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ABSITE > Basic Science > Flashcards

Basic Science Flashcards

1
Q

What is the first sign of gram-negative sepsis?

A

Hyperglycemia

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2
Q

What is the ideal glucose range in a septic patient?

A

100-120 mg/dL

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3
Q

What patients need antibiotics for an abscess?

A

DM, cellulitis, sepsis, fever, elevated WBC, bioprosthetic hardware

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4
Q

What are the common causes of SSI within 48 hours of surgery?

A 
Injury to Bowel with Leak
Invasive infection (C. Perfringens, beta hemolytic strep)
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5
Q

What is the most common organism in ICU pneumonia?

A

S. Aureus #1 bug

GNR #1 class

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6
Q

What is the most common causes of line infections?

A

1) S. Epidermidis
2) S. Aureus
3) Yeast

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7
Q

What is the definition of a line infection?

A

> 15 cfu from a central line culture

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8
Q

What are the sx of NSTI?

A

Pain out of proportion, WBC > 20, thin gray drainage, skin blisters/necrosis, crepitus or gas on x-ray

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9
Q

What is characteristic of C. perfringens gram stain?

A

GPRs without WBCs

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10
Q

What is the diagnosis of SBP based on?

A

PMNs > 500 cells/cc

Tx: Ceftriaxone

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11
Q

What must be ruled out if paracentesis is polymicrobial?

A

Intra-abdominal source (e.g. bowel perf)

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12
Q

What is the most common site of lymphoma in HIV patients?

A

Stomach, then rectum

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13
Q

What organisms are common in LGIB in HIV?

A

CMV, bacterial, HSV

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14
Q

What is the abx choice for diabetic foot infections?

A

Unasyn

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15
Q

What is the treatment for bite wounds?

A

Augmentin

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16
Q

What is the treatment for a PD cath infection?

A

IP vancomycin and gentamicin

removal of catheter if > 4-5 days

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17
Q

What is the ideal trough level for vancomycin?

A

5-10 ug/mL (too high decrease frequency)

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18
Q

What do ampicillin/amoxicillin add to coverage?

A

Enterococci + Penicillin

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19
Q

What does Unasyn/Augmentin add?

A

Pick up GPCs, GNRs, Anaerobes

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20
Q

What is the side effect of Ticarcillin and piperacillin?

A

Inhibit platelets

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21
Q

What is a side effect of Ceftriaxone?

A

Cholecstatic jaundice, GB sludge

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22
Q

What organisms do Carbapenems not cover?

A

MEP (MRSA, Eterococcus, Proteus)

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23
Q

What drug is synergistic with aminoglycosides?

A

Beta-lactams (ampicillin for Enterococcus)

24
Q

What drugs are good for enterococcus?

A

Vancomycin
Timentin/Zosyn
Gentamicin + Ampicillin
Unasyn

25
Q

What antifungals should be used for fungal sepsis?

A

Candida -> Anidulafungin
Aspergillus -> Voriconazole
All others -> liposomal Ampho B

26
Q

What drugs are good for serratia, acinetobacter, pseudomonas?

A 
Timentin/Zosyn
3rd Gen Cephalosporins
Aminoglycosides
Meropenem/Imipenem
Fluoroquinolones
27
Q

What are metyrapone and aminoglutethimide?

A

Inhibitors of adrenal steroid synthesis (used in patients with adrenocortical CA)

28
Q

What are some complications with halothane?

A

highest degree of cardiac depression and arrhythmias. Halothane hepatitis (fever, eosinophilia, jaundice)

29
Q

What is the first sign of malignant hyperthermia?

A

Increased ETCO2

30
Q

What patients should not get succynlcholine?

A

Burns, neurologic injury, neuromuscular disorder, SCI, trauma, ARF (hyperkalemia risk), open angle glaucoma

31
Q

What should be given with neostigmine or edrophonium?

A

Atropine or glycopyrolate

32
Q

What is the toxic dose of 1% lidocaine?

A

0.5 cc/kg

33
Q

What opioids should be avoided in renal failure?

A

Demerol

34
Q

What are the side effects of lidocaine in an epidural?

A

Bradycardia, Hypotension

35
Q

What patients are epidurals contraindicated in?

A

Hypertrophic Cardiomyopathy
Cyanotic Heart Disease
(decreases afterload)

36
Q

What is a spinal blockade?

A

Injection into subarachnoid space. Spread determined by position. Neurologic blockade above motor blockade

37
Q

What is different about MIs post-op?

A

Can have no pain or EKG changes

38
Q

Where should the tip of an ET tube terminate?

A

2 cm above carina

39
Q

What quantity of H2O is lost as insensible losses daily?

A

10cc/kg

40
Q

What replacement fluid should be used for GI surgery?

A

1-24 hrs: LR

After 24 hrs: D51/2NS + 20K

41
Q

What replacement fluid should be used for losses from the GI tract?

A

Gastric - D51/2NS + 20K
Panc/Bili/SI: LR + HCO3
Colon: LR + K

42
Q

What is the treatment for hyperkalemia?

A

10 U insulin + 1 amp of D50

43
Q

What is the protein adjustment for calcium?

A

For each 1 g decrease in protein add 0.8 to Ca

44
Q

How do you calculate calorie requirements in Surgery and Burns?

A

Surgery: increased 20-40%
Burns: 25kcal/kg/day + 30kcal/day x %Burn
Protein: 1-1.5 g/kg/day + 3gx%Burn

45
Q

How do you calculate IBW?

A 
Men = 106 lb + 6 lb/inch>5 feet
Women = 100 lb + 5lb/inch>5 feet
46
Q

Why don’t protein-conserving mechanisms occur after trauma?

A

Catecholamine and cortisol release

47
Q

What are the electrolyte abnormalities in re-feeding syndrome?

A

Decreased K, Mg, PO4

48
Q

How do you calculate nitrogen balance?

A

protein/6.25 - 24hour urine N + 4g

49
Q

What is the most common met to the small bowel?

A

Melanoma

50
Q

How long does it take for wound to reach max tensile strength?

A

8 weeks

51
Q

How does hyperglycemia inhibit wound healing?

A

Impedes leukocyte chemotaxis

52
Q

What can counteract the effect of steroids on wound healing?

A

Vitamin A

53
Q

What are risk factors for poor wound healing?

A 
Bacteria
Devitalized Tissue
Foreign Bodies
Cytotoxic Drugs
Diabetes
Albumin < 3.0
Steroids
Ischemia
54
Q

What is Charcot’s joint?

A

2nd MTP Joint (common for diabetic ulcers)

55
Q

How many days till chemo has no effect on wound healing?

A

14 Days

56
Q

What are the contents of Alpha granules?

A

PF4, beta-thrombomodulin, PDGF, TGF-beta

57
Q

What are in dense granules?

A

Adenosine, Serotonin, Calcium

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