Nir Hus Absite review q5b

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Slides with topics that are covered and were tested in the recent Absite exams.
Nir Hus MD., PhD.
http://www.nirhus.com

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Nir Hus Absite review q5b

  1. 1. Absite topics 13-15 Nir Hus Nir Hus
  2. 2. <ul><li>The Proper time for prophylactic dosing is: </li></ul><ul><li>1 hr. preop </li></ul><ul><li>With induction of anasthesia </li></ul><ul><li>At the time of skin incision </li></ul><ul><li>2 hrs preop </li></ul>Nir Hus
  3. 3. Q13 – Infection rate of wounds Nir Hus
  4. 4. <ul><li>~2% </li></ul><ul><li>3%-5% </li></ul><ul><li>5%-10% </li></ul><ul><li>>30% </li></ul>Nir Hus
  5. 5. Q14 - Drug dose adjust for Hemodialysis for Low Molecular Weight Heparin <ul><li>For Lovenox, no dose adjustment for H.D. </li></ul><ul><li>For CrCl < 30  DVT proph. 30 mg SQ daily not 40. </li></ul><ul><li>Normal halflife 4.5-7 hrs. </li></ul>Nir Hus
  6. 6. Q15 - Staphylococcus epidermis <ul><li>Eradication of Staphylococcus epidermis is difficult to achieve due to: </li></ul><ul><ul><li>Secretion of exotosins </li></ul></ul><ul><ul><li>Production of exoslime </li></ul></ul><ul><ul><li>Release of endotoxin </li></ul></ul><ul><ul><li>Rapid growth rate </li></ul></ul>Nir Hus
  7. 7. Staphylococcus epidermis <ul><li>Staphylococcus epidermis exoslime is a polysaccharide composed of glycosaminoglycans which allows for strong intercellular adhesion between bacterial cells and the formation of biofilms. </li></ul><ul><li>The ability to form biofilms allows S. epidermidis to cause resistant infections particularly when foreign object are present. </li></ul><ul><li>This is due to inability of antibiotics to penetrate the mucopolysaccharide of the biofilm. </li></ul><ul><li>The ica operon has been shown to control the production of “slime”. The ica genes can be tested for as a virulence marker. </li></ul>Nir Hus
  8. 8. Q - Respirator Quotient in sepsis & vent support <ul><li>Respirator Quotient (RQ) is the ratio of VCO 2 (production) to VO 2 (consumption). </li></ul><ul><li>A characteristic RQ exists for each fuel being metabolized. </li></ul><ul><li>Fat: 0.7 </li></ul><ul><li>Protein: 0.8 </li></ul><ul><li>Glucose : 1.0 </li></ul><ul><li>If RQ is greater than 1, strong indicator of overfeeding. </li></ul>Nir Hus

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