Surgical Infections Flashcards
Hypothermia: is
Hypothermia: is immunosuppressive and affects cardiovascular performance adversely.
T/F: hypothermia is immunosuppressive.
True.
Hypothermia can occur during ___ surgery from evaporative losses.
This can occur if there are evaporative losses during intracavitary (abdominal) surgery.
T/F: *Administration of supplemental oxygen reduces the risk of SSI after elective surgery.
True
Resuscitation is
resuscitation of the immune system is a persistent inflammatory response after injury associated with increased risk of nosocomial infection and death.
blood transfusions: transfusions express immunosuppression through altered leukocyte antigen presentation and increased TH2 cells. Blood transfusions are an example of:
resuscitation
T/F: transfusions increase the risk of infection five fold and the risk for surgical patients is ten fold.
False
Which of the following regarding resuscitation is TRUE?
(1) transfusions do not increase the risk for infection or resuscitation.
(2) Resuscitation is seen with central line and ventilator associated pneumonia.
(3) Transfusions can be given if not necessarily indicated.
(1) Resuscitation is seen with central line and ventilator associated pneumonia.
Moderate hyperglycemia (> 200 mg/dL) at any time on the first post-operative day increases the risk of SSI
Moderate hyperglycemia (> 200 mg/dL) at any time on the first post-operative day increases the risk of SSI FOUR- FOLD after cardiac and non-cardiac surgery.
The target blood glucose control for pre-op patients is:
140 - 180 mg/dL.
The amount of calories and nitrogen required for post-op patients:
Calories and nitrogen in excess of 25 – 30 kcal and 1 g nitrogen/kg/day is required. In burn patients, this number can be 1.5 – 2 times higher.
T/F: Endogenous flora: is the source of most bacterial pathogens.
True
Which of the following regarding surgical site infections (SSIs) is TRUE?
(1) the prevalence of SSIs in the USA is < 5% for emergency colon surgeries and > 20% for clean surgeries.
(2) SSI is not a common nosocomial infection in surgery patients.
(3) Incisional infections are the most common type of SSIs.
(4) The onset is 30 days after a procedure that has involved implantation of a foreign material.
(3) Incisional infections are the most common type of SSIs.
The most common pathogen of SSIs is:
(1) staph aureus
(2) staph coagulase negative
(3) enterococcus
(1) staph aureus
The most common pathogen of SSIs in contaminated procedures are:
e. coli and enterobacteriaceae
T/F: If you are planning for a remote and clean operation (e.g., subcutaneous mass on the foot) and a patient presents with UTI or cellulitis elsewhere, these organisms can develop an SSI at the incision site.
True
Bacterial factors: wound infection is inevitable if the bacterial inoculum is sufficiently large ( *** organisms frequently causes infection; if there is LESS Than this amount, there is usually not an infection).
10^5 organisms frequently causes infection; if there is less than this amount, there is usually not an infection.
Which group of organisms produces biofilms, causing inhibition of phagocytosis (a bacterial factor of SSIs)?
(1) klebsiella, strep pneumoniae, coagulase negative staph
(2) clostridia and strep
(1) Klebsiella, strep pneumoniae, coagulase negative staph
Which group of organisms produces endotoxins and exotoxins, contributing to SSIs?
(1) Klebsiella, strep pneumoniae, coagulase negative staph
(2) clostridia and strep
(2) clostridia and strep
You do a surgery on a patient; when you are finished, you primarily close the incision site with sutures. The surgery was not done in the alimentary, genital or urinary tract. This type of wound is considered:
Clean wound
You do a hysterectomy on a patient under controlled conditions and without contamination. This type of wound is considered:
clean-contaminated.
You are doing a colectomy procedure and accidentally perforate the bowels. This wound is considered:
Contaminated
A patient experienced perforation of the large intestine in a blunt trauma injury. The area healed. When undergoing an unrelated surgery, the area appears infected. This type of wound is:
dirty.
Intraoperative measures to prevent SSIs should include:
(1) use monofilament sutures whenever possible.
(2) if there is a risk for wound infection, use secondary healing.
(3) flaps do not have to be adequately perfused.
(1) use monofilament sutures whenever possible.
Which of the following is TRUE?
(1) Give an antibiotic an HOUR before an incision (except for ciprofloxacin and vancomycin).
(2) studies have shown that the pre-op medication is less important than discontinuing antibiotics within 24 hours.
(1) Give an antibiotic an HOUR before an incision (except for ciprofloxacin and vancomycin).
Hip and knee surgeries use:
(1) cephalosporin or vancomycin if the patient has penicillin allergies.
(2) neomycin
(3) erythromycin
Hip and knee surgeries use cephalosporin or vancomycin if the patient has penicillin allergies.
Antibiotics used to decontaminate wounds:
(1) cephalosporins
(2) vancomycin
(3) neomycin and erythromycin
(3) neomycin and erythromycin
the surgical team scrubs their hands and forearms for AT LEAST __ MINUTES for the first time in the day and for __ minutes every consecutive time.
the surgical team scrubs their hands and forearms for AT LEAST 5 MINUTES for the first time in the day and for 3 minutes every consecutive time.