Chapter 87: Complications of General Surgical Procedures

Question 1

Causes of post operative fever

Answer 1

• Wind (atelectasis or pneumonia)
• Water (urinary tract infection), - Wound
• Walking (deep vein thrombosis)
• Wonder drugs (drug fever or pseudomembranous colitis)

Question 2

Predominant cause of fever in the first 72 hours

Answer 2

Atelectasis and IV catheter-related problems

Question 3

Occurs up to 6 weeks postoperatively

Answer 3

Antibiotic-induced pseudomembranous colitis

Question 4

Becomes evident between 24 and 96 hours postoperatively

Answer 4

Pneumonia

Question 5

Antibiotic for post operative UTI

Answer 5

• Ciprofloxacin, 500 milligrams PO twice daily

- Levofloxacin, 750 milligrams PO once daily

Question 6

Wounds not involving the perineum and not associated with entry into the GI or biliary tract are most often infected with _____

Answer 6

Wounds not involving the perineum and not associated with entry into the GI or biliary tract are most often infected with S. aureus or streptococci

Question 7

C scan of necrotizing fasciitis reveal

Answer 7

Asymmetric fascial thickening, gas tracking along fascial planes, or focal fluid collections

Question 8

Hallmark of necrotizing fasciitis

Answer 8

Presence of marked systemic toxicity and pain out of proportion to local findings

Question 9

Antibiotic for necrotizing fasciitis

Answer 9

Penicillin or a cephalosporin, an aminoglycoside, and clindamycin

Question 10

Superficial thrombophlebitis of the lower extremities is most frequently secondary to stasis in ____

Answer 10

Superficial thrombophlebitis of the lower extremities is most frequently secondary to stasis in varicose veins

Question 11

The preferred diagnostic test for deep venous thrombosis

Answer 11

Doppler US

Question 12

Greatest concern in complication of drug therapy

Answer 12

Pseudomembranous colitis

Question 13

How to diagnose C. difficile

Answer 13

• Nucleic acid amplification tests
• Glutamate dehydrogenase
• Enzyme immunoassay

Question 14

Drug class most commonly implicated with fever

Answer 14

Antibiotic

Question 15

After surgery, how many day will the tone of small bowel and colonic function returns?

Answer 15

Small bowel tone usually returns to normal within 24 hours, and colonic function returns within 3 to 5 days

Question 16

Ileus can also occur after non-GI procedures and is usually secondary to _____

Answer 16

Ileus can also occur after non-GI procedures and is usually secondary to anesthetic agents

Question 17

True or False

Fistulas involving the distal GI tract are frequently high output and are of the greatest concern

Answer 17

False

Fistulas involving the proximal GI tract are frequently high output and are of the greatest concern

Question 18

Anastomotic leaks occur most frequently after ____

Answer 18

Anastomotic leaks occur most frequently after esophageal and colonic surgeries

Question 19

A common complication of the Roux-en-Y gastric bypass is ____

Answer 19

A common complication of the Roux-en-Y gastric bypass is dumping syndrome

Question 20

Dumping symptoms happens because?

Answer 20

Pylorus is bypassed or removed

Question 21

Dumping syndrome associated with reactive hypoglycemia

Answer 21

Late dumping syndrome (2-4 hours)

Question 22

Mainstay of treatment for dumping syndrome

Answer 22

The mainstay of treat- ment is dietary modification; consumption of small, dry meals; and separation of solids from liquids

Question 23

Vitamin deficiency that require emergent intervention after Roux-en-Y gastric bypass and biliopancreatic diversion is?

Answer 23

Vitamin B12 deficiency is the only one that requires emergent intervention

Question 24

The two most commonly placed stomas are

Answer 24

The two most commonly placed stomas are the ileostomy and the colostomy

Question 25

Occurs when the surgeon has not removed all redun- dant mucosa during hemorrhoidectomy and is much more common than rectal prolapse

Answer 25

Mucosal prolapse occurs when the surgeon has not removed all redun- dant mucosa during hemorrhoidectomy and is much more common than rectal prolapse

Question 26

Can occur after any anorectal surgical procedure and likely is related to injury of the puborectalis muscle

Answer 26

Rectal prolapse can occur after any anorectal surgical procedure and likely is related to injury of the puborectalis muscle