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Gastrointestinal > wk 8 6 Surgery and Complications > Flashcards

wk 8 6 Surgery and Complications Flashcards

1
Q

3 likely carvdiovascular complications postop

A

haemorrhage
MI
DVT

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2
Q

haemorrhage can be classified as reactionary or secondary, outline each

A

reactionary - immediately postop

secondary - infection (5-10d)

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3
Q

how does a haemorrhage present 4

A

overt
tachycardia
hypotension
oliguria (low urine output)

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4
Q

3 ways a haemorrhage can be prevented

A

perfect technique
sepsis advoidance
correction of coagulation disorders

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5
Q

2 things which increase risk of MI

A

severe angina

previous MI

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6
Q

how does MI postop present 3

A

often silent
cardiac failure / cardiogenic shock
arrhytmias

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7
Q

2 things which help prevent MI postop

A

avoidance of perioperative hypotensioin

correction of ischaemic heart disease

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8
Q

5 factors which increase DVT postop

A 
age >40
previous DVT
majory surgery
Obesity
Malignancy
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9
Q

immobility and ______ during surgery cause DVT

A

hypercoagulable state

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10
Q

DVT postop presentation

A 
Low grade fever (5-14d) 
unilateral ankle swelling 
Calf/thigh tenderness
Incr leg diameter
Shiny skin
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11
Q

3 ways DVT should be investigated

A

D-dimer test
Doppler Ultrasound
Venography

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12
Q

3 ways DVT can be prevented postop

A

compression stockings
Low-dose subcutaneous heparin
Early mobilisation

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13
Q

3 respiratory complications postop

A

Atelectasis (complete/partial lung collapse)
Pneumonia
PE

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14
Q

The collapse of lung tissue in atelectasis or pneumonia can be due to anesthesia, postop pain or aspiration, outline each

A

anesthesia - incr secretion and inhibits cilia
postop pain - inhibits coughing
aspiration - stomach contents

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15
Q

5 ways a chest infection could present

A 
low grade fever (0-2d) 
high grade fever (4-10d) 
Dyspnoea
Productive cough
Confusion
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16
Q

3 ways chest infections could be prevented postop

A

stopping smoking
adequate analgesia
physiotherapy

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17
Q

5 ways PE risk is increased postop

A 
Age >40 
previous PE 
major surgery 
obesity
malignancy
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18
Q

cause of PE

A

DVT

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19
Q

presentation of postop PE 6

A 
tachypnoea 
Dyspnoea
Confusion
Pleuritic pain 
Haemoptysis
Cardiopulmonary arrest
20
Q

investigations for postop PE

A

abnormal V/Q scan

CT pulmonary angiogram

21
Q

PE prevention 4

A

compression stockings (comes from DVT)
low-dose subcutaneous heparin
early mobilisation
Anticoagulation in presence of DVT

22
Q

3 GI postop problems

A

Ileus (peristalstic paralysis)
Anastomotic dehiscence (colorectal resection bursting at stitches)
Adhesions

23
Q

6 ways an ileus could occur postop

A 
handling of bowel 
peritonitis
retroperitoneal injury
immobilisation 
hypokalaemia 
drugs
24
Q

ileus postop presentation 4

A

vomiting
ab distension
dehydration
silent abdomen

25
Q

3 ways an ileus can be prevented

A

minimal operative trauma
laparoscopy
avoidance of intra-abdominal sepsis

26
Q

anastomotic dehiscence is the breakdown of anastomosis, what 3 areas could this occur at

A

intestinal
vascular
urological

27
Q

3 causes of anastomotic dehiscence

A

poor technique
poor blood supply
tension of anastomosis

28
Q

outline how anastomotic dehiscence could be presented if intestinal, vascular or urological

A

intestinal

  • peritoneal
  • abscess
  • ileus
  • fistula

vascular
- bleeding/ haematoma

urological
- leakage of urine / urinoma

29
Q

3 ways anastomotic dehiscence could be prevented

A

good technique
good blood supply
no tension

30
Q

what is adhesions in operation

A

fibrin develops, leading to fibrous tissue

31
Q

outline 3 possible adhesions

A

bowel - bowel
bowel - ab wall/other structures
lung - chest wall

32
Q

2 ways adhesions occur

A

inflammatory response

ischaemia

33
Q

t/f adhesions to chest wall are asymptomatic

A

true

34
Q

4 key things to loook out for in intestinal obstructio n

A

vomiting
pain
distension
constipation

35
Q

4 ways adhesions can be prevented

A

no powder on gloves
avoidance of infection
laparoscopic surgery
sodium hyaluronidate (natural tissue lube)

36
Q

3 wound complications

A

infection
dehiscence
hernia

37
Q

wound infection can be either exogenous or endogenous, explain each

A

exogenous - trauma

endogenous - intestinal surgery

38
Q

presentation of wound infection 5

A 
pyrexia (5-8d) 
redness 
pain
swelling
dischargw
39
Q

5 ways wound infections can be prevented

A

pre-op preparation
skin cleansing
aseptic technique
avoidance of contamination prophylactic antibiotics

40
Q

4 complications in urinary

A

acute urinary retention
UTI
urethral stricture
acute renal failure

41
Q

3 neurological complications postop

A

confusion
stroke
peripheral nerve lesions (ulnar/radial/sciatic/common peroneal nerves)

42
Q

how can confusion occur 7

A 
hypoxia (Chest infection/PE/MI)
oversedation 
sepsis
electrolyte imbalance
stroke
hyper/hypoglycaemia
alcohol/transquiliser withdrawal
43
Q

3 ways confusion can present

A

disorientation
paranoia
hallucinations

44
Q

4 ways confusion can be prevented

A

maintain oxygenation
avoid dehydration
avoid sepsis
send home asap

45
Q

what should be avoided pre-op

A

no prolonged fasting
selective bowel preparation
no premedication

46
Q

what should be avoided peri-op

A

salt and water overload changes in body temp
drains
long acting anaesthetic agents

47
Q

postop should avoid

A 
salt and water overload 
NG tube 
Catheters staying in for long 
delay in nutrition 
immobilisation

Gastrointestinal (73 decks)

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