Surgery EOR Exam [PAEA
Blueprint]||Newest Exam With over
400 Most Examinable Questions
And Correct Verified
Answers||Already Graded A+
_______is the most important anesthetic complication. Anesthesia causes an
uncontrolled increase in skeletal muscle oxidative metabolism, which overwhelms the
body's capacity to supply oxygen, remove CO2, and regulative body temperature. -
CORRECT ANSWER Malignant hyperthermia
If patient is hyperkalemic (normal range 3.8-5.0), how should you treat the patient? -
CORRECT ANSWER treat with glucose/insulin, and calcium +/-bicarb
_______is the reversing agent for opiods. -CORRECT ANSWER Naloxone
_______is the reversing agent for benzodiazipines. -CORRECT ANSWER Flumazenil
What is the best indicator used to monitor nutritional status? -CORRECT ANSWER
prealbumin - every 2-3 days
Intervention:
_________require central access and indicated when no enteral feeding for > 7 days. -
CORRECT ANSWER TPN - total peripheral nutrition
The _________is the most important part of the history before surgery. -CORRECT
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. -CORRECT ANSWER beta blockers
When accessing cardiac disease prior to surgery, what is the most important thing to
access? -CORRECT 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? -CORRECT ANSWER 1 hour
Abx of choice: cefazolin for all except colorectal then cefazolin/metronidazole
Pre-op -- Metabolic disease/syndrome -- what are the 5 criteria? -CORRECT 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 -CORRECT ANSWER Cocaine
Pre-Op -- What are the indications for EKG and CXR? -CORRECT 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? -CORRECT 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? -CORRECT ANSWER wind/atelectasis
If the post op fever occurs within days 3-5 post op, what is the most likely cause? -
CORRECT 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? -
CORRECT 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. -
CORRECT ANSWER Staph aureus
_______invades the inner ear and enteric tissues as well as the lung. -CORRECT
ANSWER Klebsiella
______organisms are often found together with anaerobes. -CORRECT ANSWER
Enteric organisms ie. enterobacteriaceae and enterococci
Among the anaerobes, ___&___are often present in surgical infections and
_____species are major pathogens in ischemic tissue. -CORRECT ANSWER
Bacteroides & Peptostreptococci; Clostridium
___&___are usually nonpathogenic surface contaminants but may be opportunistic.
Some fungi and yeast cause abscesses in sinus tracts. -CORRECT ANSWER
Pseudomonas & Serratia
,History of recent surgery, trauma, cancer, prolonged immobilization, or oral
contraceptive use increases the risk of ____. -CORRECT ANSWER DVT - deep vein
thrombosis
What is Homan's sign? -CORRECT ANSWER pain on passive dorsiflexion of ankle
What is the test of choice for DVT? -CORRECT ANSWER doppler ultrasound
How is the D-dimer text useful? -CORRECT ANSWER It is good at ruling a DVT out (if
the text is negative) but not rule it in
Tx of DVT --
1. Initiate use of ____or____to what dose?
2. Overlap with the use of ____to what therapeutic range?
3. Why overlap therapies? -CORRECT ANSWER DVT
1. Initiate Heparin to PTT of 0.3-0.7 U/mL or LMWH wo monitoring.
2. Overlap with warfarin to INR between 2-3.
3. Overlap therapies to decrease changes of hypercoagulable state.
The most common cause of SIRS (systemic inflammatory response syndrome) is
sepsis. What are the criteria for dx of SIRS? -CORRECT ANSWER At least 2 of the
following:
1. temp >38C or <36C
2. tachy >90
3. tachypnea > 20 breaths/minute
4. PCO2 <32mmHg
5. WBC > 12,000/uL or <4000/uL
After sepsis, what are the next two most common causes of SIRS? -CORRECT
ANSWER pancreatitis and drugs
What is the difference between hypovolemia and dehydration? -CORRECT ANSWER
hypovolemia is loss of both water and sodium while dehydration is loss of intracellular
water or deficit with hypernatremia -- dehydration occurs when patient can not adjust
water intake for water loss
What are the clinical signs of dehydration and hypovolemia? -CORRECT ANSWER
tachycardia, hypotension, pale skin, increased capillary refill time, dizziness, faintness,
nausea, thirst, decreased urine output -- in hypovolemia, urine will demonstrate low
sodium concentration
What are 2 common conditions with dehydration? -CORRECT ANSWER diabetes
insipidus (lack of ADH or unable to respond to ADH), fever with increased water loss
Hyponatremia Causes
, _______ = cirrhosis, CHF, nephrotic syndrome, massive edema
_______=states of severe pain or nausea, trauma, brain damage, SIADH
_______=prolonged vomiting, decreased oral intake, severe diarrhea, diuretic use
Misc causes = factitious hyponatremia, hypothyroidism, adrenal insufficiency,
malnourished states, primary polydipsia -CORRECT ANSWER Hypervolemic,
Euvolemic, Hypovolemic
What are the two most common treatments for hyponatremia?
Other less common treatment? -CORRECT ANSWER salt tabs and fluid restriction;
vasopressin receptor antagonist in SIADH, CHF, and cirrhosis
Hypernatremia is almost always due to _______. Therefore, what is the treatment? -
CORRECT ANSWER dehydration; rehydrate!
What s/s can result in a hyperkalemic patient? -CORRECT ANSWER cardiac
arrhythmias (tall peaked T waves) and weakness
If the potassium level is above 6meq/L or the patient has EKG changes, what
treatments can lower K temporarily? -CORRECT ANSWER calcium gluconate, sodium
bicarbonate, insulin and glucose, kayexalate (takes longer to be effective)
______&______ is extremely effective in decreasing potassium. -CORRECT ANSWER
Dialysis and furosemide
Hypokalemia is usually due to ________, hypomagnesemia, alkalosis, high aldosterone
levels. How is it treated? -CORRECT ANSWER potassium loss; replacement must be
slow!!!
Mild loss: oral KCl supplements or K containing foods
Severe loss: IV supplementation - rate 10mEg/hr
Causes of ________are VITAMIN D METABOLIC DISORDERS, abnormal PTH
function, primary hyperparathyroidism, Lithium, malignancy, disorders related to high
bone turnover rates (hyperthyroidism, prolonged immobilization, thiazide use, vit A
intoxication, Pagets dz of bone, multiple myeloma), renal failure -CORRECT ANSWER
hypercalcemia
How should hypercalcemia be treated? -CORRECT ANSWER fluid and diuretics,
bisphosphonates, and calcitonin
_______is usually caused by ineffective PTH (chronic renal failure, absent active vit D,
ineffective active vit D, pseudohypoparathyroidism), deficient PTH. -CORRECT
ANSWER Hypocalcemia
How should hypocalcemia be treated? -CORRECT ANSWER intravenous calcium
gluconate, Tums
Blueprint]||Newest Exam With over
400 Most Examinable Questions
And Correct Verified
Answers||Already Graded A+
_______is the most important anesthetic complication. Anesthesia causes an
uncontrolled increase in skeletal muscle oxidative metabolism, which overwhelms the
body's capacity to supply oxygen, remove CO2, and regulative body temperature. -
CORRECT ANSWER Malignant hyperthermia
If patient is hyperkalemic (normal range 3.8-5.0), how should you treat the patient? -
CORRECT ANSWER treat with glucose/insulin, and calcium +/-bicarb
_______is the reversing agent for opiods. -CORRECT ANSWER Naloxone
_______is the reversing agent for benzodiazipines. -CORRECT ANSWER Flumazenil
What is the best indicator used to monitor nutritional status? -CORRECT ANSWER
prealbumin - every 2-3 days
Intervention:
_________require central access and indicated when no enteral feeding for > 7 days. -
CORRECT ANSWER TPN - total peripheral nutrition
The _________is the most important part of the history before surgery. -CORRECT
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. -CORRECT ANSWER beta blockers
When accessing cardiac disease prior to surgery, what is the most important thing to
access? -CORRECT 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? -CORRECT ANSWER 1 hour
Abx of choice: cefazolin for all except colorectal then cefazolin/metronidazole
Pre-op -- Metabolic disease/syndrome -- what are the 5 criteria? -CORRECT 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 -CORRECT ANSWER Cocaine
Pre-Op -- What are the indications for EKG and CXR? -CORRECT 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? -CORRECT 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? -CORRECT ANSWER wind/atelectasis
If the post op fever occurs within days 3-5 post op, what is the most likely cause? -
CORRECT 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? -
CORRECT 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. -
CORRECT ANSWER Staph aureus
_______invades the inner ear and enteric tissues as well as the lung. -CORRECT
ANSWER Klebsiella
______organisms are often found together with anaerobes. -CORRECT ANSWER
Enteric organisms ie. enterobacteriaceae and enterococci
Among the anaerobes, ___&___are often present in surgical infections and
_____species are major pathogens in ischemic tissue. -CORRECT ANSWER
Bacteroides & Peptostreptococci; Clostridium
___&___are usually nonpathogenic surface contaminants but may be opportunistic.
Some fungi and yeast cause abscesses in sinus tracts. -CORRECT ANSWER
Pseudomonas & Serratia
,History of recent surgery, trauma, cancer, prolonged immobilization, or oral
contraceptive use increases the risk of ____. -CORRECT ANSWER DVT - deep vein
thrombosis
What is Homan's sign? -CORRECT ANSWER pain on passive dorsiflexion of ankle
What is the test of choice for DVT? -CORRECT ANSWER doppler ultrasound
How is the D-dimer text useful? -CORRECT ANSWER It is good at ruling a DVT out (if
the text is negative) but not rule it in
Tx of DVT --
1. Initiate use of ____or____to what dose?
2. Overlap with the use of ____to what therapeutic range?
3. Why overlap therapies? -CORRECT ANSWER DVT
1. Initiate Heparin to PTT of 0.3-0.7 U/mL or LMWH wo monitoring.
2. Overlap with warfarin to INR between 2-3.
3. Overlap therapies to decrease changes of hypercoagulable state.
The most common cause of SIRS (systemic inflammatory response syndrome) is
sepsis. What are the criteria for dx of SIRS? -CORRECT ANSWER At least 2 of the
following:
1. temp >38C or <36C
2. tachy >90
3. tachypnea > 20 breaths/minute
4. PCO2 <32mmHg
5. WBC > 12,000/uL or <4000/uL
After sepsis, what are the next two most common causes of SIRS? -CORRECT
ANSWER pancreatitis and drugs
What is the difference between hypovolemia and dehydration? -CORRECT ANSWER
hypovolemia is loss of both water and sodium while dehydration is loss of intracellular
water or deficit with hypernatremia -- dehydration occurs when patient can not adjust
water intake for water loss
What are the clinical signs of dehydration and hypovolemia? -CORRECT ANSWER
tachycardia, hypotension, pale skin, increased capillary refill time, dizziness, faintness,
nausea, thirst, decreased urine output -- in hypovolemia, urine will demonstrate low
sodium concentration
What are 2 common conditions with dehydration? -CORRECT ANSWER diabetes
insipidus (lack of ADH or unable to respond to ADH), fever with increased water loss
Hyponatremia Causes
, _______ = cirrhosis, CHF, nephrotic syndrome, massive edema
_______=states of severe pain or nausea, trauma, brain damage, SIADH
_______=prolonged vomiting, decreased oral intake, severe diarrhea, diuretic use
Misc causes = factitious hyponatremia, hypothyroidism, adrenal insufficiency,
malnourished states, primary polydipsia -CORRECT ANSWER Hypervolemic,
Euvolemic, Hypovolemic
What are the two most common treatments for hyponatremia?
Other less common treatment? -CORRECT ANSWER salt tabs and fluid restriction;
vasopressin receptor antagonist in SIADH, CHF, and cirrhosis
Hypernatremia is almost always due to _______. Therefore, what is the treatment? -
CORRECT ANSWER dehydration; rehydrate!
What s/s can result in a hyperkalemic patient? -CORRECT ANSWER cardiac
arrhythmias (tall peaked T waves) and weakness
If the potassium level is above 6meq/L or the patient has EKG changes, what
treatments can lower K temporarily? -CORRECT ANSWER calcium gluconate, sodium
bicarbonate, insulin and glucose, kayexalate (takes longer to be effective)
______&______ is extremely effective in decreasing potassium. -CORRECT ANSWER
Dialysis and furosemide
Hypokalemia is usually due to ________, hypomagnesemia, alkalosis, high aldosterone
levels. How is it treated? -CORRECT ANSWER potassium loss; replacement must be
slow!!!
Mild loss: oral KCl supplements or K containing foods
Severe loss: IV supplementation - rate 10mEg/hr
Causes of ________are VITAMIN D METABOLIC DISORDERS, abnormal PTH
function, primary hyperparathyroidism, Lithium, malignancy, disorders related to high
bone turnover rates (hyperthyroidism, prolonged immobilization, thiazide use, vit A
intoxication, Pagets dz of bone, multiple myeloma), renal failure -CORRECT ANSWER
hypercalcemia
How should hypercalcemia be treated? -CORRECT ANSWER fluid and diuretics,
bisphosphonates, and calcitonin
_______is usually caused by ineffective PTH (chronic renal failure, absent active vit D,
ineffective active vit D, pseudohypoparathyroidism), deficient PTH. -CORRECT
ANSWER Hypocalcemia
How should hypocalcemia be treated? -CORRECT ANSWER intravenous calcium
gluconate, Tums
