the revocation of Dr. King's doctoral degree,' an action that the panel said would serve no purpose.
King was on the committee from the Birmingham African-American community that looked into the case; E. Nixon and Clifford Durr decided to wait for a better case to pursue because the incident involved a minor. Gayle that ended racial segregation on all Montgomery public buses. The group was created to harness the moral authority and organizing power of black churches to conduct nonviolent protests in the service of civil rights reform. The group was inspired by the crusades of evangelist Billy Graham , who befriended King after he attended a Graham crusade in New York City.
Harris , Walter E. Fauntroy , C. Izola Curry —a mentally ill black woman who thought that King was conspiring against her with communists—stabbed him in the chest with a letter opener. Cordice ; he remained hospitalized for several weeks. Curry was later found mentally incompetent to stand trial.
Sullivan ; the case was litigated in reference to the newspaper advertisement " Heed Their Rising Voices ".
Wachtel founded a tax-exempt fund to cover the expenses of the suit and to assist the nonviolent civil rights movement through a more effective means of fundraising. This organization was named the "Gandhi Society for Human Rights.
He was displeased with the pace that President Kennedy was using to address the issue of segregation. In , King and the Gandhi Society produced a document that called on the President to follow in the footsteps of Abraham Lincoln and issue an executive order to deliver a blow for civil rights as a kind of Second Emancipation Proclamation.
Kennedy did not execute the order. Johnson and Robert F.
Kennedy when it began tapping King's telephone line in the fall of He warned King to discontinue these associations and later felt compelled to issue the written directive that authorized the FBI to wiretap King and other SCLC leaders. Edgar Hoover feared the civil rights movement and investigated the allegations of communist infiltration.Abernathy's Surgical Secrets, 6e Alden H. No notes for slide.
In , Raveling, then 26, was standing near the podium, and immediately after the oration, impulsively asked King if he could have his copy of the speech. The E-mail Address es you entered is are not in a valid format.
Cardiothoracic surgery. When the boys were six, they started school: King had to attend a school for African Americans, and the other boy went to one for whites public schools were among the facilities segregated by state law.
Decades later, an academic inquiry in October concluded that portions of his dissertation had been plagiarized and he had acted improperly. Arterial Insufficiency