Review Exam 1- baby D

Question 1

iron deficiency anemia is classified as

Answer 1

microcytic hypochromic

Question 2

initial phase of hemostasis is

Answer 2

formation of platelet plug

Question 3

the most common cause of reoperation after gastric bypass is?

Answer 3

anastomotic leaks

Question 4

mallory-weiss tear at the GE junction is associated with ETOH abuse. Common s/s is?

Answer 4

upper abd pain and bloody vomitus

Question 5

T/F
large negatively charged molecules have a more difficult time penetrating glomerular barriers to enter the ultra filtrate

Answer 5

true

Question 6

T/F

Liver receives 40% of total CO.

Answer 6

False

Question 7

adriamycin is a chemo drug that is known to cause impaired cardiac contractility. This type of cardiac dysfunction is referred to as _________ __________

Answer 7

systolic dysfunction

Question 8

decreasing afferent tone (dilation of afferent renal artery) will…..

Answer 8

increase GFR, increase glomerular blood flow

Question 9

ABG 
pH 7.37
pCO2 57
pO2 65
HCO3 34
Hgb 18
SpO2 93%
Smoker in no distress. 
What classification is this patient?

Answer 9

totally compensated chronic resp acidosis

Question 10

blood product that contains the most fibrinogen?

Answer 10

cryo

Question 11

T/F

Hyperkalemia potentiates neuromuscular blockade by decreasing the excitability of the skeletal muscle cell

Answer 11

True

Question 12

T/F

Zenkers diverticulum is contraindicated in TEE insertion

Answer 12

True

Question 13

Blood flow TO the glomerulus is provided via the ____________ renal artery. The resting tone of the vessel is primarily regulated by _____________.

Answer 13

afferent, prostaglandins

Question 14

Your patient has been febrile for the past 24 hours. No maintenance fluids have been infusing for the past 12 hours. You would expect your patient to be _____________ with an ___________ sodium level

Answer 14

hypovolemic, increased

Question 15

Which of the following is a benefit of utilizing normovolemic hemodilution as a blood conservation technique?

Answer 15

all of the above are benefits…. sorry there isn’t a list of em… ;)

Question 16

Increased __________ increased gut absorption of calcium; while __________ stimulates bone formation, decreasing plasma calcium levels.

Answer 16

calcitriol, calcitonin

Question 17

increased sympathetic nervous system stimulation initiates renin secretion. Renin begins the process of ____________ more sodium from the renal tubule.

Answer 17

retaining…..

RENIN LOVES SALT

Question 18

Which commonly used opiate or opioid medications have active metabolites which may prolong reap depression in the patient with renal failure? (2 of em)

Answer 18

demerol and morphine

Question 19

T/F

Proteins secreted into the ultra filtrate can be easily reabsorbed completely intact across the tubular membranes

Answer 19

False

Question 20

T/F
Patients who live in high altitudes are often polycythemic. The polycythemia is created by increased levels of erythropoietin as a result of lower atmospheric pressures.

Answer 20

False

Question 21

l-arginine vasopressin is secreted by the

Answer 21

posterior neural hypophysis

Question 22

anti-parasympathetic medications may cause

Answer 22

urinary retention

Question 23

Hemophilia A is an abnormality of which clotting factor?

Answer 23

factor 8 (VIII)

Question 24

the final stage in pathogenesis of chronic renal failure is

Answer 24

glomerulosclerosis

Question 25

T/F

the kidneys are primarily responsible for regulating free water concentration in the body

Answer 25

false

Question 26

the only test available to evaluate all properties of clot formation and strength is

Answer 26

TEG (thromboelastograph)

Question 27

T/F
Enzyme immunoassays are the most sensitive and specific tests to confirm heparin induced thrombocytopenia, but not the most rapid.

Answer 27

False

Question 28

T/F
Patient’s BUN is 18 and the creatinine is 3.6. the patient has azotemia because the patient is clearly in chronic renal failure.

Answer 28

False

Question 29

Which of the following factors is not part of the common pathway? 1, 2, 4

Answer 29

4

Question 30

Your patent has a Hgb of 7 mg/dL. Based on this finding you would expect a change, if any, to this patient’s oxyhemeglobin dissociation curve?

Answer 30

right shift

Question 31

The kidneys receive what percentage of the total cardiac output?

Answer 31

25%

Question 32

T/F
Obese patients must be well-preoxygentated before induction of GA. This is due to decrease in FRC not total lung capacity

Answer 32

False

Question 33

T/F
Decrease in coagulopathy is not a renal protective benefit of ACEI/ ARB medical therapy in patients with chronic renal failure.

Answer 33

False

Question 34

T/F

When there is exposure of collagen from damage to the endothelium, the intrinsic clotting pathway is activated.

Answer 34

True

Question 35

In response to injury, the capillaries

Answer 35

allow more albumin to escape the vascular space.

Question 36

According to the Society of Ambulatory Anesthesia guidelines for the management of PONV, the proper time to administer dexamethasone for the prevention of PONV is ____________, and the suggested dose is ___________.

Answer 36

at induction, 4-5 mg IV

Question 37

Your patient in septic shock is undergoing massive tissue debridement for necrotizing fasciitis. The patient is on norepinephrine at 30 mcg/min and vasopressin at 0.04u/hr. The starting Hct is 38% and the Lactate level is 5.0 mmol/L. ABG is 7.11/34/197 with bicarb at 17. You resuscitate with 6 liters of normal saline and give 100 mEq sodium bicarbonate as the patient is still hypotensive with a systolic BP of 75. After resuscitation, you are able to wean off the vasopressin but still require levophed at 12 mcg/min. Lactate is now 2.0. You repeat the ABG and get the following results. Ph 7.24/pCO2 40/ pO2 143 HCO3 22. The most likely cause of refractory acidosis is

Answer 37

hyperchloremic acidosis

Question 38

The majority of solute in the ultrafiltrate is reabsorbed via the

Answer 38

proximal tubule

Question 39

In differentiating nephrotic versus nephritic syndrome, the patient with nephrotic syndrome swill present with ___________ without __________.

Answer 39

massive proteinuria, hematuria

Question 40

Normal coagulation is balanced between hemostatic and fibrinolytic properties. The “viscous triad” of elements associated with trauma that can create or exacerbate coagulopathy include (3)

Answer 40

hypothermia, acidosis, hemodilution

Question 41

Portal HTN can lead to hypersplenism, which can result in

Answer 41

platelet trapping & thrombocytopenia

Question 42

leading cause of liver failure in the USA is

Answer 42

acetaminophen toxicity

Question 43

symptoms associated with TURP syndrome are caused by

Answer 43

free water excess

Question 44

T/F
A shift to the right of the oxyhemoglobin dissociation curve decreases the partial pressure at which 50% of hemoglobin is saturated with oxygen

Answer 44

false

Question 45

3 things that can precipitate sickling of RBC’s in the patient with homozygous sickle cell disease

Answer 45

hypothermia, PaCO2 of 40mmHg, septic shock

Question 46

T/F

A loss of sodium in excess of water is a more common cause of hyponatremia than an excess of total body water

Answer 46

False

Question 47

Patients being treated with ankylating chemo drugs can experience what with benzos?

Answer 47

potentiation of benzodiazepines

Question 48

When a patient is undergoing GA is hyperventilating to a state of alkalosis, intracellular potassium levels ____________ while serum potassium levels ________________

Answer 48

increase, decrease

Question 49

ADH exerts its action by

Answer 49

changing the water permeability of renal collecting ducts