外科学总论练习题英文-围手术期

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1、1.Apatientwithanonobstructingcarcinomaofthesigmoidcolonisbeingpreparedforelectiveresection.Tominimizetheriskofpostoperativeinfectiouscomplications,yourplanningshoudincludea.Asinglepreoperativeparenteraldoseofantibioticeffectiveagainstaerobesandanaerobes.b・Avoidanceoforala

2、ntibioticstopreventemergenceofClostridiumdifficile・c.Postoperativeadministrationfor2-4daysofparenteralantibioticseffectiveagainseaerobesandanaerobesd・Postoperativeadministrationfor5-7daysofparenteralantibioticseffetiveagainstaerobesandanaerobese.Operativetimelessthan5h2.A

3、70-year-oldmanwithaorticandmitralvalvularegurgitationundergoesanemergencysigmoidcolectomyandendcolostomyforperforateddivcrticulitis.Hispostoperativecourseiscomplicatedbyamyocardialinfarctionandatrialfibrillation.Fourweekslater,hehasimprovedandrequestselectivecolostomyclos

4、ure.Youwouldrecommenda.Discontinuationofantiarrhythmicandantihypertensivemedicationsonthemorningofsurgeryb.Discontinuationofbeta-blockingmedicationsonthedaypriortosurgeryc・Controlofcongestiveheartfailurewithdiureticsanddigitalisinseverecasesd.Administrationofprophylactica

5、ntibiotics,otherthanampicillinandgentamicin,forpatientswithvalvularheartdiseasewhoareundergoinggastrointestinalprocedurese.Postponementofelectivesurgeryfor6-8wkafterasubendocardialmyocardialinfarction.3.A65-ycar-oldmanundergoesatechnicallydifficultabdominoperinealresectio

6、nforarectalcancerduringwhichhereceivesthreeunitsofpackedredbloodcells,Fourhourslaterintheintensivecareunitheisbleedingheavilyfromhisperinealwound.Emergencycoagulationstudiesrevealnormalprothrombin,partialthromboplastin,andbleedingtimes.Thefibrindegradationproductsarenotel

7、evatedbuttheserumfibrinogencontentisdepressedandtheplateletcountis70,000/Ul.Themostlikelycauseofthebleedingisa.Delayedbloodtransfusionreactionb.Autoimmunefibrinolysisc.Ableedingbloodvesselinthesurgicalfieldd.FactorVIIIdeficiencyc.Hypothermiccoagulopathy4.A78-year-oldmanwi

8、thahistoryofcoronaryarterydiseaseandanasymptomaticreducibleinguinalherniarequestsanelectivehermi