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Pathophys II > Pathyophys final review part 3 > Flashcards

Pathyophys final review part 3 Flashcards

1
Q

What product carries the lowest risk for patients with hemophilia A?

A

desmopressin b/c it is synthetic rather than cryo and factor concentrates as they carry risk of infectious disease transmission

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2
Q

FFP contains

A

all of the clotting factors
does not have RBCs/Hgb so it does not increase oxygen carrying capacity & is not indicated for plasma volume augmentation

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3
Q

Cryoprecipitate contains

A

fibrinogen, VII, XIII, and vWF

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4
Q

Treatment of vWF can contain

A

desmopressin, factor VIII, cryo, & FFP

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5
Q

Erythropoietin is formed in the

A

kidneys

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6
Q

Methemoglobinemia producing oxidizing agents include

A

LAs, nitrates, & nitric oxide

nitrous oxide does not produce methemoglobinemia

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7
Q

Methemoglobinemia is a disorder characterized by

A

the presence of >1% metHb in the blood
methemoglobin is an oxidized form of hemoglobin (contains Fe3+ in place of Fe2+ in Hb) & has slightly greater affinity for oxygen due to its chemical structure

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8
Q

Double vision and worsening weakness can be indicative of

A

myasthenia gravis

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9
Q

The treatment of choice for myasthenia gravis is

A

anticholinesterase inhibitors

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10
Q

Describe the use of paralytics for patients with myasthenia gravis.

A

sensitive to rocuronium, resistant to succinylcholine

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11
Q

Anesthetic management of a patient with mitochondrial disease includes

A 
no need to reduce opioid requirements 
regional & locals are controversial
avoid nitrous LR & propofol infusions
can still use volatiles
Ketamine> propofol for induction
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12
Q

______ should be avoided in patients with Parkinson’s

A

metoclopramide- dopamine antagonist

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13
Q

Any condition that decreases oxygen transport to tissues will stimulate

A

erythropoietin

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14
Q

Chronic blood loss is the result of

A

inability to absorb enough iron from the gut to make hemoglobin as rapidly as it is lost

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15
Q

Acute blood loss.

A

body replaces fluid portion of plasma in 1-3 days

RBCs within 3-6 weeks

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16
Q

There is clear evidence to support hemoglobin levels below ________ benefit from transfusion

A

6 mg/dL

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17
Q

The lifespan of RBCs is

A

120 days

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18
Q

Blood tests for hemolytic anemia include

A

increased immature erythrocytes, unconjugated hyperbilirubinemia/jaundice, increased lactate dehydrogenase, decreased haptoglobin

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19
Q

For patients with sickle cell, blood transfusion

A

before surgery desires more HbA than HbS

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20
Q

The sickle cell trait

A

does not increase morbidity & mortality

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21
Q

With erythroblastosis fetalis, the fetus is

A

RhD-antigen positive and the mother is RhD antigen negative

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22
Q

Rhesus factor is

A

a protein found on the surface of RBCs (antigen)

23
Q

Anesthetic risks for development of hemolysis for patients with G6PD deficiency includes

A

metoclopramide
penicillin
sulfa
methylene blue

24
Q

Concentrated polycythemia is a result of

A

dehydration, diuretics, or vomiting

25
Q

Physiologic polycythemia

A

does not result in symptoms

its an environmental adaption

26
Q

Polycythemia vera may be as high as 60-70% instead of normal & many die from

A

thrombus complications

27
Q

Hemoglobin A is made up of

A

2 alpha & 2 beta

28
Q

Methemoglobin is formed when

A

the iron in HB is oxidized from the ferrous (Fe2+) to the ferric (Fe3+) state

29
Q

_________ is contraindicated in someone with G6PD deficiency

A

methylene blue

30
Q

Anesthesia management for the patient with thalassemia includes

A

risk of difficult intubation due to oro-facial malformations, risk for infection-broad spectrum antibiotics, DVT prophylaxis, blood bank alerted that patient has thalassemia

31
Q

Sickle cell disease is when

A

the amino acid valine is substituted for glutamic acid at one point in each of the 2 beta chains

32
Q

Factor VIII level should be brought to at least

A

> 50% prior to surgery

33
Q

The half life of factor VIII is approximately

A

12 hours in adults, 6 in children

34
Q

The treatment for hemophilia can include

A

FFP, cryo, TXA, desmopressin, & factor VIII concentratie

35
Q

Treatment for vWF includes

A

FFP, cryo, & factor concentrate

36
Q

Causes of DIC include

A

sepsis, burns, trauma, & obstetric complications

37
Q

Blood tests in DIC show

A

low platelets, low fibrinogen, high INR & PT, High PTT, high d-dimer

38
Q

In presenting hyperfibrinolysis DIC

A

give TXA with blood products

39
Q

In presenting procoagulant DIC

A

consider anticoagulation first & blood product support for bleeding or invasive procedures

40
Q

Upper motor neurons are

A

motor pathways that begin in the cerebral cortex & end in the ventral horn of the spinal cord

41
Q

The corticospinal tract

A

supplies the voluntary muscles of the trunk & extremities

42
Q

75-90% of the corticospinal tract

A

decussates in the medulla & forms the lateral corticospinal tract

43
Q

The corticobulbar tract

A

supplies the voluntary muscles of the head & follows the corticospinal tract until they reach the brainstem

44
Q

Lower motor neurons are

A

located in the brain stem or spinal cord

45
Q

Lower motor neurons send axons out through

A

nerves in the peripheral nervous system to synapse & control skeletal muscles

46
Q

The lower motor neurons that pass through the spinal nerves

A

primarily control muscles of the limbs & the trunk

47
Q

The lower motor neurons that pass through cranial nerves

A

primarily control the skeletal muscles of the head & neck

48
Q

The upper motor neuron motor cortex is

A

muscle groups affected
minimal disuse muscle atrophy
hypertonia
spasticity & babinski

49
Q

The lower motor neuron cortex involves

A 
individual muscles may be affected
marked muscle atrophy
fasciculations
decreased muscle stretch reflex
hypotonia
flaccidity
50
Q

Cerebral palsy does not

A

cause progressive intellectual disability

51
Q

This type of anesthetic technique should be avoided for patients with MS

A

spinal

52
Q

Succinylcholine should be avoided in patients with

A

MS, Huntington’s & LEMs

53
Q

Treatment for myasthenia gravis includes

A

cholinesterase inhibitor

54
Q

The difference between Duchenne’s & Becker’s is

A

the age of diagnosis

Pathophys II (43 decks)

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