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Comprehensive Exam #1 Study Guide > Main points from brain dump > Flashcards

Main points from brain dump Flashcards

1
Q

A deficiency of what causes angioedema?

A

C-1 esterase inhibitor

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2
Q

What are 2 treatment options for angioedema?

A

C1 inhibitor concentrate or FFP

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3
Q

What are the 3 goals of treatment for anaphylaxis?

A
  1. reverse hypotension
  2. reverse hypoxemia
  3. inhibit cell degranulation
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4
Q

What causes anaphylaxis?

A

mass release of vasoactive mediators via degranulation of mast cells and basophils - the antigen reacts with IgE

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5
Q

_____ and ____ undergo degranulation during anaphylaxis

A

mast cells and basophils

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6
Q

______ is not associated with an IgE reaction.

A

Anaphylactoid

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7
Q

What is lost after heart transplant?

A

Vagal tone

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8
Q

There are no ___,___,or___ innervation after heart transplant.

A

sympathetic, parasympathetic, or sensory

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9
Q

After heart transplant, the patient is ____ dependent.

A

preload

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10
Q

What drugs do not work after heart transplant?

A

Ephedrine and Atropine

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11
Q

How long is a kidney viable for transplantation?

A

48 hours

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12
Q

After kidney transplant, the SBP should be ____ and volume status should be ______ to maintain urine output.

A

high-normal SBP; euvolemia

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13
Q

Can a newly transplanted kidney clear NMBD and anticholinesterase?

A

yes

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14
Q

What is given to faciliate urine formation by new kidney after transplant?

A

Mannitol

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15
Q

What happens after unclamping during kidney transplnat?

A

hypotension

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16
Q

What is the treatment for acute rejection of kidney?

A

removal

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17
Q

What are the LFT after liver tranplant?

A

normal

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18
Q

What are respiratory considerations wtih liver transplant?

A

oxygenation improves, but intrapulmonary shunt may persist

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19
Q

What is the most common indication for liver transplant?

A

cirrhosis d/t HCV

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20
Q

Post-op liver transplant, the normal physiologic mechanism that protect hepatic blood flow are ____

A

blunted

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21
Q

Post-op liver transplant, autotransfusion of blood voluem in shock via a vasoconstrictive response is _____

A

impaired

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22
Q

What hormones are released with small cell lung cancer?

A

ADH, ACTH, PTH

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23
Q

With shock, resuscitation is targeted to achieve a MAP >____

A

65

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24
Q

With shock, resuscitation is targeted to achieve a CVP __-___

A

8-12

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25
With shock, resuscitation is targeted to achieve a ____ UO
adequate
26
With shock, resuscitation is targeted to achieve a ____ pH
normal
27
With shock, resuscitation is targeted to achieve a mixed venous oxygen saturation >____
70%
28
How long does processing of harvested bone marrow take?
2-12 hours
29
How long does bone marrow engraftment take?
10-28 days
30
When are MG exacerbations most likely to occur during pregnancy?
1st trimester and early postpartum
31
Type ____ MG is limited to extraocular muscles
1
32
What is MG?
An autoimmune disorder that causes decrease in functional Ach receptors at NMJ d/t destruction by antibodies
33
MG has a related occur to _____ problems
thymus gland
34
What is 1st line treatment for MG?
Anticholinesterase (Pyridostigmine)
35
What medications exacerbate MG?
Penicillamine ND NMBD AMinoglycosides Procainamide
36
What population is MG most common in?
Women 20-30
37
Can you give ND NMBD with MG?
yes, if you need to, you should decrease dose by 1/2-1/3
38
What response might be absent with GB?
compensatory CV response
39
When can profound hypotension occur with GB?
positioning, blood loss, PPV
40
Can you administer sux with GB?
No
41
Why can you not administer sux with GB?
risk for excessive K+ release
42
What should ventilation be initiated in patients wtih GB?
VC <15 mL /kg
43
What NMB can be used with GB?
Vec or Nimbex - no histmaine release and minimal circulatory effects
44
Where does weakness start with GB?
in legs and spreads cephalad
45
What happens to postsynaptic receptors in GB? What does this cause?
upregulation of receptors; exaggerated response to indirect-acting vasopressors
46
Myasthentic syndrome is also called what?
Eaton-Lambert
47
What is eaton-lambert?
a disorder of NM transmission that resembles MG; IgG antibodies to voltage-sensitive Ca+ channels causes defiiences in these channels
48
In eaton-lambert, ___ antibodies to voltage-sensitive ___ channels cuase deficiency fo these channels.
IgG; Ca+
49
Will you see an improvement of S/S of Eaton-Lambert with anticholinesterase?
No
50
Will you see an improvement of MG with anticholinesterase?
Yes
51
How do you treat eaton-lambert?
IVIG, Plasmapheresis, cancer treatment
52
What patient population is eaton-lambert more common in?
Males
53
Are patients with eaton lambert sensitive to Sux? What about other ND NMBD?
Yes; and yes
54
Eaton-Lambert/Myasthenic syndrome has a relationship to what other problem?
SCC of lung
55
What is another name for anti-glomerular basement membrane antibody disease?
Goodpasture syndrome
56
What 2 things are associated with goodpasture syndrome?
glomerulonephritis and pulmonary hemorrhage
57
GOodpasture is most common in waht patient population?
young males
58
Why is plasmapheresis used in goodpasture?
to remove disease-causing antibodies
59
What are the 2 treatments used in goodpasture?
plasmaphereiss and corticosteroids
60
What is the prognosis of goodpasture?
poor
61
How soon does renal failure develop in patients with goodpasture?
1 year
62
In pts with goodpasture, pulmonary dx occurs in ___%
50-60%
63
For patients iwth COPD, post-op ventilation may be needed if the FEV1/FVC ratio is ____ or pre-op PaCO2 ____-
<50%; >50
64
COPD patients have: ____ RV ___ FRC ___TLC
increased RV, FRC, and TLC
65
What deficiency is associated with COPD?
alpha1-antitrypsin
66
What is the diagnosis for COPD?
FEV1/FVC <70% not reversible with bronchodilators
67
When is O2 recommended for COPD patients?
PaO2 <55 Hct >55 Cor pulmonale
68
What is a predictor of post-op complciations in COPD patients?
Poor nutritional status w/ albumin <3.5
69
What happens in Aperts?
Cranium, midface, bones, soft tissue of hands and feet all fuse
70
What are anesthetic considerations with Aperts?
Possible difficult airway/airway obstruction, OSA, difficult IV access
71
What is Crouzons?
Fusion of cranium, midface bones (DOES NOT INCLUDE VISCERA AND EXTREMITIES LIKE APERTS)
72
How do you treat porphyria crisis?
hydration and carbs
73
What meds should NOT be given to porphyria?
Etomidate, barbiturates, toradol
74
In porphyria, single exposure to potent triggers may be well-tolerated, ______ acute attack
not during
75
What porphyria condition is life-threatening?
acute intermittent porphyria
76
What is the induction drug of choice in patients with porphyria?
propofol
77
How do you treat acute attcks of porphyria?
heme therapy
78
What is charcot-marie-tooth?
inherited disorder that leads to alterations in peripheral nerve function
79
The peripheral nerve dysfunction associated with charcot-marie-tooth is limited to ____
lower 1/3 of legs
80
What deformities occur with charcot-marie-tooth?
foot deformities and peroneal muscle atrophy
81
What are the anesthesia considerations for charcot-marie-tooth?
focus on respnse to NMB and possible post-op respiratory fialure
82
What 3 things are done to manage pheochromocytoma?
1. volume loading 2. phenoxybenzamine 3. DNP
83
Where does pheochromocytoma arise from?
chromaffin cells
84
Does clonidine have an effect in pheochromocytomae?
no
85
When should you d/c phenoxybenzamine before pheochromocytoma revmoal?
24-48 horus prior to surgery (to avoid vascular unresponsiveness after tumor removal)
86
With pheochromocytoma, never give ____ before _____ b/c it can lead to unopposed alpha agonism/HTN.
BB; alpha locker
87
What is the agent of choice for HTN in pheochromocytoma?
SNP
88
WHat is the most common nerve damaged with coarctation of aorta?
left laryngeal nerve
89
What problems are associated with aortic clamping?
renal failure, gut ischemia, paraplegia
90
where should you monitor BP for coarctation of aorta?
right arm (above clamp)
91
What is the medical management for aortic aneurysms?
Statins, BB, avoid exercise
92
What 3 conditions are commonly associated wtih aortic aneyrsym
ischemic heart dx, DM, renal dx
93
DeBakey Class I:
proximal ascending aort, aortic arch, descending thoracic and abomdinal aorta
94
Debakey class II:
ascending aorta only
95
Debakey class III
descending or extends into abdominal or iliac arteries
96
Surgery for AAA is recommended when AAA>___ or expands by >___/year
5.5cm or 0.6-0.6cm/yr
97
What is the triad of S/S for ruptured AAA?
hypotension, back pain, pulsatile mass
98
What is seen on X-ray wtih AAA?
wide mediastinum
99
What heart chamber is most likley to be injured?
RV

Comprehensive Exam #1 Study Guide (3 decks)

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