Review Exam 1- baby D Flashcards
iron deficiency anemia is classified as
microcytic hypochromic
initial phase of hemostasis is
formation of platelet plug
the most common cause of reoperation after gastric bypass is?
anastomotic leaks
mallory-weiss tear at the GE junction is associated with ETOH abuse. Common s/s is?
upper abd pain and bloody vomitus
T/F
large negatively charged molecules have a more difficult time penetrating glomerular barriers to enter the ultra filtrate
true
T/F
Liver receives 40% of total CO.
False
adriamycin is a chemo drug that is known to cause impaired cardiac contractility. This type of cardiac dysfunction is referred to as _________ __________
systolic dysfunction
decreasing afferent tone (dilation of afferent renal artery) will…..
increase GFR, increase glomerular blood flow
ABG pH 7.37 pCO2 57 pO2 65 HCO3 34 Hgb 18 SpO2 93% Smoker in no distress. What classification is this patient?
totally compensated chronic resp acidosis
blood product that contains the most fibrinogen?
cryo
T/F
Hyperkalemia potentiates neuromuscular blockade by decreasing the excitability of the skeletal muscle cell
True
T/F
Zenkers diverticulum is contraindicated in TEE insertion
True
Blood flow TO the glomerulus is provided via the ____________ renal artery. The resting tone of the vessel is primarily regulated by _____________.
afferent, prostaglandins
Your patient has been febrile for the past 24 hours. No maintenance fluids have been infusing for the past 12 hours. You would expect your patient to be _____________ with an ___________ sodium level
hypovolemic, increased
Which of the following is a benefit of utilizing normovolemic hemodilution as a blood conservation technique?
all of the above are benefits…. sorry there isn’t a list of em… ;)
Increased __________ increased gut absorption of calcium; while __________ stimulates bone formation, decreasing plasma calcium levels.
calcitriol, calcitonin
increased sympathetic nervous system stimulation initiates renin secretion. Renin begins the process of ____________ more sodium from the renal tubule.
retaining…..
RENIN LOVES SALT
Which commonly used opiate or opioid medications have active metabolites which may prolong reap depression in the patient with renal failure? (2 of em)
demerol and morphine
T/F
Proteins secreted into the ultra filtrate can be easily reabsorbed completely intact across the tubular membranes
False
T/F
Patients who live in high altitudes are often polycythemic. The polycythemia is created by increased levels of erythropoietin as a result of lower atmospheric pressures.
False
l-arginine vasopressin is secreted by the
posterior neural hypophysis
anti-parasympathetic medications may cause
urinary retention
Hemophilia A is an abnormality of which clotting factor?
factor 8 (VIII)
the final stage in pathogenesis of chronic renal failure is
glomerulosclerosis
T/F
the kidneys are primarily responsible for regulating free water concentration in the body
false
the only test available to evaluate all properties of clot formation and strength is
TEG (thromboelastograph)
T/F
Enzyme immunoassays are the most sensitive and specific tests to confirm heparin induced thrombocytopenia, but not the most rapid.
False
T/F
Patient’s BUN is 18 and the creatinine is 3.6. the patient has azotemia because the patient is clearly in chronic renal failure.
False
Which of the following factors is not part of the common pathway? 1, 2, 4
4
Your patent has a Hgb of 7 mg/dL. Based on this finding you would expect a change, if any, to this patient’s oxyhemeglobin dissociation curve?
right shift
The kidneys receive what percentage of the total cardiac output?
25%
T/F
Obese patients must be well-preoxygentated before induction of GA. This is due to decrease in FRC not total lung capacity
False
T/F
Decrease in coagulopathy is not a renal protective benefit of ACEI/ ARB medical therapy in patients with chronic renal failure.
False
T/F
When there is exposure of collagen from damage to the endothelium, the intrinsic clotting pathway is activated.
True
In response to injury, the capillaries
allow more albumin to escape the vascular space.
According to the Society of Ambulatory Anesthesia guidelines for the management of PONV, the proper time to administer dexamethasone for the prevention of PONV is ____________, and the suggested dose is ___________.
at induction, 4-5 mg IV
Your patient in septic shock is undergoing massive tissue debridement for necrotizing fasciitis. The patient is on norepinephrine at 30 mcg/min and vasopressin at 0.04u/hr. The starting Hct is 38% and the Lactate level is 5.0 mmol/L. ABG is 7.11/34/197 with bicarb at 17. You resuscitate with 6 liters of normal saline and give 100 mEq sodium bicarbonate as the patient is still hypotensive with a systolic BP of 75. After resuscitation, you are able to wean off the vasopressin but still require levophed at 12 mcg/min. Lactate is now 2.0. You repeat the ABG and get the following results. Ph 7.24/pCO2 40/ pO2 143 HCO3 22. The most likely cause of refractory acidosis is
hyperchloremic acidosis
The majority of solute in the ultrafiltrate is reabsorbed via the
proximal tubule
In differentiating nephrotic versus nephritic syndrome, the patient with nephrotic syndrome swill present with ___________ without __________.
massive proteinuria, hematuria
Normal coagulation is balanced between hemostatic and fibrinolytic properties. The “viscous triad” of elements associated with trauma that can create or exacerbate coagulopathy include (3)
hypothermia, acidosis, hemodilution
Portal HTN can lead to hypersplenism, which can result in
platelet trapping & thrombocytopenia
leading cause of liver failure in the USA is
acetaminophen toxicity
symptoms associated with TURP syndrome are caused by
free water excess
T/F
A shift to the right of the oxyhemoglobin dissociation curve decreases the partial pressure at which 50% of hemoglobin is saturated with oxygen
false
3 things that can precipitate sickling of RBC’s in the patient with homozygous sickle cell disease
hypothermia, PaCO2 of 40mmHg, septic shock
T/F
A loss of sodium in excess of water is a more common cause of hyponatremia than an excess of total body water
False
Patients being treated with ankylating chemo drugs can experience what with benzos?
potentiation of benzodiazepines
When a patient is undergoing GA is hyperventilating to a state of alkalosis, intracellular potassium levels ____________ while serum potassium levels ________________
increase, decrease
ADH exerts its action by
changing the water permeability of renal collecting ducts
