ACE 2014-11a Flashcards
Things to do within 3 hours of severe sepsis:
Measure lactate
Blood cultures prior to atbx
Broad spectrum atbx
30 mL/kg of crystalloid
Plexus block to relieve visceral pelvic pain
Superior hypogastric plexus block
Occurrence of spontaneous bleeding in patients with HIT
Rare
Medications that induce p450 system
Carbamazepine Dexamethasone Modafinil Omeprazole St. John's wort
Transfusion associated graft vs host disease occurs most commonly in what age group?
Patients over age 60 yrs, developing 1-6 weeks after transfusion
Induction drug associated with increased seizure duration for ECT
Etomidate
Preop test that is best predictor of post thoracotomy morbidity and mortality
VO2: Maximal oxygen consumption
< 12mL/kg/min = 7x risk
< 1 flight of stairs = < 10mL/kg/min
5 flights = > 20mL/kg/min
Traditional cutoff for preop paCO2 level for pulmonary resection
paCO2 > 69 mmHg
Single most important cause of morbidity and mortality in patients with subarachnoid hemorrhage who survive initial bleed
Delayed cerebral ischemia, presenting 3-14 days after initial bleed
Only drug demonstrating benefit to subarachnoid hemorrhage patient
Nimodipine
Adrenergic agonist that is metabolized by lungs
Norepinephrine
Mechanism of fenoldopam
Selective dopamine type 1 receptor agonist that decreases renal vascular resistance and increases renal blood flow
Only intervention with documented efficacy in resolving the inability to ventilate with opioid induced rigidity
administration of neuromuscular blocking drugs
Single most important stimulus for hypoxic pulmonary vasoconstriction
PAO2, partial pressure of oxygen at the alveoli
Drugs to treat wide complex SVT associated with WPW
Lidocaine, amiodarone, procainamide
Why is aspirin contraindicated in patients with hyperthyroidism
It inhibits binding of thyroid hormone and can increase levels of free t4 and t3
Conditions that increase carbon monoxide diffusion capacity
Exercise, asthma, polycythemia, pulmonary hemorrhage, left to right intracardiac shunting
What causes exacerbation of multiple sclerosis (MS) symptoms?
Increased body temperature, emotional and physiological stress
Pretreatment with what medication may decrease frequency of abnormal movements during induction?
Fentanyl
Only consistent method to prevent dementia or postop cognitive dysfunction (POCD)
Identifying patients at risk preoperatively with geriatric consultation
Cherry red colored blood occurs when carbon monoxide levels are greater than?
40%
Treatment of choice for thrombotic thrombocytopenic purpura (TTP)
Plasma exchange
Why is succinylcholine contraindicated with Guillain-Barré syndrome (GBS) patients?
Hyperkalemia risk is increased due to proliferation of post synaptic receptors
Cyclosporine most commonly causes toxicity in what organ?
Kidneys
