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WorksheetsSurgical infections- Hawkins
Total questions: 50
Worksheet time: 25mins
Which of the following is a patient-related risk factor for surgical site infection (SSI)?
Use of laparoscopic approach
Obesity
Short surgical duration
Appropriate antibiotic timing
Which of the following is a process-related risk factor for SSI?
Smoking
Diabetes
Rough surgical technique
Immunosuppression
Which of the following contributes to creating a “suitable medium” for surgical infection?
High oxygen tension
Adequate blood flow
Closed space with low pH
Open air exposure
The most common pathogen involved in SSIs is:
E. coli
Pseudomonas
Staphylococcus aureus
Streptococcus viridans
Which host condition increases susceptibility to surgical infection?
Vigorous physical activity
Immunocompromised state
Low ASA score
Good nutritional status
Which wound class has the lowest expected infection rate?
Class I – Clean
Class II – Clean-contaminated
Class III – Contaminated
Class IV – Dirty-infected
A bowel resection with visible necrotic tissue but no pus is classified as:
Clean
Clean-contaminated
Contaminated
Dirty-infected
Which of the following is an example of a clean-contaminated procedure?
Inguinal hernia repair
Appendectomy with no perforation
Dog bite wound
Ruptured appendix
A surgical wound with frank pus and retained devitalized tissue is best classified as:
Class I – Clean
Class II – Clean-contaminated
Class III – Contaminated
Class IV – Dirty-infected
What is the expected infection rate for a Class III contaminated wound?
~2%
5–15%
>15%
>30%
Prophylactic antibiotics should ideally be administered:
2 hours before incision
At wound closure
After signs of infection develop
Within 1 hour prior to incision
Which procedure does not routinely require prophylactic antibiotics unless high-risk?
Clean-contaminated
Contaminated
Dirty
Certain clean surgeries
Antibiotic doses should be repeated during surgery based on:
Surgical duration
Patient weight
Antibiotic half-life
Wound classification
Which consideration is least important in choosing a prophylactic antibiotic?
Local flora
Known MRSA status
Duration of surgery
Medication allergies
What is the appropriate intraoperative redosing interval for cefazolin?
Every 1 hour
Every 2 hours
Every 4 hours
Only at incision
Which patient history factor most likely impacts antibiotic sensitivity?
Vegetarian diet
Prior hospitalization
Family history of MRSA
Lack of prior illness
In vitro antibiotic sensitivity results may not correlate in vivo due to:
Short half-life of antibiotics
Drug allergy
Host immunity
Site penetration issues
Which of the following increases the likelihood of antibiotic resistance?
No prior infection
Prior infection with resistant organisms
Surgical procedure in a clean site
Low ASA score
Which factor should be most considered when empirical antibiotic therapy fails?
Patient's sex
Antibiotic cost
Prior antibiotic exposure
Family history
Failure to respond to antibiotic therapy despite culture sensitivity may be due to:
Resistance at the lab
Allergy
Inability of antibiotic to reach infection site
Lack of hygiene
Which mechanism is used by bacteria to resist antibiotics?
Increasing permeability to antibiotics
Developing enzymes that destroy antibiotics
Enhancing antibiotic absorption
Lowering host immunity
Which structural modification contributes to MRSA resistance?
New capsule formation
Biofilm development
Altered cell wall proteins preventing drug binding
Increased protein synthesis
What allows bacteria to avoid antibiotic effects through decreased exposure?
Active drug uptake
Antibiotic trapping
Efflux pumps
Enzyme inactivation
A surgical patient develops resistance to a previously effective drug. What likely happened?
Drug degradation by liver
Spontaneous mutation or gene acquisition
Drug underdosing
Patient noncompliance
Which of the following most contributes to multidrug resistance in hospital settings?
Short hospital stay
Strict isolation
Repeated antibiotic use
High ASA scores
A patient presents with a painful, red swelling on the fingertip pulp. What is the most likely diagnosis?
Paronychia
Felon
Eponychia
Herpetic whitlow
Which of the following is the best treatment for a subungual abscess?
Oral steroids
Nail removal only
Incision and drainage at the point of fluctuance
Topical antifungals
Which hand infection is characterized by fusiform digit swelling, pain with passive extension, and flexed posture?
Human bite infection
Pyogenic tenosynovitis
Felon
Paronychia
What is the appropriate initial treatment for early paronychia without abscess?
Nail removal
I&D only
Soaks, elevation, and oral antibiotics
IV antifungals
Which organism is most associated with necrotizing hand infections such as streptococcal gangrene?
Pasteurella multocida
Staphylococcus aureus
Streptococcus pyogenes
E. coli
Which of the following increases the risk of diabetic foot infections?
Peripheral neuropathy
Good glucose control
High protein diet
Use of antifungal creams
What is the most common initial presentation of a diabetic foot infection?
Painless swelling
Osteomyelitis
Skin and soft tissue lesion with purulence
Gangrene
Which test suggests underlying osteomyelitis in a diabetic foot wound?
Babinski reflex
Probe-to-bone test
ABI index
Tinel's sign
What is the first-line treatment for mild diabetic foot infections?
Surgical amputation
IV antibiotics
Antivirals and wound debridement
Oral antibiotics, wound care, and pressure offloading
What percentage of diabetic foot infection patients have PAD?
<10%
~20%
~40%
>75%
Which pathogen is most commonly associated with dog bite infections?
Pseudomonas
Pasteurella multocida
E. coli
Streptococcus pneumoniae
A patient has acute cholecystitis. What bacterial group is most likely involved?
Anaerobes only
Fungi
Gram-negative bacilli and gram-positive cocci
Mycobacteria
What is the most common pathogen found in acute perforated appendicitis?
Streptococcus pyogenes
H. pylori
E. coli
Clostridium difficile
Which organism is most likely found 2 hours after perforation of a duodenal ulcer?
Klebsiella
H. pylori
Enterobacter
MRSA
Which of the following is not typically associated with dog bite wound flora?
Capnocytophaga canimorsus
Pasteurella canis
Staphylococcus aureus
Salmonella typhi
Which virus poses the greatest occupational risk to surgeons due to high transmissibility?
A. HSV
B. HCV
C. HIV
D. HBV
What is the most effective method to protect against occupational transmission of bloodborne viruses?
Prophylactic antibiotics
Face shields alone
Universal precautions
Hand sanitizer
Which viruses are included in the CDC’s list of common bloodborne pathogens?
HIV, Hep A, CMV
HSV, EBV, CMV
HBV, HCV, HIV
RSV, HCV, HBV
What should a surgeon do immediately after a needlestick injury?
Finish the procedure and report later
Rinse and wait for symptoms
Wash vigorously and report exposure
Ignore unless symptoms develop
Which of the following is not part of universal precautions?
Double gloving
One-handed needle recapping
Patient HIV testing
Eye protection
A fever on post-op day 1 is most commonly caused by:
Wound infection
UTI
Atelectasis
DVT
Which of the following is the most likely cause of a post-op fever associated with localized erythema and drainage from an incision?
Pulmonary embolism
Surgical site infection
UTI
Atelectasis
What does “Wonder Drugs” refer to in the 5 W's?
Post-op pain medications
Anesthesia-related fevers
Drug-induced fever or transfusion reactions
Herbal supplements
What symptom would lead you to suspect DVT as the cause of post-op fever?
Flank pain
Calf tenderness and swelling
Jaundice
Bradycardia
Which action is most appropriate in evaluating an early post-op fever with pulmonary findings?
Begin steroids
Order abdominal ultrasound
Obtain chest X-ray
Start antifungal therapy
