Organ Faillure

Question 1

Define mods

Answer 1

Multi organ dysfunction syndrome

Progressive, potentially reversible organ dysfunction of 2 or more organs

Question 2

Name 4 manifestations of acute kidney injury

Answer 2

• Oliguria
• hyperkalaemia
• metabolic acidosis
• uraemia
All are also hard indications for dialysis
• fluid overload
• increased urea and creatinine

Question 3

Name 7 contraindications to enteral feeding

Answer 3

• Uncontrolled shock- escalating inotrope/ vasopressor requirements with haemodynamic instability
• uncontrolled life threatening hypoxemia or hypercapnia
. Active git bleeding
• overt bowel ischaemia
• high output intestinal fistulas
• abdominal compartment syndrome
• high NGT drainage >500 ml in 6 hours

Question 4

Which patients will need ICU care? (4)

Answer 4

• Require advanced respiratory support
• support. 2 or more organ systems
• organ failure needs to be reversible
• concept of potential benefit
• early referral or consultation of critical care team

Question 5

Principles of care in ICU? (8)

Answer 5

Fast HUGL
Fluids feeds
Analgesia
Sedation
Thromboprophylaxis
Head up 30 degrees to decrease risk aspiration
Ulcer prophylaxis (pantaloc)
Glucose control (most hyper)
Lines

Question 6

Describe type 2 intestinal failure (4)

Answer 6

• Prolonged more than 28 days
• Associated with multiple other organ dysfunctions
• will require TPN
• due to surgical complications, enterocutaneous fistulas, sepsis

Question 7

Describe type 3 intestinal failure (4)

Answer 7

• Chronic and irreversible
. Short bowel syndrome
• need lifelong TPN
• only cure is intestinal transplant

Question 8

Absent gut function for how long after surgery mandates further investigation, and for what?

Answer 8

3-5 days to exclude anastomotic leak or intra-abdominal abscess.

Question 9

Name 10 complications of intestinal failure

Answer 9

• Dehydration
• AKI
• electrolyte abnormal
• vitamin deficiencies
• protein energy malnutrition
• sepsis central line associated
• alteration gut microbiome
• LIVER dysfunction related to prolonged TPN
• Depression
• narcotic dependence

Question 10

The sequential organ failure assessment (sofa) is a quantitave measure of organ function of which 5 organs?

Answer 10

• Lungs
• kidneys
• LIVER
. Brain
• coagulation