surgery Flashcards
surgical risk factor
male>45 ejection fraction below 35% recent MI (defere 6 months) CHF Diabetes=coronary artery disease Hypertension High cholesterol
pulmoary risk assessment
stop smoking 6 weeks prior to surgery
surgery assessment in a cardiac diseased patietn
AKG
Stresst test
Echocargiogram(structural damage and ejection fraction)
SIRS critera
2 or MORE
- Temp 38
- HR >90
- Tachypnea >20 BPM or PCO2 12000
best initial test for ischemic bowel disease
CT scan of the abdomen
most accurate angiography
best next step in ACUTEmesenteric ischemia
Angiography
diverticulitis
- first bout are treated edically
- recurrent will need resection
mosty common complication os diverticulitis
abscess
abdominla pain radiates to the back
pancreatitis
aortic dissection
surgery indication for AAA
> 5cm
Aortic Dissection inial best step
stable patient: MRA
unstable: TEE
Aortic disection treatment
ascendin: surgery
descending: b blocker
postoperative fever
1-2d=Wind:atelectasis or postoperative pneumonia
3-4d=water:UTI
5-7d=walking:}DVT or thrombophlebitis of IV lines
7d=wound: wound infection and cellulitis
8-15d=weird:drug fever or deep abscess
postoperative confusion
PE
atelectasia
Pneumonia
supracondilar humeral fracture
bracheal artery damage and median nerver
gastric perforation initial best step
-upright chest x-ray
gastric perforation most acccurate test
CT scan
anterior shoulder dislocation lession assoaciation
axillary artery axillary nerve(flat deltoid,loss sensation on lat arm)
clavicular fracture associated lession
subclavian artery or brachial plexus
scaphoid fracture treatment
thumb spica cast
fat embolism ABG and chast x-ray findings
- ABG- show PO2 under 60 mmHg
- infiltrates on chest-xray
most common type of nosocomial bacteremia
CAUTI
- most accurate test: Urine culture
- long-term prevention: Intermittent catheterization
- CAUTI short-term prevention: Early removal
how to treat CLABSI
treat for S.aureus immediately after blood cultures are obtained
treatment of meconimu illeus
Gastrografin enema
treatment for intussusception
air enema
Both diagnostic and therapeutic.
diagnosis for meckel diverticulum
radioisotope scan
antibiotics for abdominal infecction
Cipro/metronidazole
Levoflox/clinda
Cefoxitin or cefotetan
Ampicillin/sulbactam
