OnlineMedEd: Surgery: General - "Postop Fever"

Question 1

What is the mnemonic for postop fever?

Answer 1

• Wind: atelectasis, pneumonia
• Water: UTI
• Wound: cellulitis, abscess
• Walking: DVT, PE
• Wonder drugs: malignant hyperthermia

Question 2

Review the timeline of fever in relation to surgery and the most likely diagnosis.

Answer 2

• During surgery: malignant hyperthermia
• Immediately after: bacteremia from breaking the sterile field
• POD #1: atelectasis
• POD #2: pneumonia
• POD #3: UTI
• POD #5: DVT/PE
• POD #7: wound
• POD #10-14: abscess

Question 3

How is malignant hyperthermia treated?

Answer 3

• Dantrolene
• O2
• Cool IVF

Question 4

The best prophylactic measure against malignant hyperthermia is ______________.

Answer 4

history

“Ever had a bad reaction to anesthesia before? Any family members have bad reactions to anesthesia?”

Question 5

How do you work up and treat bacteremia?

Answer 5

• Blood culture

* Broad-spectrum abx (usually vancomycin and piperacillin/tazobactam)

Question 6

What is the prophylaxis against atelectasis?

Answer 6

Incentive spirometry and ambulation

Question 7

You need to rule out ____________ in diagnosis postop atelectasis.

Answer 7

pneumonia (with a CXR)

Question 8

The way to prophylactically treat postop UTI is _______________.

Answer 8

remove foley ASAP

Question 9

DVTs classically cause the affected leg to be __________ bigger than the other.

Answer 9

2 cm

Question 10

____________ surgeries are at the highest risk of developing DVTs.

Answer 10

Orthopedic

Question 11

Abscesses should be worked up with _________________.

Answer 11

ultrasound to identify it, surgery to lance it, and antibiotics to treat it