Random 1 Flashcards
nitrous oxide expands spaces because
diffuses in faster than nitrogen can diffuse out
what can cause blindness during TURP
glycine solution
other complications:
DIC (hemolysis), acidosis (glycine breakdown), HTN, EKG changes (Na), pulmonary/cerebral/gut edema (-> cheyne stokes, AMS, n/v)
why isnt normal saline used in TURPs?
current dispersion (conducts). so distilled (hypotonic) is used
when to use desmopressin?
von willebrand
uremic bleeding
causes release of F8 and vwf as well as platelet matrix glycocalyces
what’s the rule of 6’s with TEGs
R: 6 min
Alpha angle: 60 degrees
MA: 60 mm
Lysis: 6%
reversal agent for direct Xa inhibitors
andexanet alfa
(binds and sequesters)
direct thrombin inhibitor reversal
(ex: dabigatran)
idarucizumab
what paralytic has a significant metabolite
vecuronium
what volatile agent is an inhibitor of HPV?
sevoflorane
(HPV begins after PaO2 <60, peak effect at 30mmHg)
(IV anesthetics have little effect)
what other factors inhibit hypoxic pulmonary vasoconstriction?
vasodilators (nitroprusside), acetazolamide, alkalemia, hypocarbia, hypothermia, infection, PDE-i, ACE-i
effects of cholinesterase-inhibitors in MG vs Lambert-Eaton?
MG: responsive
LE: not responsive
how to prevent an attack of hyperkalemic periodic paralysis
near paralysis, AD, complete penetrance, NOT in respiratory or cardiac muscles.
treat: insulin, glucose, mild exercise!
avoid: hypothermia (bad for hypoK+ periodic paralysis too)
what happens to LES and intragastric tone with succinylcholine
both increase but lower esophageal sphincter tone > intragastric so risk of aspiration is low. If concerned, give no more than 10% ED95 non-depolarizing
side effects of IV oxytocin
hypotension, MI (vasoconstrictive to uterine and coronary arteries), tachycardia
short half life - 6 min!
first line uterotonic (increase in receptors peri-delivery)
uterotonic MOA
ergot alkaloids - poorly understood. bad in HTN (can cause CVA)
prostaglandin - increase Ca2+, increasing constriction. bad in asthmatic (bronchospasm)
