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surgery > peritonitis > Flashcards

peritonitis Flashcards

1
Q

T/F

focal contamination of the peritoneum quickly inoculates the entire pertioneum

A

yes

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2
Q

a cranially located source takes __ min to inoculate the peritoneum

A

19 min

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3
Q

a caudally located source takes __ min to inoculate the peritoneum

A

72min

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4
Q

classification of peritonitis

spontaneous inflammation in the absence of intraperitoneal source

A

primary

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5
Q

peritonitis that is usually gram positive and monobacterial

A

primary

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6
Q

peritonitis that is mostly gram negative and polymicrobial

A

secondary

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7
Q

T/F

primary peritonitis is more common than secondary

A

false – secondary is more common - it is the consequence of an underlying primary disease

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8
Q

septic peritonitis

A

infectious etiologies present

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9
Q

T/F

surgery is not routinely indicated for secondary peritonitis but is a requisite for primary

A

false - opposite!!

must differentiate primary vs secondary

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10
Q

Gi origin accounts for what percentage of septic peritonitis

A

38-75%

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11
Q

this drug has the tendency to cause proximal duodenal peritonitis

A

deramaxx - NSAIDS

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12
Q

steroids cause peritonitis in what part of the GI

A

proximal descending colon

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13
Q

T/F

the more aboral the higher the bacterial counts and higher the anaerobes and higher the mortality

A

TRUE

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14
Q

two biggest offenders of septic peritonitis in the bowel

A

Ecoli - alpha hemolysin tox

bascteriodes fragilus - anaerobe that enhances the lethal potential of ecoli

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15
Q

hepatbiliary causes of septic peritonitis

A

ruptured gall bladder

necrotizing cholecystitis

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16
Q

urogenital septic peritonitis

A

pyometra

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17
Q

penetrating trauma that can cause septic peritonitis

A

bites

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18
Q

terminal effects

A

DIC

sIRS
MODS

19
Q

hyperdynamic shock

A 
vasomotor dysfunction
cytokine induced peripheral vasodilation
tachycardia 
hyperemic mm
rapid CRT 
bounding pulses 
hyperthermia
20
Q

hypodynamic shock

A 
decreased contractility and CO
pale mm and low CRT 
weak peripheral pulses 
high RR and HR 
hypothermia 
dehydrated 
dull mentation
21
Q

classic peritonitis signs

A

painful
vomiting
fever
distended abdomen and maybe shock

22
Q

T/F

cats are painful on abdominal palpation in septic peritonitis cases

A

FALSE

23
Q

describe relative bradycardia in cats

A

< 140 bpm

inappropriately low for a hemodynamic state of cat

24
Q

How long can residual air remain after abdominal surgery

A

30days

25
Q

preferred dx technique in people

A

CT

26
Q

gold standard DX for peritonitis

A

cytology - ultrasound guided aFAST

27
Q

what is seen on cytology

A

degenerative neutrophils with intracellular bacteria

28
Q

what is the accuracy of cytology

A

57 - 87 % accurate

29
Q

dogs with septic effusion

the peritoneal fluid glucose conc will always be ____ than the blood glucose concentration

A

20 points lower

30
Q

the peritoneal fluid lactate will always be ____ than blood lactate

A

2 points higher

31
Q

diagnostic for uroperitoneum

A

peritoneal fluid CREA > serum CREA

32
Q

bile peritonitis DX

A

peritoneal fluid bilirubin will be > 2.5 times the serum bilirubin concentration

33
Q

four quadrant treatment

A

IV ampicillin
baytril
metonidazole

if aminoglycoside is used instead of baytril be careful because it can potentiate renal failure in patients with poor perfusion

34
Q

lavage surgery with ____

A

WARM isotonic saline

35
Q

critical aspects of post op care in peritonitis

A

enteral nutrition – these animals need feeding tubes

drainage po is CRITICAL

36
Q

most efficient way to drain

A

open

37
Q

peritoneal drain with lower risk of evisceration

A

closed

38
Q

drain that limits anaerobic growth

A

open

39
Q

drain that requires a longer hospital stay anf more intensive care

A

open

40
Q

drain of choice for abdominal drainage

A

active drain - jackson pratt

41
Q

best type of feeding tube

A

combo G and J – gastrojejunostomy

42
Q

prognosis for young stable patient with acute onset

A

80:20 chance living

43
Q

prognosis for ill patient with unknown source peritonitis

A

50:50

44
Q

negative risk factors

A

decreased blood pressure pre, intra, or post op
presence of DIC
ineffective ABx used

surgery (18 decks)

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