1
Q
Alphagan P
A
glaucoma
2
Q
Actonel
A
osteoporosis
3
Q
Azor
A
hypertension (ARB/CCB)
4
Q
Effient
A
platelet inhibitor
5
Q
Viibryd
A
depression
6
Q
Levitra
A
erectile dysfunction
7
Q
Novir
A
HIV
8
Q
Lipitor
A
cholesterol
9
Q
Tradjenta
A
DM II
10
Q
Aggrenox
A
aspirin and dipyridamole
prevent platelet aggregation
11
Q
Lexapro
A
depression
SSRI
12
Q
Diuril
A
high blood pressure
diuretic
13
Q
Micardis
A
anti-hypertensive
ARB
14
Q
Atacand
A
ARB
15
Q
Voltaren
A
NSAID
16
Q
Deplin
A
vitamin B deficiency for depression
17
Q
Dexilant
A
proton pump inhibitor
18
Q
Imuran
A
immunosuppressant for arthritis
19
Q
Ultracet
A
acetaminophen and tramadol
20
Q
Patanol
A
ocular anti-histamine
21
Q
Amitiza
A
IBS
22
Q
Advair
A
asthma and COPD
23
Q
Lotemax
A
ocular steroid
24
Q
Uloric
A
gout
25
Cardiovascular manifestations of Rheumatoid Arthritis
- pericardial inflammation and effusions
- myocarditis
- vasculitis
- valvular fibrosis
26
Pulmonary manifestations of Rheumatoid Arthritis
- pleural effusions
- pulmonary fibrosis
- fibrotic nodules (Caplan syndrome)
27
Hematopoietic manifestations of Rheumatoid Arthritis
- normocytic normochromic anemia
| - Felty synrdome
28
Renal manifestations of Rheumatoid Arthritis
amyloidosis
29
Endocrine manifestations of Rheumatoid Arthritis
adrenal insufficiency
30
Acute normovolemic hemodilution
initially take blood from patient with normal hemoglobin, hydrate them during case, and replace blood at the end
31
2 Procoagulant drugs
Tranexemic acid and aminocaproic acid
32
Bier Block
Using two cuffs, replace intrervascular space with local anesthetic
- Esmark bandage
- Lidocaine 0.5% 30mL
- only gives 30 min of pain relief
- cuff must remain on for 30 min to avoid local toxicity
33
Systolic difference between head and heart
1. 86 mmHg difference
| - therefore, 22mmHg difference if 1 foot
34
Max systolic of tourniquet on arm
50-75 mmHg
35
Max systolic of tourniquet on lower extremity
100-150 mmHg
36
Deflation of tourniquet
- decrease in blood pressure
+ due to lactic acid and vasodilation
- excess CO2
- temperature may decrease
37
Tourniquet safe time
2 hours
38
Compartment Syndrome
pressure buildup from internal bleeding or swelling of tissue
- treat with fasciotomy
39
Neurogenic Shock
spinal cord disruption, usually above T6
- hypotension and bradycardia
40
Most common place for fat embolism to come from
long bone fractures
41
Major features of Fat Embolism syndrome
- respiratory distress
- cerebral changes
- petechial rash
- aterial blood gas
42
Bone cement
Methylmethacrylate
- can enter circulation and cause hypotension, bronchoconstriction, hypoxia, and cardiac arrest
43
Which patients should not be given NSAIDS?
asthmatics, kidney disease, and peptic ulcers
44
FESS
functional endoscopic sinus surgery
45
Epiglottitis
- avoid muscle relaxation
- inhalational induction
- use 0.5 smaller ETT
- keep patient spontaneously breathing
46
Tonsillectomy
- "gagging" may cause vagal response
- extubate on side so blood falls out
- risk of bleeding
47
Biggest risk of bleeding after tonsillectomy
right after surgery and 7 days
48
Ludwig's Angina
skin infection that occurs on the floor of the mouth, under the tongue
49
Foreign Body Aspiration
inhalational induction so the patient continues to breath spontaneously
50
Apenic Oxygenation
hyperventilate patient then surgeon can work a little bit, they go back and hyperventilate again
51
Airway Fire Precautions
- use a laser ETT
- reduce inspired O2 to less than 30%
- avoid nitrous
- fill cuff with saline dye
- place a soaked gauze around airway
- use only water-based solvents
- limit laser exposure
- maintain a ready source of water
52
Subglottic stenosis
narrowing of the trachea by a fixed lesion that compromised air flow
53
Le Fort Classification
I - lower third of the nose and jaw
II - upper nasal bone and pterygoid plate
III - base of skull separate from midface
54
Free Flaps vs. Pedicle Flap
Free Flap
- donor tissue taken from distant site
- blood supply not intact
Pedicle
- tissue maintains blood supply
- taken from area near by
55
Flap Procedures
- avoid vasoconstriction
- keep patient warm
- nerve monitoring
56
NIMS tube
nerve integrity monitor
- recurrent laryngeal nerve sensory
- no long acting muscle relaxants
57
Parathyroid removal
- regulate calcium
| - could get a laryngospasm and closure of cords
58
Location of Kidney
retroperitoneal space
- between T12 and L4
- inferior to liver
59
What is a effect of compartment syndrome
rhabdomyolysis
60
TURBT
Transurethral resection of bladder tumors
61
Autonomic hyperreflexia
- mostly commonly seen about T6 spinal cord injuries
- headache, cardiac ischemia, nasal congestion due to hypertension
- most commonly caused by bladder distension
62
TURP
Transurethral resection of the prostate
- inability to completely empty bladder
- treat with alpha blockers
63
TURP syndrome
absorption of irrigation fluid causing hyponatremia
64
Signs of TURP syndrome in the awake patient
- Confusion
- nausea
- visual loss
- coma
- seizures
65
Management of TURP syndrome
- inform surgeon
- stop procedure
- obtain electrolytes and ABG
- support breathing
- treat fluid overload
66
Central Pontine Myelinolysis
Can occur if hyponatremia is treated too quickly; irreversible
- 1 meq/L/hr sodium correction
67
ESWL
Extracorporeal shock-wave Lithotripsy
68
Percutaneous Nephrolithotomy
incision in prone to remove stone
69
Prostate Cancer
- second leading oncologic cause of death in men
| - PSA elevated
70
Prostatectomy
reduce fluid administration
- will obscure surgical field due to high urine output
71
Immediate Treatment for Airway Fire
```
- Remove endotracheal tube
+ pour saline into airway
- Stop all airway gas flow
- Re-establish ventilation
- Inspect ETT
```
72
Immediate care for Fire on Patient
- stop flow
- remove burning materials
- extinguish fire
- care for patient
- consider evacuating
73
What medicines should you hold before surgery?
Hold ACE, ARB, and diuretics
74
Normal insufflation for a laparoscopic procedure
12-15 mmHg
Quarter 3
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