Post-Op

Question 1

What are laboratory findings of prerenal AKI due to intravascular volume depletion?

Answer 1

BUN/Cr ratio > 20:1

oliguria <500 mL of urine/24 hours

Question 2

____ antibiotics is a common cause of intrinsic AKI.

Answer 2

beta-lactam (pip/tazo)

Question 3

What are the causes of post-op fever?

Answer 3

Wind (lungs)
Wound
Water (UTI)
Walk (DVT)
Wonder drugs

Question 4

What is the most common cause of post-op fever within first week of operation?

Answer 4

surgical site infection, PE, DVT

Question 5

What bacteria is commonly found on intravascular related infections?

Answer 5

staph epidermidis

Question 6

A widened mediastinum in a post-op cardiac surgery may indicate what?

Answer 6

mediastinitis

-confirmed surgically when pus noted in mediastinum

Question 7

What POD does fluid tend to return to the intravascular space?

Answer 7

POD 3

Question 8

What conditions cause metabolic acidosis?

Answer 8

diarrhea, ileus, fistula, carbonic anhydrase inhibitors, lactic acidosis, renal failure, necrosis

Question 9

What conditions cause metabolic alkalosis?

Answer 9

vomiting, NG suction, diuretics, meralocorticoid excess

Question 10

What type of alkalosis is caused by NGT suction/vomiting?

Answer 10

Hypokalemic hypochloremic metabolic alkalosis

Question 11

What is in normal saline?

Answer 11

154 mEq Na and Cl

Question 12

So 1/2 NS is….?

Answer 12

77 mEq Cl and Na

approx half mEq of NS

Question 13

What is in LR?

Answer 13

130 mEq Na
109 mEq Cl
28 mEq lactate
4 mEq K
3 mEq Ca

Question 14

What is in D5W?

Answer 14

5% dextrose (50 g) in H20

Question 15

What is hourly maintenance IV fluid rate for a 70 kg man?

Answer 15

110 mL/hr
(4 mL/kg for first 10 kg
2 mL/kg for second 10 kg
1 mL/kg for remaining kgs)

Question 16

What is the rule for daily maintenance IV fluids?

Answer 16

100/50/20:
100 mL/kg for first 10 kg
50 mL/kg for second 10 kg
20 mL/kg for ever kg over 20

Question 17

What is the most common maintenance fluid in adults?

Answer 17

D5 1/2 NS with 20 mEq KCl /L

Question 18

How is pediatric maintenance fluid make up different?

Answer 18

D5 1/4 NS rather than 1/2 NS

Question 19

What is minimum urine output while on maintenance IVF?

Answer 19

30 mL/hr (0.5cc/kg/hr)

or 50 mL/hr is trauma pt

Question 20

Fever + abdominal symptoms several days after abd surgery should make you think of what?

Answer 20

abdominal abscess

-treated with drainage and IV abx

Question 21

What are clinical signs of chronic osteomyelitis?

Answer 21

nonunion fraction
sinus tract formation
persistent pain, swelling, chronic wound