Review from TEST 1 Flashcards
Iron deficiency anemia is classified as ________.
microcytic hypochromic (anemia characterized by small red blood cells; pale and relatively colorless)
The initial phase of hemostasis is __________.
formation of the platelet plug (hemostasis= process in which to stop bleeding….blood vessels actually vasoconstrict first…. but for the test, the initial step is platelet plug)
As with all surgeries, gastric bypass has complications associated with the procedure. The most common cause for reoperation after gastric bypass is ________.
anastomotic leaks
Mallory-Weis tear at the GE junction is closely associated with chronic alcohol abuse. The most common signs/symptoms are ________.
upper abdominal pain and bloody vomitus
(T/F?) Large, negatively charged molecules have a more difficult time penetrating glomerular barriers to enter the ultrafiltrate.
TRUE
All of the following statements are true regarding hepatic physiology EXCEPT:
A: liver receives 40% of total CO
B: 25% of total flow is supplied by hepatic artery
C: the portal vein has partially deoxygenated blood and contains nutrient/compounds absorbed from gut
D: portal vein supplies 75% of total flow to the liver
A: The liver receives 40% of the CO
FACTS= normal hepatic blood flow is 25-30% of CO and is provided by hepatic artery and portal vein…. hepatic artery supplies about 45-50% and portal vein the other 50-55%; ALL coagulation factors with the exception of factor VIII and vWF are produced by the liver; Vit K is necessary for synthesis of prothrombin (factor II), and factors VII, IX, X; albumin
Adriamycin is a chemotherapeutic agent commonly known to cause impaired cardiac contractility. This type of cardiac dysfunction is referred to as _______.
systolic dysfunction
Decreasing afferent tone (dilation of the afferent renal artery) will have the following effects… Choose ALL THAT APPLY:
correct answers: increasing GFR, increasing glomerular blood flow
You are evaluating a patient preoperatively for a laparoscopic cholecystectomy. You note a recent ABG measurement in the chart… results are pH 7.37, PCO2 57, PO2 65, HCO3 34, Hgb 18, SPO2 93%. The patient has a long history of smoking and is in no distress. The patient has no chronic renal disease. This patient can be classified as having a _________.
totally compensated chronic respiratory acidosis
The blood bank product which contains the most fibrinogen is _______.
cryoprecipitate (FFP are spun and the precipitate is collected… vWF, fibrinogen, VIII)
Hyperkalemia potentiates neuromuscular blockade by decreasing the excitability of the skeletal muscle cells. (T/F)?
TRUE
Zenker’s diverticulum is a contraindication to TEE insertion. (T/F)
TRUE
Facts: aka pharyngeal pouch….it is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle–upper sphincter of esophagus–In simple words, when there is excessive pressure within the lower pharynx, the weakest portion of the pharyngeal wall balloons out, forming a diverticulum which may reach several centimetres in diameter.
Blood flow TO the glomerulus is provided via the _______ renal artery. The resting tone of this vessel is primarily regulated by _________.
afferent; prostaglandins
prostaglandins: variety of strong physiological effects, such as regulating the contraction and relaxation of smooth muscle tissue. Prostaglandins are not endocrine hormones, but autocrine or paracrine, which are locally acting messenger molecules. They differ from hormones in that they are not produced at a discrete site but in many places throughout the human body. Also, their target cells are present in the immediate vicinity of the site of their secretion (of which there are many).
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 a _________ sodium level.
hypovolemic; increased (kidneys conserve Na during states of volume depletion)
Which of the following is a benefit of utilizing normovolemic hemodilution as a blood conservation technique? ALL OF THE ABOVE ARE BENEFITS
ALL OF THE ABOVE: decreased total loss of oxygen carrying capacity (Hgb) per mL of surgical blood loss, maintaining normal oxygen delivery by maintaining overall fluid volume status and hemoglobin WNL, ability to transfuse autologous blood as needed
Increased _________ increases gut absorption of calcium, while _________ stimulates bone formation, decreasing plasma calcium levels.
calcitriol; calcitonin
calcitriol (hormonally active vitamin D)
calcitonin (hormone produced by parafollicular cells of the thyroid…. reduces blood calcium, opposing effects of PTH…. stimulated by increase in serum calcium)
Increased sympathetic nervous system stimulation initiates renin secretion. Renin begins the process of ________ more sodium from the renal tubule.
retaining (renin just LOVES salt)
Which of the following commonly used opiate or opioid medications have active metabolites which may prolong respiratory depression in the patient with renal failure?
demerol & morphine
T/F?? Proteins secreted into the ultrafiltrate can be easily reabsorbed completely intact across the tubular membranes.
FALSE
The cause of the restrictive ventilatory defect in obese patients is ___________.
BOTH A&B: additional weight on the thoracic cage, additional abdominal fat/weight impairing diaphragmatic excursion