Channel ORANGE Flashcards
(21 cards)
How does subdural analgesia present?
High epidural blockade without poor pain control and Horner’s syndrome, maybe sacral sparing
What are common GI side-effects from neuraxial?
-Increased secretions
-Increased peristalsis
-Constriction of the bowel
-Decreased sphincter tone
-Neuraxial blocks the nociceptive afferent nerves or the thoracolumbar sympathetic efferent nerves which improve GI motility.
How does placental abruption present?
Painful vaginal bleeding, uterine irritability, and fetal distress
How does placenta previa present?
Painless vaginal bleeding, not associated with labor or another inciting event, in the 2nd or 3rd trimester
What distance from the uterine os to the edge of placenta can a trial of labor be offered in placenta previa?
Greater than 1 cm (with minimal bleeding)
How does uterine rupture present?
Sudden and severe maternal abdominal pain, hypotension, or shock with profound fetal bradycardia
What is involved in the MELD score?
“I Crush Beer Daily”
-INR
-Creatinine
-Bilirubin
-Dialysis
What are common physiologic changes seen after brain death?
-Myocardial dysfunction
-Catecholamine storm
-Hemodynamic instability
-Hypernatremia
-Hypovolemia
-Pulmonary edema
-Hyperglycemia
-Polyuria
What is hypokalemic periodic paralysis?
-Autosomal dominant disease affecting voltage gated channels of sodium (type 2) or calcium (type 1) in the muscles
-Common symptoms are flaccid paralysis attacks after eating carb heavy meals and during exercise.
-Other exacerbating factors are high salt meals, stress, hypothermia, menstruation, glucose-insulin infusions
What is the respiratory quotient?
Volume of CO2 released over the volume of O2 consumed during respiration or when a substance is metabolized.
Which macronutrient has the lowest respiratory quotient?
Fats (0.7) < Proteins (0.8) < Carbs (1.0)
RQ = Vol CO2/ Vol O2
What is involved in the Child-Pugh score?
“Pour Another Beer At Eleven”
-PT
-Ascites
-Bilirubin
-Albumin
-Encephalopathy
What are the metabolic derangements of a pyloric stenosis case?
-Hypochloremia
-Hypokalemia
-Metabolic alkalosis
-Changes in sodium can be varied depending on dehydration (hyponatremia or hypernatremia)
What is the effect of sodium bicarb administration on potassium?
-Transiently lowers serum potassium and calcium
-During transient alkalosis, extracellular potassium ions move into cells to balance movement of hydrogen extracellularly.
How does the body compensate with chronic anemia?
-Cardiac output increases due to sympathetic surge of anemia and hypoxia.
-Decreased vascular resistance and afterload due to decreased blood viscosity which leads to larger stroke volumes
-Decreased sheer force leads to increased flow through microvasculature and venous return to heart.
-Increase in 2,3-biphosphoglycerate causing a right shift leading to decreased affinity for oxygen at the level of the tissues (more unloading)
What channels does myotonia congenita attack?
chloride
What is the effect on sodium bicarb administration on end-tidal CO2?
Can transiently increase end-tidal CO2 due to conversion of carbonic anhydrase to water and CO2.
What channels are mutated in Andersen-Tawil syndrome
Potassium
What drugs are based on TBW?
Dexmedetomidine, succinylcholine, and synthetic opioids
