peritonitis

Question 1

T/F

focal contamination of the peritoneum quickly inoculates the entire pertioneum

Answer 1

yes

Question 2

a cranially located source takes __ min to inoculate the peritoneum

Answer 2

19 min

Question 3

a caudally located source takes __ min to inoculate the peritoneum

Answer 3

72min

Question 4

classification of peritonitis

spontaneous inflammation in the absence of intraperitoneal source

Answer 4

primary

Question 5

peritonitis that is usually gram positive and monobacterial

Answer 5

primary

Question 6

peritonitis that is mostly gram negative and polymicrobial

Answer 6

secondary

Question 7

T/F

primary peritonitis is more common than secondary

Answer 7

false – secondary is more common - it is the consequence of an underlying primary disease

Question 8

septic peritonitis

Answer 8

infectious etiologies present

Question 9

T/F

surgery is not routinely indicated for secondary peritonitis but is a requisite for primary

Answer 9

false - opposite!!

must differentiate primary vs secondary

Question 10

Gi origin accounts for what percentage of septic peritonitis

Answer 10

38-75%

Question 11

this drug has the tendency to cause proximal duodenal peritonitis

Answer 11

deramaxx - NSAIDS

Question 12

steroids cause peritonitis in what part of the GI

Answer 12

proximal descending colon

Question 13

T/F

the more aboral the higher the bacterial counts and higher the anaerobes and higher the mortality

Answer 13

TRUE

Question 14

two biggest offenders of septic peritonitis in the bowel

Answer 14

Ecoli - alpha hemolysin tox

bascteriodes fragilus - anaerobe that enhances the lethal potential of ecoli

Question 15

hepatbiliary causes of septic peritonitis

Answer 15

ruptured gall bladder

necrotizing cholecystitis

Question 16

urogenital septic peritonitis

Answer 16

pyometra

Question 17

penetrating trauma that can cause septic peritonitis

Answer 17

bites

Question 18

terminal effects

Answer 18

DIC

sIRS
MODS

Question 19

hyperdynamic shock

Answer 19

vasomotor dysfunction
cytokine induced peripheral vasodilation
tachycardia 
hyperemic mm
rapid CRT 
bounding pulses 
hyperthermia

Question 20

hypodynamic shock

Answer 20

decreased contractility and CO
pale mm and low CRT 
weak peripheral pulses 
high RR and HR 
hypothermia 
dehydrated 
dull mentation

Question 21

classic peritonitis signs

Answer 21

painful
vomiting
fever
distended abdomen and maybe shock

Question 22

T/F

cats are painful on abdominal palpation in septic peritonitis cases

Answer 22

FALSE

Question 23

describe relative bradycardia in cats

Answer 23

< 140 bpm

inappropriately low for a hemodynamic state of cat

Question 24

How long can residual air remain after abdominal surgery

Answer 24

30days

Question 25

preferred dx technique in people

Answer 25

CT

Question 26

gold standard DX for peritonitis

Answer 26

cytology - ultrasound guided aFAST

Question 27

what is seen on cytology

Answer 27

degenerative neutrophils with intracellular bacteria

Question 28

what is the accuracy of cytology

Answer 28

57 - 87 % accurate

Question 29

dogs with septic effusion | the peritoneal fluid glucose conc will always be ____ than the blood glucose concentration

Answer 29

20 points lower

Question 30

the peritoneal fluid lactate will always be ____ than blood lactate

Answer 30

2 points higher

Question 31

diagnostic for uroperitoneum

Answer 31

peritoneal fluid CREA > serum CREA

Question 32

bile peritonitis DX

Answer 32

peritoneal fluid bilirubin will be > 2.5 times the serum bilirubin concentration

Question 33

four quadrant treatment

Answer 33

IV ampicillin baytril metonidazole if aminoglycoside is used instead of baytril be careful because it can potentiate renal failure in patients with poor perfusion

Question 34

lavage surgery with ____

Answer 34

WARM isotonic saline

Question 35

critical aspects of post op care in peritonitis

Answer 35

enteral nutrition -- these animals need feeding tubes drainage po is CRITICAL

Question 36

most efficient way to drain

Answer 36

open

Question 37

peritoneal drain with lower risk of evisceration

Answer 37

closed

Question 38

drain that limits anaerobic growth

Answer 38

open

Question 39

drain that requires a longer hospital stay anf more intensive care

Answer 39

open

Question 40

drain of choice for abdominal drainage

Answer 40

active drain - jackson pratt

Question 41

best type of feeding tube

Answer 41

combo G and J -- gastrojejunostomy

Question 42

prognosis for young stable patient with acute onset

Answer 42

80:20 chance living

Question 43

prognosis for ill patient with unknown source peritonitis

Answer 43

50:50

Question 44

negative risk factors

Answer 44

decreased blood pressure pre, intra, or post op presence of DIC ineffective ABx used