#may2020amc1
You review a patient on the High Dependancy Unit two days following a low anterior resection for ischaemic colitis. The patient is in mild renal failure, has a low Hb requiring transfusion, but is otherwise stable. He is mildly hypothyroid and diet controlled type II diabetic. Which of the following is to be expected after this kind of operation and will help you manage the post-operative period in this patient?
A. Decrease in ACTH, ADH and TSH
B. Decrease in systemic insulin release and glycogenolysis
C. Decrease in TSH and systemic insulin release
D. An increase in nor-adrenaline, gluconeogenesis and TSH
E. An increase in systemic insulin release, T3 and T4.
Explanatory Notes:
The systemic response to surgery involves many organ systems:
Renal: increase renin-angiotensin system
Pituitary: increase ACTH, ADH & GH; decrease TSH
Thyroid: decrease T3 & T4
Hepatic: increase gluconeogenesis & glycogenolysis. Pancreatic: increase glucagon and decrease insulin
You review a patient on the High Dependancy Unit two days following a low anterior resection for ischaemic colitis. The patient is in mild renal failure, has a low Hb requiring transfusion, but is otherwise stable. He is mildly hypothyroid and diet controlled type II diabetic. Which of the following is to be expected after this kind of operation and will help you manage the post-operative period in this patient?
A. Decrease in ACTH, ADH and TSH
B. Decrease in systemic insulin release and glycogenolysis
C. Decrease in TSH and systemic insulin release
D. An increase in nor-adrenaline, gluconeogenesis and TSH
E. An increase in systemic insulin release, T3 and T4.
Explanatory Notes:
The systemic response to surgery involves many organ systems:
Renal: increase renin-angiotensin system
Pituitary: increase ACTH, ADH & GH; decrease TSH
Thyroid: decrease T3 & T4
Hepatic: increase gluconeogenesis & glycogenolysis. Pancreatic: increase glucagon and decrease insulin
Last edited: