Term
aortic stenosis
valve area, gradient, Jet?? |
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Definition
normal valve area 3
severe 1 or less, gradient 40-50
critical 0.7 gradient 50 |
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Term
| AHA reasons for endocarditis ppx |
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Definition
1. previous IE
2. bioprosthetic valve
3. UNREPAIRED cyanotic heart disease
4. cardiac transplant with valvulopathy
5. REPAIRED congenital heart disease with residual defects |
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Term
concerns in high spinal cord injury
Tests? |
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Definition
1. Autonomic dysreflexia
2. Pulmonary dysfunction(diaphragm weakness, reccurent infections due to decreased secretion clearance.
3. renal dysfunction(chronic catheter, infections), stones
4. altered thermoregulation
5. neck ROM
6. ulcers, DVTs
ECG, CXR, BUN/Cr, CBC, temp, PFTs?, neck films, lytes, possible abg |
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Term
| complications of PDA ligation |
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Definition
1. left phrenic nerve or recurrent laryngeal nerve injury
2. thoracic duct injury
3. laceration of aorta or PA
4. hypothermia, retinopathy of prematuraty, hypoglycemia, post-op apnea
5. hypoxemia, massive blood loss, heart failure, hypotension
6. hypertension post op |
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Term
| equation for maximum allowable blood loss |
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Definition
| EBV*crit differing all divided by initial crit |
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Term
| Central DI labs and treatment |
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Definition
hypernatremia, low urine specific gravity( less than 1.0005)
treatment 1/2 NS and possibly desmopressin |
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Term
| LITHIUM ANESTHESIA management changes |
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Definition
| watch for increased duration of polarizing and depolarizing muscle relaxants, give NS to prevent reabsorption, MAC may be lower also, avoide thiazide, NSAIDS, ACE, QRS may be wide |
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Term
| preop optimization of hyperthyroid |
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Definition
| PTU, B blocker, glucocorticoids(reduce secretion), IOPANOIC ACID(reduce T3 levels in 6-12 hours) |
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Term
| total thyroid post op concerns |
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Definition
HYPOCALCEMIA!
Hematoma
laryngeal nerve injury |
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Term
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Definition
| beta blocker, cooling measures, IV fluid, PTU, steroids |
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Term
| systemic manefestations of RA? |
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Definition
| pericarditis, valve fibrosis, nodules in conduction system causing arrythmias, carpal tunnel syndrome, liver and kidney dysfunction, pulmonary HTN, cervical spine involvement |
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Term
| porphyria acute crisis treatment |
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Definition
treat symptoms(tachycardia b blocker, nausea antiemetic etc), give carbs, fluids,
HEMATIN(supress ala synthatase)
stop porphyrinogenic drugs(etomidate, toradol) |
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Term
| conscience sedation definition |
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Definition
| respond to verbal, light touch, no airway intervention needed |
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Term
| phases of amniotic fluid embolism |
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Definition
1st: dyspnea, pulm HTN, RH failure(acute hypotension
2nd: left heart failure, pulm edema |
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Term
|
Definition
| severe OSA causing pulm HTN and RH failure |
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Term
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Definition
1. HTN evetually leading to LVH and CHF(increased sypmathetic tone)
2. Pulm HTN, RH failure (HPV)(cor pulmonale)
3. polycythemia(more thrombotic and embolic cardiac and CVA events
4. cardiac arrythmias, increased platelet aggrgability |
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Term
| how to perform block of superior laryngeal and lingual nerves?? |
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Definition
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Term
| review adult, peds and infant ACLS |
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Definition
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Term
|
Definition
| increased circulating VWF and factor VIII |
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Term
|
Definition
predicted postop FEV1 <40% predicted order a VQ scan to asses preop contribution of lung to be resected(more accurate) and echo the RV(increased risk of RV faulure postop)
<20% PPO FEV1 unnaceptable. same numbers for DCLO |
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Term
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Definition
| creatinin, biliruben, INR |
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Term
| hepatopulmonary syndrome triad |
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Definition
| liver disease, decreased Oxygenation, intrapulmonary vascular dilation |
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Term
| aortic aneurysm BP control |
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Definition
| give beta blocker before vasodilator, otherwiise could lead to increased aortic wall stress(lower rate of rise of systolic pressure) |
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Term
| sodium nitroprusside toxicity |
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Definition
| Cyanide toxicity! (metabolic acidosis, increased SVO2 |
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Term
| cyanide toxicity treatment |
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Definition
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Term
|
Definition
increased MV(increased TV not RR)
Vital capacity unchanged CC unchanged
FRC decreased 20% |
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Term
|
Definition
Neuraxial can cause relapse, PNB and GA ok
avoid hyperthermia, avoid sux |
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Term
| myasthenia gravis considerations |
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Definition
use regional if possible
avoid NMBs if possible(prolonged NDMR, resistance to sux)
neostigmine(cholinesterase inhibitors) may cause cholinergic crises(also causes weakness, can differentiate with small dose of edrophonium)
stress dose steroids?
plasmapharesis for severe weakness |
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Term
| myasthenic syndrome(lambert eaton) consideratiosn |
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Definition
very sensitive to sux and Ndmb
regional best option, avoid NMB if GA(small doses if needed) |
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Term
|
Definition
fast full tight(avoid bradycardia, maintain preload and contractility, maintain SVR)
avoid PPV |
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Term
| how to differentiate CSWS and SIADH |
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Definition
both have hyponatremia
CSWS hypovolemic, often urine sodium>100
SIADH euvolimic, urine sodium high but not >100 |
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Term
how to differentiate CSWS and SIADH
TX? |
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Definition
both have hyponatremia
CSWS hypovolemic(tx hydration NS), often urine sodium>100
SIADH hyper/euvolimic(tx water restriction, diuresis), urine sodium high but not >100 |
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Term
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Definition
snoring
tired
observed apnea
pressure
BMI >35
Age >50
Neck circ >40
Gender M |
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Term
| the tee views and review pals acts, |
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Definition
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