Liver Renal Burns

Question 1

Renal pain

Answer 1

T10-L1 sympathetic

Question 2

parasympathetic renal inervation

Answer 2

vagus nerve

Question 3

renal sympathetic innervation

Answer 3

T8-L1 preganglionic

Question 4

ureters innervation

Answer 4

S2-S4

Question 5

Innervation of bladder

Answer 5

sympathetic T11-L2
parasympathetic S2-S4

Question 6

another name for aterial pressure

Answer 6

glomerular capillary pressure

Question 7

another name for renal blood flow

Answer 7

glomerular oncotic pressure

Question 8

major determinents of GFR?

Answer 8

aterial pressure and renal blood floqw

Question 9

intense SNS stimulation does what?

Answer 9

consctrict afferent and decreae RBF

Question 10

mild SNS does what?

Answer 10

constricts efferent to increase RBF

Question 11

what do NO and prostaglandins do?

Answer 11

dilate afferent to increase GFR

Question 12

what does angiotensin activity do?

Answer 12

constrict efferent

Question 13

myogenic reflex

Answer 13

pressure

increase in arterial pressure = constriction by reflex
decrase in pressure = dilation by reflex

Question 14

where is 2/3 of Na and H2O reabsorbed?

Answer 14

PCT
Na is active transport
H2O is passive reabsorption

Question 15

ANP does waht?

Answer 15

diuresis, systemic vasodilation

Question 16

name three renal vasodilators

Answer 16

NO prostaglandins ANP

Question 17

where are prostaglandins produced?

Answer 17

kidneys

Question 18

what does renal vasodilation cause?

Answer 18

increae in Na and H20 excretion. Thus the reason ANP wants to cause vasodilation

Question 19

when do you see symptoms for hypnatremia?

Answer 19

<125

Question 20

most common cause of AKI in surgical patients?

Answer 20

actue tubular necrosis

Question 21

how does AKI cause excess nitrogenous substances adn waste?

Answer 21

cant excrete them. accumulation of creatinine and urea in the blood

Question 22

name some nephrotoxins

Answer 22

aminoglycosides, chemo drugs, NSAIDS, contrast dye

may take 24-48 hours to develop and peaks in 3-5 days

Question 23

endogenous nephrotoxins?

Answer 23

calcium
uric acid
myoglobin (rhabdo)
hemoglboin (hemolysis)
bilirubin
paraproteins

Question 24

when is renal azotemia irreversible?

Answer 24

if ischemia is severe or prolonged

Question 25

what causes actue intersitital nephriits?

Answer 25

acute druge rxn

Question 26

increase interval of waht two meds?

Answer 26

APAP and ASA

Question 27

intervel stays the same for what meds?

Answer 27

al/remi/sufentanil

Question 28

decrease dose of?

Answer 28

codeine fentanyl torodol meperidine methadone morphine

Question 29

is chronic renal failure irreversible?

Answer 29

yes

Question 30

electrolyte imbalances in CKD?

Answer 30

hyp kalmemia mag and calcemia hyperphosphatemia

Question 31

how does urea affect platle function?

Answer 31

makes them dysfunctional

Question 32

what is renal osteodystrophy?

Answer 32

join issues from the hyperphos and hypocalcemia

Question 33

what causes pruritius?

Answer 33

uremia and waste build up

Question 34

how do kidney patiens respond to induction?

Answer 34

as if hypovolemic

Question 35

Anes meds in kindey patients?

Answer 35

N2O is okay, ISO is most hemodynamically stable

Question 36

when do you get uremic syndrome?

Answer 36

when GFR drops to < 10%

Question 37

what is nephrolithiasis?

Answer 37

kidney stones most and calcium oxalate flank pain can be a sign of ureteral stone

Question 38

you can get what with glycine solution?

Answer 38

hyperammonemia

Question 39

when might you see a wide QRS and elevated ST?

Answer 39

TURP syndrome

Question 40

can you get DIC in TURP?

Answer 40

yes. from hyponatremia??

Question 41

what to do to prevent TURP

Answer 41

resesction time < 1hour bag no >30cm from bed to start and 15 during end of resection avoidi hypotonic solution

Question 42

are spinals good during turp?

Answer 42

yes they say awake so they can talk to you, ensure they dont get TURP syndrome

Question 43

TURP tx

Answer 43

oxygenation and ciruclatory support tell surgeon to stop ASAP invasive monitors send labs

Question 44

how to tx mld TURP?

Answer 44

fluid restriction and loop diurectics

Question 45

how to tx severe turp?

Answer 45

3% NS at <100ml/hr DC when NA>120

Question 46

is extra or intra peritoneal more common?

Answer 46

extra peritoneal this also heals itself intraperitoneal needs surgery

Question 47

bladder rupture

Answer 47

more common in peds than adults

Question 48

what would cause chemical peritonitis?

Answer 48

intraperitoneal bladder rupture

Question 49

intraperitoneal symptoms are more like what?

Answer 49

MI. extraperiotneal symptoms are more generalized pain

Question 50

which volatiles directly cause renal dysfunction?

Answer 50

methoxyflurane and enflurane

Question 51

is thiopenal good in renal patients?

Answer 51

no

Question 52

ketamine?

Answer 52

okay

Question 53

etomidate

Answer 53

okay, incrased free fraction decrease dose?

Question 54

benzos

Answer 54

decraes dose

Question 55

propofol

Answer 55

go slow

Question 56

dex

Answer 56

okay

Question 57

can you use codeine or meperidine?

Answer 57

no

Question 58

morphine?

Answer 58

single dose okay, nothing more

Question 59

order of NMB agents

Answer 59

cis, atracurium, then ROC Vec is prolonged

Question 60

what NMB have minimal renal excretion?

Answer 60

succ, atracurium, cis, micacurium

Question 61

short acting NMB?

Answer 61

micacron. eliminated by plasma cholinesterase at rate slower than succ

Question 62

what meds undergoe hoffman elimination>

Answer 62

cis-attracurium and attracuriuym

Question 63

where does acetezoalmide work?

Answer 63

PCT

Question 64

where does mannitol work?

Answer 64

descending tuble

Question 65

where do thiazide diurecgics work?

Answer 65

DCT

Question 66

where does spiro work?

Answer 66

Collecting duct

Question 67

where do loop diuretics work?

Answer 67

ascending loop