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Gastrointestinal > GI Surgery and Complications > Flashcards

GI Surgery and Complications Flashcards

1
Q

cardiovascular complications of surgery

A

haemorrhage
MI
DVT

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2
Q

types of haemorrhage due to complications of surgery

A

reactionary

secondary

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3
Q

when would reactionary haemorrhage occur

A

immediate postoperative

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4
Q

when would secondary haemorrhage occur

A

infection; 5-10 days

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5
Q

presentation of haemorrhage

A

overt
tachycardia
hypotension
oliguria

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6
Q

outcome of haemorrhage

A

blood loss

fluid restriction

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7
Q

prevention of haemorrhage

A

meticulous technique
avoidance of sepsis
correction of coagulation disorders

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8
Q

presentation of MI post-op

A

silent
cardiac failure/caridogenic shock
arrhythmias

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9
Q

prevention of MI

A

delay surgery after MI
avoidance of preoperative hypertension
correction of ischaemic heart disease

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10
Q

risk factors of DVT

A 
age > 40
hx DVT
majory surgery 
obese 
malignancy
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11
Q

causes of DVT

A

immobility during surgery

hypercoagulable state

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12
Q

presentation of DVT

A 
low grade fever 
unilateral ankle swelling 
calf of thigh tenderness 
increased leg diameter 
shiny skin
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13
Q

tests for DVT

A

D-dimer - low risk
doppler ultrasound
venography

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14
Q

prevention of DVT

A

compression stockings
low-dose subcutaneous heparin
early mobilisation

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15
Q

respiratory complications of surgery

A

atelectasis
pneumonia
PE

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16
Q

risks factors of surgery predisposing patient to atelectasis/pneumonia

A

collapse of lung tissue
anaesthesia
post-op pain
aspiration

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17
Q

how is anaesthesia a respiratory risk factor for post-op

A

increases secretion
inhibits cilia
how is

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18
Q

how is post-op pain a respiratory risk factor for post-op

A

inhibits coughing

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19
Q

presentation of post-op chest infection

A 
low Grade fever - 0-2 days
high grade fever - 4-10 days 
dyspnoea 
productive cough 
confusion
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20
Q

prevention of chest infection

A

stop smoking
adequate analgesia
physiotherapy

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21
Q

risk factors of PE

A 
age > 40
hx PE
major surgery 
obesity
malignancy
22
Q

causes of PE

A

DVT

23
Q

presentation of PE

A 
tachypnoea 
dyspnoea 
confusion 
pleuritic pain 
haemoptysis 
cardiopulmonary arrest
24
Q

tests for PE

A

CT pulmonary angiogram - first line

V/Q scan

25
Q

prevention of PE

A

compression stockings
low-dose subcutaneous heparin
early mobilisation
anticoagulation in presence of DVT

26
Q

GI complications of surgery

A

ileus
anastomotic dehiscence
adhesions

27
Q

what is ileus

A

paralysis of intestinal motility

28
Q

causes of ileus

A 
handling of bowel
peritonitis 
retroperitoneal injury 
immobilisation 
hypokalaemia 
drugs
29
Q

presentation of ileus

A

vomiting
abdominal distension
dehydration
silent abdomen

30
Q

prevention of ileus

A

minimal operative trauma
laparoscopy
avoidance of intra-abdominal sepsis

31
Q

what is anastomotic dehiscence

A

breakdown of anastomosis;
intestinal
vascular
urological

32
Q

causes of anastomotic dehiscence

A

poor technique
poor blood supply
tension on anastomosis

33
Q

intestinal presentation of anastomotic dehiscence

A

peritonitis
abscess
ileus
fistula

34
Q

vascular presentation of anastomotic dehiscence

A

bleeding/haemorrhage

35
Q

urological presentation of anastomotic dehiscence

A

leakage of urine/urinoma

36
Q

prevention of anastomotic dehiscence

A

good technique
good blood supply
tension

37
Q

what are adhesions

A

when fibrin turns into fibrous tissue

38
Q

where are adhesions in chest/abdomen

A

bowel to bowel
bowel to abdominal wall and other structures
lung to chest wall

39
Q

causes of adhesions

A

inflammatory response

ischaemia

40
Q

presentation of adhesions

A

asymptomatic (chest wall)

intestinal obstruction

41
Q

symptoms of intestinal obstruction

A

vomiting
pain
distension
constipation

42
Q

prevention of adhesions

A

no powder on gloves
avoidance of infection
laparoscopic surgery
sodium hyaluronidate

43
Q

types of wound infection

A

trauma - exogenous

intestinal surgery - endogenous

44
Q

presentation of wound infection

A 
pyrexia 
redness
pain 
swelling 
discharge
45
Q

prevention of wound infection

A 
pre-op preparation 
skin cleansing 
aseptic technique 
avoidance of contamination 
prophylactic antibiotics
46
Q

urinary complications of surgery

A

acute retention of urine
UTI
urethral stricture
acute renal failure

47
Q

neurological complications of surgery

A

confusion
stroke
peripheral nerve lesions

48
Q

causes of confusion post-op

A 
hypoxia 
over sedation 
sepsis 
electrolyte imbalance 
stroke 
hyper/hypoglyceamia 
alcohol or tranquilliser withdrawal
49
Q

presentation of confusion

A

disorientation - time and place
paranoia
hallucinations

50
Q

prevention of confusion

A

maintain oxygenation
avoid dehydration
avoid sepsis

51
Q

what is ERAS

A

enhanced recovery after surgery - a multimode programme of enhanced care to minimise post-op complications and return patient to normality ASAP

52
Q

objectives of ERAS

A

promotes;
pain control
GI function
mobility

Gastrointestinal (71 decks)

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