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Principles of Anesthesia I > Module 5 Week 4 > Flashcards

Module 5 Week 4 Flashcards

1
Q

the most common endocrinopathy

[C.A. CH23]

A

Diabetes Mellitus (DM)

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2
Q

defined as a blood glucose above 200 mg/dL in the absence of known diabetes

[C.A. CH23]

A

Critical illness-induced hyperglycemia

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3
Q

Diabetics have an increased risk of

[C.A. CH23]

A

CAD, hypertension, congestive heart failure, and perioperative MI

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4
Q

The incidence of silent ischemia is increased in patients with

[C.A. CH23]

A

DM

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5
Q

Characterized by severe dehydration, hyperglycemia, and hyperosmolarity

[C.A. CH23]

A

nonketotic hyperosmolar state

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6
Q

Target HgA1c for type 1 diabetics

[C.A. CH23]

A

<7.5%

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7
Q

Target HgA1c for type 2 diabetics

[C.A. CH23]

A

<7%

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8
Q

Initiation of β-blockers prior to the day of surgery should be considered in diabetic patients with at least

[C.A. CH23]

A

two other risk factors for an adverse cardiac event

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9
Q

Preoperative blood glucose should be kept below

[C.A. CH23]

A

<200mg/dL

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10
Q

How long before surgery should oral hypoglycemics be held

[C.A. CH23]

A

Held on the Day of surgery

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11
Q

During surgery patients on insulin drips should have their BG checked at what frequency?

[C.A. CH23]

A

Every 1-2 Hours

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12
Q

Hypothyroidism can lead to the development of

[C.A. CH23]

A

hypothermia, hypoglycemia, hypoventilation, hyponatremia, and heart failure

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13
Q

In cases where the patient has a large thyroid mass that may distort the airway what should be done

[C.A. CH23]

A

a chest x-ray should be obtained looking for evidence of tracheal deviation or narrowing

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14
Q

Patients with hyperparathyroidism often have

[C.A. CH23]

A

Hypercalcemia

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15
Q

Preoperative consideration for patients with hyperparathyroidism

[C.A. CH23]

A

Evaluation of serum calcium level

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16
Q

General clinical manifestation of hyperthyroidism

[C.A. CH23]

A

Weight loss; heat intolerance; warm, moist skin

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17
Q

Cardiovascular clinical manifestation of hyperthyroidism

[C.A. CH23]

A

Tachycardia, atrial fibrillation, congestive heart failure

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18
Q

Neurologic clinical manifestation of hyperthyroidism

[C.A. CH23]

A

Nervousness, tremor, hyperactive reflexes

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19
Q

Musculoskeletal clinical manifestation of hyperthyroidism

[C.A. CH23]

A

Muscle weakness, bone resorption

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20
Q

GI clinical manifestation of hyperthyroidism

[C.A. CH23]

A

Diarrhea

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21
Q

Hematologic clinical manifestation of hyperthyroidism

[C.A. CH23]

A

Anemia, thrombocytopenia

22
Q

General clinical manifestation of hypothyroidism

[C.A. CH23]

A

Cold intolerance

23
Q

Cardiovascular clinical manifestation of hypothyroidism

[C.A. CH23]

A

Bradycardia, congestive heart failure, cardiomegaly, pericardial or pleural effusion

24
Q

Neurologic clinical manifestation of hypothyroidism

[C.A. CH23]

A

Slow mental function, minimal reflexes

25
Q

Musculoskeletal clinical manifestation of hypothyroidism

[C.A. CH23]

A

Large tongue, amyloidosis

26
Q

GI clinical manifestation of hypothyroidism

[C.A. CH23]

A

Delayed gastric emptying

27
Q

Renal clinical manifestation of hypothyroidism

[C.A. CH23]

A

Impaired free water clearance

28
Q

General clinical manifestation of Hyperparathyroidism

[C.A. CH23]

A

Hyperparathyroidism

29
Q

Cardiovascular clinical manifestation of Hyperparathyroidism

[C.A. CH23]

A

Hypertension, heart block

30
Q

Neurologic clinical manifestation of Hyperparathyroidism

[C.A. CH23]

A

Weakness, lethargy, headache, insomnia, apathy, depression

31
Q

Musculoskeletal clinical manifestation of Hyperparathyroidism

[C.A. CH23]

A

Bone pains, arthritis, pathologic fractures

32
Q

GI clinical manifestation of Hyperparathyroidism

[C.A. CH23]

A

Anorexia, nausea, vomiting, constipation, epigastric pain

33
Q

Renal clinical manifestation of Hyperparathyroidism

[C.A. CH23]

A

Polyuria, hematuria

34
Q

Clinical presentation of patients with a pheochromocytoma

[C.A. CH23]

A

intermittent hypertension, headache, diaphoresis, and tachycardia

35
Q

most obvious manifestation of long-term high-dose steroid treatment

[C.A. CH23]

A

Cushing syndrome

36
Q

Clinical manifestation of Cushing Syndrome

[C.A. CH23]

A

moon facies, striations of the skin, truncal obesity, hypertension, easy bruisability, and hypovolemia

37
Q

Liver disease is associated with decreased plasma protein production, thereby affecting

[C.A. CH23]

A

drug binding, volume of distribution, metabolism and clearance

38
Q

__________ accompanies liver failure

[C.A. CH23]

A

Coagulopathy

39
Q

Specific risk factors for Liver Disease

[C.A. CH23]

A

previous blood transfusions, illicit drug use, or excessive alcohol intake

40
Q

Signs of underlying liver disease

[C.A. CH23]

A

jaundice, spider nevi, ascites, hepatosplenomegaly, or palmar erythema

41
Q

Severity of hepatic disfunction is assessed by using

[C.A. CH23]

A

the Model for End-Stage Liver Disease (MELD) score

42
Q

Acceptable preoperative hemoglobin level for patients without systemic disease

[C.A. CH23]

43
Q

Top 10 risk factors for aspiration

[C.A. CH23]

A

Emergency Surgery, Inadequate anesthesia, Abdominal pathology, obesity, opioid medication, neurological deficit, Lithotomy, difficult intubation/airway, Reflux, Hiatal Hernia

44
Q

Minimum fasting period for Clear liquids

[C.A. CH23]

A

At least 2 hours

45
Q

Minimum fasting period for Breast milk

[C.A. CH23]

A

At least 4 hours

46
Q

Minimum fasting period for Infant formula, nonhuman milk and light meal

[C.A. CH23]

A

At least 6 hours

47
Q

ERAS prep interventions

A
  • targeted pt edu
  • carb loading
  • less fasting time
  • warming
  • selective Bowel prep
48
Q

ERAS intra-op interventions

A
  • epidural if possible
  • warming
  • no tubes or drains
  • short acting anesthetics
  • MIS sx
49
Q

ERAS POST OP

A
  • regular analgesia such as NSAIDs
  • preemptive pain and nausea management
  • early feeding
  • nutritional supplements
  • early mobilization
50
Q

What is the esophageal doppler also used for preop?

A

You can assess SV and assess pt fluid status

51
Q

What can you use to replace volume loss?

A

Crystalloids 3:1

Colliods 1:1

52
Q

EABL= EBl × HCTstart - HCTallowable

÷ HCTstart

A

This will give you the amount of blood that can be lost before CONSIDERING transfusion

Principles of Anesthesia I (6 decks)

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