Perioperative Risk & Postoperative Problems
This postoperative gastrointestinal complication occurs in about 25% of patients after abdominal surgery and is characterized by temporary loss of bowel motility without a mechanical obstruction.
What is ileus (paralytic ileus)?
This is the only coagulation factor that is not produced by the liver.
What is Factor 8?
This is the appropriate initial treatment for a patient with peaked T waves on ECG and K 6.5.
What is calcium gluconate?
This part of the nephron is considered the "workhorse" because it is where amino acids, glusoe, sodium, water, and bicarbonate are reabsorbed.
What is the proximal convoluted tubule?
This is the correct management for a grade IV splenic injury in a trauma patient.
What is a splenectomy?
These three components make up the classic Virchow triad that predisposes surgical patients to deep vein thrombosis.
What are vessel wall damage, venous stasis, and hypercoagulability?
This is the platelet goal prior to performing a central line placement.
What is 20,000 platelets?
These electrolyte changes would be expected in a patient with refeeding syndrome.
What are low phosphate, low potassium, and low magnesium?
This acid-base disorder commonly occurs after persistent vomiting
What is hypochloremic, hypokalemic metabolic alkalosis?
This is the appropriate timeline for next colonoscopy in a patient who was found to have a tubulovillous polyp.
What is 3 years?
A patient who can perform activities requiring at least this many metabolic equivalents (METs) is generally considered fit for surgery.
What is 4 METs?
The TRICC trial demonstrated that this is an appropriate threshold to transfuse blood in critically ill patients (as long as they are not having an acute MI).
What is Hb 7?
When working up hyperkalemia, this lab value would demosntrate tumor lysis syndrome.
What is uric acid-lactate dehydrogenase?
In hemorrhagic shock, this laboratory marker, along with base deficit, is commonly used to assess tissue hypoperfusion and guide resuscitation.
What is lactic acid?
This is the appropriate management for a patient with 1.2mm deep melanoma.
Excision with 1-2cm margin and SLNB.
This perioperative cardiac risk assessment tool estimates the risk of cardiac complications after noncardiac surgery using factors such as cardiovascular disease, renal dysfunction, and insulin dependence
What is the Revised Cardiac Risk Index (RCRI)?
This is the indicated medication for a LY30 >3% on TEG.
What is tranexamic acid?
This electrolyte abnormality can cause difficulty with weaning from the ventilator
What is hypophosphatemia?
This formula calculates a patient's free water deficit
What is ([Na]/140 – 1) × TBW
This is the standard of treatment for inflammatory breast cancer.
What is modified radical mastectomy (mastectomy with level I & II axillary dissection)?
100 Bonus points:
-neoadjuvant chemotherapy
-adjuvant XRT for all patients with IBC
This enhanced perioperative care program combines interventions such as prehabilitation, multimodal pain control, early feeding, and early ambulation, reducing complications by about 30%.
What is Enhanced Recovery After Surgery (ERAS)?
These are the contents of PCC.
What are factors II, IX, and X (3-factor PCC), or, II, VII, IX, and X (4-factor PCC)?
These are the physical exam signs of hypocalcemia.
What are Chvostek sign (facial twitching with tapping the facial nerve) and Trousseau sign (carpopedal spasm when inflating BP cuff)?
This endocrine disorder results in hyponatremia, decreased serum osmolality, and increased urine osmolality.
What is syndrome of inappropriate antidiuretic hormone secretion (SIADH)?
This is the most common surgical incision for a patient undergoing esophageal atresia repair.
What is a right thoracotomy?