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discussion: in 1952 king and schumaker suggested that children who had undergone splenectomy were at risk for the development of bacterial infections, and the syndrome of overwhelming postsplenectomy sepsis (opss) was suggested by ...
just write what i want: Soal pediatric lainnya
Penyakit yg sering ditemukan pd bayi premature. SSGN; Perdarahan otak; Hiperbilirubinemia; Pneumonia aspirasi; Smua bnr. Ikterus yang timbul setelah 3 hari lahir, biasanya disebabkan oleh. Fisiologis; Sepsis; Hepatitis; Obstruksi; Smua bnr. Yang dimaksud dg dismatur .... Melangkah ke fasa baru - Opss..saja je tayang buku..tengah nak seru mood belajar nih..haha..Cuti ni langsung tak sentuh buku. Dasar pemalas. Sila jangan contohi saya. Apapun, kena... 18 jam yang lalu ...
I did it my way
londonspirit I am still waiting for your response to my debate on the forums ( I've been waiting for 5 days ). If you don't respond my tomorrow night ( US time ), I am taking it down and you can forgot about debating me. ...
Queries 2
Splenic Trauma
26 SPLENIC TRAUMA
David J. Ciesla M.D., Ernest E. Moore M.D.
1. What is the physiologic role of the spleen?
Show answer
In fetal development, the spleen serves as a major site for hematopoiesis. In early childhood the spleen produces immunoglobulin M (IgM) and tuftsin. The spleen also functions as a filter, allowing resident macrophages to remove abnormal red blood cells (RBCs), cellular debris, and encapsulated and poorly opsonized bacteria.
Surgical Infectious Disease. Management Of Surgical Infections
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, even if injected directly into the abscess, would be worthless because the abscess contains a soup of dead microorganisms and white blood cells (WBCs). Even if the organisms were barely alive, they would not be reproducing and incorporating the antibiotic. The drug most likely would not work at all at the pH and pKa conditions of the abscess environment.
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Incoming search terms
where there is pus let there be steel, where there is pus let there be steel?, is pus infectious, surgical infectious disease, what does where there is puss let there be steel mean, when there is pus let there be steel, where there is pus there must be steel, where there is puss let there be steel,Nutritional Assessment & Enteral Nutrition. Controversies
CONTROVERSIES
23. How fat is fat?
Show answer
Lean body mass is three times more metabolically active than adipose tissue. Multiple definitions of clinical obesity exist: > 120% ideal body weight (IBW), > 130% IBW, body mass index (BMI) > 30, body fat > 24-28% of body weight in men and > 30-35% in women. Measured weight is a poor indicator of relative adiposity. Self-reported weights or weights reported by family members are often erroneous in the ICU setting. Fluid resuscitation and edema make visual assessment challenging and limit the usefulness of noninvasive technology such as bioelectrical impedance (BIA) for measuring body composition. Although measured energy expenditure in kcal/kg of actual weight may sometimes approach that of normal-weight patients, feeding at the measured body weight level may be associated with profound hyperglycemia, hypercapnea, and the inability to clear triglycerides.
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.
Thoracic Surgery For Non-Neoplastic Disease. Empyema
EMPYEMA
10. What is an empyema, and what causes it?
Show answer
An empyema is a purulent (infected) effusion. Fluid or blood in the pleural space can be directly innoculated (with bugs) during surgery or trauma (33%) or by contamination from contiguous sites (50%) such as bronchopulmonary infection (most common). Most empyemas are parapneumonic, and the most commonly involved organisms are Staphylococcus aureus, enteric gram-negative bacilli, and anaerobes. Many times, infections are polymicrobial. Often there is no growth of an empyema culture because of effective antibiotic therapy or inadequate culture techniques, particularly with anaerobes.
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Central Venous & Pulmonary Artery Pressure Monitoring
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 the same pressure. A catheter in the central venous circulation (anywhere) measures this central venous pressure (CVP) (or right atrial pressure). CVP, plus a little right atrial “kick,” pushes blood into the right ventricle. This right ventricular “filling pressure” is also termed preload.
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Incoming search terms
pulmonary artery catheter central venous pressure and saturation, wedging svo2,Parental Nutrition
9 PARENTERAL NUTRITION
Margaret M. McQuiggan M.S., R.D., CNSD, Frederick A. Moore M.D.
1. What is parenteral nutrition?
Show answer
Parenteral nutrition is the provision of protein as amino acids (4 kcal/g), dextrose (3.4 kcal/g), and fat (lipid 20% solution delivers 2 kcal/mL), vitamins, minerals, trace elements, fluid, and sometimes insulin through an intravenous (IV) infusion. Acid-base status may be influenced by the amount of chloride and acetate used in providing sodium and potassium. The concentrations of calcium and phosphorus are limited to avoid precipitation of a calcium phosphate salt.
Surgical Infectious Disease
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 care unit (ICU) settings, the problems of sepsis have increased and remain among the principal causes of death in ICU patients, especially those with multiple organ failure and impairments of host defense. Antibiotic treatment may change the biographical sketch of the flora associated with patients’ deaths but cannot overcome the multiple causes of failing host resistance to infection that accompany barrier breeches to microbial invasion and the inflammatory and immunologic responses to the “usual suspects.”
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How to Think About Shock?
4 HOW TO THINK ABOUT SHOCK
Alden H. Harken M.D.
1. Define shock. Show answer
Shock is:
* Not just low blood pressure
* Not just decreased peripheral perfusion
* Not just limited systemic oxygen delivery
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Nutritional Assessment & Enteral Nutrition. Nutritional Assessment
8 NUTRITIONAL ASSESSMENT AND ENTERAL NUTRITION
Margaret M. McQuiggan M.S., R.D., CNSD, Frederick A. Moore M.D.
NUTRITIONAL ASSESSMENT
1. What does a nutritional assessment include? Show answer
Incoming search terms
chilocalorie diprivan,Esophageal Cancer
44 ESOPHAGEAL CANCER
Casey M. Calkins M.D.
1. What are the risk factors for developing esophageal cancer?
Show answer
Both alcohol and tobacco increase the risk of carcinoma of the esophagus by a factor of 10. Additional risk factors include Barrett’s esophagus with dysplasia, carcinogen exposures (e.g., nitrosamines in the Eastern world), vitamin and trace element deficiencies, and Plummer-Vinson syndrome.
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Incoming search terms
r-zero resection, r zero resection, r0 resection definition, esophageal cancer untreated, untreated esophageal cancer, 0, 10% 5-year survival rate esophageal cancer, adenocarcinoma esophageal cancer iv a survival rates, cancer of esophagus stage 2 survival rate, chemoradiotherapy for stage 1 esophageal cancer, ct scan of the chest show the esophagus, define 5 year survival rate esophageal cancer, empyema ivor lewis, esophageal adenocarcinoma surgery recovery, esophageal cancer and supraclavicular, esophageal cancer sepsis, esophageal cancer surgery medline, four stages of esophageal cancer describe, gross- esophageal carcinoma, lewis esophagus technique, most common presenting symptoms of esophageal cancer, nodule with a localized distribution upper third esophagus, nodule \localized distribution\ esophagus, oesophegus cancer stage 2 survival rates, r1 r0 r2 resection definition esophageal cancer, recovery from surgery of esophageal and celiac lymph nodes, stage 1 esophageal cancer, stage 3 esophageal cancer survival rate, stage iv esophageal cancer five year survival, stage-2 survival rateadenocarcinoma,Acute Pancreatitis
40 ACUTE PANCREATITIS
Clay Cothren M.D., Jon M. Burch M.D.
1. What are the common causes of acute pancreatitis?
Show answer
Gallstones (45%), alcohol (35%), and other (20%).
2. What are the uncommon causes?
Show answer
Hyperlipidemia, hypercalcemia (hyperparathyroidism, multiple myeloma), iatrogenic factors (endoscopic retrograde cholangiopancreatography), drugs (didanosine, thiazide diuretics, H2 blockers, tetracycline, azathioprine), infections (mumps, coxsackievirus), pancreas divisum, and scorpion bites (favorite pimp question on rounds). Approximately 10% of cases are considered truly idiopathic.
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Incoming search terms
isolated elevation of lipase,Facial Lacerations
33 FACIAL LACERATIONS
Lawrence L. Ketch M.D.
1. What distinguishes facial from other lacerations?
Show answer
Appearance is clearly of primary importance. Quality of the final result depends on strict adherence to basic principles of wound management and painstaking technique. Copious irrigation, judicious debridement, gentle tissue handling, meticulous hemostasis, and minimization of sutures combined with early stitch removal are critical to an optimal result. Fine suture and sharp instruments should be used; eversion of the wound margin with layered closure, obliteration of dead space, and lack of tension are mandatory.
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35 BURNS
Paulus C. Bauling MBChB, M.Med., FACS
1. Why is it essential to have sound clinical knowledge of urgent and emergent burn care?
Show answer
The events of September 11, 2001, have vividly underlined the fact that wars, plane crashes, nuclear and industrial accidents, and many other potential disasters can produce large numbers of burn-injured victims in an instant
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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
