Surgery

Question 1

Syndrome when inadequate amount of circulating cortisol and aldosterone

Answer 1

Adrenal Insufficiency

Question 2

CRH acts on?

Answer 2

ACTH

Question 3

ACTH acts on?

Answer 3

Zona Fasiculata of Adrenal Glands

Question 4

Major Glucocorticoid?

Answer 4

Cortisol

Question 5

Nutritional Formulas:

Fat Content increase to 50% and reduction of carbohydrates

Answer 5

Pulmonary Failure Formula

• reduce Co2 production alleviate ventillation burden

Question 6

Nutritional Formulas:

Essential AA, lower Ng, Phos, Mg, high non protein calorie, nitrogen ratio 150:1, no vitamins and elements

Answer 6

Renal Failure Formulas

Question 7

Nutritional Formulas:

50% of protein - branched chain AA ( valine, leucine, isoleucine)

Answer 7

Hepatic Failure Formulas

Question 8

best Resuscitate fluid?

Answer 8

Lactate Ringer’s Solution

Question 9

Clotting Factor common to both extrinsic and intrinsic

Answer 9

Factor 10

Question 10

1. Vascular Phase ( Vasoconstriction)
2. Platelet Phase ( Platelet aggregation)
3. Coagulation Phase (Clot Formation)
4. Fibrinolysis ( Clot Retraction & Clot Destruction)

Answer 10

4 major physiologic events of hemostasis

Question 11

1. Failure of production - impaired bone marrow function
2. Decrease survival of platelet
3. Sequestration

Answer 11

Quantitative Disorder of Platelets

Question 12

1. Massive Transfusion
2. Therapeutic platelet inhibitors
3. Disease state ( Myeloproliferative disorders, Monoclonal gammopathies, Liver dse)

Answer 12

Qualitative Disease of Platelets

Question 13

Warfarin: extrinsic pathway

Answer 13

Prothrombin time

Question 14

Heparin: Intrinsic pathway

Answer 14

Partial thromboplastin time

Question 15

Treatment for PT

Answer 15

Vitamin K and FFP

Question 16

Treatment for PTT

Answer 16

Protamine Sulfate

Question 17

Aspirin/NSAIDs: Platelet Disorder

Answer 17

Bleeding Time

Question 18

Factor Xa inhibitor

Answer 18

Rivaroxaban, Apixaban

Question 19

Antidote of Rivaroxaban and Apixaban

Answer 19

Andexanet

Question 20

Indirect Factor Xa inhibitor and Antithrombin III increase

Answer 20

Fondaparinux

Question 21

Indirect Thrombin (IIa) Inhibitors which increase Antithrombin III

Answer 21

Heparin, LMWH

Question 22

Direct Thrombin Inhibitors ( Factor IIa)

Answer 22

Argatroban, Dabigatran, Bivalirubin

Question 23

Argatroban, Dabigatran, Bivalirubin Antidote

Answer 23

Idarucizumab

Question 24

Leading cause of transfusion related deaths

Answer 24

Transfusion-related acute lung injury

Question 25

Type of Shock: Pericardial Tamponade? (Obstructive, Cardiogenic, Vasodilatory)

Answer 25

Obstructive

Question 26

Type of shock: Pulmonary embolus (Obstructive, Cardiogenic, Vasodilatory)

Answer 26

Obstructive

Question 27

Type of Shock: Tension pneumothorax (Obstructive, Cardiogenic, Vasodilatory)

Answer 27

Obstructive

Question 28

Type of shock Systemic Response to infection (Obstructive, Cardiogenic, Vasodilatory)

Answer 28

Vasodilatory

Question 29

Type of Shock Pancreatitis (Obstructive, Cardiogenic, Vasodilatory)

Answer 29

Vasodilatory

Question 30

Type of Shock Anaphylaxis (Obstructive, Cardiogenic, Vasodilatory)

Answer 30

Vasodilatory

Question 31

Type of Shock Burns (Obstructive, Cardiogenic, Vasodilatory/ Vasogenic)

Answer 31

Vasodilatory

Question 32

Cool moist skin | Obstructive, Cardiogenic, Vasodilatory

Answer 32

Cardiogenic shock

Question 33

Increase cardiac output | Obstructive, Cardiogenic, Vasodilatory

Answer 33

Septic shock - Vasodilatory

Question 34

Inflammatory mediators of shock: IL - 4, IL - 10, IL - 13, PGE2, TGF beta “IL - 10”

Answer 34

Anti-Inflammatory

Question 35

Inflammatory mediators of shock: ``` IL - 1 alpha, beta IL - 2 IL - 6 IL - 8 Interferon Tumor Necrosis Factor (TNF) Platelet Activating Factor (PAF) ```

Answer 35

Proinflammatory *causes fever

Question 36

Body Temp: >38 or <36 Heart Rate: >90 bpm Tachypnea: >20 cpm or PaCO2 <32 mmHg WBC: >12,000/mm3 or <4,000/mm3 or >10% immature neutrophils

Answer 36

Inclusion criteria of Systemic Inflammatory Response Syndrome *with focus of infection - SEPSIS

Question 37

Surgical Site Infection Skin and Subcutaneous

Answer 37

Superficial SSI

Question 38

Surgical Site Infection Skin, Subcutaneous, Deep soft tissue (fascia and muscle)

Answer 38

Deep Incisional SSI

Question 39

Surgical Site Infection Skin, Subcutaneous, Deep soft tissue (fascia and muscle) and Organ/Space

Answer 39

Organ/Space SSI * need to explore

Question 40

Site for Needle Thoracostomy

Answer 40

2nd ICS MCL Gauge 16 needle

Question 41

Site for Tube Thoracostomy

Answer 41

5th ICS AAL