Metabolism & Diseases Of Aging Flashcards
Acute attacks of porphyria are most commonly precipitated by events that decrease _____ and increase activity of _______ and stimulate production of porphyrinogens
Heme concentration; ALA synthase
The most important tirggers in the development of acute porphyria
Enzyme-inducing drugs
Patients at known risk of porphyria but perviously asymptomatic (silent or latent porphyria) may experience their first symptoms in response to?
Administration of tirggering drugs during the perioperative period
Which drugs are okay to give with porphyrias? Which are bad?
All inhalational drugs ok;
Toradol, ketamine, etomidate, thiopental, & amio = Bad
Particular attention myst be given to _______ and ________ since these signs may predict impending respiratory failure and an increased risk of pulmonary aspiration
Skeletal muscle strength; cranial nerve function
Drug of choice for management of acute gouty arthritis
Colchicine (lacks any effect on purine metabolism)
Self-mutilation often involves trauma to ______ with Lesch-nyhan syndrome
Perioral tissues
The mainstay treatment of hemochromatosis
Phlebotomy to physically remove iron from the body
Brown rings around the rim of the cornea seen with wilson’s dz
Kayser-fleischer rings
Hallmark of atherosclerosis
Inflammation, with inceased cholesterol as a cofactor
Any systolic dysfunction in the elderly should be considered abnormal, especially if it is accompanies by _________
Wall motion abnormality
Cardiovascular changes with aging:
LA chamber size ⬆️;
The electrical system declines with age;
The number of pacemaker cells is reduced by 90% by age 70;
Prolongation of PR interval, QRS duration, & QT interval;
Slowere resting HR
A state of reduced physiologic reserve that is a/w increased susceptibility to disability
Frailty
_______ is an independent predictor of in-hospital mortality
Frailty
One of the early hallmarks of dementia
Intellectual decline
MAC values decrease by about _____ per decade after age 40 for volatile anesthetics and about ____ per decade for nitrous oxide
6%; 8%
The ________ of neuromuscular blocking drugs are not significantly altered by age
Pharmacodynamics
Which patients are considered to be at severe nutritional risk?
Unintentional weight loss > 10% - 15% over the last 6 mos;
BMI < 18.5;
Or serum albumin below 3g/dL
A 3 item recall and clock drawing test that efficiently screens for cognitive impariment; 1 point is awarded for each item recalled and 2 points for a normal-appearing clock
The mini-cog
The strongest predisposing factor for postop delirium
Preexisting dementia
