GI

Question 1

Pre-op ppx for aspiration in high risk pts

Answer 1

Reglan + ranitidine

Question 2

Downsides of elemental tube feeds compared to standard polymeric feeds

Answer 2

Elemental tube feeds are more expensive and associated with increased risk of hospital LOS and mortality.

Question 3

NGTs are associated with increased risk of what two infections?

Answer 3

Otitis media and sinusitis. The larger the tube the greater the risk.

Question 4

Propofol effect on pancreatitis

Answer 4

Propofol can worsen pancreatitis (thought to be d/t hypertriglyceridemia)

Question 5

Alvimopan MOA and indication

Answer 5

MOA: mu antagonist in the periphery; does not cross BBB

Prevents post-op lieus without disrupting pain management with opioids.

Question 6

Medications that are contraindicated iso SBO

Answer 6

Reglan and nitrous oxide

Question 7

What is the strongest predictor of peri-operative outcomes in pts on TPN?

Answer 7

Serum albumin

Question 8

Best test to measure synthetic function of the liver and why

Answer 8

PT. It measures clotting time of the extrinsic pathway involving factor VII, which has the shortest half-life of the clotting factors, so it is an early and reliable measure of synthetic function.