Principles Final Flashcards
Alphagan P
glaucoma
Actonel
osteoporosis
Azor
hypertension (ARB/CCB)
Effient
platelet inhibitor
Viibryd
depression
Levitra
erectile dysfunction
Novir
HIV
Lipitor
cholesterol
Tradjenta
DM II
Aggrenox
aspirin and dipyridamole
prevent platelet aggregation
Lexapro
depression
SSRI
Diuril
high blood pressure
diuretic
Micardis
anti-hypertensive
ARB
Atacand
ARB
Voltaren
NSAID
Deplin
vitamin B deficiency for depression
Dexilant
proton pump inhibitor
Imuran
immunosuppressant for arthritis
Ultracet
acetaminophen and tramadol
Patanol
ocular anti-histamine
Amitiza
IBS
Advair
asthma and COPD
Lotemax
ocular steroid
Uloric
gout
Cardiovascular manifestations of Rheumatoid Arthritis
- pericardial inflammation and effusions
- myocarditis
- vasculitis
- valvular fibrosis
Pulmonary manifestations of Rheumatoid Arthritis
- pleural effusions
- pulmonary fibrosis
- fibrotic nodules (Caplan syndrome)
Hematopoietic manifestations of Rheumatoid Arthritis
- normocytic normochromic anemia
- Felty synrdome
Renal manifestations of Rheumatoid Arthritis
amyloidosis
Endocrine manifestations of Rheumatoid Arthritis
adrenal insufficiency
Acute normovolemic hemodilution
initially take blood from patient with normal hemoglobin, hydrate them during case, and replace blood at the end
2 Procoagulant drugs
Tranexemic acid and aminocaproic acid
Bier Block
Using two cuffs, replace intrervascular space with local anesthetic
- Esmark bandage
- Lidocaine 0.5% 30mL
- only gives 30 min of pain relief
- cuff must remain on for 30 min to avoid local toxicity
Systolic difference between head and heart
- 86 mmHg difference
- therefore, 22mmHg difference if 1 foot
Max systolic of tourniquet on arm
50-75 mmHg
Max systolic of tourniquet on lower extremity
100-150 mmHg
Deflation of tourniquet
- decrease in blood pressure
+ due to lactic acid and vasodilation - excess CO2
- temperature may decrease
Tourniquet safe time
2 hours
Compartment Syndrome
pressure buildup from internal bleeding or swelling of tissue
- treat with fasciotomy
Neurogenic Shock
spinal cord disruption, usually above T6
- hypotension and bradycardia
Most common place for fat embolism to come from
long bone fractures
Major features of Fat Embolism syndrome
- respiratory distress
- cerebral changes
- petechial rash
- aterial blood gas
Bone cement
Methylmethacrylate
- can enter circulation and cause hypotension, bronchoconstriction, hypoxia, and cardiac arrest
Which patients should not be given NSAIDS?
asthmatics, kidney disease, and peptic ulcers
FESS
functional endoscopic sinus surgery
Epiglottitis
- avoid muscle relaxation
- inhalational induction
- use 0.5 smaller ETT
- keep patient spontaneously breathing
Tonsillectomy
- “gagging” may cause vagal response
- extubate on side so blood falls out
- risk of bleeding
Biggest risk of bleeding after tonsillectomy
right after surgery and 7 days
Ludwig’s Angina
skin infection that occurs on the floor of the mouth, under the tongue
Foreign Body Aspiration
inhalational induction so the patient continues to breath spontaneously
Apenic Oxygenation
hyperventilate patient then surgeon can work a little bit, they go back and hyperventilate again
Airway Fire Precautions
- use a laser ETT
- reduce inspired O2 to less than 30%
- avoid nitrous
- fill cuff with saline dye
- place a soaked gauze around airway
- use only water-based solvents
- limit laser exposure
- maintain a ready source of water
Subglottic stenosis
narrowing of the trachea by a fixed lesion that compromised air flow
Le Fort Classification
I - lower third of the nose and jaw
II - upper nasal bone and pterygoid plate
III - base of skull separate from midface
Free Flaps vs. Pedicle Flap
Free Flap
- donor tissue taken from distant site
- blood supply not intact
Pedicle
- tissue maintains blood supply
- taken from area near by
Flap Procedures
- avoid vasoconstriction
- keep patient warm
- nerve monitoring
NIMS tube
nerve integrity monitor
- recurrent laryngeal nerve sensory
- no long acting muscle relaxants
Parathyroid removal
- regulate calcium
- could get a laryngospasm and closure of cords
Location of Kidney
retroperitoneal space
- between T12 and L4
- inferior to liver
What is a effect of compartment syndrome
rhabdomyolysis
TURBT
Transurethral resection of bladder tumors
Autonomic hyperreflexia
- mostly commonly seen about T6 spinal cord injuries
- headache, cardiac ischemia, nasal congestion due to hypertension
- most commonly caused by bladder distension
TURP
Transurethral resection of the prostate
- inability to completely empty bladder
- treat with alpha blockers
TURP syndrome
absorption of irrigation fluid causing hyponatremia
Signs of TURP syndrome in the awake patient
- Confusion
- nausea
- visual loss
- coma
- seizures
Management of TURP syndrome
- inform surgeon
- stop procedure
- obtain electrolytes and ABG
- support breathing
- treat fluid overload
Central Pontine Myelinolysis
Can occur if hyponatremia is treated too quickly; irreversible
- 1 meq/L/hr sodium correction
ESWL
Extracorporeal shock-wave Lithotripsy
Percutaneous Nephrolithotomy
incision in prone to remove stone
Prostate Cancer
- second leading oncologic cause of death in men
- PSA elevated
Prostatectomy
reduce fluid administration
- will obscure surgical field due to high urine output
Immediate Treatment for Airway Fire
- Remove endotracheal tube
\+ pour saline into airway
- Stop all airway gas flow
- Re-establish ventilation
- Inspect ETTImmediate care for Fire on Patient
- stop flow
- remove burning materials
- extinguish fire
- care for patient
- consider evacuating
What medicines should you hold before surgery?
Hold ACE, ARB, and diuretics
Normal insufflation for a laparoscopic procedure
12-15 mmHg
