Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

abs > PERIOPERATIVE > Flashcards

PERIOPERATIVE Flashcards

1
Q

urine dipstick positive for “trace” blood without RBCs

A

myoglobinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

serum CK seen in rhabdo

A

10 fold upper limit of normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

potassium during and after exercise

A

rise markedly during extreme exercise but fall to concentrations well below baseline even at 5 min after cessation of activity and remain below baseline for several hrs
directly proportional to bulk of muscle mass used during exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

change in pH of 0.1 equates to a change in bicarb of approx

A

6 mEq/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how do you measure anion gap

A

Na + K - Cl - HCO3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

high anion gap causes

A 
Methanol ingestion
Uremia
DKA
Propylene glycol
Isoniazid intox
Lactate
Ethylene glycol ingestion
Rhabdo
Salicylates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

fenestrating subtotal chole

A

leaving infundibulum/cystic duct orifice open with placement of drain in Morison poiuch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

reconstituting method for subtotal chole

A

closure of a cuff of infundibulkum over the top of the cystic duct orifice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

highest risk of stroke according to CHADS VASC

A

age 75 or older, previous stroke/TIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

variables involved in Frailty index

A

comorbidiites
ADL
attitude
Nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

gram negative infections resistant to other antibiotics - consider what type of abx?

A

aminoglycoside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

acid base disturbance seen in malignant hyperthermia

A

respiratory acidosis and in most cases metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pathophys of MH

A

uncontrolled release of intracellular calcium from SR of skeletal muscle –> abnormal skeletal muscle metabolism –> skeletal muscle contraction, rigidity, increased oxygen consumption and CO2 production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

which type of anesthetics are known triggers for MH

A

all inhalation anesthetics EXCEPT ITROUS OCIDE

succinylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

dose of dantrolene

A

2.5 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MOA of dantrolene

A

inhibits ryanodine receptor channel which reduces RyR1 channel activity in muscle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

tx of MH aside from dantrolene

A

admin of IV saline at 4 degrees celsius
topical ice to all exposed areas
peritoneal washing with cold saline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what electrolyte can worsen the clinical syndrome of MH

A

calcium!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

repeated ventricular dysrhythmias in MH - treatment?

A

amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

first sign of MH

A

increase in end tidal CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

1st to go down and last to recover from paralytics

A

neck msucles and face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

last muscle to go down and first to recover from paralytics

A

diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

depolarizing paralytic

A

succinylcholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

which non depolarizing agent undergoes hoffman elimination

A

cis atracurium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

which non depolarizing agent can be used in liver and renal failure

A

cis atracurium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

rocuronium undergoes what kind of metabolism

A

hepatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

pancuronium undergoes which metabolism

A

renal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

most common side effect of pancuronium

A

tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

which drugs should be given with neostigmine/edrophonium

A

atropine or glycopyrrolate to counteract effects of generalized acetylcholine overdose (these drugs block acetylcholinesterase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

if thrombotic risk is high and hemorrhagic risk is intermediate

A

continue ASA
discontinue plavix
Resume within 24-72 hr with loading dose
consider bridging with short acting IV APT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

anti PD-1

A

pembrolizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

anti CTLA-4

A

iplimumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

anti MEK

A

trametinib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

“-tinib”

A

tyrosine kinase inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

“-zomib”

A

proteasome inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

“ciclib”

A

cyclin dependent kinase inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

prehabilitation to reduce postop complications has been shown to decrease

A

ICU LOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

preoperative oral carb loading will

A

reduce insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

after stopping blood transfusion, best option in mgmt for treating incompatibility transfusion reaction

A

IVF resuscitation with NS, goal UOP 100 mL/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

how to prevent future febrile transfusion reactions

A

leukocyte filters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

MOA of milrinone

A

PDE-3 inhibitor
decreases cAMP degradation and improves myocardial contractile mechanism by increasing inflxu of calcium into cells
Peripheral vasodilation and reduced resistance
same MOA as cilostazol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

MOA of midodrine

A

alpha 1 receptor agonist causes vasoconstriction by increasing phospholipase C activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

alpha adrenergic anatgonists - MOA and examples

A

reduce arteriolar resistance by blocking alpha receptors normally bound by epi and norepi. common ones are dozazosin, prazosin and tamsulosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

MOA Factor V Leiden

A

factor V is usaually inactivated by an activated protein C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

MC fisolated gram negative and gram positive organism assoc with VAP

A

P. aeuruginosa

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

highest percentage of RAS mutations

A

pancreatic adenoCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

during the 1st 24 hrs stress or starvation, organ with highest glycogen stores

A

liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

2/3 of bodys glycogen stores are where

A

skeletal muscle

muscle doesnt have enzyme glucose 6 phosphatase which allows release of free glucose into circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

ID accessory spleen

A

technetium sulfur colloid scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

during wound healing when does the maximum accumulation of collagen occur

A

day 21

after this the AMOUNT stays the same but continued collagen cross linking improves strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

first cells to arrive in wound

A

platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

predominant cell type days 0-2 injury

A

PMNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

predominant cell type days 3-4 injury

A

macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

predominant cell type day 5 + after injury

A

fibroblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

most impt factor in healing open wounds

A

epithelial integrity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

most important factor in healing closed incisions

A

tensile strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

predominant collagen type synthesized during proliferation

A

type III collagen

58
Q

predominant collagen type synthesized during remodeling

A

type I

59
Q

at 3 weeks of wound healing what is the collagen like

A

type III replaced by type I

60
Q

osteogenesis imperfecta is due to

A

type I collagen defect

61
Q

tx of epidermolysis bullosa

A

phenytoin

62
Q

casue of epidermolysis bullosa

A

excessive fibroblasts

63
Q

chemo has no effect on wound healing after

A

14 days

64
Q

keloids - goes beyond or stays within scar confines

A

goes beyond

65
Q

dense granules contain

A

adenosine, serotonin and calcium

66
Q

platelet aggregation factors (3)

A

TXA2
thrombin
platelet factor 4

67
Q

EKG chagne in hypercalcemia

A

shirtened QT interval

68
Q

most significant facvtors influencing the oxygen content of blood

A

Hgb and Hct

69
Q

Oxygen content equation

A

CaO2. = (Hgb x 1.34 x 02 sat) + (0.003 x PaO2)

70
Q

MC cause of emphysematous cholecystitis

A

Clostridia (anaerobic gram + rods)

71
Q

Clostridia species are what kind of bacteria

A

anaerobic gram + rod

72
Q

MC small bowel met

A

melanoma

73
Q

deficiency of C5-C9 would result in

A

reduced bacterial cell lysis due to difficult in formation of MAC

74
Q

CD4 receptor binding and upregulation of T cell functio nis afunction of

A

CD4 helper T cells

75
Q

why do transfusions lead to hyperkalemia?

A

plasma concentration of potassium icnreases by approx 1 mEq/L per day in stored packed RBC due to passive leakage of potassium from RBCs.

76
Q

elemental formulas supply ___ insteado f ___

A

free AA instead of proteins therefore they are more easily absorbed

77
Q

indications for elemental formulas (3)

A

inshort bowel syndrome
eosinophilic esophagitis
milk protein allergy

78
Q

most powerful stimulus for adrenal aldosterone secretion

A

Angiotensin II

79
Q

ACTH and potassium do what to aldosterone secretion

A

stimulate

80
Q

decrease in plasma sodium has what effect on aldosterone

A

stimulates release

81
Q

hinchey Ia

A

confined pericolic inflammation/phlegmon

82
Q

hinchey Ib

A

confined pericolic abscess (<5 cm)

83
Q

MC side effect Zosyn

A

diarrhea

84
Q

malignancy assoc with EBV

A

gastric CA, Burkitt lymphoma, Hodgkins lymphoma

85
Q

which virus is Kaposi sarcoma ssoc with

A

HHV 8

86
Q

what do you give pt with antithrombin III deficiency

A

FFP

87
Q

which product contains highest concentration of vWF-VIIII

A

cryo

88
Q

FFP contains

A

high levels of all coag factors, protein C, protein S, and AT-IIII

89
Q

best test for liver synthetic function

A

PT

90
Q

MC bacteria in postop parotititis

A

staph auerus

91
Q

refractory SB AVM bleeding

A

thalidomide

92
Q

greatest amt of protein turnover occurs in

A

skeletal muscle

93
Q

which enzyme cleaves AT I from circulating angiotensinogen

A

renin

94
Q

acid base disturbance from ileostomy

A

normal AG metabolic acidosis

95
Q

hypoventilation –> what respiratory disorder

A

acidosis

96
Q

how does amphotericin B work

A

prevents fungal growth and kills fungi by binding to fungal cell wall sterols and causing cell death via lysis

97
Q

side effect of amphotericin B

A

nephrotoxicity (liposomal type has fewer AE)

98
Q

invasive aspergillosis –>

A

voriconazole

99
Q

candidemia tx

A

nidulafungin (Eraxis)

100
Q

how do the fungins work

A

inhibit synthesis of cell wall glucan

101
Q

how does voriconazole work

A

inhibits ergosterol synthesis which is needed for cell wall

102
Q

tx of fungal sepsis OTHEr than candida and aspergillus

A

liposomal amphotericin

103
Q

function of IL 2 and who is it secreted by

A

regulkates activity of WBC , increases fibroblast infiltration and metabolism
secreted by T lymphocytes

104
Q

IL-4 does what to naive T helper cells

A

helps then to become T helper.2 cells

105
Q

major liver resection can cause significant decrease in levels of

A

phosphate - repaid phosphate utilization in regenerating hepatocytes h

106
Q

effect of hyperthermia on phosphate levels

A

HYPERphosphatemia due to large load of intracellular phopshate that spills into blood secondary to cell death

107
Q

hypoPTH impact on phosphate levels

A

HYPERphosphatemia as PTH is responsible for stimulating phosphate EXCRETION at level of kidneys

108
Q

metabolic acidosis impact on phosphate levels

A

HYPERphosphatemia due to compensatory shifts of phosphate from intraceullar to extracellular compartment

109
Q

deficiency in which mineral can lead to hyperglycemia

A

chromium

110
Q

which 2 vitamin deficiencies can lead to cardiomyopathy

A

thiamine or B1 as well as selenium

111
Q

deficiency of which vitamin can lead to sideroblastic anemia

A

pyridoxine or vitamin B6

112
Q

deficiency of essential FA

A

dermatitits, hair loss, thrombocytopenia

113
Q

vitamin E deficiency

A

neuropathy, ataxia, retinol degeneration, hemolytic anemia, infertilita

114
Q

prerenal azotemia will have what imapct on urine sodium

A

decrease to <20 because it stimulates release of aldosterone which leads to resorption of sodium rom collecting ducts

115
Q

if renal failure due to retroperitoneal fibrosis occurs the tx is

A

surgery to free up the ureters should be done

if active infection can de percutaneous nephrostomy untik definitivie surgery can be performed

116
Q

which phase of cell cycle is most susceptible to radiation

A

M phase

117
Q

MOA of tamoxifen

A

estrogen agonist in non breast tissues but competitive estrogen antagonist in the breast

118
Q

where does the process of collagen production begin in the prolif phase of wound healing

A

finroblast

119
Q

highest rate of blood transfusion related infection

A

hepatiatis B

120
Q

contraindications to resection of hepatic mets in GI NET

A 
diffuse bilobar liver involvement
pre existing liver dysfunction
extrahepatic mets
poorly differentiated CA
inability to resecvt majority of tumor
121
Q

carcinoid syndrome MC in pts with tumors located where in GI tract

A

midgut (jejunum, ilkeum and cecum)

122
Q

how much fluid is ABSORBED by small bowel daily

A

8.5 L (out of 9L total)

123
Q

howm uch fluid produced via saliva daily

A

1500 mL

124
Q

Ig most commonly provided to neonate during breast feeding

A

IgA

125
Q

initial Ab secreted after exposure to antigen

A

IgM

126
Q

MC Ab in spleen

A

IgM

127
Q

most abundant antibody in body

A

IgG

128
Q

Which Ig crosses placenta

A

IgG

129
Q

whcih Ig is a membrane bound receptor on B cells

A

IgD

130
Q

how many antigen binding sites does IgM have

A

10 (everyone else has 2)

131
Q

secondary lymphoid organs

A

spleen, LN

132
Q

bolus feeds should only be delivered through

A

stomach NOT jejunum

133
Q

MC genetic alteration in pancreatic CA

A

KRAS

134
Q

MOA metronidazole

A

produces O2 radicals that break up DNA structure

135
Q

inhibition of protein synthesis by acting on 50S ribosomal subunit describes what 3 drugs

A

linezolid
erythryomycin
clindamycin

136
Q

inhibition of protein synthesis by acting on 30S ribosomal subunit describes what 2 drugs

A

tetracycline

aminoglycoside

137
Q

inhibitor of RNA polymerase

A

rifampin

138
Q

which abx class considered bactericidal

A

aminoglycosides

139
Q

which abx are PABA analogues and inhibit purine synthesis

A

sulfonamides

140
Q

MCC LGIB in AIDS pt

A

CMV

141
Q

Dabigatran prolongs what time

A

PTT but NON DOSE RELATED FASHION

142
Q

Xarelto elevates what lab

A

aPTT and PTT although inconsistently

abs (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions