Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced > 2 > Flashcards

2 Flashcards

1
Q

Carbon dioxide carried in blood

A
  • dissolved
  • buffered with water as carbonic acid
  • attach within erythrocytes; carbaminohemoglobin (75%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Anion gap

A
  • Na- Cl- HcO3

- 12 +/- 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Respiratory compensations

A
  • acute: for every 10 mm Hg change in PaCo2 the pH should change the opposite by 0.08
  • chronic: every 10 mmHg the pH should change in the opposite by 0.03
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Metabolic compensations

A
  • acidosis: PaCo2 = 1.5(HCO3-) +8

- alkalosis: for every 10 mmol/L change in HCO3-, PaCO2 changes by 7 in the opposite direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Metabolic Acidosis causes (gap)

A

MUDPILES

methanol, uremia, DKA, propylene glycol, Isoniazid, lactic acidosis, ethelyne gylcol, salicylates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Metabolic Acidosis causes (non gap)

A

HARDUP

hyperalimentation, acetazolamide, renal tubular acidosis, diarrhea, ureterosigmoidotomy, pancreatic fistula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

pH during CPB hypothermia

A
  • natural alkaline shift which causes increase gas solubility and reduce PaCO2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

pH stat

A
  • maintains physiological level of pH throughout hypothermia
  • correct for alkaline shift and maintain a neutral pH by ADDING CO2 to the actual bypass circuit
  • This addition of CO2, and maintenance of pH neutrality, will increase your total body CO2
  • addition of CO2 will increase the speed of homogenous cerebral cooling through global cerebral vasodilation (which at the same time improves oxygenation but also increases delivery of emboli to the brain)
  • pediatrics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Alpha stat

A
  • ioniation state that affects protein function and therefor pH (unprotanated imidazoles on histidine) should not be corrected
  • goal is to keep the ionization state (alpha) constant
  • temperature corrected will show pH in normal physiologic range
  • better preserved cerebral autoregulation and better neurologic outcomes
  • adults (to high a risk for embolic events in adults to use pH)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

reasons for hypoxemia

A
  • low inspired FiO2
  • V/Q mismatch
  • shunt
  • impaired alveolar capillary diffusion
  • hypoventilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ABG in pregnancy

A
  • slight respiratory alkalosis (paCo2 around 33)

- compensatory metabolic acidosis with HCo3 15-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Flow Volume loop

A

Flow on Y, Volume on X (expiration on top, inspiration on bottom)
-Intrathorasic shows airflow reduction during expiration, extrathorasic on inspiration, fixed on both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

asthma

A
  • antigen bind to immunoglobulin E (IgE) on mast cell surface
  • release of histamine, bradykinin, leukotriences, platlet-activating factor and prostagladins
  • results in bronchoconstriction, increased secretion and edema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Drugs associated with histamine release

A
  • atracurium
  • morphine
  • thiopental
  • meperidine
  • avoid in asthmatics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Absolute indications for one lung ventilation

A

1) prevent contamination: infection or blood
2) control ventilation: fistula, cyst/bullae, bronchial disruption
3) unilateral lavage
4) VATS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Relative indication for one lung ventialtion

A

Surgical exposure

  • high priority: Thoracic aortic aneurysm, pneumonectomy, upper lobectomy
  • low priority: esophageal, middle/lower lobectomy, thoracoscopy under GETA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

1 MET

A
  • oxygen consumption of an average person at rest

- 3-5ml/kg/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

clinical risk factors from ACC/AHA

A
  • history of MI
  • CHF
  • cerebrovascular disease
  • diabetes
  • renal impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

dual antiplatelet time table before elective non cardiac surgery

A
  • balloon angioplasty: 14 days
  • BMS: 30-45 days
  • DES: 1 year
20
Q

V1-V6

A

Anterior; LAD

21
Q

2,3, AVF

A

Inferior: RCA, circumflex

22
Q

1, avL, V4-V6

A

anterolateral: circumflex, LAD (diagonal branch)

23
Q

1, avL, V1-4

A

anterolateral; LAD

24
Q

physiologic effects of CPB

A
  • severe inflammatory response
  • platelet, endothelium and leukocyte activation
  • initiation of the coag cascade (decreases coag factors)
  • leads to increased risk of myocardial dysfunction, vasodilation and bleeding
25
Q

retro vs anterograde cardioplegia

A
  • retro from coronary sinus

- antero from coronary ostia

26
Q

Heparin

A
  • sulfated glycosaminoglycan polymer, negatively charged
  • excreted by kidneys, metabolized by reticuloendothelial system
  • binds to antithrombin III
27
Q

Heparin resistance

A
  • deficiency of antibthrombin III
  • sepsis
  • pregnancy
  • extremes of age
  • Give more heparin or FFP/ antithrombin III
28
Q

centrifugal vs roller pumps

A
  • centrifugal pump: less trauma to RBC and fewer air bubbles than roller pumps
  • also less risk of line rupture because centrifugal pumps are afterload dependent
  • The tradeoff is that flow cannot be guaranteed, thus necessitating a downstream flow meter).
29
Q

intra-aortic balloon pump position

A
  • 2 cm distal to the takeoff of the left subclavian artery (2nd rib) and proximal to renal arteries (1st and second lumbar vertebral bodies)
30
Q

IABP contraindications

A
  • Severe AR
  • Aortic dissection
  • Aortic stent
  • End stage cardimyopathy with no other remaining therapeutic options
  • B/L fem-pop bypass
31
Q

IABP indications

A
  • refractory unstable angina
  • acute MI
  • cardiogenic shock
  • failure to wean of bypass
  • refractory ventricular dysrhythmias
  • high risk coronary artery bypass grafting
32
Q

IABP assisted waveform

A

lower diastolic pressures

significant increase in pressure at the the normal location of the dicrotic notch

33
Q

timing of IABO

A
  • inflation occurs at the time of aortic valve closure

- deflation occurs during early systole

34
Q

Nitrous tank

A
  • holds roughly 1590L
  • will read 745 psi until roughly 250 L is left
  • at that point decreases proportionally
  • x/745 * 250= L left
35
Q

Time constant

A
  • circuit volume/ fresh gas flow

- 63%, 84%, 95%, and 99%

36
Q

standard deviation intervals

A

68%, 95%, 99.7%

37
Q

Bainbridge reflux

A
  • increase in heart rate due to an increase in central venous pressure
  • detected by baroreceptors in the atria
38
Q

RQ

A

carbon dioxide production/ oxygen consumption

  • based off of diet
  • .8 is average
39
Q

BMI

A

kg/m^2

40
Q

Hepatorenal syndrom

A
  • retention of salt and water along with decreased GFR and renal perfusion
  • type 1: rapidly progressive renal failure
  • type 2: gradual and characterized by refractive acites
41
Q

Hepatopulomary syndrom

A
  • characterized by arterial hypoxemia caused by pulmonary vasodilatation
  • orthodeoxia (a decrease in arterial PaO2 with a change in position from supine to upright), which may cause the patient to feel the symptom of platypnea (worsening shortness of breath when changing position from supine to sitting or standing)
  • increase in nitric oxide causes vasodilation of pulmonary vessels
42
Q

Portopulomonary hypertension

A
  • Portopulmonary hypertension is an obstruction of blood flow through the pulmonary arterial bed caused by vasoconstriction which leads to an increased PVR with eventual right heart failure.
43
Q

Prehepatic dysfunction

A
  • Hemolysis (unconjugated hyperbili): blood transfusions, absorption of hematoma, blood reactions ect.
  • ischemic hepatitis: drastic increase in ALT/AST
44
Q

Intrahepatic dysfunction

A
  • drug induced: tylenol
  • Viral
  • Anesthetic induced: Halothane: female > 40 obesity, repeat exposures
  • TPN
45
Q

Posthepatic dysfunction

A
  • benign post op cholestasis

- bile duct obstruction: pancreatitis, edema, bile duct injury

Advanced (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions