Surgery

Leg swelling following hip replacement

A patient who has just had total hip replacement complains of significant leg swelling on the affected side. There is no calf or posterior knee pain. What is the appropriate response?—Michael Flosi, PA-C, Jensen Beach, Fla. Some degree of leg swelling is normal following surgery. Your patient simply may be relatively immobile or may not…

HRT after bilateral mastectomy

A 37-year-old woman was found to be positive for the BRCA mutation after being treated with chemotherapy, mastectomy, and radiation therapy for breast cancer. She then underwent prophylactic oophorectomy and contralateral mastectomy. Within four months of the oophorectomy, her bone mineral density decreased 18%. (She is also on chronic low-dose prednisone for rheumatoid arthritis.) She…

Recombinant factor VIII for hemophilia A

Product: Xyntha Company: Wyeth Pharmacologic class: Clotting factor Active ingredient: Antihemophilic Factor (recombinant): nominally 250 IU, 500 IU, 1,000 IU, or 2,000 IU per vial; powder for IV infusion after reconstitution; plasma/ albumin-free; preservative-free; contains polysorbate 80. Actual factor VIII activity noted on each vial. Continue Reading Indication: In hemophilia A: to control bleeding episodes,…

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