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Absite topics 13-15

Nir Hus



      Nir Hus
     The Proper time for prophylactic dosing
      is:
A.    1 hr. preop
B.    With induction of anasthesia
C.    At the time of skin incision
D.    2 hrs preop


                       Nir Hus
Q13 – Infection rate of wounds




              Nir Hus
~2%

          3%-5%

          5%-10%

           >30%

Nir Hus
Q14 - Drug dose adjust for
Hemodialysis for Low Molecular
Weight Heparin
  For Lovenox, no dose adjustment for H.D.
  For CrCl < 30  DVT proph. 30 mg SQ
   daily not 40.
  Normal halflife 4.5-7 hrs.




                    Nir Hus
Q15 - Staphylococcus epidermis

     Eradication of Staphylococcus epidermis
      is difficult to achieve due to:
     A.    Secretion of exotosins
     B.    Production of exoslime
     C.    Release of endotoxin
     D.    Rapid growth rate



                            Nir Hus
Staphylococcus epidermis
    Staphylococcus epidermis exoslime is a polysaccharide
     composed of glycosaminoglycans which allows for
     strong intercellular adhesion between bacterial cells and
     the formation of biofilms.
    The ability to form biofilms allows S. epidermidis to
     cause resistant infections particularly when foreign object
     are present.
    This is due to inability of antibiotics to penetrate the
     mucopolysaccharide of the biofilm.
    The ica operon has been shown to control the production
     of slime . The ica genes can be tested for as a
     virulence marker.
                               Nir Hus
Q - Respirator Quotient in sepsis
& vent support
    Respirator Quotient (RQ) is the ratio of VCO2
     (production) to VO2 (consumption).
    A characteristic RQ exists for each fuel being
     metabolized.
    Fat: 0.7
    Protein: 0.8
    Glucose : 1.0
    If RQ is greater than 1, strong indicator of
     overfeeding.
                          Nir Hus

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Nir Hus Absite review q5b

  • 2.   The Proper time for prophylactic dosing is: A.  1 hr. preop B.  With induction of anasthesia C.  At the time of skin incision D.  2 hrs preop Nir Hus
  • 3. Q13 – Infection rate of wounds Nir Hus
  • 4. ~2% 3%-5% 5%-10% >30% Nir Hus
  • 5. Q14 - Drug dose adjust for Hemodialysis for Low Molecular Weight Heparin   For Lovenox, no dose adjustment for H.D.   For CrCl < 30  DVT proph. 30 mg SQ daily not 40.   Normal halflife 4.5-7 hrs. Nir Hus
  • 6. Q15 - Staphylococcus epidermis   Eradication of Staphylococcus epidermis is difficult to achieve due to: A.  Secretion of exotosins B.  Production of exoslime C.  Release of endotoxin D.  Rapid growth rate Nir Hus
  • 7. Staphylococcus epidermis   Staphylococcus epidermis exoslime is a polysaccharide composed of glycosaminoglycans which allows for strong intercellular adhesion between bacterial cells and the formation of biofilms.   The ability to form biofilms allows S. epidermidis to cause resistant infections particularly when foreign object are present.   This is due to inability of antibiotics to penetrate the mucopolysaccharide of the biofilm.   The ica operon has been shown to control the production of slime . The ica genes can be tested for as a virulence marker. Nir Hus
  • 8. Q - Respirator Quotient in sepsis & vent support   Respirator Quotient (RQ) is the ratio of VCO2 (production) to VO2 (consumption).   A characteristic RQ exists for each fuel being metabolized.   Fat: 0.7   Protein: 0.8   Glucose : 1.0   If RQ is greater than 1, strong indicator of overfeeding. Nir Hus