Surgery

Question 1

What is one common serious complication of parenteral nutrition (given through central venous catheter)?

Answer 1

bloodstream infection (bacterial or fungal) is a serious complication of parenteral nutrition

Question 2

how is superficial wound dehiscence (skin and subcutaneous tissue; fascia intact) managed?

Answer 2

conservatively with regular dressing changes

Question 3

how is a deep (fascial) wound dehiscence managed?

Answer 3

emergency surgery

Question 4

person falls or has trauma with rapid deceleration. Signs and sx include: upper extremity HTN, lower extremity hypotension, and/or hoarse voice. What is the most common injury associated with this?

Answer 4

blunt thoracic aortic injury

Question 5

how do you confirm diagnosis of blunt thoracic aortic injury/

Answer 5

CT angiogram of the chest

Question 6

someones finger is amputated. how do you transport it to the hospital?

Answer 6

wrap with saline moistened gauze in a plastic bag immersed in ice water

Question 7

best form of nutrition in critically ill patients (even if intubated)

Answer 7

enteral nutrition, initiate early w/in 48 hours

Question 8

what labs will be lelevated in acute mesenteric ischemia?

Answer 8

leukocytosis, elevated hemoglobin, elevated amylase, metabolic acidosis

Question 9

when should you. do exploratory laparotomy in a trauma?

Answer 9

1. hemodynamioc instability
2. peritonitis
3. evisceration (externally exposed intestines)

Question 10

first step in management of a perforated peptic ulcer (especially with hypotension)

Answer 10

1. fluid resuscitation
2. then surgery