Surgery Flashcards
(119 cards)
________ presents with mid-systolic, crescendo-decrescrendo right 2nd intercostal+ left sternal border
Aortic stenosis
Aortic stenosis radiates to _________
carotid
______ increases the murmur of aortic stenosis
squatting
_______ decreases the murmur of aortic stenosis
valsalva
when is the valve replaced in aortic stenosis
if symptomatic, gradient > 50 or CHF
________ presents with Holosystolic murmur with click at the apex radiating to axilla
mitral regurgitation
Most common cause of mirtal regurgitation
MVP (Marfans)
Early peaking systolic ejection murmur increased by Valsalva,
decreased by squatting/handgrip
HOCM
if pt with HOCM present with syncope, arrhythmia or FH of HOCM
place an Implantable Cardioverter Defibrillator
Acute: young person with endocarditis & sudden CHF with
loud diastolic murmur at right 2nd intercostal space
Acute Aortic Regurgitation/Insufficiency
blowing high-pitched diastolic at 2nd intercostal space
+ left lower sternal border assoc’d with wide pulse pressure.
Chronic Aortic Regurgitation/Insufficiency
what is the first line treatment of chronic aortic regurgitation
medical therapy with vasodilators
Low pitched rumbling diastolic at apex with opening snap
mitral stenosis
complication of mitral stenosis
atrial fibrillation
extreme drop in platelets + clots in post-op patient who has received
heparin within 5-14 days
Heparin Induced Thrombocytopenia
treatment of heparin Induced Thrmbocytopenia includes _________
STOP HEPARIN, give lepirudin or argatroban
Lidocaine + epinephrine should not be given in the following places: ______, _______, _______ and _____
fingers, nose, penis and toes
A patient takes amlodipine for hypertension. When should
this patient discontinue this medication prior to surgery?
Hold morning dose
For how long should an active smoker be told to quit before surgery?
8 weeks
why are patients with nephrotic syndrome at increased risk of clotting?
loss of antithrombin III in urine
symptoms of malignant hyperthermia
high fever (>104 degrees celcius), muscle rigidity, metabolic acidosis, hyperkalemia
treatment of malignant hyperthermia
IV dantrolene, 100% oxygen, Cooling blankets, correct acidosis
patient presents with fever less than 24hrs of surgical operation. most likely cause?
malignant hyperthermia
patient presents with fever within 24hrs of surgical operation. most likely causes?
atelectasis, necrotizing fasciitis
