Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

*** Co-Existing Disease *** > Random Cards for Comprehensive Exam > Flashcards

Random Cards for Comprehensive Exam Flashcards

1
Q

What’s a way to get an idea of BP if no a-line and cuff is taking forever?

A

Look at EtCO2.

A sudden drop in EtCO2 would indicated a sudden drop in BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

S/S of Parkinson’s treatments (Carbidopa/Levodopa)

A

Overall, think about effects of increased DA

Motor (Dyskinesias)

Psychiatric (mania, agitation, hallucunations, paranoia)

CV effects (increased contractility and HR, orthostatic hypotension)

GI (N/V d/t stimulation of CRTZ by DA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Autonomic dysreflexia

A

1) Cutaneous or visceral stimulation below level of lesion 2) This activates preganglionic SNS nerves 3) Vasoconstriction below injury 4) SEVERE HTN 5) Bradycardia and vasodilation above injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When is the peak risk for hyperkalemia with sux after spinal cord injury?

A

3-6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

After acute head injury, the pt may experience a hyperdynamic circulatory response. S/S and tx of this

A

S/S: Increased HR, BP, and CO Arrhythmia secondary to epi surge Labetolol and esmolol are useful to treat this.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Monitors for crani for head trauma

A

All standard monitors Probs art-line but don’t delay crani for placement!! May or may not need CVP (to monitor hemodynamics and for VAE risk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Monitoring best able to detect VAE

A

1) TEE (best) 2) Doppler 3) EtCO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Isthmus of the thyroid is located over these trachial rings

A

2nd to 4th tracheal rings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of hypoaldosteronism

A

1) Congenital deficiency 2) Hyporeninemia - May happen in long-standing DM, renal failure, or treatment with ACE-inhibitors (causes loss of angiotensin stimulation) 3) NSAIDs - May inhibit renin release and exacerbate existing renal insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

S/S of Hypoaldosteronism

A

Severe hyperkalemia Hyperkalemic acidosis Hyponatremia Defects in cardiac conduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment for hypoaldosteronism

A

Mineralcorticoids (Fludrocortisone) Liberal salt intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nucleoside Reverse Transcriptase Inhibitors

A

N/V/D, myalgia, increased LFTs, renal toxicity, pancreatitis, peripheral neuropathies, BM suppression, anemia, lactic acidosis, and CYP450 inhibition Zidovudine + corticosteroids = severe myopathy, including resp. muscle inpairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Non-Nucleoside Reverse Transcriptase Inhibitors

A

Delavirdine= Inhibition of CYP450 and causes increased concentration of sedatives, antiarrhythmics, warfarin, and CCBs Nevirapine induces CYP450 by 98%!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Protease Inhibitors

A

Ritonavir HLD, glucose intolerance, abnormal fat distribution, altered LFTs, and CYP450 inhibition!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

HIV Med CYP450 Inducers and Inhibitors

A

Inhibitors: - Ritonavir - Delavirdine - Zidovudine Inducer: Nevirapine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Considerations for the patient on Ritonavir

A

They will have more pronounced effects with Midaz and Fentanyl (start on low end of dosing) Ritonavir is a CYP450 inhibitor. Avoid MAD: Meperidine Amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Most frequent S/S of TB

A

Non-productive cough Weight loss Fever and night sweats Malaise Hemoptysis and chest pain (late s/s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

TB treatments and their effects

A

Most can cause hepatotoxicity (INH, rifampin, and pyrazinamide) Rifampin is a CYP450 inducer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

SBE Prophylaxis is Recommended in these Heart Conditions

A

1) Damaged heart valves 2) Artificial heart valves 3) Cardiac transplant pt who develops problems with heart valves 4) Hx of endocarditis 5) HCM 6) Certain congenital malformations - Cyanotic congenital heart disease - Congenital defect that has been repaired with artificial material for the first 6 months after the procedure - A congenital problem that has been repaired, but has residual effects (persisting leak, etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SBE Prophylaxis is recommended in these surgical procedures

A

1) Dental or oral surgery, where perforation of the oral mucosa is likely 2) Respiratory tract surgery, where the resp. mucosa will likely be perforated 3) Procedures to treat infection of GI/GU tract, skin, or musculoskeletal tissue 4) Cardiac surgery 5) Hepatobiliary procedures with high risk of bacteremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Antibiotics used for SBE prophylaxis

A

ACCC (Ampicillin, Cefazolin, Ceftriaxone, and Clindamycin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is an anaphylactoid reaction?

A

A reaction that isn’t antibody-mediated The drug itself causes histamine release from basophils. Size of reaction depends on how much of the agent was given and how rapidly. NMBs (sux, atra, curare, and miva), opioids (morphine and demerol), and protamine can all cause this type of reaction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Medications that can be used to prevent anaphylactoid reactions

A

H1 and H2 antagonists. Corticosteroids (these cause transcription of anti-inflammatory proteins, and decrease the transcription of pro-inflammatory proteins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Basically all anesthetics we give cause allergic reactions except

A

Ketamine and benzos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

S/S of Anaphylaxis

A
  • CV collapse is often the first sign (accompanied by MI and dysrhythmias) - Hypotension (50% of intravascular fluid may be lost) - Flushing - Increased PIPs or difficulty ventilating (bronchospasm) - Difficulty intubating d/t laryngeal edema Overall, think anaphylaxis with sudden hypotension and bronchoconstriction following drug administration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What should you do if your patient has an LMA in place and you suspect anaphylaxis?

A

Remove that shit and intubate!! They will have bronchoconstriction and need assistance ventilating. If you wait, they can develop laryngeal edema and cause a difficult intubation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Volume replacement in anaphylaxis

A

Colloids preferred d/t leaky capillaries Colloid replacement: 10mL/kg Crystalloid: 10-25mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Basic interventions in anaphylaxis

A

Stop offending drug Communicate to the surgeon what is happening Administer 100% O2 Intubate if haven’t done so already Elevate legs Give fluids (10-25mL/kg) Give epinephrine (10mcg-1mg –> start low if just suspecting anaphylaxis, and see how they respond) - If resistant to epi, try Glucagon, Norepi, or Vasopressin Second-line pharmacology: - B2 agonists (albuterol and terbutaline) - H1&2 antagonists (better for prevention than actual treatment) - Corticosteroids (hydrocortisone 250mg IV) –> corticosteroids work by enhancing the B effect of other agents and inhibiting arachidonic acid release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the best regional technique in the septic patient?

A

PSYCH! Regional anesthesia is contraindicated in sepsis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

This is the only anesthetic gas that is consistently teratogenic

A

N2O. Increases the rate of spontaneous abortions and causes birth defects. (remember that it inhibits enzymes responsible for DNA synthesis and myelin formation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Effect of gases other than N2O

A

Studies are inconclusive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Gas concentration standards set by NIOSH and OSHA

A

N2O less than 25ppm Anesthetic gases

33
Q

When are you at greatest risk of VA exposure?

A

Filling the vaporizers

34
Q

Air turns over in the OR ____ times per hour

A

15-20

35
Q

When are you at greatest risk of HIV?

A

Deep cutaneous needle-stick injury with a large, hollow needle Can also occur with small breaks in skin or splatters in mouth

36
Q

When is post-exposure anti-retroviral therapy begun after exposure?

A
37
Q

This virus is the most serious occupational health danger facing anesthesia providers

A

Hep B 20-50% of providers have markers of previous Heb-B exposure Risk of infection after exposure is 37-62% Virus can remain active up to 1 week in dried blood

38
Q

Hep C infections occur mostly due to

A

blood transfusions

39
Q

You have a ___% chance of developing TB after exposure

A

10%

40
Q

Who is most at risk of developing a latex allergy?

A

Those with chronic exposure (Spina bifida, urologic patients, and healthcare providers)

41
Q

Latex allergy is often associated with these food allergies

A

Avocado, potato, banana, tomato, chestbuts, kiwi, and papaya

42
Q

WTF is methylmethacrylate?

A

Acrylic cement used for prostheses Supplied as separate powder and liquid components that are then mixed together. Can release toxic vapors and causes heat production.

43
Q

Risks of methylmathacrylate

A

Patient: - Hypotension Providers: - Dyspnea, wheezing, caughing, and rhinorrea - HTN - Erythema - HA - Unknown effects in pregnancy

44
Q

NIOSH recommends that 8 hour exposure to methylmethacrylate should be limited to

A

100ppm (although levels may reach 300ppm during mixing)

45
Q

Effects of Sarin Gas

A

Inhibits acetylcholinesterses and butyrylcholinesterases, causing an increase in Ach in muscarinic and nitotinic receptors (effects similar to neostigmine). Excessive secretions, bradycardia, HB, bronchospasm, sz, resp depression, and paralysis.

46
Q

Treatment for sarin gas exposure

A

1) Atropine (b/c anticholinergics are given with anticholinesterases). 2) Oximes

47
Q

Vesicant Agents (Mustard Gas)

A

These are blistering agents Treatment: Respiratory and fluid support

48
Q

Choking agents (Chlorine gas / Phosgene)

A

Causes laryngospasm and pulmonary edema Treatment: Respiratory support and to limit inflammation

49
Q

Cyanide. What does it do and what is the treatment?

A

It inhibits cytochrome oxidase enzymes (CYP450) and causes hypoxia. Treatment: Sodium thiosulfate

50
Q

Botulinum Toxin. What does it do and what is the treatment?

A

Inhibits the release of Ach. Treatment: Antiserums

51
Q

Anthrax. What does it do and what is the treatment?

A

Bacterium that causes pulmonary edema and a widened mediastinum. Treatment: Vaccination and antibiotics (Cipro)

52
Q

Greatest risk of radiation is during

A

Fluroscopy

53
Q

Max yearly radiation exposure

A
54
Q

When an x-ray is taken you should be a minimum of ___ feet away

A

3

55
Q

6 feet of air space provides the same protection from radiation as

A

9 inches of concrete or 2.5mm of lead

56
Q

Order of things to do in the event of a fire

A

ERASE Evacuate, rescue, activate, shut doors, evaluate

57
Q

Steps in an airway fire

A

Remove the ETT Turn off all gasses Extinguish the fire by pouring saline down the airway Remove any burning materials Mask ventilate. Assess, and re-intubate. Bronchoscopy if pieces of ETT left behind.

58
Q

Macroshocks

A

Large shocks of electricity 1mA = perception threshold 5mA = maximal harmless current 10-20mA = let-go threshold 50-100mA = pain 100-300 = Vfib, resp failure, and apnea > 6000mA = sustained myocardial contraction, temporary resp paralysis, and burns

59
Q

Microshock

A

Direct application of a very small amount of electrical current to someone who has an external conduit that is in direct contact with the heart (cardiac pacing wires, or invasive monitoring catheters) - Maximum leakage allowed is 10 micro-amprs - A current as low as 100 micro-amps can cause v-fib - A ground wire is the most important factor in preventing microshock**

60
Q

What is the line isolation monitor (LIM)?

A

A monitor that continually evaluates the integrity of the isolate power system. It alarms at 2-5mA or resistance of 60,000 ohms. If it detects a faulty piece of equipment, it converts to a grounded system to prevent shocks. If it alarms, check the gauge: 2-5 means there are too many pieces of equipment plugged in >5 means there is a faulty piece of equipment

61
Q

Type of electrocautery recommended for those with pacemakers

A

Bipolar

62
Q

Hazardous noise is considered to be

A

> 90 decibels for 8 hours/day

63
Q

Electrical power is usually (grounded/ungrounded) in the hospital

A

Ungrounded

64
Q

___% of providers will have at least one medication error or near miss in their career

A

85% The most common error is giving relaxant instead of reversal at the end of a case.

65
Q

__% of medication errors result in death

A

1.8%

66
Q

Addiction

A

Primary, chronic disease characterized by: - Lack of control over drug use - Compulsion and craving - Continued use despite adverse consequences

67
Q

What is a covered entity?

A

Hospitals, dentist offices, pharmacies, health care plans, providers, clearing houses, billing services, business associates, etc.

68
Q

What is protected health information?

A

Patient health information in any form (oral, paper, electronic, or recorded). Demographic information is also included in PHI (name, DOB, etc.)

69
Q

What is disclosed PHI?

A

PHI that is released, transferred, or accessed by anyone outside of the covered entity. Even to billing companies. The patient must sign a release contract prior to ANY disclosure happening.

70
Q

This is included in authorization forms

A
  • Description of the PHI that will be disclosed. - Who the PHI is being disclosed to and why - If the covered entity will get financial gain from release of the info - Letting the pt know that they have the right to refuse authorization - Date and signature
71
Q

When is written authorization not required during sharing of PHI?

A
  • For the pt directory within the facility - When informing appropriate agencies during disasters - For public health issues related to disease control - In reporting abuse or neglect - For health oversight activities - To coroners, medical examiners, and funeral directors (b/c these people have a right to know what they’re dealing with) - Organ and tissue donations - In research, public health, or healthcare operations as a limited data set (any identifying info is removed)
72
Q

Patient rights

A
  • Patients can exercise rights over their PHI - Patients will receive a privacy notice at first delivery of service - PHI will be communicated in a way to protect confidentiality - Pt can inspect, amend, correct, and obtain copies of their PHI - Request a history of disclosures for the last 6 years (be able to see who your health info was divulged to and why) - Pt can contact ppl within the facility regarding concerns or breaches of confidentiality
73
Q

Parents have control over PHI of minors except when it comes to

A
  • HIV testing - Abuse - If parents agree to give control to the minor - If the state takes over control of the child
74
Q

These meds should be avoided in parkinson’s

A
  • Anti-emetics that are DA antagonists - Fentanyl and alfentanil (may have some anti-DA activity)
75
Q

Loss of diaphragm functioning if injury above

A

C4

76
Q

Loss of cardiac accelerators if injury above

A

T6

77
Q

Methylprednisolone dosing within 8 hours of spinal cord injury

A

30mg/kg IV bolus, then Infusion at 5.4mg/kg/hr for 24-48 hours

78
Q

Blood loss is greater in these areas of the spine

A

Lumbar and thoracic > cervical

*** Co-Existing Disease *** (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions