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50 Cards in this Set

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  • Back
What does tennis have to do with blood loss?
It describes the classes of blood loss
class 1 - 15%
class 2 - 15-30%
class 3 - 30-40%
class 4 - loss of >40% (game over)
T or F:
Septic shock can be initiated by gram positive, gram negative bacteria or fungal organisms.
True!
What does SIRS stand for? Infection with which type of organism initiates this?
Systemic Inflammatory ResponSe;
Gram negative bacteria (endotoxin; LPS) initiates SIRS
Which of the following is associated with SIRS?
a) infection with a gram positive bacteria
b) infection with a gram negative bacteria
c) local and severe infection
d) multiple organs involved
e) infection enters systemic circulation
b) infection with a gram negative bacteria
c) local and severe infection
d) multiple organs involved
e) infection enters systemic circulation
What commonly binds to the lipid A portion of LPS in systemic circulation? What cell-surface molecule potentiates the expression of this antigen?
HDL or Lipopolysaccharide Binding Proteins (LBPs);
CD14 expresses the antigen
What are clinical signs of endotoxemia?
tachycardia, tachypnea, prolonged CRT, hyperemic mm, muscle fasciculations, fever, decreased GI sounds/colic, changes in mentation
What is usually seen in the CBC in a patient with endotoxemia?
leukopenia, neutropenia, left shift, metabolic acidosis, increased blood lactate
What are some examples of crystalloid fluids?
LRS
Plasmalyte A
Normasol-R
0.9% NaCl
What are the 4 methods of calculating a fluid dose for shock?
1) Estimate % blood loss and administer 4x this volume
2) 90ml/kg for dogs; 55 ml/kg for cats
3) administer 1 circulating blood volume
4) Give 1 ECF volume (daily fluid maintenance) in one hour
What is the "golden period" in wound healing?
4-6 hrs
Choose clean, clean-contaminated, contaminated, or dirty wound...
...splenectomy.
Clean
Choose clean, clean-contaminated, contaminated, or dirty wound...
...lung lobectomy.
Clean-contaminated
Choose clean, clean-contaminated, contaminated, or dirty wound...
...intussecption reduction with spillage of GI contents.
contaminated
Choose clean, clean-contaminated, contaminated, or dirty wound...
...3 day old bite wound
dirty
What are the approximate times before suturing for the following:
Primary closure
Delayed primary closure
Secondary closure
Second intention
Primary closure (immediate)
Delayed primary closure (1-5d)
Secondary closure (>5d)
Second intention (never sutured)
What are the 4 phases of wound healing?
coagulation
inflammation
proliferation
maturation
When does granulation tissue usually appear in wound healing?
by day 3 to 5
Put these cells in the order of inflammatory appearance:
Granulocytes
Lymphocytes
Macrophages
Granulocytes
Macrophages
Lymphocytes
What type of collagen is laid-down first in wound healing?
Collagen III
What are the steps to wound proliferation?
Fibroplasia
Angiogenesis
Epithelization
Contraction
When is the wound the most reliant on sutures for stability?
Days 3-5
What are the two physiologic factors affecting wound healing?
Oxygen
Temperature
(higher levels of both positively influence wound healing)
How does diabetes affect healing response?
decreases chemotaxis and adhesion of neutrophils
T or F:
Corticosteroids are contraindicated in wound healing.
False, one dose at time of wounding has been shown to have no effect on healing rate
What are the three layers used in bandaging?
Contact (Primary) layer
Intermediate (secondary) layer
Outer (tertiary) layer
Choose adherent-absorption, occlusive, or semi-occlusive bandage...
...used for debridement of road rash.
adherent-absorptive
Choose adherent-absorption, occlusive, or semi-occlusive bandage...
...used when granulation tissue is present.
semiocclusive
Choose adherent-absorption, occlusive, or semi-occlusive bandage...
...dry-dry is an example.
adherent-absorptive
Choose adherent-absorption, occlusive, or semi-occlusive bandage...
...stimulates granulation tissue.
adherent-absorptive
Choose adherent-absorption, occlusive, or semi-occlusive bandage...
...increases epithelialization.
occlusive
What is the most common type of bandage?
Robert-Jones (stabilizing or modified)
Which bandage types are non weight-bearing? What is a possible complication with all of these?
i) Velpeau
ii) Carpal flexion
iii) Ehmir
iv) 90/90

All can cause nerve damage
How can limb viability be assessed when a bandage has been put on too tight?
Pinch toes (clamp bone if necessary);
cut toenail and look for bleeding
What is the golden rule for joint stabilization?
Stabilize the joint above and below the affected joint
What should be unbandaged in order to monitor swelling?
Two toes!
How often should bandages be changed?
Every 3 to 7 days
What are emergency situations that a client should look for when monitoring a bandage?
Swelling
Hot/cold extremities
Pain
Soilage, wet
Strike-through
Sudden lameness
How should a bandage be wrapped?
a) distal to proximal
b) proximal to distal
a) distal to proximal
The introduction of organisms into a wound describes
a) infection
b) contamination
c) sepsis
d) dirty wound
b) contamination
The establishment of organisms in a wound and subsequent host reaction describes...
...infection
The presence of bacteria in blood describes
a) sepsis
b) infection
c) bacteremia
d) endotoxemia
c) bacteremia
The presence of sufficient bacteria in the blood causing illness describes
a) sepsis
b) infection
c) bacteremia
d) endotoxemia
a) sepsis
What are the classifications of surgical site infection?
Superficial incisional SSI
Deep incisional SSI
Organ or space SSI
What host factors increase risk of post-op infections?
Immunocompromization
Prior irradiation to surgical site
Older age of the animal (SA) (>8 years)
Distant sites of active infection
Fat or thin animal
What are some pre-surgery factors contributing to increased post-op infection risk?
Clipping b4 anesthetic induction
Inadequate skin prep
Anesthesia duration >1hr
Use of propofol
What is the approximate critical level of contamination before infection occurs?
10^5 organisms/gm tissue
What are some factors DURING surgery that will increase post-op infection risk?
>10^5 organisms/gm tissue
Surgery duration of >90min
Multifilament suture used
Foreign material (implants)
Avascular tissues
T or F:
Antimicrobial prophylaxis is recommended for clean-contaminated, contaminated, and dirty surgeries.
False!
If using antibiotics in dirty surgeries, this is treatment not prophylaxis
When should antibiotic prophylaxis be used in clean surgeries?
When an infection would be catastrophic (eg: hip replacement)
When should prophylactic antibiotics be administered?
Between 30 and 60 minutes before surgery.