Ashley's random factoids - feel free to ignore Flashcards
Timing of wound dehiscence
1 week
What is the most common cause of fever POD 1 & 2
atelectasis
Bad thing after long bone fx, joint replacement
fat embolism
Bad thing when placing central line
air embolism - air lodges in right atrium - place in Trendelenburg while placing central line
Common cause of fever POD 3+
IV phlebitis
give what for massive hemorrhage
whole blood
give what to raise hematocrit
PRBCs
give what for warfarin overdose
FFP (coag factors & plasma proteins)
what’s so bad about Demerol
active neurotoxic metabolites
narcotics, strongest to weakest
Fentanyl-Dilaudid (hydromorphone)-Percocet (oxycodone)-morphine-tramadol-Tylenol w/ codeine
HIDA scan is aka
cholescintigraphy
Hepatobiliary Iminodiacetic Acid Scan
why do HIDA scan
cholecystitis, neonatal hepatitis, biliary atresia
core needle bx for
breast
fine needle aspiration for
body fluids, seromas, thyroid nodules
give what for staph/strep cellulitis
penicillin or 1st gen ceph
gas gangrene bacteria
C. perfringens
hemorrhagic bullae in
necrotizing fasciitis
abnormal communication between two epithelialized surfaces
fistula
basic approach to burns
cleanse
debride
topical antimicrobials
dressing changes
stuff you can put on burns
xeroform silver sulfadiazine polysporin chlorhexidine povidine-iodine mafenide Dakins' solution
biggest baddest burn complication
multiple organ dysfunction syndrome secondary to hypoperfusion (early) or sepsis (late)
pros of G tube
more physiological
easier to place
can give continuous bolus
need J tube instead of G tube if
if recurrent aspiration of gastric contents
regurgitation
delayed gastric emptying
when consider PEG/PEJ
if enteral support will be needed more than 4-5 weeks
ONLY USE TPN IF:
GI tract cannot be used or no oral intake for 7-14 days
what is ‘acute abdomen’
sudden, spontaneous, nontraumatic disorder manifesting in abdominal area for which urgent operation may be necessary
examples of acute abdomen
acute appendicitis bowel obstruction cholecystitis cancer vascular stuff
some signs that surgery is needed (acute abdomen)
acidosis distension fever, tachycardia increasing tenderness mass hardness pneumoperitoneum perforation paracentesis w/ blood, bile, pus, urine, poop
normal ankle-brachial index (ABI)
1.0 or greater
ABI with claudication
< 0.6
ABI with rest pain
< 0.4
medication for claudication
pentoxifylline
increases RBC flexibility
surgical options for claudication
- bypass graft
- balloon dilation (angioplasty)
- endarterectomy (remove diseased intima & media)
- surgical patch angioplasty (place patch over stenosis)
what is blue toe syndrome
intermittent painful blue toes secondary to microemboli from a proximal arterial plaque
what is best suture for vascular anastomosis to prosthetic graft
synthetic nonabsorbable
what is best suture for GI anastamosis
synthetic absorbable
electrolyte complication of thyroidectomy
HYPOcalcemia
parathyroids get gone/annoyed -> hypoparathyroid -> hypocalcemia
Meckel diverticulum rule of 2s
2% of population 2% symptomatic within 2 feet of ileocecal valve 2 inches in length 2:1 M:F
