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Post-Op Pyrexia Flashcards

(29 cards)

1
Q

What is considered to be early post-op pyrexia?

A

0-5days post-op

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2
Q

What are the causes of early post-op pyrexia?

A
Blood transfusion 
Physiological 
Pulmonary atelecasis
Infection
Drug reaction
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3
Q

Give an example of a physiological cause of post-op pyrexia?

A

SIRS from trauma

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4
Q

When does pyrexia caused by SIRS from trauma occur?

A

0-1 days

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5
Q

When does pyrexia caused by pulmonary atelectasis occur?

A

24-48 hours

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6
Q

What infections can cause early post-op pyrexia?

A

UTI
Superficial thrombophlebitis
Cellulitis

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7
Q

What is considered to be delayed post-op pyrexia?

A

> 5 days post-op

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8
Q

What are the causes of delayed post-op pyrexia?

A
Pneumonia
VTE
Wound infection
Anastomotic leak
Collection
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9
Q

When does pyrexia caused by VTE occur?

A

5-10 days post-op

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10
Q

When does pyrexia caused by wound infection occur?

A

5-7 days post-op

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11
Q

When does pyrexia caused by anastomotic leak occur?

A

7 days post-op

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12
Q

When does pyrexia caused by collection occur?

A

5-20 days post-op

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13
Q

What should be examined in a post-op febrile patient?

A
Observation chart, notes, and drug chart
Wound
Abdo + DRE
Legs
Chest
Lines
Urine
Stool
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14
Q

What investigations should be done in post-op febrile patient?

A

Urine dip and MCS
Blood
Wound swab cultures
CXR

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15
Q

What blood tests should be done in a post-op febrile patient?

A

FBC
CRP
Cultures
LFTs in some cases

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16
Q

What can cause post-op pneumonia?

A

Atelectasis due to anaesthesia and pain causing reduced cough
Immunosuppression due to surgery

17
Q

How is post-op pneumonia managed>

A

Chest physio to encourage coughing
Good analgesia
Abx

18
Q

How does a collection present?

A

Malaise
Swinging fever and rigors
Localised peritonitis
Shoulder tip pain if subphrenic

19
Q

Where might collections be located?

A
Pelvic
Subphrenic
Paracolic gutters
Lesser sac
Hepatorenal recess
Small bowel
20
Q

When do pelvic collections present?

A

4-10 days post op

21
Q

When do suphrenic collection present?

A

7-21 days post op

22
Q

What is the hepatorenal recess also known as?

A

Morrison’s space

23
Q

Where in the small bowel can collections develop?

A

Interloop spaces

24
Q

How might suspected collections be investigated?

A

FBC, CRP, and cultures
Ultrasound and CT
Diagnostic laparoscopy

25
How is post-op collections managed?
Abx | Drainage or washout
26
What is cellulitis?
An acute infection of the subcutaneous connective tissue
27
What causes cellulitis post-operatively?
ß-haemolytic streps | Staph aureus
28
How does cellulitis present?
Pain, swelling, erythema, and warmth Systemic upset May have lymphadenopathy
29
How is cellulitis managed?
Benpen IV or pen V and fluclox PO