Chapter VIII. POSTOPERATIVE PERIOD

1. The catabolic stage of the postoperative period is characterised by:

1. Activation of the sympathetic nervous system and adrenals.

2. Hyperglycaemia.

3. Increase in protein degradation.

4. Increase in pulmonary vital capacity.

5. Decrease in urinary output.

Choose the right combination of answers:

A. 1, 2, 3. B. 2, 3, 4, 5. C. 1, 3, 5. D. 1, 2, 3, 5. E. 1, 2, 3, 4, 5.

2. The reverse stage of the postoperative period without complications is characterised by:

1. Duration of 2 to 3 days.

2. Duration of 4 to 6 days.

3. Positive nitrogen balance.

4. Decreased activity of the sympathetic nervous system and adrenals.

5. Restoration of GI tract activity.

Choose the right combination of answers:

A. 1, 3, 5. B. 2, 3, 5. C. 2, 5. D. 1, 4, 5. E. 2, 3, 4, 5.

3. Which of the following clinical findings suggest grave deterioration of the patient:

1. Pulse rate above 120/minute.

2. Fall in blood pressure to as low as 80 mm Hg.

3. Respiratory rate 20/minute.

4. Perspiration.

5. Gaseous abdominal distension with absence of flatus for 24 hours.

Choose the right combination of answers:

A. 1, 2, 3. B. 2, 3, 4. C. 1, 3, 4. D. 1, 3, 5. E. 1, 2, 4.

4. A weight to press on the wound after the operation is applied to:

A. Prevent wound dehiscence.

B. Relieve pain.

C. Prevent infection.

D. Prevent thrombosis and embolism.

E. Prevent bleeding.

Choose the correct answer.

5. Non-specific prevention of postoperative thromboem-bolism includes which of the following measures:

1. Strict bed rest.

2. Application of elastic bandage on the lower limbs.

3. Active patient's motion in bed.

4. Short bed-ridden period.

5. Use of anticoagulants.

Choose the right combination of answers:

A. 1, 2, 3. B. 2, 3, 4, 5. C. 2, 3, 4. D. 3, 4, 5. E. 1, 2, 5.

6. Therapeutic measures in postoperative urinary retention are as follows:

1. Warming the bladder area.

2. Hypertonic enema.

3. 10 ml urotropin 40%.

4. Diuretics.

5. Bladder catheterization.

Choose the right combination of answers:

A. 1, 2, 3. B. 1, 2, 3, 4. C. 1, 2, 3, 5. D. 1, 3, 5. E. 1, 2, 3, 4, 5.

7. To prevent postoperative pneumonia, the following should be used:

1. Respiratory gymnastics.

2. Anaesthetics.

3. Vigorous hydration.

4. Proserine.

5. Cupping glass and mustard plaster on the chest.

Choose the right combination of answers:

A. 1, 2, 3. B. 1, 2, 4. C. 1, 2, 5. D. 1, 3, 5. E. 2, 3, 4.

8. The most common complication of prolonged and traumatic abdominal surgery is which of the following:

A. GI paresis.

B. Peritonitis.

C. Pneumonia.

D. Anuria.

E. Thromboembolism.

Choose the correct answer.

9. The following measures are all applicable in GI paresis, except:

A. Paranephric block.

B. Hypertonic sodium chloride IV.

C. Proserine.

D. Hypertonic enema.

E. Vigorous antibacterial therapy.

Choose the correct answer.

On day 3 postoperatively, a male patient operated on for perforation of gastric ulcer complains of a sudden worsening of abdominal pain. He denies having nausea or vomiting. On examination: pale skin, dry tongue, pulse 120/min, BP 120/80 mm Hg, abdominal distension, total rebound tenderness on abdominal palpation. Blumberg's sign is positive. Bowel peristaltic sounds are inaudible, acid (according to pH measuring) serous and purulent secretion through the abdominal wall is evident. Identify the complication.

A. Dehiscence of gastric sutures.

B. Endogenous bleeding.

C. Early adhesive intestinal obstruction.

D.Thromboembolism of the upper mesenteric artery.

E. Eventration.

Choose the correct answer.

11. The major postoperative therapeutic measures in diffuse peritonitis are which of the following:

1. Correction of fluid and electrolyte balance.

2. Antibacterial therapy.

3. Haemodilution.

4. Restoration of intestinal motor function.

5. Correction of dysproteinaemia.

Choose the right combination of answers:

A. 1, 2, 3, 5. B. 2, 3, 4. C. 1, 2, 4, 5. D. 2, 3, 5. E. 2, 4, 5.

12. The early local postoperative complications are as follows:

1. Pain in the wound.

2. Haematoma.

3. Bleeding.

4. Wound infiltration.

5. Suppuration of wound.

6. Ligature fistula.

Choose the right combination of answers:

A. 1, 2, 3, 4, 5. B. 2, 3, 4, 5, 6. C. 2, 3, 5, 6. D. 2, 3, 4. E. 1, 2, 3, 4, 5, 6.

13. The early postoperative period ends after:

A. Resolution of early postoperative complications.

B. Removal of suture from the operation wound.

C. Healing of the operation wound.

D.The patient's discharge from the hospital.

E. Recovery of the patient.

Choose the correct answer.

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