Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery Revision > Principles of Surgical Care > Flashcards

Principles of Surgical Care Flashcards

1
Q

Definition of shock

A

Inadequate peripheral tissue perfusion resulting from lack of oxygen and nutrient supply to the cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

4 stages of shock

A
  • initial
  • compensatory
  • progressive
  • refractory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of shock

A
  • hypovolaemic
  • cardiogenic
  • distributive (Septic, anaphylactic, neurogenic)
  • obstructive (cardiac tamponade, PE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Definition of severe sepsis

A

Acute organ dysfunction secondary to infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Definition of septic shock

A

Severe sepsis and hyptension not reversed with fluid resus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Diagnosis of septic shock

A

Both criteria met:

  • evidence of infection
  • refractory hypotension

Plus 2 or more:

  • tachypnoea
  • HR >90
  • WCC <4000 or >12000
  • T <36 or >38
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pathophysiology of septic shock

A
  • usually endotoxin-producing gram negative bacilli
  • Free LPS bind to CD14 on monos, macs and neuts
  • cytokine release causes systemic vasodilatation and decreases cardiac contractility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Treatment of septic shock (OVERS)

A
  • oxygen admin and airway support
  • volume resus
  • early AB admin
  • rapid source ID and control
  • support of major organ dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Layers of the skin

A
  • epidermis
  • dermis
  • subcutaneous fat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is secondary healing?

A
  • edges of full thickness wound are not approximated
  • granulation tissue
  • contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

4 phases of wound healing

A
  • haemostasis
  • thromboxane and prostaglandin release
  • inflammation
  • proliferation
  • remodelling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Criteria for diagnosis of surgical site infection

A
  • purulent drainage from surgical incision
  • organism isoalted from culture of fluid/tissue
  • at least one of:
    pain/tenderness, localised swelling, redness, heat
  • systemic findings
  • an abscess or other infection of deep layers of the incision/cavity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Surgical wound classification

A 
Class 1 = clean
Class 2 = clean-contam
Class 3 = contam
Class 4 = dirty-infected
Class 5 = unclassified
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Definition of an acute wound

A

Healed in 3 weeks and remodelled in 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Definition of chronic wound

A

Persists beyond 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Characteristics of the ideal dressing

A
  • removes exudates and toxins
  • maintains high humidity
  • debrides necrotic tissue
  • allows for gaseous exchange
  • anti-bacterial
  • hypoallergenic
  • free from particulate matter
  • no trauma with removal
  • reasonably priced and easily available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Risk factors for pressure sores

A
  • immobilization
  • PVD
  • CCF
  • advanced age
  • malnutrition
  • cachexia
  • obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Variables that influence surgical recovery

A
  • patient factors
  • precipitating factors
  • surgical strategy
  • type of anaesthesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Common surgical respiratory complications

A
  • atelectasis

- pneumonia

20
Q

Less common surgical respiratory complications

A
  • aspiration
  • ARDS
  • pneumothorax
  • pleural effusion
  • PE
21
Q

When does periop MI usually happen?

A

3 days post op

22
Q

Risk factors for periop MI

A

Patient factors

  • AS
  • recent MI
  • arrythmia
  • heart failure

Op factors

  • vascular surgery
  • surgery >3 hours
23
Q

Risk factors for surgical haemorrhage

A
  • coagulopathy

- massive transfusion

24
Q

Cardiovascular complications in surgery

A
  • periop MI
  • haemorrhage
  • DVT
25
Q

Common GI surgery complications

A
  • ileus
  • constipation
  • wound complication
  • intra-abdominal sepsis
26
Q

Less common GI surgery complications

A
  • stress gastritis
  • jaundice
  • pancreatitis
  • enterocutaneous fistula
27
Q

Wound complications

A
  • infection
  • dehiscence
  • sinus
  • entercutaneous fistula
28
Q

Practical clinical post-op problems

A
  • pyrexia
  • respiratory distress
  • inadequate urine output
  • confusion/delirium
29
Q

Causes of delirium

A
  • drugs/withdrawal
  • infection/ischaemia
  • metabolic
  • trauma of CNS/ temp
  • oxygen lack
  • psych
30
Q

What structures are infected in erysipelas?

A
  • upper dermis

- superficial lyphatics

31
Q

What structures are infected in cellulitis?

A
  • deeper dermis

- subcutaneous fat

32
Q

Organisms that cause cellulitis

A
  • beta-haemolytic strep

- S. aureus

33
Q

Predisposing factors for cellulitis and erysipelas

A

Local

  • trauma
  • inflammation
  • infection
  • oedema

Systemic

  • HIC
  • DM
  • CF
34
Q

Important differentials for cellulitis and erysipelas

A
  • necrotizing infection

- DVT

35
Q

Supportive treatment of cellulitis and erysipelas

A
  • elevation
  • treat underlying cause
  • hydrate skin
  • compression stockings
36
Q

Antibiotics for cellulitis

A

Cloxacillin for 5-10 days

37
Q

Antibiotics for erysipelas

A
  • penicillin

- cloxacillin

38
Q

Who gets recurrent cellulitis

A
  • Obese

- lymphoedema

39
Q

Definition of necrotising skin and tissue infections

A

Fulminant tissue destruction, systemic signs of toxicity, early organ dysfunction and high mortality
- muscle often spared (good blood supply)

40
Q

Types of necrotizing infections

A

Type 1 = polymicrobial
Type 2 = hemolytic strep gangrene
Nectrotizing myositis = clostridium perfringens

41
Q

Clinical findings in necrotizing infections

A

Local

  • pain out of keeping
  • crepitus
  • skin anaesthesia
  • tissue necrosis

Systemic

  • high pyrexia
  • organ dysfunction

Lab

  • WCC >20000
  • metabolic acidosis
  • renal failure
42
Q

Surgical management of necrotizing infections

A
  • aggressive debridement
  • re-evaluation in 24 hrs
  • skin grafts
43
Q

Definition of an abscess

A

Collection of pus within the dermis and deeper skin tissues

44
Q

Furuncle

A

Infection of hair follicle

45
Q

Carbuncle

A

Coalescence of several inflamed follices

46
Q

Which abscesses need AB?

A
  • > 5cm
  • multiple lesions
  • extensive cellulitis
  • associated co-morbidities
  • immunosuppression
  • systemic signs
  • lack of response to drainage

Surgery Revision (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions