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Quarter 5 > Principles Exam II > Flashcards

Principles Exam II Flashcards

1
Q

What is the incidence of herbal medicine use in the surgical population?

A

40%

women greater than men

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2
Q

Ephedra

A

weight loss and energy

  • cardiovascular and CNS stimulants
  • can cause severe hypertension, dysrhythmia, MI, seizures, CVA, and death
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3
Q

Vitamin E

A

prevent cardiovascular disease, diabetes, and cancer

  • can antagonize vitamin K dependent clotting factors and platelet aggregation
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4
Q

Fish Oil

A

hyperlipidemia, hypertension, and inflammation

  • decrease blood viscosity, increase red blood cell deformability, inhibits prostacyclin, and prolongs bleeding time
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5
Q

Gingko

A

dementia

  • inhibits platelet aggregation
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6
Q

Ginseng

A

general “well-being”

  • can raise blood pressure and interferes with platelet aggregation
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7
Q

Ginger

A

arthritis, GI, and anti-emetic

  • inhibits prostaglandin, leukotriene synthesis, and decreases platelet aggregation
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8
Q

IV contrast

A

typically Iodine

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9
Q

What patients are at increased risk of renal failure following the use of contrast?

A
  • renal disease, diabetes, jaundice, myeloma, and decreased renal blood flow
  • patients taking Metformin must be discontinued for 48 hours
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10
Q

percentage of cross-sensitivity between penicillins and cephalosporins

A

8-10%

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11
Q

Anaphylaxis

A

Severe immune mediated allergic reaction manifest as hypotension, tachycardia, cardiovascular collapse, bronchospasm, flushing, urticaria, angioedema, GI Symptoms

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12
Q

anaphylactoid reaction

A

severe non-immune allergic reaction

  • release of inflammatory mediators from mast cells and basophils results in activation of complement cascade
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13
Q

80% of all anaphylactic reactions in the OR are due to ______

A

muscle relaxants or latex

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14
Q

percentage of cross sensitivity between amides and esters

A

none

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15
Q

key factors associated with awareness

A

higher ASA and muscule relaxants

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16
Q

most common organ injured in penetrating trauma

A

liver

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17
Q

most common organ injured in blunt trauma

A

spleen

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18
Q

approximately ____% of all patients requiring laparotomy for trauma will have _____ injuries

A

30% of all patients will have hepatic injuries

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19
Q

Shock and transfusion related coagulopathy in the immediate postop period are responsible for ______% of deaths in liver injury patients

A

80%

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20
Q

Portal Triad

A

portal vein, hepatic artery, and common bile duct

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21
Q

at what percentage of blood loss will you see a drop in pressure?

A

15-30%

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22
Q

Signs of Tension Pneumothorax

A

uneven chest rise, unequal breath sounds, deviated trachea, distended neck veins, increased airway pressure

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23
Q

Treatment of Tension Pneumothorax

A

large bore needle in 2nd intercostal space midclavicular line

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24
Q

Easy Cap

A

detect expired CO2

y=yellow= yes for CO2

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25
massive transfusion
* 3-4 units over 1 hour * replacement of 50% total blood volume within 3 hours * transfusion greater than 20 units in 24 hours
26
Complications of Massive Transfusion
* coagulopathy * hyperkalemia * hypocalcemia * acidosis * decreased 2,3 DPG * hypothermia
27
average human blood volume
5 L | (3L of plasma and 2L of RBC)
28
HCT in one unit of RBC
70%
29
volume in one unit of RBC
300-350 mL
30
what are leukocyte reduced RBCs used
to reduce febrile transfusion reactions
31
Risk of Hepatits
C = 1:800k B = 1:220k
32
Risk of HIV
1 : 1,000,000
33
What blood component has the greatest risk of transmission of infectious disease?
platelets
34
why is cryoprecipitate given?
replace factor VIII * hemophilia, fibrinogen deficiencies, von Willebrand's disease, DIC
35
storage defects that occur in stored blood
* decreased * pH * 2,3 DPG * ATP * glucose * clotting facotrs V and VIII * Inreased * potassium and phosphate
36
plasma makes up \_\_\_\_% of total blood volume
55%
37
shelf-life of PRBC
42 days
38
1 Unit of platetles will increase platelet count by \_\_\_\_\_
10,000 / mm3
39
how much plasma is in each cryo unit?
15 mL
40
frozen expiration date for cryo
365 days
41
1 unit of cryo will increase fibrinogen by \_\_\_\_\_
20-30 mg / 100 mL
42
AHTG
Acute Hemolytic Transfusion Reaction
43
Acute Hemolytic Transfusion Reaction
occurs when ABO incompatible blood is transfused * RBC lysis * release of bradykinin -\> hypotension * mast cell activation -\> serotonin and histamine release
44
signs and sypmtoms of AHTR
* fever * hypotension and tachycardia * hemoylobinuria * unexplained bleeding * renal shutdown
45
Incidence of fatal hemolytic transfusion reaction
1 in 1,000,000
46
symptoms of AHTR in awake patients
chills, fever, nausea, chest pain, and flank pain
47
Delayed Hemolytic Transfusion Reaction [causes]
incompatible minor antigens
48
presentation of delayed HTR
2 days to 1 month after transfusion characterized by extravascular hemolysis
49
FNHTR
Febrile Non-Hemolytic Transfusion Reaction
50
most common transfusion reaction
FNHTR
51
most common cause of FNHTR
platelets With what blood component is there the greatest risk of transmission of infectious disease?
52
allergic transfusion reaction
recipient antibody response to donor plasma proteins
53
TRALI
transfusion related acute lung injury
54
TRALI cause
Reaction between recipient WBC and donor leukocyte antibodies
55
Metabolic complications in massive blood transfusion
K+, Ca2+, acid/base, and DIC
56
transfusion is usually more acidodic or alkalotic?
alkalotic * banked blood is usually acidic, but the citrate has a higher effect
57
NAT
Nucelic Acid Testing
58
a 6 pack of platelets will raise the patient's paltelet count by \_\_\_\_\_
25,000 cells/mm3
59
FFP is necessary when PT and/or PTT is greater than \_\_\_\_\_
1.5x normal
60
each bag of cryo contains _____ and \_\_\_\_\_
200mg of fibrinogen and 100 units of Factor VIII
61
indications for transfusion: O2ER \> _____ in patients with adequate CO
0.5
62
indications for transfusion VO2 \< \_\_\_\_\_
100 mL/min/m2
63
#1 cause of transfusion related death in the US
TRALI
64
CPDA
citrate-phosphate-dextrose-adenine anticoagulant given to whole blood
65
AABB
american association of blood banks
66
CMV
cytomegalovirus
67
what sound is heard in an obstructing patient
stridor
68
Mendelson syndrome
aspiration pneumonitis chemical injury to the lungs caused by inhalation of sterile acidic gastric contents
69
aspiration pneumonia
inhalation of particulates that become colonized by bacteria
70
cardiogenic pulmonary edema
elevated left atrial pressure that may be precipitated by fluid overload
71
causes of pre-renal AKI
decreased blood volume or impaired renal hemodynamics
72
causes of post-renal AKI
obstruction of urinary blood flow
73
always rule out ___ and ____ in delirium
hypoxia and hypercarbia
74
Differential Diagnosis of Anaphylaxis
* vasovagal reaction * MI * pulmonary embolism * aspiration * seizure * carcinoid tumor
75
TIPS
Transjugular intrahepatic portosystemic shunt
76
Transjugular intrahepatic portosystemic shunt
procedure that may be used to reduce portal hypertension

Quarter 5 (8 decks)

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