SurgeryProcedure.info

EXTRA-CREDIT QUESTIONS 25. Should all patients undergoing elective laparotomy receive prophylactic antibiotic coverage? Show answer No. Doing so would contribute to driving up the cost of antibiotics and their complication rate and devaluing...

MANAGEMENT OF SURGICAL INFECTIONS 21. What is the drug of choice for the treatment of an abscess? Show answer A knife. Surgically drain the abscess. Abscesses have no circulation of blood within them to deliver an antibiotic. The antibiotic,...

PROPHYLAXIS 17. Should systemic antibiotic prophylaxis be used in elective colon resection? Show answer Yes, beyond any statistical shadow of a doubt. At least two dozen clinical trials have been carried out using placebo controls against a...

ANTIBIOTICS 11. Are antibiotics the classic wonder drugs? Show answer Only because you wonder if they are going to work, if they are going to cause more harm than good, and if the next generation will be unaffordable or toxic. Skepticism is...

15 SURGICAL INFECTIOUS DISEASE Glenn W. Geelhoed M.D., M.P.H., DTMH 1. Have modern antibiotic developments controlled many, if not most, of the problems of surgical infection? Show answer No. In seriously ill surgical patients in intensive...

SURGICAL TREATMENT 22. If the patient is sick (and not getting better), what should be done? Show answer After fluid resuscitation, the patient's abdomen should be explored. An exploratory laparotomy has been touted as the logical conclusion...

LABORATORY STUDIES 15. How is a complete blood count helpful? Show answer 1. Hematocrit. If the hematocrit is high (> 45%), the patient is most likely dry or may have chronic obstructive pulmonary disease. If it is low (< 30%), the patient probably...

PHYSICAL EXAMINATION 7. Are vital signs important? Show answer Yes. They are vital. If heart rate and blood pressure are on the wrong side of 100 (heart rate > 100 beats/min, systolic blood pressure < 100 mmHg), watch out! Tachypnea...

14 PRIORITIES IN EVALUATION OF THE ACUTE ABDOMEN Alden H. Harken M.D. 1. What is the surgeon's responsibility when confronted by a patient with an acute abdomen? Show answer 1. To identify how sick the patient is 2. To...

13 SURGICAL WOUND INFECTION Steven L. Peterson D.V.M., M.D. 1. Why should we worry about surgical wound infection? Show answer Approximately 30 million patients undergo surgery each year in the United States, and 20% of these patients...

12 CENTRAL VENOUS AND PULMONARY ARTERY PRESSURE MONITORING Dipin Gupta M.D., Glenn J.R. Whitman M.D., Alden H. Harken M.D. 1. What does a catheter in the central venous circulation measure? Show answer All intrathoracic veins have nearly...

EXTRA-CREDIT QUESTIONS 22. Four hours after your patient undergoes an exploratory laparotomy following a motor vehicle accident, the nurse reports that the patient's vital signs, urine output, and oxygen transport numbers are normal. Can the...

11 OXYGEN MONITORING AND ASSESSMENT James B. Haenel R.R.T., Jeffrey L. Johnson M.D. 1. How does a pulse oximeter work? Show answer Light-absorption characteristics differ for the four most common circulating species of hemoglobin in...

10 WHAT DOES POSTOPERATIVE FEVER MEAN? Alden H. Harken M.D. 1. What is a fever? Show answer Normal core temperature varies between 36°C and 38°C. Because we hibernate a little at night, we are cool (36°C) just before rising in the morning;...

CONTROVERSIES 20. Does preoperative TPN enhance surgical outcome? Show answer It is well documented that malnourished patients are at an increased risk for septic complications, problems with wound healing, longer hospital stays, and...