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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
Q

massive transfusion

A
  • 3-4 units over 1 hour
  • replacement of 50% total blood volume within 3 hours
  • transfusion greater than 20 units in 24 hours
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26
Q

Complications of Massive Transfusion

A
  • coagulopathy
  • hyperkalemia
  • hypocalcemia
  • acidosis
  • decreased 2,3 DPG
  • hypothermia
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27
Q

average human blood volume

A

5 L

(3L of plasma and 2L of RBC)

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28
Q

HCT in one unit of RBC

A

70%

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29
Q

volume in one unit of RBC

A

300-350 mL

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30
Q

what are leukocyte reduced RBCs used

A

to reduce febrile transfusion reactions

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31
Q

Risk of Hepatits

A

C = 1:800k

B = 1:220k

32
Q

Risk of HIV

A

1 : 1,000,000

33
Q

What blood component has the greatest risk of transmission of infectious disease?

A

platelets

34
Q

why is cryoprecipitate given?

A

replace factor VIII

  • hemophilia, fibrinogen deficiencies, von Willebrand’s disease, DIC
35
Q

storage defects that occur in stored blood

A
  • decreased
    • pH
    • 2,3 DPG
    • ATP
    • glucose
    • clotting facotrs V and VIII
  • Inreased
    • potassium and phosphate
36
Q

plasma makes up ____% of total blood volume

A

55%

37
Q

shelf-life of PRBC

A

42 days

38
Q

1 Unit of platetles will increase platelet count by _____

A

10,000 / mm3

39
Q

how much plasma is in each cryo unit?

A

15 mL

40
Q

frozen expiration date for cryo

A

365 days

41
Q

1 unit of cryo will increase fibrinogen by _____

A

20-30 mg / 100 mL

42
Q

AHTG

A

Acute Hemolytic Transfusion Reaction

43
Q

Acute Hemolytic Transfusion Reaction

A

occurs when ABO incompatible blood is transfused

  • RBC lysis
  • release of bradykinin -> hypotension
  • mast cell activation -> serotonin and histamine release
44
Q

signs and sypmtoms of AHTR

A
  • fever
  • hypotension and tachycardia
  • hemoylobinuria
  • unexplained bleeding
  • renal shutdown
45
Q

Incidence of fatal hemolytic transfusion reaction

A

1 in 1,000,000

46
Q

symptoms of AHTR in awake patients

A

chills, fever, nausea, chest pain, and flank pain

47
Q

Delayed Hemolytic Transfusion Reaction

[causes]

A

incompatible minor antigens

48
Q

presentation of delayed HTR

A

2 days to 1 month after transfusion

characterized by extravascular hemolysis

49
Q

FNHTR

A

Febrile Non-Hemolytic Transfusion Reaction

50
Q

most common transfusion reaction

A

FNHTR

51
Q

most common cause of FNHTR

A

platelets

With what blood component is there the greatest risk of transmission of infectious disease?

52
Q

allergic transfusion reaction

A

recipient antibody response to donor plasma proteins

53
Q

TRALI

A

transfusion related acute lung injury

54
Q

TRALI cause

A

Reaction between recipient WBC and donor leukocyte antibodies

55
Q

Metabolic complications in massive blood transfusion

A

K+, Ca2+, acid/base, and DIC

56
Q

transfusion is usually more acidodic or alkalotic?

A

alkalotic

  • banked blood is usually acidic, but the citrate has a higher effect
57
Q

NAT

A

Nucelic Acid Testing

58
Q

a 6 pack of platelets will raise the patient’s paltelet count by _____

A

25,000 cells/mm3

59
Q

FFP is necessary when PT and/or PTT is greater than _____

A

1.5x normal

60
Q

each bag of cryo contains _____ and _____

A

200mg of fibrinogen and 100 units of Factor VIII

61
Q

indications for transfusion:

O2ER > _____ in patients with adequate CO

A

0.5

62
Q

indications for transfusion

VO2 < _____

A

100 mL/min/m2

63
Q

1 cause of transfusion related death in the US

A

TRALI

64
Q

CPDA

A

citrate-phosphate-dextrose-adenine

anticoagulant given to whole blood

65
Q

AABB

A

american association of blood banks

66
Q

CMV

A

cytomegalovirus

67
Q

what sound is heard in an obstructing patient

A

stridor

68
Q

Mendelson syndrome

A

aspiration pneumonitis

chemical injury to the lungs caused by inhalation of sterile acidic gastric contents

69
Q

aspiration pneumonia

A

inhalation of particulates that become colonized by bacteria

70
Q

cardiogenic pulmonary edema

A

elevated left atrial pressure that may be precipitated by fluid overload

71
Q

causes of pre-renal AKI

A

decreased blood volume or impaired renal hemodynamics

72
Q

causes of post-renal AKI

A

obstruction of urinary blood flow

73
Q

always rule out ___ and ____ in delirium

A

hypoxia and hypercarbia

74
Q

Differential Diagnosis of Anaphylaxis

A
  • vasovagal reaction
  • MI
  • pulmonary embolism
  • aspiration
  • seizure
  • carcinoid tumor
75
Q

TIPS

A

Transjugular intrahepatic portosystemic shunt

76
Q

Transjugular intrahepatic portosystemic shunt

A

procedure that may be used to reduce portal hypertension

Quarter 5 (8 decks)

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