Symptom of Baroreceptor activation post carotid endarterectomy? what else can activate it?
bradycardia
mediastinoscopy and phenylephrine
Drugs to give for carcinoid syndrome?
If hypotensive?
- Octreotide/Lanreotide
- antihistamines (H1 and H2 blockers)
- 5-HT3 antagonists
- steroids
- Phenylephrine or Vasopressin
In pregnancy in respect to coagulation? What increases and what decreases?
Increases:
- Clotting factors (1,7-10,12)
- Fibrinolytic system
Decreases:
- Protein C & S
- Antifibinolytic system (XI and XIII)
What controls Renal vascular resistance to Glomerulus?
Afferent arteriole (this is controlled by the myogenic mechanism)
Osmolarity of TURP syndrome? S/S?
Hypo-osmolar
Triple H-BANS
- HTN (fluid overload)
- Hyponatremia
- hemolysis
- Bradycardia
- AMS
- N/V
- Seizures
What is mixed with cell saver?
heparin
Citrate
What is blocked in retrobulbar block?
- CN II
- CN III
- CN VI ?
Landmarks for TAP block
- External Oblique
- Latissimus Dorsi
- Illiac Crest
Valve off hanger yoke?
Check valve
Neonatal abstinence syndrome
- Defined as post-birth drug withdrawal from maternal exposure during utero
- Can only be prevented if mom stops using before or directly when finds out pregnant
- symptoms as soon as 24-48h after birth or as late as 5-10 days after birth
qTC at risk for arrhythmias?
>500
“Prolonged” per Apex:
Men > 0.45
Women > 0.47
Decreases cardiac contractility:
- ischemia
- hypoxia
- acidosis
- hypercapnia (hypercarbia)
- hyperkalemia
- hypocalcemia
- volatile anesthetics
- propofol
- B.blockers
- CCB
Hypokalemia:
Presentation?
EKG?
Presentation
- muscle cramps
- weakness
- paralysis
- worsens dig toxicity
EKG
- Long PR, QT
- Flat T wave
- U wave present
Hyperkalemia:
Presentation?
EKG?
Presentation
- Cardiac rhythm disturbances
- decrease contractility
EKG
- 5.5-6.5: peaked T waves
- 6.5-7.5 P flat and prolonged PR
- 7-8: Wide QRS (antidromic)
- >8.5: sine wave, VF
EKG findings for hypo and hypercalcemia
Hypo - long QT
Hyper - Short QT
Hypercalcemia
H-NAPS
- HTN
- Nausea
- abd pain
- psychosis
- Seizures
Hypocalcemia
LPM-CT
- Laryngospasm
- parasthesias and tetany (nerve irritability)
- muscle cramps
- Chvosteks
- Troussseaus
MH Labs:
- Mixed metabolic and respiratory acidosis (mostly respiratory acidosis)
- Hyperkalemia
- Elevated CK (creatinine Kinase)
- Myoglobinuria
- DIC (late) (increased PT, PTT, Ddimer - decreased: Fibrinogen, platelets)
1: 200,000 Epi per mL
1: 100,000 ?
5 mcg per ml (0.005mg)
10 mcg/ml (0.010mg)
What nerves blocked by popliteal block?
- Peroneal
- Tibial
Wiggers diagram:
- Note Valve opening and closures
- Note location of PR, QRS, QT
what tests to be done if pt taking statin?
Lasix?
if over 50?
LFTs
Electrolytes
EKG
NDNMB vs Succ on receptors and fade:
NDNMB
- Antagonize presynaptic Nn receptor - this produces fade
Succ
- Agonizes presynaptic Nn receptor
NMB recover criteria, list 50% criteria? 60%?
