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UT Houston Morning Report: April 20th - MHH - Fever in the MICU
This is not a common cause, but should be considered when other workup is non-revealing. You should, however consider drug fever in a patient that has relative bradycardia in relation to the temperature!!! Especially consider this with the ... There is some "controversy" that atelectasis actually causes fever. Some believe that the post-operative state, which causes atelectasis, is the actual cause of fever. Still, this is up for debate... Alcholol Withdrawal and Delerium ...
Surgical Pearls: Ahhh Crap! My Patient has Post Operative Fever!
Obviously your management work up depends upon the cause of your post op fever. The work up for a PE is obviously different than draining a collection of pus. Both should be considered if your patient is not responding to your current ...
medical science 2007 mains question paper « Xmnotes's Blog
Describe the steps of emergency tracheostomy and its post-operative management. (c) What are the risks associated with termination of pregnancy? (d) Describe briefly the prevention of nutritional blindness in a community. ... (c) A 14 years old boy presents with a painful swelling on the left side of the neck with fever for 2 weeks. Discuss the differential diagnosis and investigative workup. Outline the management of tuberculosis lymphadenitis. (20) ...
What Does Postoperative Fever Mean?
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; after revving our engines all day, we are hot at night (38°C). A fever is a pathologic state reflecting a systemic inflammatory process. The core temperature is > 38°C but rarely > 40°C.
Queries 2
Surgical Infectious Disease. Extra Credit Questions
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 formerly good drugs by rendering them useless against common flora against which they were once highly potent. Operating room nurses have always classified the kind of operation by its status with respect to microbial exposure: clean, contaminated, or septic. These categories are approximation of the microbial risk exposure, and if additionally are superimposed categories of patient resistance (higher risk associated with aging, obesity or other malnutrition, concomitant drugs, or viral or mycobacterial or neoplastic disease immune compromise), these same strata are called class I, II, and III.
Bladder Cancer
96 BLADDER CANCER
Brett B. Abernathy M.D.
1. How common is bladder cancer?
Show answer
Approximately 54,300 new cases of bladder cancer were diagnosed in 2001 in the United States, and 12,400 patients died. The male-to-female ratio is almost 3:1.
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mesh rejection symptoms,Mitral Stenosis
75 MITRAL STENOSIS
David A. Fullerton M.D., Glenn J.R. Whitman M.D.
1. What causes mitral stenosis?
Show answer
Rheumatic fever.
2. Which gender most commonly gets mitral stenosis?
Show answer
Women by a ratio of 3:2.
3. What are the physical findings of mitral stenosis?
Show answer
On ascultation, an opening snap and a diastolic murmer are heard best at the apex.
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Properties In Evaluation Of The Acute Abdomen. Physical Exam
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 (respiratory rate >16) reflects either pain or systemic acidosis. Fever may develop late, particularly in the immunosuppressed patient who may be afebrile in the face of florid peritonitis.
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Thoracic Surgery For Non-Neoplastic Disease. Tuberculosis
TUBERCULOSIS
1. What are the clinical manifestations of pulmonary tuberculosis?
Show answer
They can be almost anything or nothing (it has been stated that if you know tuberculosis, you know all of medicine), but the most common symptoms and signs are chronic fever; weight loss; night sweats; and cough, sometimes with hemoptysis. Chest radiograph typically shows upper lobe infiltrates, with or without cavitation, and can be misdiagnosed as a neoplastic process. HIV-positive or immunocompromised patients usually have mediastinal adenopathy, pleural effusions, and a miliary pattern.
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mdr tb surgery, mdrtb surgical, whats neoplastic surgery,Fluids, Electrolytes, Gatorade & Seat
7 FLUIDS, ELECTROLYTES, GATORADE, AND SWEAT
Alden H. Harken M.D.
1. What is hypertonic saline?
Show answer
Normal saline is 0.9% sodium chloride. Hypertonic saline is 7.5% sodium chloride (eight times as concentrated as normal saline).
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Incoming search terms
, albumin lasix sandwich, gatorade chloride electrolyte content, gatorade meq, gatorade sodium meq, how many meq of sodium does gatorade have per liter, how many meq of sodium in gatorade, how many milliequivalents of potassium in gatorade, how much meq potassium in gatorade, how to make 7 5 % sodium chloride meq, meq of sodium in gatorade, meq potassium gatorade, milliequivalents of potassium in gatorade, 25% albumin fluid interstitial space, albumine gatorade, aldosterone lasix albumin sandwich, cation electrolyte gatorade, chloride in gatorade, chloride in gatorade meq, concentration of normal saline and gatorade, electrolytes gatorade, electrolytes gatoraid and heart rate, furosemide and gatorade, gatorade and meq, gatorade and urine output, gatorade chloride content, gatorade electrolyte content, gatorade electrolyte content meq, gatorade hypertonic, gatorade meq sodium,Liver Transplantation
89 LIVER TRANSPLANTATION
Thomas E. Bak M.D., Michael E. Wachs M.D., Igal Kam M.D.
1. When and where was the first liver transplant performed?
Show answer
Dr. Thomas Starzl performed the first operation on March 1, 1963, at the University of Colorado in Denver.
2. Is liver transplantation considered a safe and effective operation?
Show answer
Yes. Although still a major operation with significant risks, patient and graft survival have continuously improved. One-year survival should be well over 90% in major centers.
3. What are the most common indications for liver transplantation in the United States?
Gastroesophageal Reflux Disease. Controversies
CONTROVERSIES
15. Is GERD better treated in the long term by PPI therapy or Nissen fundoplication?
Show answer
PPIs really work in resolving esophagitis and eliminating symptoms of GERD, but the long-term side effects are not fully known. Fundoplication potentially frees the patient from daily medicine (this has been challenged recently) and may cause morbidity in ≤ 10% of patients.
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Abdominal Aortic Aneurysm
71 ABDOMINAL AORTIC ANEURYSM
Mark Nehler M.D., William C. Krupski M.D.
1. What is an abdominal aortic aneurysm (AAA)?
Show answer
A ≥ 50% increase in normal aortic diameter. Normal infrarenal aortic diameter is 2.0 cm for men. A definition of AAA as an aorta ≥ 3.0 cm in diameter is appropriate.
2. What is the incidence of AAA?
Solitary Pulmonary Nodule
80 SOLITARY PULMONARY NODULE
Jamie M. Brown M.D., Marvin Pomerantz M.D.
1. What is a solitary pulmonary nodule?
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A solitary pulmonary nodule or “coin lesion” is < 3 cm and is discrete on chest radiograph. It is usually surrounded by lung parenchyma.
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should an infectious solitary pulmonary nodule be removed,Parental Nutrition. Cotroversies
CONTROVERSIES
20. Does preoperative TPN enhance surgical outcome?
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It is well documented that malnourished patients are at an increased risk for septic complications, problems with wound healing, longer hospital stays, and increased mortality. However, nutritional status may be a reflection of the severity of disease. Results of studies evaluating preoperative TPN and outcome are variable. Preoperative TPN may decrease the rate of postoperative complications, but not mortality, in moderately malnourished patients with GI cancers. When malnourished GI cancer patients were fed high-kilocalorie TPN only after surgery, complication rates increased. Perioperative enteral nutrition may lower postoperative complications in patients with a variety of cancers. Provision of immune-enhancing diets, when adequately tolerated, may decrease complications and reduce length of hospital stays after surgical resection of upper GI cancer. In elderly, underweight women with hip fractures, supplemental enteral feedings increase functional status, reduce complications, and decrease length of stay. After major abdominal surgery, early enteral nutrition reduces complications, especially wound infection. Further research is needed in homogenous patient populations using current level of feeding practice and glycemic control in order to determine the impact on outcome of perioperative nutritional support.
Anorectal Disease. Anorectal Abscess & Fistula In Ano
ANORECTAL ABSCESS AND FISTULA IN ANO
5. What is the most common cause of anorectal abscess?
Show answer
Ninety percent result from cryptoglandular infection.
6. What are the four potential anorectal spaces used to classify anorectal abscesses?
Show answer
1. Perianal (area of the anal verge)
2. Ischiorectal (area lateral to the external sphincter muscles, extending from the levator ani muscles to the perineum)
3. Intersphincteric (area between the internal and external sphincter muscles, continuous inferiorly with the perianal space and superiorly with the rectal wall)
4. Supralevator (area superior to the levator ani muscles, inferior to the peritoneum, and lateral to the rectal wall)
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, anorectal disease, purpose of a seton for a fistula in ano,Renal Cell Carcinoma
95 RENAL CELL CARCINOMA
Brett B. Abernathy M.D.
1. How common is renal cell carcinoma?
Show answer
In the United States, 30,000 new cases of renal cell carcinoma are predicted for 2004 and 2005, about 3% of all adult malignancies.
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Abernathy’s Surgical Secrets, Updated Edition (Book w / Student Consult)
Author / s: Harken Alden H., Abernathy Charles, Moore Ernest Eugene
Year: 2004
Pages: 473
Publishers: Elsevier Mosby; 5th Bk & Acc edition
ISBN: 0323034160
