unit 10

Question 1

Which comorbidities are most likely associated with CKD?

Answer 1

DM

Systemic HTN

Question 2

What is the most common cause of death with CKD patients?

Answer 2

CAD

Question 3

What is an example of a mineralocorticoid?

Answer 3

Aldosterone

Question 4

Which endogenous steroid has the highest glucocorticoid effects?

Answer 4

Cortisol

Question 5

What is the treatment for Myxedema? What is it?

Answer 5

Severe hypothyroidism

IV triiodothyronine + thyroxine
Also give hydrocortisone

S&S - hypothermia, hypotension, bradycardia

*Responds poorly to pressors until underlying issue is fixed

Question 6

Which drugs heavily rely on the kidneys for excretion and caution should be used in CKD

Answer 6

Anything with an active metabolite

Meperidine
Morphine
Dilauded

Cephalosporins

Panc, Roc, Vec

Reversal agents

Question 7

When is ANP released?

Answer 7

During hypervolemia

A stretched atrium signals the body to excrete sodium and decrease reabsorption

Question 8

How should a bronchospasm be treated with carcinoid syndrome?

Answer 8

Must give octreotide along with ipratropium and antihistamines

Question 9

What can happen if a patient with carcinoid syndrome is given epi or albuterol?

Answer 9

Epi - causes catecholamine induced stimulation of tumor release

Albuterol - facilitates further mediator released from tumor

Question 10

Which hormone increases due to surgical stress?

Answer 10

Vasopressin

Growth hormone
Adrenocorticotropic
Arginine
Cortisol

Question 11

What is the hepatic artery buffer response?

Answer 11

Maintains arterial liver blood flow in response to portal vein flow

Ensures oxygen delivery

Question 12

Hormones of adrenal gland

Answer 12

Question 13

Hormones of adrenal gland 2

Answer 13

Question 14

Liver synthesis

Answer 14

Question 15

How does surgical stress affect insulin?

Answer 15

Creates a resistance, resulting in hyperglycemia

More sugar to feed the body

Question 16

How does hypoparathyroidism affect calcium levels?

Answer 16

Directly linked

hypoparathyroidism = hypocalcemia

Question 17

S&S of hypoparathyroidism

Answer 17

Question 18

Drug of choice for a pheochromocytoma?

Answer 18

Phenoxybenzamine

Must alpha block before beta block

Question 19

What is the most common renal injury in the perioperative period?

Answer 19

ischemia-reperfusion injury

Question 20

Do diuretics help prevent an AKI?

Answer 20

No

Question 21

Dose renal dose dopamine help protect the kidneys?

Answer 21

No

Question 22

Which antibiotics should be given as a last resort in order to prevent an AKI??

Answer 22

Aminoglycosides

Question 23

Does hypothyroidism create increased or decreased cardiac output?

Answer 23

Decreased

Question 24

Does hypothyroidism cause cool/pale skin or hot/dry?

Answer 24

cool/pale

Question 25

Does hypothyroidism create increased or decreased PVR?

Answer 25

Increased PVR Decreases pretty much everything else

Question 26

What do acinar cells of the pancreas produce?

Answer 26

Exocrine hormones (digestive enzymes and bicarb)

Question 27

What is the order for thyroid hormone production?

Answer 27

1. Hypothalamus 2. Thyrotropin-releasing hormone 3. Anterior pituitary gland 4. thyroid-stimulating hormone 5. Thyroid 6. T4, T3

Question 28

What is T3 and T4?

Answer 28

T4 = Thyroxine T3 = Triiodothyronine T4 stimulates T3

Question 29

What phase is the neohepatic phase for liver transplant?

Answer 29

Reperfusion of donor liver

Question 30

What phase is the anhepatic phase for liver transplant?

Answer 30

Removal of the recipient's liver

Question 31

What complications are seen in the reperfusion of the liver after transplant?

Answer 31

Hyperkalemia Hypocalcemia Cytokine release Lactic acidosis Embolic debris Hypovolemia Decreased SVR Increased PVR Hypothermia

Question 32

Conns Cushing Addisons Graves

Answer 32

Question 33

An AST/ALT ratio > 2 times is a sign of which disease? What about a ratio of 1:1?

Answer 33

2:1 Alcoholic liver disease 1:1 viral hepatitis

Question 34

Is ALT or AST more specific to a liver injury?

Answer 34

ALT (think of the L) AST is found in other organs

Question 35

T3 vs T4

Answer 35