2005 With Explanations (2005 AK No Answers) Flashcards
- All are true for Vit D EXCEPT?
a) Decreases PTH secretion
b) Transformed to 25-OH Vit D in the liver
c) Transformed to 1,25-(OH)2 Vit D in the kidney
d) Transformed to 24,25-(OH)2 Vit D in the kidney
a) Decreases PTH secretion.
Vit D does not directly modulate PTH. It instead modulates calcium and phosphorous which have the ability to modulate PTH secretion.
Vit D Pathway:
- Activated by sunlight in the skin (Vit D)
- Hydroxylated to 25-(OH)Vit D in the liver (calcidiol)
Next transported to the Kidney where:
3a. Hydroxilated to 1,25-(OH)2 Vit D (cholecalciferol) in the kidney **active form of VitD
OR 3b. Hydroxylated to 24,25-(OH)2 Vit D in the kidney **inactive form
Effects of Cholecalciferol:
- promotes osteoclasts for Ca2+ resorbtion in bone
- increases Ca2+ absorption in stomach
- A 30 yo ♂fell 15m. He sustained a T8 burst fracture and a complete spinal cord lesion. He is alert and oriented wih a BP of 90/50, HR 50 and no change after 2 L Ringer’s. A FAST is negative. What is the MOST likely cause of his hypotension?
A. Unrecognized thoracic injury
B. Unrecognized abdominal injury
C. Inadequate fluid resuscitation
D. Neurogenic Shock
D. Neurogenic Shock
Low HR and low BP indicate compromise of sympathetic response as a result of spinal cord injury.
Signs:
- Hypotension
- Bradycardia
- Warm extremities
- A patient is receiving chemotherapy with doxorubicin. The medication goes interstitial during administration through a vein in the forearm. What is the MOST appropriate immediate treatment?
A. Instill leukovarin antidote immediately
B. Cold compress, elevation, and topical burn ointment
C. Topical sodium mafenide ointment
D. Debride devitalized tissues immediately
B. Cold compress, elevation and topical burn ointment.
** answer may also be D, literature does not point to burn ointment, instead refers to local analgesia.
- Leukovarin is antidote to methotrexate.
- Only substance shown to improve outcomes with anthracyclin extravasation (doxorubicin included), is dexrazoxane.
- Cold compress and elevation is first management
- Irrigation and debridement of necrotic tissue to follow if openly visible or persistent pain for >10 days.
Management of chemotherapy extravasation: ESMO–EONS Clinical Practice Guidelines.Ann Oncol (2012) 23 (suppl 7): vii167-vii173.
doi: 10.1093/annonc/mds294
- Parathyroid hormone does all of the following EXCEPT:
A. Decreases 1,25-VitD3 (OH)2
B. Decreases PO4
C. Decreases urinary Ca2+
D. Decreases 25-hydroxyvitamin D
A. Decreases 1,25-VitD3 (OH)2
Stimulates the production of 1,25-VitD3(OH)2 aka cholecalciferol. Will decreased 25OHVitD by stimulating pathway for it to become cholecalciferol.
PTH:
- stimulated by low serum Ca2+ and high serum Phosphate
- Increased Ca2+
- Increased Calcitriol
- Decreased Phosphate
- A 70 y.o. ♂ immediately post op has a BP 70/50, HR = 105 and ST depression in the anteroseptal leads. The MOST appropriate management is:
A. β blocker B. Nitro s/l C. Nitro IV D. Epinephrine E. Dobutamine
D. Epinephrine
Cardiogenic Shock. Ionotrope, Chronotrope, Vasoconstriciton
Indicated in:
- anaphylaxis
- cardiogenic shock
- cardiac arrest
Dobutamine is only indicated in low cariogenic shock where there is no evidence of infarct. Dobutamine is mostly b1 for inotropy but can also do to some extent b2 which can vasodilate peripherally which is not desirable if the patient is in shock.
First line is norepinephrine from ER trial, with dobutamine as second line (add it since the norepi will counteract possible vasodilation).
A 58 y.o. ♂ with cirrhosis presents with an UGI bleed. Initial resuscitation measures are carried out. What is the MOST helpful adjunct to treatment?
A. Synthetic vasopressin
B. Somatostatin
C. Ranitidine
D. NG tube
D. NG Tube
A. Synthetic vasopressin - should volume resuscitate
B. Somatostatin or octeotride are indicated in variceal bleeds
C. PPIs are indicated not H2 blockers
An achondroplastic dwarf is undergoing spinal fusion surgery and is placed in the prone position. In the recovery room, he is unable to see out of either eye. What is the MOST likely cause of his blindness?
A. Retinal detachment
B. Acute open angle glaucoma
C. Retinal ischemia
D. Occipital artery infarct
C. Retinal Ischemia
In patients undergoing spine surgery, prolonged use of the prone position is also implicated as a risk factor for PION (posterior ischemic optic neuropathy), presumably by increasing venous pressure and secondarily decreasing arterial perfusion pressure
- A middle-aged ♂ patient could not urinate 8 hours postoperatively following an inguinal hernia repair. A Foley catheter was inserted and only drained 15cc. It was noted that it was difficult to inflate the balloon with more than 1cc of saline. What is the BEST next step?
A. Deflate the balloon and remove the catheter
B. Deflate the balloon and advance the catheter even further
C. Insert a suprapubic catheter
D. Increase the patient’s IVF rate
B. Deflate the baloon and advance the catheter
The incidence of urinary retention following laparoscopic inguinal and femoral hernia repair varies depending upon the type of anesthesia used and the nature of the repair [7-11]. Urinary retention occurs in about 2.2 percent of patients if the repair is performed under general anesthesia and 0.4 percent if local anesthesia is used
(Up to date)
- Macrophages are the most predominant cell type in which phase of wound healing?
A. Lag phase
B. Proliferative phase
C. Maturational phase
D. Remodelling phase
Lag Phase (Also known as inflammatory)
- When do platelets return to normal function after stopping naproxen?
A. 2 days
B. 4 days
C. 6 days
D. 8 days
TBD
- All of the following fractures are associated with avascular necrosis EXCEPT:
A. Scaphoid B. 4-part proximal humerus C. Intertrochanteric hip fracture D. Talar neck E. Capitellum
C. IT hip #
Previous answer thought it was capitellum, but IT # is extra-articular and shouldn’t cause AVN, and Orthobullets says capitellum # has risk of AVN whereas AVN not listed as complication for IT#
- Cardiac toxicity in hyperkalemia would be BEST treated with:
A. Insulin
B. Metoprolol
C. Calcium
D. Bicarbonate
C. Calcium
Calcium directly antagonizes the membrane actions of hyperkalemia [3], while hypocalcemia increases the cardiotoxicity of hyperkalemia [4]. As discussed elsewhere, hyperkalemia-induced depolarization of the resting membrane potential leads to inactivation of sodium channels and decreased membrane excitability
Calcium only lasts 30-60minutes so needs to be combined with alternative therapy
CaCl provides 3x the amt of calcium compared to calcium gluconate
- The process of disclosure includes all EXCEPT:
A. Risks of procedure
B. Risks and expected outcome of not doing procedure
C. Alternative treatment modalities available
D. Whatever a reasonable physician would say
D. Whatever a reasonable physician would say
- A chest xray shows a right tension pneumothorax and a left diaphragmatic hernia. What is the MOST appropriate immediate action?
A. Insert chest tube on the right
B. Insert chest tube on the left
C. Perform an emergent thoracotomy
D. Insert NG tube
A. Insert chest on the right
- Define standard deviation.
A. Difference between mean and median
B. Measure of variance and dispersion
C. The midpoint in a series of numbers
D. Measure of dispersion around the mode
B. Measure of variance and dispersion
- The initial treatment of thyrotoxic storm may include all of the following EXCEPT:
A. Propranolol
B. Urgent thyroidectomy
C. Propylthiouracil (PTU)
D. Lithium
B. Urgent thyrodectomy
Answer: Tx with PTU (thyroid blocker), beta-blocker, iodine or lithium.
Thyroid can be very vascular so not a good option.
- A patient presents after having a total non–cemented hip arthroplasty 6 months earlier. No pain but dramatically limited range of motion. An Xray shows heterotopic ossification (HO). Which of the following may have limited the degree of HO?
A. Bisphosphanates
B. NSAIDS
C. Low molecular weight heparin
D. Intraarticular cement
B. NSAIDs
- The body system MOST sensitive to changes in sodium homeostasis is:
A. CVS
B. CNS
C. Respiratory
D. Musculoskeletal
CNS
- A 67-year-old ♀ is on a ventilator in the ICU. Her blood pressure is noted to be 100/72. The tidal volume is noted to be 15cc/kg. The PaO2:FiO2 ratio is
MISSING END OF THE QUESTION
A. Decrease the Vt to 5-7cc/kg
PaO2:FiO2 of 100-200 is moderate ARDS.
PaO2:FiO2 rtio at atm should be 500mmHg.
Normal CO = ~5L/min
So if this is ARDS, we should be treating with low tidal volumen ventilation
- A patient has renal insufficiency and requires nutritional support. Which of the following is the BEST recommendation?
A. Lower the caloric/ nitrogen ratio
B. Increase the caloric / nitrogen ratio
C. Avoid branched chain amino acids
D. Recommend an alternate source of calories other than glucose
B. Increase the caloric / nitrogen ratio
Up to date wasn’t very clear – but essentially need to increase calorie intake to improve overall nutrition, and improve albumin.
- A 60 year old man with carcinoma of the colon is started on morphine
for abdominal pain. On review the next day, his family reports that he has
been having hallucinations. You would:
A. Rotate to hydromorphone
B. Rotate to fentanyl as it has less metabolites
C. Use haloperidol
D. Use a benzodiazepine (typically clonazepam)
E. Avoid opioids (try a NSAID or steroid instead)
A. Rotate to hydromorphone
Answer: Colon cancer likely GI bleed. Do not use NSAIDS. Hydromorph less active metabolites and lower incidence of delerium.
- Which of the following is the LEAST consistent with child abuse?
A. Multiple bruises on anterior shins B. Long bone spiral fractures in toddler C. Retinal hemorrhages D. Femur fracture in non-walking infant E. Sharply demarcated burns
A. Multiple bruises on anterior shins
Others are al documented signs of child abuse
- Which of the following is MOST effective in preventing LATE complications of splenectomy?
A. Adminstration of pneumococcal and H. flu vaccines
B. Perform only laparoscopic splenectomy
C. Perform sub-total splenectomy
D. Give patients antibiotic prophylaxis post-operatively
A. Adminstration of pneumococcal and H. flu vaccines
At risk for encapsulated organisms
- Which of the following is the MOST sensitive indicator of malignancy in an incisional biopsy for an epithelial tumour?
A. Aneuploidy on flow cytometry
B. Positive stain for cytokeratin
C. Tumor cells breaking through the basement membrane layer
D. Multiple mitotic figures and prominent nucleoli
C.
From Schwarz:
A feature of malignant cells is their ability to invade the surrounding normal tissue. Tumors in which the malignant cells appear to lie exclusively above the basement membrane are referred to as in situ cancer, whereas tumors in which the malignant cells are demonstrated to breach the basement membrane, penetrating into surrounding stroma, are termed invasive cancer.
The ability to invade involves changes in adhesion, initiation of motility, and proteolysis of the extracellular matrix (ECM
- Which of the following causes of polyuria is associated with a high urine specific gravity?
A. Diabetes Mellitus
B. SIADH
C. Acute non-oliguric renal failure
D. ATN
A. DM
A. Diabetes Mellitus – High urine specific gravity and polyuria
B. SIADH – I don’t think they have polyuria
C. Acute non-oliguric renal failure – usually decreased specific gravity
D. ATN – Also decreased specific gravity
- A patient was placed in a left lateral decubitus position for total hip arthroplasty which lasts over 4 hours. Post operatively he wakes up complaining of arm/hand weakness. What is the MOST likely abnormality?
A. Weak finger flexion
B. Weak wrist extension
C. Weak finger adduction
D. Weak finger abduction
B. Weak wrist extension
- Which cytokine may reduce scar hypertrophy?
A. EGF
B. FGF
C. IFN-gamma
D. IL-2
C. IFN-gamma
Inhibits collagen synthesis. Remaining choices promote wound healing.
- Which factor deficiency is MOST likely to cause a high INR but normal
PTT?
A. VII
B. VIII
C. IX
D. XI
A. VII
PT/INR measures: extrinsic pathway (VII) and common pathway factors including , V, X,
prothrombin/thrombin (II), and fibrinogen/fibrin.
PTT measures: intrinsic pathway factors (HMWK, prekallikrein, VIII, IX, XI, XII) and common pathwayfactors (II/thrombin, V, X and fibrinogen/fibrin)
- Hypomagnesemia MOST likely causes:
A. Decreased deep tendon reflexes
B. Tremor
C. Constipation
D. Muscle paralysis
B. Tremor
Clinical Manifestations of Mg
- Cardiac manifestations (7):
1. Prolonged PR interval
2. Prolonged QT
3. T-wave flattening
4. Tachyarrhythmias (unstable VT)
5. A. fib
6. Torsades de pointes
7. Digitalis toxicity enhanced as both inhibit the membrane pump
-Neurologic manifestations:
• Changes in mental status, seizures, Tremors, Hyperreflexia
• All uncommon, non-specific and have little clinical value
• Tremor is the MOST CHARACTERISTIC finding with hypomagnesemia but tetany is first sign.
- A patient sustains a transverse fracture through the pterygoid plate, inferior to floor of maxillary sinus. What type of fracture does this represent?
A. LeFort I
B. Lefort II
C. Lefort III
D. Panfacial fracture
A. Lefort I
LEFORT I: Through maxilla (separates maxilla from rest of skull)
LEFORT II: Maxilla inferior orbit lacrimal bone (bridge of nose)
LEFORT III: Zygomatic arch lateral orbit inferior orbit lacrimal bone
- A melanoma of 2.5mm thickness requires what margin?
A. 2mm
B. 5mm
C. 2cm
D. 5cm
C. 2cm
Wide resection down to fascia.
2mm -trial French Cooperative Group consisted of 362 patients with melanomas ≤2 mm in thickness, who were randomly assigned to 2 cm versus 5 cm margins. There was no difference between the groups in the risk of local recurrence or in overall survival.
- The MOST common cause of SVC syndrome is:
A. Lymphoma
B. Primary lung cancer
C. Mediastinal fibrosis
D. Tuberculosis
B. Primary Lung Cancer
Small cell lung cancer is most common cause ~50 of SVC syndrome cases. (UptoDate)
- What cell is responsible for skin immune function?
A. Kupffer Cell
B. Melanocyte
C. Langerhans Cell
D. Keratinocyte
C. Langerhans Cell
Antigen presenting cells mediating skin immunity.
- Which of the following will NOT cause hypercalcemia?
A. Thiazide diuretics
B. Sarcoidosis
C. Paget’s disease
D. Multiple fractures
D. Multiple Fractures
**of note, paget’s doesn’t normally cause elevated Ca2+, but can with periods of immobility.
Causes of hypercalcemia 1. Parathyroid mediated -Primary hyperparathyroidism (sporadic) Inherited variants -Multiple endocrine neoplasia (MEN) syndromes -Familial isolated hyperparathyroidism -Hyperparathyroidism-jaw tumor syndrome -Familial hypocalciuric hypercalcemia -Tertiary hyperparathyroidism (renal failure)
2.Non-parathyroid mediated
-Hypercalcemia of malignancy
PTHrp
-Activation of extrarenal 1 alpha-hydroxylase (increased calcitriol)
-Osteolytic bone metastases and local cytokines
-Vitamin D intoxication
-Chronic granulomatous disorders
-Activation of extrarenal 1 alpha-hydroxylase (increased calcitriol)
- Medications
- Thiazide diuretics
- Lithium
- Teriparatide
- Excessive vitamin A
- Theophylline toxicity - Miscellaneous
- Hyperthyroidism
- Acromegaly
- Pheochromocytoma
- Adrenal insufficiency
- Immobilization
- Parenteral nutrition
- Milk alkali syndrome
- What is the MOST likely electrolyte abnormality associated with adrenal insufficiency?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypermagnesemia
A. Hyperkalemia
LABS • Hypo Na • Hypo Cl • Hypo Bicarb • Hypoglycaemia • Hyper K • +/- Hypercalcemia
- A patient has their ulnar nerve transected at the wrist. He/she will be unable to:
A. Flex DIP of 5th digit
B. Extend 4th digit
C. Adduct the thumb
D. Cross 1st and 2nd fingers
D. Cross 1st and 2nd Fingers (Adduction)
Ulnar nerve innervates Below wrist: -Interossei - 3rd and 4th lumbricle -Hypothenars -Adductor Pollicis -Deep head of flexor pollicis braves
Above Wrist:
- FCU
- 4th and 5th FDS
- In the setting of major trauma, which of the following is MOST responsible for the hypermetabolic state?
A. Cytokines
B. Catecholamines
C. Acute phase reactant proteins
D. Glucocorticoids
B. Catecholamines
Effects of EPI and NE (7) = mobilize glucose & run your ass off
- Tachycardia
- Ionotropy
- Peripheral vasoconstriciton
- METABOLIC RATE
- Glycogenolysis
- gluconeogenesis
- Inhibition of insulin secretion
- Which factor stimulates angiogenesis?
A. Basic fibroblast growth factor
B. C5a/C3a
C. Decreased wound O2 tension
D. IL1
A. Basic Fibroblast Growth Factor
C5a/C3a promote vasodilation
Decreased wound O2 causes dehiscence
IL-1 promotes and aggregates inflammatory response.
- The MOST important supplemental therapy to consider when starting
patients on opioids for pain is:
A. Amphetamines to increase alertness
B. Antidepressants to supplement pain relief
C. Antiepileptic medications to treat neuropathic pain
D. Antiemetics to counteract nausea
E. Non-steroidals (NSAID’s) to treat inflammation
D. Antiemetics to counteract nausea
Most common side effect.
- Heparin does all of the following EXCEPT:
A. Reduces available thrombin
B. Potentiates antithrombin III activity
C. Decreases thromboxane A2 production
D. Decreases platelet aggregation
C. Decreases thromboxane A2 production
Mechanism of Heparin:
- Accelerates the reaction between thrombin and anti-thrombin III, accelerating the inhibition of thrombin (II) and other serine proteases (VII, IX, X, XI, and Kallikreinin) by antithrombin III. It is not consumed by this reaciton
- Directly binds and inhibits coagulation proteases and is important for the selective inhibitor of thrombin, heparin cofactor II.
- Decreases platelet aggregability.
- All of the following are true of fractures in children EXCEPT:
A. Fracture across the growth plate has the greatest potential for growth disturbance
B. Fracture partially through the growth plate has the greatest potential for growth disturbance
C. Potential for remodeling is greater in children vs. adults
D. Intact periostium facilitates reduction in children
E. Greenstick fractures occur in children, but not in adults
E. Greenstick fractures occur in children, but not in adults
They can occur in adults, just much more uncommon.
A &B are salter Harris 1&2, lowest potential for growth disturbance - potential for arrest increases as you go up the classification.
- Which returns latest and LEAST completely after repair of a severed nerve?
A. Pin prick sensation
B. Proprioception
C. Pain
D. 2 point discrimination
D. 2-point discrimination
Pain is the first to return.
- A patient has a C8 lesion. Which of the following is the patient MOST likely able to perform?
A. Wrist extension B. Finger abduction C. Elbow extension D. Elbow flexion E. Finger extension
D. Elbow flexion
C5-C6 responsible for elbow flexion.
C7/C8- elbow extension/wrist extension/finger extension/finger flexion
T1- Finger abduction
- Which of the following is the MOST helpful in establishing a causal relationship between exposure and disease?
A. Positive predictive value
B. Sensitivity
C. Odds ratio
D. T-test
C. Odds Ratio
The odds ratio equals the odds that an individual with a specific condition has been exposed to a risk factor divided by the odds that a control has been exposed. The odds ratio is used in case-control studies and is often generated in multivariate analyses. The odds ratio provides a reasonable estimate of the relative risk for uncommon conditions. (UptoDate)
PPV - represents the likelihood that a patient with a positive test has the disease
Sensitivity- the number of patients with a positive test who have a disease divided by all patients who have the disease.
T-Test- test used to terming if two data sets are significantly different from each other, if both follow normal distribution.
- A child sustains a supracondylar fracture and is placed in an above elbow cast. He continues to complain of pain despite narcotic administration. What is the MOST appropriate next step in his management?
A. Doppler ultrasound study B. Assess pulses C. Split cast D. Arrange arteriogram E. Take to OR for immediate fasciotomy
C. Split Cast
Supracondylars - associated with Volkmann’s Ischemic Contractures (comparment syndrome causing decreased vascularity and schema).
Want to decrease pressure, split the cast and monitor.
- A young patient sustains a clean laceration to the volar forearm. There is no significant soft tissue injury and he presents to your ER. Clinically, you detect a deficit in the ulnar nerve distribution, and suspect ulnar nerve injury from laceration. What is the NEXT most appropriate action?
A. Irrigate, close, and send urgently to appropriate surgical specialist
B. Irrigate, close, splint wrist, and arrange for F/U in 4/52
C. Expore wound to confirm clinical suspicion
D. Leave open, pack with saline-soaked gauze, refer to appropriate surgical specialist
E. Immediately consult appropriate surgical specialist
A. Irrigate, close, and send urgently to appropriate surgical specialist
Nerve repair isn’t an A-case, but is relatively urgent. Should irrigate the wound, can close because it’s clean, and urgent referral (24 hrs or less) to plastics.
- A young ♂ patient is involved in an MVC. He is unconscious on presentation with unknown neurological status preoperatively. He had a vertical shear pelvic fracture with right SI joint dislocation repaired through an anterior approach. Post-operatively, the patient is noted to have decreased sensation in the 1st dorsal webspace of the right foot, with decreased right extensor hallucis longus power. What is the MOST likely cause of his deficit?
A. Injury to deep peroneal nerve at time of accident
B. L5 nerve root injury at time of accident
C. Injury to sciatic nerve at time of accident
D. Injury to sciatic nerve at time of surgery
E. Saphenous nerve injury at time of surgery
B. L5 nerve root injury at time of accident.
Sensation of first dorsal webspace innervated by L5 nerve root.
- A patient is involved in a deceleration MVC and sustains chest trauma, presenting tachycardic and hypotensive. CXR shows a widened mediastinum.
What is the MOST appropriate course of action?
A. Insert left sided chest tube
B. Obtain an aortogram
C. Obtain a CT scan with contrast
D. Perform cardiac catheterization
B. Obtain an aortogram.
Widened mediastinum is the most common signs of aortic dissection on radiographs- emergency, needs to be ruled out
- With regard to heart transplantation, all of the following are true EXCEPT:
A. Infection is the # 1 cause of late death
B. 5 year survival is ~ 75%
C. Approximately half of patients undergoing heart Tx have underlying ischemic cardiomyopathy
D. Patients with HIV are not eligible for cardiac transplantation
A. Infection is the #1 cause of late death
causes of death post transplant:
- graft failure- first 30 days
- infection - 6mos-1 year
- Acute rejection 1 - 3 years
- Cardiac Alograft Vasculopathy - after 1 year
- Malignancy and Lymphoma - after 5 years
(UptoDate)
half of pts have ischemic disease, but better prognosis for those without
- What is the mechanism of action of bisphosphonates?
A. Increased calcium absorption.
B. Decreased calcium absorption
C. Increased vitamin D absorption
D. Osteoclast inhibition
D. osteoclast inhibition
- What is the most common abnormality associated with a Meckel’s diverticulum?
A. Patent urachus
B. Enteroumbilical fistula
C. Ectopic gastric mucosa
D. Intestinal volvulus
C. Ectopic gastric mucosa
- Meckel’s diverticulum is a true diverticulum, containing all layers of the small bowel wall. They arise from the antimesenteric surface of the middle-to-distal ileum. The diverticulum represents a persistent remnant of the omphalomesenteric duct, which connects the midgut to the yolk sac in the fetus.
- Case series have found that 12 to 21 percent of patients with Meckel’s diverticula have ectopic tissue within the diverticulum [5,10,25,26]. Gastric heterotopia is more common in patients with symptomatic versus asymptomatic Meckel’s diverticula [6,10,11].
- A patient is having an abdominal CT with IV contrast. You should avoid which of the following medications?
A. Metformin
B. Glyburide
C. Synthroid
D. Insulin
A. Metformin
Metformin is contraindicated in patients with factors predisposing to lactic acidosis.
These predisposing factors/contraindications are:
●Impaired renal function
●Concurrent liver disease or alcohol abuse
●Unstable or acute heart failure at risk of hypoperfusion and hypoxemia
●Past history of lactic acidosis
●Decreased tissue perfusion or hemodynamic instability due to infection or other causes
In clinical practice, some experts use an estimated glomerular filtration rate (eGFR) of >30 mL/min as a threshold for the safe use of metformin.
- Which of the following is TRUE regarding bi-polar cautery?
A. Confines tissue damage to between tines
B. Low frequency current for coagulation
C. Will not work in a wet environment
D. Causes extensive tissue damage
A. Confines tissue damage to between the tines.
Bipolar advantages (5):
- Less thermal injury to surrounding tissue
- Less risk of patient burn
- No interference with ECG
- No interference with pacemakers
- Can be used in wet fields
- Which of the following factors is most deplete in FFP?
A. Factor II
B. Factor VII
C. Factor V
D. Factor X
B
FFP has all factors but VII has shortest half life
It is used mostly for Vit K factors and is the only replacement that has Factor V (as per schwarz)
