Surgery Specific Care

Question 1

What are some non cardiac thoracic surgeries that would need ICU post op?

Answer 1

Pulmonary resection, pleural disease, diaphragm hernia repair, esophagectomy, chest wall tumor resection

Question 2

What are the typical thoracic surgery patients?

Answer 2

Older, CV cormorbidities, COPD, active smokers

Question 3

Treatment plan for non cardiac thoracic surgery patients; including most common complication

Answer 3

IVF
o2 vs mechanical ventilation
A fib (most common complication): BB or CCB
EKG and Cardiac enzymes
Mobility
Chest physiotherapy

Question 4

What does a new onset a fib post esophagectomy suggest?

Answer 4

Anastomotic leak

Question 5

What suction level is optimal for non-cardiac thoracic chest tubes

Answer 5

-20

Question 6

What CXR result indicates a need to remove a chest tube

Answer 6

Significant pneumothorax or pleural effusion

Question 7

What are the risks of a prolonged air leak in a chest tube

Answer 7

Pneumonia, emphysema, pleurodesis or re-operation repair

Question 8

What are common diagnoses that exist among vascular surgery patients

Answer 8

CAD
Intra op MI
AKI

Question 9

Treatment plan for post op vascular patients

Answer 9

Pain control, hemodynamic monitoring, BB, statin, IVF, blood product, avoid nephrotoxic agents

Question 10

What are the most common organisms in abdominal surgery?

Answer 10

E.Coli and Enterococcus

Question 11

Abdominal surgery managment; including abx, IVF, feeding, and labs

Answer 11

ABX for 7 days (typically rocephin and micafungin)
ISO tonic IVF and blood products
Lactate levels
Enteral nutrition

Question 12

What is a common cause of death amongst liver transplant patients

Answer 12

Infection

Question 13

Liver transplant management

Answer 13

Correct coagulopathies and thrombocytopenia
RE-exploration
Elevated liver enzymes suggest dysfunction
Doppler US for technical surgical errors

Question 14

What is the most common cause of early infection in liver transplant patients

Answer 14

Biliary anastomotic leak

Question 15

Treatment plan for infections in liver transplant patients

Answer 15

Broad spectrum ABX (cover gram pos, neg, fungus, and MRSA)
Percutaneous drain
Re-exploration

Question 16

What is the most common opportunistic infections in liver transplant patients

Answer 16

Pneumocystis and CMV
Bactrim and Ganciclovir

Question 17

When does acute liver transplant rejection occur? S/s? Treatment?

Answer 17

6-8weeks post op
Fatigue, fever, elevated liver enzymes
Prednisone, CAlcineurin inhibitors, and antimetabolites

Question 18

What is Hyper Acute Rejection in liver transplants? S/s? Diagnostics? Treatment?

Answer 18

ABO cross match
Elevated bili, encephalopathy, weakness, thrombocytopenia, coagulopathy, fever, hypotension
Doppler US for portal vein thrombosis and absence of biliary duct obstruction
Re-transplant