jensen2 Flashcards
best indicator liver synthetic ability
PT
best indicator liver excretory function
bilirubin
anion gap
Na - (Cl + HCO3)
increased anion gap
LUK SEMP - lactic acidosis, uremia, ketoacidosis, salicylates, ethylene glycol, methanol, paraldehyde
large a waves
MS, heart block, atrial myxoma
large v waves
MR, MS, CHF, VSD
ascites with hepatic failure
decreased intravascular oncotic pressure
citrate toxicity symptoms
hypotension, poor CO, decreased SVR - aggravated by hypothermia and hyperkalemia (more pronounced with renal failure)
increased risk for TNS
lidocaine, lithotomy, out patient
altitude change and gas
high altitudes/lower atmospheric pressure = increased vapor pressure (higher amount delivered than on dial)
nitrogen wash out
breathe 100% O2, measure nitrogen volume at initial concentration and final to calculate FRC
biceps strength dermatome
C5-C6
thumb dermatome
C6
triceps strength dermatome
C7-C8
little finger dermatome
C8
nipple dermatome
T4-5
umbilicus dermatome
T10
iliopsoas strength dermatome
L2-3
knee jerk/quads dermatome
L3-4
toe extension dermatome
L4-5
great toe dermatome
L5
plantar flexion dermatome
S1
factor Xa mechanism of action
catalyzes conversion of prothrombin to thrombin
clopidogrel/ticlopidine
noncompetitively and irreversibly inhibits ADp induced platelet aggregation
argatroban metabolism and monitor
metabolized by liver, monitor with PTT (used for patients with history of HIT)
lepirudin mechanism and metab
direct thrombin inhibitor; renally cleared (used for patients with history of HIT)
argatroban mechanism
direct thrombin inhibitor (liver metabolism)
fondaparinux (arixtra) mechanism
inhibitor of activated factor X (for DVT prophylaxis)
best indication of ischemia in OR
(TEE) lead II and V ST depression is 95% sensitive
treat heparin resistance
FFP or recombinant antithrombin III
common MAOIs
Isocarboxazid (Marplan), Phenelzine (Nardil)
Selegiline (Emsam), Tranylcypromine (Parnate)
face mask flow and %
8-10 L/min; 40-60%
nasal cannula O2 enhancement
4-5% per liter (max ~55%)
nasal cannula reservoir
concentration of O2 is function of oxygen flow rate (does not exceed peak inspiratory flow rate for normal tidal 40 L/min) and minute ventilation - hypovent=FiO2 high vs hypervent=FiO2 low
venture mask
FiO2 is independent of minute ventilation and inspiratory flow rate - oxygen concentration can be controlled
NO mechanism
acetylcholine stim release of NO which stim cGMP - decrease in intracellular calcium
highest MAC requirements
2-3 months old
sevo/mac/peds
same MAC for neonates and infants
hyperaldosteronism
HTN, hypokalemia (ass with polyuria and polydipsia), treat with aldosterone antagonist spironolactone
fluid for craniotomy
NS ok, avoid solutions with glucose, avoid LR (273 osm) because decreases plasma osm and may increase incidence of cerebral edema
avoid CMV in blood products
WBC washed
hyperventilation treats…
hyperkalemia
baclofen mechanism
GABA B agonist that works centrally
baclofen se
drowsiness, dizziness, GI symptoms, confusion, hypotension
central retinal artery
ass with venous drainage obstruction or cardiac surgery with emboli; cherry red macula
ant ischemic optical neuropathy
ass with older, DM, HTN, SLE, open heart surgery; unilateral blindess 2/2 pressure on globe
post ischemic optical neuropathy
ass with hypotension, decreased hct; bilateral, prone position, no optic disk abnormality
cortical blindness
ass with cardiac/thoracic surgery, CABG, hypotension; bilateral with loss of optokinetic reflex
meperidine and heart
causes tachycardia
midazolam bioavailability
higher with IM than intranasal
estimating age with weight
(age x 2) +9
rocuronium and vecuronium metab
mainly biliary excretion, but use caution with liver and renal dysfunction
anticholinesterase inhibitors and kidney
renal failure prolongs
oxygen delivery equation
O2 content ([1.34xhgbxSaO2] + [0.003 x PaO2]) x CO
zoster common location
thoracic and upper lumbar
trifurcation on bronchoscope
right upper lobe bronchial segment
dead space increase
upright position, neck extension, age, anticholinergics, PE, hypotension, emphysema, COPD, anesthesia machine, rebreathing
electrical cardioversion contraindications
dig toxicity and hypokalemia
fixed lesion
subglottic stenosis
variable extra-thoracic lesion
supraglottic tumor
variable intra-thoracic lesion
bronchial adenoma
abductor of vocal cords
posterior cricoarytenoid muscle innervated by RLN
direct thrombin inhibitors
argatraban, lepirudin, hirudin, dabigatran, bivalirudin,