Exam Review from class -josh Flashcards
All taken from Ingrids notes she took
ECF volume is controlled by what
Aldosterone
ECF osmolarity is controlled by what?
ADH
Creatiinine is not reabsorbed by the kidneys, it is a waste product of what?
muscle metabolism
does normal creatinine equal good renal fxn?
nope could still have decreased GFR
BUN has alot of confounding factors a level of what usually indicats bad GFR
> 50 mg/dL
what is teh first thing to go w/ injury to the kidneys?
ability to concentrate urine (you can’t concentrate it)
What test is expensive but is a better indication of renal function than creatinine
Cystatin C
what is a blanket term to describe bad things that happen to the kidneys?
AKI
what is Oliguric AKI UOP
< 400 cc/day
What is non-oliguric AKI UOP
> 400 cc/day
GFR is determined by what?
ultrafiltration coefficient
In the kidneys there are 2 smooth muscle sphincters at teh capillary bed. it can constrict what 2 things
Efferent arterioles
or
Afferent arteriole
what is prerenal Azotemia
nothing wrong w/ the kidney but something is making them work harder
What is intrarenal Azotemia
problem lies within parenchyma
what labs will help you differentiate b/t pre and interrenal Azotemia
BUN/Creatinine and osmolality
so if BUN/Creatinine ratio 20 x more BUN than creatine it is what pre or intra renal
Prerenal (BUN is dehydration status indicator-creatinine not reabsorbed)
BUN/Creatine ration if 10-20 x more BUN then is it pre or intra renal
Intrarenal
if urine osmolality > 500 mOsm/kg what is it pre or inter
pre
if urine osmolality is < 400 mOsm/Kg what is it pre or inter renal
interrenal
Obstruction of urinary outflow tract is what type of renal faliure?
post
does n dopamine work?
nope
what drug is know to be renal protective
fenoldopam
should you give pt’s in AKI diuretics?
nope doesnt show to help
what does PEEP and pneumoperitineum do to RBF?
decreases it
what does CPB/ non-pulseatile flow do to renal perfusion? and what does it produce?
Decreases it
produces free radicals
what drugs are big offenders for pt’s w/ AKI
NSAIDs
ace inhibitors
aminoglycosides
immunosupressents
why would pt’s w/ AKI get poss RSI and no LMA?
delayed gastric emptying
basics to TURP syndrome?
Open venous sinus in prostate allows absorption of irrigation fluid
what clotting factors are pro clot
1-13
what factors are anticlot
protein c/s
Plasmin
Plasminogen
tpa
what is a big preop assessment that can show bleeding disorders?
ask about bleeding gums
what are teh major vitamins involved in anemia
B12 & folic Acid
what is the most common type of anemia
iron deficiency
skeletal malformations with increased severty , will cause intubation problems w/ what type of anemia
Thalassemia
Aplastic anemia will show what with labs?
pancytopenia
____ or ____ dz can also cause anemia
kidney or liver
what type of anemia do you get neuro deficits (parasthesia, gait disturbances, decreased reflexes)
B12
what type of anemia is most common in the surgical world?
dilutional anemia
1 unit of PRBCs will increase Hgb amd Hct how much
Hgb 1 g
HCT 3%
what is the biggest trigger for Sickle cell
hypoxemia
what happens when the ODC when 2,3 DPG decreases
shift to left
when id teh most common time you will see a decrease in 2,3 DPG levels
stored PRBCs
what is te biggest factor for 2,3 DPG levels in stored blood
storage time
10-12 units of cryoprecipitate will increase fibrinogen by how much?
100mg/dL
stress and anxiety are linked to what GI disturbance?
IBS
what GI inflammatory affects the entire thickness of the bowel
Crohn’s
what GI inflammatory disease affects the inner most lining of the COLON
Ulcertive colitis
what age/sex is most effected by Anorexia?
young girls
what age/sex is most effected by binging?
older males
what eating d/o is associated w/ mallory weiss syndrome or gastroesophageal lacerations?
Bulimia -b/c you throw up so hard you injure the esophagus
what is the basics principles w/ malabsorption syndromes?
you body isn’t absorbing what it needs
what malabsorption syndrome is associated w/ zollinger ellison syndrome?
MEN1
what malabsorption syndrome is associated w/ hormone secreting glands?
MEN 2
what is worse OHS or OSA
OHS
