05 - Surgical site infections

Question 1

Prophylactic antibiotic for biliary tract surgery with active infection

Answer 1

1. ampicillin sulbactam
2. piperacillin sulbactam
3. ticarcillin sulbactam

Question 2

Prophylactic antibiotic for colorectal, obstructed small bowel

Answer 2

1. cefazolin + metronidazole

Question 3

Types of SSI

Answer 3

1. incisional
2. organ/ space infections

Question 4

Treatment of incisional SSI

Answer 4

1. incision and drainage
2. without antibiotics - except in SIRS or cellulitis

Question 5

Characteristic of primary microbial peritonitis

Answer 5

1. diffuse tenderness and guarding without localized findings
2. aabsence of pneumoperitoneum
3. presence of >100 wbc
4. single morphology of microbe

Question 6

Treatment of primary microbial peritonitis

Answer 6

antibiotic therapy for 14 to 21 days removal of indwelling devices

Question 7

Cause of secondary microbial peritonitis

Answer 7

contamination of the peritoneal cavity due to perforation or severe inflammation and infection of an intra abdominal organ

Question 8

Treatment of secondary microbial peritonitis

Answer 8

1.source control 2. resect or repair diseased organ 3. debridement of necrotic, infected tissue 4. administer antibiotics

Question 9

Cause of tertiary/ persistent peritonitis or postoperative peritonitis

Answer 9

leakage from a GI anastomosis or intra abdominal abscess in whom standard therapy fails

Question 10

Treatment of tertiary peritonitis

Answer 10

CT guided percutaneous drainage of intra abdominal abscess

Question 11

Hemodynamic critera of cardiogenic shock

Answer 11

1. SBP < 90 mmHg for at least 30 mins 2. Reduced cardiac index < 2.2 3. elevated pulmonary artery wedge pressure > 15 mmHg

Question 12

What percentage of the blood volume is in the splanchnic circulation

Answer 12

20%

Question 13

This best describes hemodynamic response to neurogenic shock

Answer 13

increased cardiac index unchanged volume capacitance