On call

Question 1

5 W’s which cause pyrexia post op

Answer 1

• Wind - LRTI - 2 days post op
• Water - UTI - 3 days post op
• Walking - DVT - 4-6 days post op
• Wound - infection - 7 days post op
• Wonder - everything else - drugs?

Question 2

What can happen on ECG secondary to sepsis?

Answer 2

Atrial fibrillation

Question 3

Cause of sepsis following bowel resection

Answer 3

• Anastomotic leak - resected bowel is tied back together but leak forms

Question 4

Diagnosis for anastomotic leak

Answer 4

CT abdo - if CT is early may not see collection of fluid

Question 5

Management of AF if secondary to sepsis

Answer 5

• Treat sepsis
• Don’t treat with beta blockers as you would with primary - could cause BP to crash

Question 6

What is PCA?

Answer 6

Patient controlled analgesia - press when in pain

Question 7

What to do is suspect PE post surgery?

Answer 7

• DO NOT DO D-dimer - will be high anyway, do CTPA if suspect

Question 8

What happens if someone has reduced consciousness and has low BMs?

Answer 8

• Cannot give food orally - not safe to swallow
• Needs IV feeding via dextrose - called TPN
• Use IV dextrose 20% 100-200mls

Question 9

Antiemetic used often in hopsital

Answer 9

• Ondansetron
• Can also have metoclopromide but is prokinetic cyclizine

Question 10

Cyclizine problem IV

Answer 10

ADDICTIVE

Question 11

When can people eat and drink before op if NBM before op?

Answer 11

• Cannot eat 6hrs before op
• Cannot have fluids (clear) from 2hrs before

Question 12

Insulin regime if NBM

Answer 12

Sliding scale - check BMs then dose insulin based on this