Surgery-ID

Question 1

Timeline of cause of postoperative fever (Immediate)

0-2hrs (3listed)

Answer 1

• Prior trauma/infection
• blood products
• malignant hyperthermia

Question 2

Timeline of cause of postoperative fever (acute)

24hr-1 wk (3 listed)

Answer 2

• Nosocomial infection
• Surgical site infection (group A streptococcus or Clostridium perfringens
• noninfectious (MI, PE, DVT)

Question 3

Timeline of cause of postoperative fever (subacute)

1wk-1month (4 listed)

Answer 3

• Surgical site infection/ Catheter Site infection
• C-diff
• Drug fever
• PE/DVT

Question 4

Timeline of cause of postoperative fever (delayed)

>1 month (2 listed)

Answer 4

• Viral infections

- indolent organisms

Question 5

Intense pain in the wound, decreased sensitivity at the edges of the wound, cloudy-gray discharge, crepitus. NSIM

Answer 5

Early surgical exploration-debridement & parenteral antibiotics

Question 6

Erythema and swelling, sever pain out of proportion to the physical examination and sign of tissue necrosis (crepitus, purulent drainage, or gas in the deep tissues), fever & hyptension. Dx? NSIM?

Answer 6

• Necrotizing fasciitis

- Surgical debridement and broad-spectrum abx

Question 7

Define postoperative fever

Answer 7

> 38c or 100.4F, after surgery, infectious or non-infections causes

Question 8

The most frequent cause of nosocomial bloodstream infection in pt with intravascular devices

Answer 8

Coagulase-negative staphylococci (eg. Stap Epidermidis)

Question 9

Prosthetic joint infection early onset (<3months), presentation? and organisms?

Answer 9

• Acute pain, would infection/breakdown, fever

- Staph aureus, Gram neg rods, Anaerobes

Question 10

Prosthetic joint infection delayed onset (3-12 months), presentation? and organisms?

Answer 10

• Chronic joint pain, implant loosening, Sinus tract formation
• Coagulase-neg staphylococci, Propionibacterium species, Enterococci

Question 11

Prosthetic joint infection Late onset (>12 months), presentation? and organisms?

Answer 11

• Acute symptoms in previously asymptomatic joint, recent infection at distant site
• Staph aureus, Gram-neg rods, Beta-hemolytic strep

Question 12

Painful swelling of the parotid gland that is aggravated by chewing after surgery. Dx? Tx?

Answer 12

Acute bacterial parotitis; prevention with adequate fluid hydration and oral hygiene

Question 13

Common infectious agent for acute bacterial parotitis

Answer 13

Staph aureus