Các yếu tố gây ảnh hưởng các rebleeding Sau đây là: Tuổi 60 Sốc nhập viện dạ dày mãn tính hơn Thay loét cấp tính loét Bên dưới vấn đề y tế không rõ nguồn Chảy máu Chảy máu từ 5 đơn vị truyền dãn tĩnh mạch hoặc bệnh ác tính | Other Systems and Multisystem Failure Answers A 1. A. false B. true C. false D. false E. true Glasgow Ranson s criteria are used for indication of a severe attack of pancreatitis. The defined criteria are Age 55 years White cell count WCC 15 X 109 l Urea 16mmol l Glucose 10mmol l Calcium 2mmol l Albumin 32 g l Arterial pO2 8kPa Lactate dehydrogenase LDH 600 iu l Surgery 1999 17 11 261-265 SCC pp 131-135 A 2. A. true B. false C. true D. false E. true The following are factors influencing rebleeding Age 60 Shock on admission Chronic rather than acute ulcer Gastric ulcer Underlying medical problem Bleeding source unknown 5 unit transfusion Bleeding from varices or malignancy Surgery 1999 17 12 293-298 SCC pp 129-131 A 3. A. false B. false C. false D. false E. true Organ failure in severe pancreatitis is usually respiratory cardiovascular renal then disseminated intravascular coagulation DIC . Two organ system failure has a mortality of about 55 whereas three or more is associated with a mortality of 90 . MCQs Key Questions in Surgical Critical Care 111 Other Systems and Multisystem Failure Hypercalcaemia and hypomagnesaemia are the most common metabolic disturbances and solid infected necrosis requires surgical debridement. Positive end expiratory pressure PEEP may prevent the development of adult respiratory distress syndrome ARDS . Surgery 1999 17 11 261-265 SCC pp 131-135 A 4. A. true B. false C. false D. true E. false Vesical distension is common supravesical uncommon. A percutaneous nephrostomy should be performed to decompress a supravesical obstruction. For pelvic malignancy double J stents should be used palliatively and nephrostomy tubes avoided. Surgery 1996 14 12 272-275 SCC pp 117-124 A 5. A. true B. false C. true D. false E. false Most chest injuries can be managed by intercostal tube drainage analgesia and appropriate fluid management. Massive haemothorax is 1500 ml blood and blood loss of 200 ml is an indication for thoracotomy. Surgery 1996 14 1 9-12 .
