R8 Flashcards
what cases do you STOP aspirin for?
intracranial nsgy, middle ear surgery, posterior eye, intramedullary spine, prostate
benefits of low molecular weight heparin over unfractionated heparin?
selective inhibition of Xa
this is helpful bc Xa has limited function outside of coagulation system whereas thrombin is involved in immune system and inflammatory pathways
BOTH bind AT3 which inhibits activated factor X and thrombin
aspirin inhibits platelet aggregation by blocking what?
thromboxane
Can you use NDMB with LE and MG?
yes!
but can only use DEPOLARIZING with LE. MG is resistant
what opiate does not cause increase in sphincter of oddi tone?
butorphanol
preferred opiate for biliary spasm therefore. more effective in women than in men.
mu agonist/antagonist with partial K agonism
the liver synthesizes most coagulation factors except for
3, 4, 8
8: endothelial cells and bone marrow
why is peak expiratory pressure decreased by up to 40% by epidurals?
because it is largely dependent on abdominal musculature
common complication of jet ventilation
hypercarbia
infrequently: necrotizing tracheobronchitis. PTX
treatment of AT3 deficiency?
AT3 replacement or ffp (1u per kg)
typical in patients with high dose heparization (heparin gtts)
lisinopril’s side effects
cough, angioedema, teratogen, increased creatinine, hypotension, hypercalemia,
how does METs play in with MACE?
if >4 METs, very rarely need further testing
why do kids get bradycardic with succs?
because they have high vagal tone which increases Ach muscarinic receptors. prevent with pre-admin of atropine
when does phase 2 block occur with succs?
ongoing infusion or doses > 4mg/kg
stays on receptor
only reliable muscle relaxant with IM admin?
succs – shot to the tongue best!
mechanism of tetanus?
inhibition of nt release from the inhibitory neurons in the CNS
nicardipine is metabolized by
the liver (then bile and feces). liver dz prolongs half life
coronary and peripheral artery dilator without decreasing cardiac function
half life 60-100 minutes
in volume controlled ventilation, breaths are triggered by
respiratory rate interval
pressure required to deliver TV determined by pulmonary compliance
increase in CO2 after initial (15-30m) equilibrium is usually due to
subcutaneous emphysema
can O2/N2/xenon be measured by infrared light?
no, only CO2 can be (and volatile, N20)
intensity of the infrared light is inversely proportional to the CO2 partial pressure
risk factors for post-operative cognitive dysfunction
advanced age
lower education levels
hx of CVA without residual deficits
typical air handlers fully exchange the air in how long
3-5minutes
what imaging do you need for initial diagnosis of retained epidural catheter?
CT scan (fast, high sensitivity)
what is CVP used to assess?
R heart function and overall blood volume
2-8mmhg supine normally
what happens with atrial fibrillation in CVP wave forms?
loss of a wave, which represents atrial contraction
