730 Flashcards

1
Q

Zwitterion

A

Molecule with positive and negative charge

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2
Q

MAP calculation

A
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3
Q

Metric chart

A
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4
Q

Henrys law-gas/liquids

A

At constant temperature the amount of gas dissolved in a liquid is directly proportional to the partial pressure of the gas at equilibrium above the gas-liquid interface

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5
Q

Grahams Law

A

The rate of effusion (gas diffusion through an orifice) of a gas is inversely proportional to the square root of its molecular weight….
i.e. small molecules diffuse faster…

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6
Q

Diffusion vs osmosis

A

Diffusion is the movement of particles from high to low concentration

Osmosis is the movement of water (or the solvent) from a less concentrated solution to a more concentrated solution in an attempt to reach equilibrium

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7
Q

Osmotic pressure

A

The pressure required to prevent osmosis

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8
Q

Ideal body weight calc men and women

A

Women: 100 + (5lbs/inch over 5ft)

Men: 105 + (6lbs/inch over 5 ft)

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9
Q

Fahrenheit from C

A

F= (5/9*C)+32

C to f : double it and add 30

F to C: subtract 30 an halve it

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10
Q

C from Fahrenheit

A

C=5/9(F-32)

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11
Q

Acceptable Blood Loss calculation
(ABL)

A

Based on EBV (estimated blood volume)
EBV*0.20=ABL

EBV for Men: 75mL/kg an Women: 65mL/kg

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12
Q

You have ephedrine 50 mg in 1 mL. You want to prepare a syringe with 10 mg/mL. What size syringe should you use? In the second step, you set up a proportion to answer the question, If the final concentration is to be 10 mg/mL, how much diluent do you add to 1 mL of ephedrine (50 mg/mL)?

A

5mL syringe,
1mL to 4mL lol

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13
Q

example 4: Epinephrine is available, marked “1/1,000” and “1 mg/mL.” You are asked to “double-dilute” it, so you take 1 mL of the epinephrine 1:1,000 and add 9 mL diluent. Then you discard all but one mL of the new mixture, and add 9 mL diluent. What is the resulting concentration of epinephrine in micrograms/mL?

A

• Epi 1:1,000 contains 1 mg/mL (= 1,000 mcg/mL). Taking 1 mL and adding 9 mL diluent yields a syringe with 1,000 mcg/10 mL (100 mcg/1 mL).
• Taking 1 mL of this mixture (containing 100 mcg/mL) and adding 9 mL diluent to it yields a syringe containing 100 mcg/10 mL. Each mL of the “double-diluted” new mixture contains 10 mcg/mL.

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14
Q

What is 0.0625% Bupivicaine in mg/ml?

A

0.625 mg/ml
% is g/100ml so it is 62.5mg/100ml or
0.625mg/ml

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15
Q

Give me mcg/ml from bag of 400mg in 250ml using the trick thingy

A

In each 0.25 mL (1/1,000th of the volume), there is 1/1,000th of the drug mass the entire bag holds.
• 400 mg x 0.001 = 0.4 mg = 400 mcg
• 250 mL x 0.001 = 0.25 mL

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16
Q

Epi 1:100,000
Give me micrograms/ml

A

Ratios are grams/ml

10mcg/ml

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17
Q

Epi 1:200,000

A

5mcg/ml

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18
Q

Epi 1:1,000,000

A

1mcg/ml

19
Q

Epi 1:1,000,000

A

1mcg/ml

20
Q

Impact of hypokalemia on cell membranes

A

Hyperpolarizes

21
Q

Impact of hyperkalemia on cell membranes

A

Depolarizes

22
Q

Potassium redistribution

A

(shift intracellularly)
-insulin+D50
-hyperventilation
-bicarbonate
-Beta-2 agonist (Albuterol)

Elimination
-potassium wasting diuretics
-kayexalate
-dialysis

23
Q

EKG response to hypokalemia

A

Long PR and QT
Flat T wave
U wave

24
Q

EKG response to hyperkalemia

A

5.5-6.5 Peaked Twaves
6.5-7.5 Pwave flattening
7-8. QRS prolongation
>8.5 QRS-Sine wave- VF

25
Q

Calcium gluconate in Hyperkalemia

A

The role of calcium gluconate in treating hyperkalemia is to stabilize cardiac cell membranes. Calcium should promptly be administered to any patient with hyperkalemia and EKG changes indicating a hyperkalemic emergency.

Elevated potassium levels destabilize cardiac membranes by increasing the threshold potential of cardiac myocytes.

Calcium supplementation decreases the threshold to restore the transmembrane voltage gradient.

26
Q

Tidal volume

A

Amount of gas inhaled and exhaled during breath

6-8 ml/kg

27
Q

Minute ventilation
Vs
Alveolar ventilation

A

Tidal volume x respiratory rate

(Tv-dead space)x resp rate

28
Q

What does increased dead space (Vd) lead to?

A

Widens paCO2-EtCO2 gradient- causes co2 retention

29
Q

A-a Gradient

A

Difference between alveolar oxygen and arterial oxygen

Normal when breathing room air is <15mmHg

Causes of increased gradient:
-aging
-vasodilators- decreased HPV
-R to L shunt-defect or bronchial intub
-diffusion limitation

30
Q

Estimation of % shunt based on A-a gradient

A

Shunt increases by 1% for every 20mmHg

31
Q

Why is acidosis associated with hyperkalemia?

A

When H+ is transported into cells K+ is transported out

32
Q

Normal HCO3-

A

22-26mEq/L

33
Q

ABG
How do we know if it is a respiratory disorder?

A

pH and PaCO2 move in opposite directions

34
Q

ABG
How do we know it’s a metabolic disorder?

A

Bicarbonate and ph move in same direction

35
Q

Normal anion gap

A

8-12 mEq/L

36
Q

Causes of Metabolic Acidosis
Elevated Anion Gap

A

M ethanol
U remia
D iabetic ketoacids

P araldehyde
I soniazid
L actate (sepsis/cyanide)
E thanol, ethylene glycol
S alicylates (inhibits Kreb cycle)

37
Q

Metabolic acidosis
Normal Anion Gap

A

HARDUP
H ypoaldosteronism
A cetazolamide
R enal tubular acidosis
D iarrhea
U retosigmoid fistula
P ancreatic fistula

38
Q

Hypercarbia in PULMONARY blood vessels vs peripheral circulation

A

CO2 is a vasoconstrictor in the lungs and can cause pulmonary hypertension and increase right heart workload

39
Q

What metabolic disturbance can an MTP cause?

A

Metabolic alkalosis

-liver converts citrate to bicarbonate

40
Q

Key difference between gap and non-gap acidosis

A

Accumulation of acid=gap acidosis. NO BICARBONATE

Loss of bicarbonate or ECF dilution= non-gap acidosis. GIVE BICARBONATE

41
Q

How does pulse oximeter work

A

Based on beer-lambert- relates light passed through solution and the concentration of solute

Two wavelengths
660- absorbed by deoxyhemoglobin
940- absorbed by oxyhemoglobin

Spo2 is the ratio- (oxy/(oxy+deoxy)) *100

42
Q

Explain left shift on oxygen/hemoglobin curve

A

Increased affinity for O2 (binding at lower partial pressure of Oxygen)

Left=Love

In Lungs:
Decreased H+, Lower CO2, Lower temp

43
Q

Explain right shift of Oxy/hemoglobin curve

A

Decreased affinity for O2-
Right=Release

Occurs near metabolically active tissue
Higher temp, increased CO2 and H+