SURGERY EOR EXAM PAEA BLUEPRINT FULL
SOLUTION STUDY GUIDE
◉ If patient is hyperkalemic (normal range 3.8-5.0), how should you
treat the patient?
Answer: treat with glucose/insulin, and calcium +/-bicarb
◉ _______is the reversing agent for opiods.
Answer: Naloxone
◉ _______is the reversing agent for benzodiazipines.
Answer: Flumazenil
◉ What is the best indicator used to monitor nutritional status?
Answer: prealbumin - every 2-3 days
◉ Intervention:
_________require central access and indicated when no enteral feeding
for > 7 days.
Answer: TPN - total peripheral nutrition
,◉ The _________is the most important part of the history before
surgery.
Answer: cardiac history -- history of MI, unstable angina, valvular
disease
◉ In patients with known cardiac disease, aggressive intraoperative
lowering of myocardial oxygen demand with ____ has been shown in
RCT's to improve outcomes and should be used.
Answer: beta blockers
◉ When accessing cardiac disease prior to surgery, what is the most
important thing to access?
Answer: aortic stenosis -- crescendo diastolic rumble at apex
◉ Guidelines for the use of antibiotics include administration within
_______ of surgery and redosing after 4 hours. What is the abx of
choice?
Answer: 1 hour
Abx of choice: cefazolin for all except colorectal then
cefazolin/metronidazole
◉ Pre-op -- Metabolic disease/syndrome -- what are the 5 criteria?
Answer: 3/5 to diagnose:
1 - diabetes
,2 - central obesity
3 - HTN
4 - high serum triglycerrides
5 - low HDL levels
◉ ______should be monitored before surgery bc it is a stimulant and
vasoconstrictor -- can lead to severe tachycardia
Answer: Cocaine
◉ Pre-Op -- What are the indications for EKG and CXR?
Answer: EKG - men >40, women>50, known CAD, DM, or HTN
CXR - age >50, known cardiac or pulmonary disease
◉ What are the 5 classic "W's" of post operative fever?
Answer: W - wind (atelectasis)
W - water (UTI)
W - wound (wound infection)
W - walking (DVT/thrombophlebitis)
W - wonder drugs (drug fever)
◉ If the post op fever occurs within the first 24 hours of surgery,
what is the most likely cause?
, Answer: wind/atelectasis
◉ If the post op fever occurs within days 3-5 post op, what is the
most likely cause?
Answer: water/UTI, catheter related phlebitis, pneumonia
◉ If the post op fever occurs within days 5-10 post op, what is the
most likely cause?
Answer: wound infection, pneumonia, abscess, infected hematoma, C
diff colitis, anastomotic leak, DVT, peritoneal abscess, drug fever, PE,
parotitis
◉ _______is the most common pathogen in wound infections and
around foreign bodies.
Answer: Staph aureus
◉ _______invades the inner ear and enteric tissues as well as the lung.
Answer: Klebsiella
◉ ______organisms are often found together with anaerobes.
Answer: Enteric organisms ie. enterobacteriaceae and enterococci
SOLUTION STUDY GUIDE
◉ If patient is hyperkalemic (normal range 3.8-5.0), how should you
treat the patient?
Answer: treat with glucose/insulin, and calcium +/-bicarb
◉ _______is the reversing agent for opiods.
Answer: Naloxone
◉ _______is the reversing agent for benzodiazipines.
Answer: Flumazenil
◉ What is the best indicator used to monitor nutritional status?
Answer: prealbumin - every 2-3 days
◉ Intervention:
_________require central access and indicated when no enteral feeding
for > 7 days.
Answer: TPN - total peripheral nutrition
,◉ The _________is the most important part of the history before
surgery.
Answer: cardiac history -- history of MI, unstable angina, valvular
disease
◉ In patients with known cardiac disease, aggressive intraoperative
lowering of myocardial oxygen demand with ____ has been shown in
RCT's to improve outcomes and should be used.
Answer: beta blockers
◉ When accessing cardiac disease prior to surgery, what is the most
important thing to access?
Answer: aortic stenosis -- crescendo diastolic rumble at apex
◉ Guidelines for the use of antibiotics include administration within
_______ of surgery and redosing after 4 hours. What is the abx of
choice?
Answer: 1 hour
Abx of choice: cefazolin for all except colorectal then
cefazolin/metronidazole
◉ Pre-op -- Metabolic disease/syndrome -- what are the 5 criteria?
Answer: 3/5 to diagnose:
1 - diabetes
,2 - central obesity
3 - HTN
4 - high serum triglycerrides
5 - low HDL levels
◉ ______should be monitored before surgery bc it is a stimulant and
vasoconstrictor -- can lead to severe tachycardia
Answer: Cocaine
◉ Pre-Op -- What are the indications for EKG and CXR?
Answer: EKG - men >40, women>50, known CAD, DM, or HTN
CXR - age >50, known cardiac or pulmonary disease
◉ What are the 5 classic "W's" of post operative fever?
Answer: W - wind (atelectasis)
W - water (UTI)
W - wound (wound infection)
W - walking (DVT/thrombophlebitis)
W - wonder drugs (drug fever)
◉ If the post op fever occurs within the first 24 hours of surgery,
what is the most likely cause?
, Answer: wind/atelectasis
◉ If the post op fever occurs within days 3-5 post op, what is the
most likely cause?
Answer: water/UTI, catheter related phlebitis, pneumonia
◉ If the post op fever occurs within days 5-10 post op, what is the
most likely cause?
Answer: wound infection, pneumonia, abscess, infected hematoma, C
diff colitis, anastomotic leak, DVT, peritoneal abscess, drug fever, PE,
parotitis
◉ _______is the most common pathogen in wound infections and
around foreign bodies.
Answer: Staph aureus
◉ _______invades the inner ear and enteric tissues as well as the lung.
Answer: Klebsiella
◉ ______organisms are often found together with anaerobes.
Answer: Enteric organisms ie. enterobacteriaceae and enterococci
