Post-Op

Question 1

What are the clinical features of toxic shock syndrome?

Answer 1

1. Fever
2. Hypotension
3. Diffuse macular erythroderma
4. Skin desquamation
5. N / V / D
6. Thrombocytopenia
7. Severe myalgia
8. Mucous membrane hyperemia
9. Other (elevated LFTs and BUN-Cr, delirium)

Any recent wound picking will be a clue to this.

Question 2

What is the median onset of toxic shock syndrome?

Answer 2

2-3 days

Question 3

A post-op patient is having respiratory issues. After a positive CXR revealing lobar infiltrate, what should be the next diagnostic step? What are we looking for?

Answer 3

We need to do lower RT sampling with culture and begin empiric ABX.

We are looking for ventilator/nosocomial pneumonia (VAP).

Question 4

What is the most common organism for VAP?

Answer 4

Aerobic gram negative bacilli

• Pseudomonas
• E. coli
• Klebsiella

Gram positive cocci

• MRSA
• Streptococcus

Question 5

When does VAP occur?

Answer 5

> 48 hours after intubation