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Asymptomatic Patient with Positive Test

Surgery

Assumptions

The student understands the concepts of test sensitivity, specificity, false negative and false positive rates, positive and negative predictability, and prior probability.

Knowledge Objectives

Through their reading and patient care experiences, at the end of the rotation students should be able to:

Elevated PSA

Understand the significance of the PSA and its implications for screening, diagnosis, and follow-up.
What is the sensitivity and specificity of the PSA for detecting prostatic cancer.
Discuss the use of the PSA in screening healthy adults.
When should it be used?
How often should it be done?
Prostate Nodule

Understand the significance of a prostatic nodule, its differential diagnosis, evaluation, and treatment.
Discuss the differential diagnosis.
Discuss the evaluation of a nodule.
role of ultrasound
role of biopsy
different biopsy techniques
Discuss the staging of cancer of the prostate.
Discuss treatment options for cancer of the prostate.
Gallstones

Understand the natural history of symptomatic and asymptomatic gallstone disease.
Define "symptomatic" in the context of gallstone disease.
Discuss the available literature on the natural history of asymptomatic gallstones.
Discuss the indications for cholecystectomy.
Discuss the options, pros and cons, for treatment of gallstones:
cholecystectomy
dissolution therapy
watchful waiting
Discuss impact of associated medical conditions on the decision to treat gallstones.
Discuss the association of cancer of the gallbladder and gallstones.
Carotid Bruit

Understand the significance of a carotid bruit found in an asymptomatic person and how and when to further evaluate it.
What is the significance of a bruit?
What are the symptoms of carotid disease?
How should a patient with a carotid bruit be evaluated?
What are the available treatments for carotid disease and what are their indications?
Hypercalcemia

Discuss and understand calcium homeostasis.
Understand the symptoms and signs of acute and chronic hypercalcemia.
Discuss the differential diagnosis of hypercalcemia.
Discuss the evaluation and management of hypercalcemia
Incidental Mass on Computer Tomography

Discuss the differential diagnosis of incidental masses of:
Adrenal gland
Liver
Kidney
Discuss the further evaluation of the mass.