The most common cause of postrenal failure is:
Renal failure can be classified as prerenal failure, intrinsic renal failure, and postrenal failure. Postrenal failure, or obstructive renal failure, should always be considered when low urine output (oliguria) or anuria occurs. The most common cause is a misplaced or clogged urinary catheter. Other, less common causes to consider are unintentional ligation or transection of ureters during a difficult surgical dissection ( eg, colon resection for diverticular disease) or a large retroperitoneal hematoma ( eg, ruptured aortic aneurysm).
Laryngoscopic findings after a superior laryngeal nerve injury include:
Superior laryngeal nerve injury is less debilitating, as the common symptom is loss of projection of the voice. The glottis aperture is asymmetrical on direct laryngoscopy, and management is limited to clinical observation.
All of the following are true statements regarding wound infection EXCEPT:
No prospective, randomized, double-blind, controlled studies exist that demonstrate antibiotics used beyond 24 hours in the perioperative period prevent infections. Prophylactic use of antibiotics should simply not be continued beyond this time. Irrigation of the operative field and the surgical wound with saline solution has shown benefit in controlling wound inoculum. Irrigation with an antibiotic-based solution has not demonstrated significant benefit in controlling postoperative infection.
Antibacterial-impregnated polyvinyl placed over the operative wound area for the duration of the surgical procedure has not been shown to decrease the rate of wound infection. Although skin preparation with 70% isopropyl alcohol has the best bactericidal effect, it is flammable and could be hazardous when electrocautery is used. The contemporary formulas of chlorhexidine gluconate with isopropyl alcohol remain more advantageous.
The most common cause of an empyema in the postoperative patient is:
One of the most debilitating infections is an empyema, or infection of the pleural space. Frequently, an overwhelming pneumonia is the source of an empyema, but a retained hemothorax, systemic sepsis, esophageal perforation from any cause, and infections with a predilection for the lung (eg, tuberculosis) are potential etiologies as well.
The primary cause of hyperbilirubinemia in the surgical patient is:
Hyperbilirubinemia in the surgical patient can be a complex problem. Cholestasis makes up the majority of causes for hyperbilirubinemia, but other mechanisms of hyperbilirubinemia include reabsorption of blood ( eg, hematoma from trauma), decreased bile excretion (eg, sepsis), increased unconjugated bilirubin due to hemolysis, hyperthyroidism, and impaired excretion due to congenital abnormalities or acquired disease. Errors in surgery that cause hyperbilirubinemia largely involve missed or iatrogenic injuries.
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