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Absite topics 13-15

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A. B. C. D.

The Proper time for prophylactic dosing is: 1 hr. preop With induction of anasthesia At the time of skin incision 2 hrs preop

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Q13 Infection rate of wounds

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~2% 3%-5% 5%-10% >30%


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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.

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Q15 - Staphylococcus epidermis

Eradication of Staphylococcus epidermis is difficult to achieve due to:


A. B. C. D.

Secretion of exotosins Production of exoslime Release of endotoxin Rapid growth rate

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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.
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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.
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