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Medication

  1. Antibiotics may not penetrate the ischemic muscle but are important adjuncts to surgery.
  2. Antibiotics: Although penicillin G is effective against clostridial species, mixed infections are common, thus treatment include aminoglycosides, penicillinase-resistant penicillins, or vancomycin. If a patient is allergic to penicillin, alternative choices are clindamycin, third-generation cephalosporin, metronidazole, & chloramphenicol.
  3. Medicinal gas: Oxygen is used at a pressure greater than 1 atm in an attempt to minimize tissue necrosis caused by clostridial species.
  4. Typical therapy is 100% oxygen at 3 atm of pressure for 90 min with 2-3 dives in first 24 h, followed by 2-3 dives/d for a total of 7-10 dives
  5. Toxoids -- Used to induce active immunity.
  6. Adult Dose: Primary immunization: 0.5 mL IM; administer 2 injections 4-8 wk apart; third dose 6-12 mo after second injection Booster dose: 0.5 mL q10y
  7. Pediatric Dose: Administer as in adults
  8. Immunoglobulins -- Used to induce passive immunity.
  9. Adult Dose: Prophylaxis: 250-500 U IM in opposite extremity to tetanus toxoid lesion
     
    Clinical tetanus: 3,000-10,000 U IM
  10. Pediatric Dose: Prophylaxis: 250 U IM in opposite extremity to tetanus toxoid
     
    Clinical tetanus: 3,000-10,000 U IM

Example

Most common cause for nosocomial infection (AIIMS May 09)
A. Admission for elective surgery                     
B. Admission for normal delivery
C. Neoplasm patient in OPD for followup          
D. Endoscopic evaluation

Solution

Ans. D. Endoscopic evaluation

 

Example

A person with multiple injuries develops fever tachycardia tachypnea and a periumbilical rash. Diagnosis is? (AIIMS Nov 08)
A. Fat embolism               
B. Pulmonary embolism           
C. Pneumonia          
D. ARDS

Solution

Ans. A. Fat embolism

 

Example

The children hospital of Eastern Ontario Pain Scale (CHEOPS) for rating post operative pain in children includes all except? (AIIMS Nov 08)
A. Cry              
B. Touch          
C. Torso          
D. Oxygen saturation

Solution

Ans: D. Oxygen saturation





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