HAExamIII Flashcards
(239 cards)
1
Q
Which fluid space is more immediately altered by the kidneys?
A
ECF
2
Q
What composes the ECF? What’s its volume?
A
ISF and Plasma = <1/2 volume of TBW
3
Q
________ is mainly mediated by osmolality-sensors in the anterior hypothalamus
A
Osmolar Homeostasis
4
Q
What does osmolar homeostasis consist of?
A
- Stimulate thirst
- Cause pituitary to release ADH
- Cardiac atria releases ANP
5
Q
What mediates volume homeostasis? How?
A
Juxtaglomerular apparatus; Decreased volume at JGA triggers RAAS to stimulate Na+ H2 reabsorption
6
Q
What’s the underlying cause of hyponatremia?
A
Hypervolemia
7
Q
What levels of Na+ needs to be corrected before to an elective cases?
A
≤125 mEq or ≥ 155 mEq
8
Q
What are 4 causes different causes of hypovolemia?
A
- Diuretics
- GI Loss (vomitting/diarrhea)
- Burns
- Truama
9
Q
What are some causes of euvolemia?
A
- Glucocorticoid deficiency
- Hypothyroidism
- High sympathetic drive
- Drugs
- SIADH
10
Q
What are some causes of hypervolemia?
A
- ARF
- HF
- Hyperaldosteronism
- Cushings
11
Q
Serum Na+: <120 mEq/L
A
- Restlessness
- Lethargy
- Seizures
- Brain-stem hernation
- Respiratory arrest
- Death
12
Q
Serum Na+: 120-130 mEq/L
A
- Malaise
- Unsteadiness
13
Q
Serum Na+: 130-135 mEq/L
A
Depressed reflexes
14
Q
How fast can we run hypertonic saline (3% NaCl)?
A
80 mL/hr
15
Q
What can cause osmotic demyelination syndrome?
A
> 6 mEq/L of Na+ in 24 hours
16
Q
What can cause hypernatremia?
A
- Excessive evaporation
- DI
- Excessive NaHCO3
- GI Losses
17
Q
What should be the Na+ reduction rate?
A
≤ 0.5 mmol/L/hr or ≤ 10 mmol/L per day to avoid cerebral edema, seizures, and neurological damage
18
Q
What is a major ICF cation?
A
K+
19
Q
Serum K+ reflects?
A
Transmembrane K+ regulation
20
Q
What does aldosterone do?
A
Causes the distal nephron to secrete K+ and reabsorb Na+
Aldosterone inversely effects K+
21
Q
What are some common causes of hypokalemia?
A
- Renal Loss - diuretics, hyperaldosteronism
- GI loss - V/D, malabsortion
- Transcellular shift
- Low PO intake
- DKA
- Excessive black licorice
22
Q
What causes an intracellular shift of K+?
A
- Alkalosis
- Beta Agonists
- Insulin
23
Q
For every 10 mEq IV K+, serum K+ increases by how much?
A
0.1 mmol/L
24
Q
What can cause hyperkalemia?
A
- Renal failure
- Hypoaldosteronism
- Depolarizing NMB (Succs)
- Acidosis
- Cell death (trauma)
- Drugs that inhibit RAAS
25
What is the EKG progression of hyperkalemia?
1. Peaked T wave
2. P wave disappearance
3. Prolonged QRS complex
4. Sine wives
5. Asystole
26
What are some of the primary treatments for hyperkalemia?
1. Dialysis
2. **Ca2+**
3. Hyperventilation
4. Insulin + Glucose (10-20minutes)
5. Bicarb
6. Kayexalate (hrs to days)
27
How much does hyperventilating improve pH? K+?
*Increases* pH by 0.1 for every 0.4-1.5 mmol/L *decrease* in K+
28
How much Ca2+ is in the ECF? bone?
1%; 99%
29
What is ionized Ca2+? Why is this important?
Ca2+ is not protein bound. Only non-protein bound Ca2+ is physiologically active
30
What is a normal iCa2+?
1.2-1.38 mmol/L
31
What two things affect iCa2+?
1. Albumin level
2. pH
32
What is the effect of increased pH/alkalosis on Ca2+?
Increases Ca2+ binding to albumin
33
What do we need to avoid with hyperkalemia?
1. Succs
2. Hypoventilation
3. LR & K+ containing IV fluids
34
What does PTH do?
Increases GI absorption, renal reabsorption of Ca2+ and Ca2+ resorption from the bone.
35
What does calcitonin do?
promotes Ca2+ reabsorption (decreases plasma Ca2+) into the bone
Calcitonin inhibits bone resorption to decreases serum Ca2+
36
What can cause hypocalcemia?
1. **Complication of thyroid/PT surgery**
2. Mg2+deficiency
3. Low vitamin D
4. **Decreased PTH**
5. Renal failure
6. **Massive blood transfusion**
37
What can cause hypercalcemia?
**Hyper-parathyroid or cancer**
Less common causes include:
1. Vitamin D intoxication
2. **Milk-alkali syndrome**
3. Granulomatous diseases (sarcoidosis)
38
When should we check our iCa2+?
After 4+ units of PRBCs
39
What is milk-alkali syndrome?
Excessive GI Ca2+ absorption
40
What can be caused by chronic hypercalcemia?
1. Hypercalciuria
2. Nephrolithiasis
41
What is the major complication of post-parathyroidectomy?
Hypocalcemia induced laryngospasm
| Life threatening
42
What is the serum Ca2+ for hyperparathyroid? Cancer?
Hyperparathyroid: < 11
Cancer: >13
43
What electrolyte is necessary for PTH production?
Mg2+
44
What are the causes of hypomagnesia?
1. Low dietary intake or absorption
2. Renal wasting
45
What causes hypermagnesemia?
Overtreatment pre-eclampsia/eclampsia
46
Serum Magnesium: 4-5 mEq/L
Lethargy, N/V, flushing
47
Serum Magnesium: > 6 mEq/L
HoTN, decreased DTR
48
Serum Magnesium: >10 mEq/L
Paralysis
Apnea
Heart blocks
Cardiac arrest
49
Where are the kidneys located?
Retroperitoneal between T-12 and L-4
50
How much of the total CO do the kidneys recieve?
20%; 1-1.25 L/min
51
What part of the kidney is particularly vulnerable for developing necrosis in response to hypotension?
Loop of Henle
52
What does the RAAS do in simple terms?
Increases serum Na+ and H2O reabsorption
53
What hormones do the kidneys make?
Renin
Erythropoietin
Calcitriol
Prostaglandins
54
What are the kidneys functions according to HA class?
1. Regulate the volume, composition, and osmolarity of ECF
2. Regulate BP
3. Maintain acid/base balance
4. Excrete toxins/metabolites
5. Produce hormones
55
What is a normal GFR?
125-140 mL/min; best measure of renal function over time
56
What's important to know about measuring GFR?
1. **Best measure of renal function over time**
2. Heavily influced by hydration status
3. **GFR better for trending**
57
What's a normal creatinine clearance?
110-140 mL/min
58
What's important to know about creatinine clearance?
Most reliable measure of GFR
59
What is the normal serum creatinine?
0.6-1.3 mg/dL
| **Correlates with muscle mass**
60
What is good about serum creatinine?
1. Inversely related to GFR
2. **Better for detecting an acute change in kidney function**
3. Can be influced by high protein diet, supplements, and muscle breakdown
61
What is a normal BUN?
10-20 mg/dL
62
What is a normal BUN:Creatinine ratio? What is this a measurement of?
10:1; hydration status
63
64
What is normal proteinuria? Abnormal?
< 150 mg/dL; > 500 mg/dL
| > 500 mg/dL suggests glomerular injury or UTI
65
What is a normal specific gravity?
1.001-1035
66
What is considered to be a late sign of volume loss?
Drop in UOP
67
What volume is considered to be oliguria?
< 500 mL in 24 hours
68
What collapse indicates a fluid deficit?
IVC collapse > 50%
69
What is considered powerful stimuli for renal vasoconstriction?
LAP, PCWP
70
A build up nitrogenous products such as urea and creatinine
Azotemia
| **Hallmark of AKI**
71
What causes prerenal azotemia? (long list)
1. **Hemorrhage**
2. **GI fluid loss**
3. **Trauma**
4. **Surgery**
5. **Burns**
6. Shock
7. Sepsis
8. Aortic Clamping
9. Thromboembolism
| *First 5 most important*
72
What causes (intra)renal azotemia?
1. Acute glomerulonephritis
2. Interstitial nephritis
3. Vasculitis
4. Contrast dye
5. ATN
73
What causes post renal azotemia?
1. Nephrolithiasis
2. BPH
3. Clot retention
4. Bladder carcinoma
74
Primary risk factors of AKI
1. **Pre-existing renal disease**
2. Age
3. CHF
4. Diabetes
5. PVD
75
Azotemia: Pre-renal
1. Decreased renal perfusion
2. **Most common form**
3. **Reversible**
4. Tx: Restore RBF
76
Azotemia: (Intra)renal
1. **Nephron injury**
2. Intrinsic renal disease
3. potentially reversible
4. decreased GFR is a late sign
77
Azotemia: Post Renal
1. **Outflow obstruction**
2. Easiest to treat
3. Tx: Remove obstruction
4. **Hydronephrosis (increased nephron hydrostatic pressure)**
78
BUN:Cr ratio pre-renal azotemia
> 20:1
79
BUN:Cr ratio intra-renal azotemia
< 15:1
80
Vasopressin preferentially constricts what? Why is this important?
Efferent arteriole; better than alpha agonists for maintaining RBF
81
In anesthesia preparation for the AKI patient, what recent lab is the most important?
K+
82
What are the two leading causes of CKD?
1. Diabetes
2. Hypertension
83
How much does GFR decrease per decade?
10 mL per decade starting from age 20
84
What is first line treatment for hypertension in the CKD patient?
Thiazide diuretics
85
What medications are held on the day of surgery to decrease the risk of profound hypotension?
ACE-I/ARBs
86
What is considered to be dyslipidemia?
Triglycerides > 500
LDL > 100
87
What is the target Hgb for anemic patients?
10
88
Which populations are high risk for silent MI?
1. Women
2. Diabetics
89
What is the peak and duration of desmopressin (DDAVP)?
Peak: 2-4 hours
Duration: 6-8 hours
90
Which NMB is best for kidney patients?
What reversal is **NOT** recommended for kidney patients?
Nimbex (Cisatracurium); Sugammadex
91
What does the patient's K+ level have to be prior to surgery?
< 5.5 mEq/L
| for elective surgery
92
Functions of the liver
| Long list, just read through them
1. **Synthesizes glucose via gluconeogensis**
2. Stores excess glucose as glycogen
3. **Synthesizes cholesterol and proteins into hormones and vitamins**
4. Metabolizes fats, proteins, carbs to generate NRG
5. **Detoxifies blood**
6. Metabolizes drugs via CYP450 and other pathways
7. Involved in the acute-phase of immune support
8. Processes Hgb and stores iron
9. **Synthesizes coagulation factors**
10. Aids in volume control as a blood reservoir
93
What are the three hepatic veins? Where do they empty?
Right, middle, left; IVC
94
Where does bile enter the duodenum?
Ampulla of Vater
95
# s
How much CO does the liver receive?
25%; 1.25-1.5 L/min
| Highest proportion out of all the organs
96
How is hepatic blood flow split up? O2 delivery?
Portal vein = 75% of HBF
Hepatic artery = 25% of HBF
50:50 O2 delivery
97
What are the coagulation factors that the liver does **NOT** synthesize?
III, IV, VIII, vWF
98
What is portal HTN?
Hepatic arterial blood flow inversely related to portal venous blood flow
99
What results from increased portal venous pressure?
esophageal and gastic varices
100
HVPG: 1-5 mmHg
| Hepatic Venous Pressure Gradient
Normal portal venous pressure
101
HVPG: >10 mmHg
| Hepatic Venous Pressure Gradient
Clinically significant portal HTN (cirrhosis, varices)
102
HVPG: > 12 mmHg
| Hepatic Venous Pressure Gradient
Variceal rupture
103
What is asterixis?
flapping tremor
104
What is the most liver specific enzyme?
Alanine aminotransferase (ALT)
105
AST/ALT: Acute liver failure
AST/ALT elevated 25x
106
AST/ALT: alcoholic liver diagnoses
ratio 2:1
107
What is the primary symptom of gallstones?
RUQ pain, referred to shoulders
108
What is choledocolithiasis?
stone onstructing CBD causing biliary colic
| Will see cramping, N/V in addition to RUQ pain
109
What is proper patient positioning for ERCP?
1. Patient is prone
2. Head to patient's right
3. Tape ETT to the left
110
What is bilirubin?
end product of heme-breakdown
111
Why is unconjugated bilirubin "indrect"?
bilirubin is bound to albumin
112
What causes conjugated (direct) hyperbilirubinemia?
an obstruction
113
Why is conjugated bilirubin "direct"?
H2O soluable direct state, excreted into blie
114
What hepatitis requires the most liver transplantation?
Hep C
115
What causes unconjugated (indirect) hyperbilirubinemia?
Imbalance between bilirubin synthesis and conjugation
116
Which hepatitis does NOT progress to chronic liver disease?
A
117
Which hepatitis results as a coinfection with B?
D
118
Which hepatitis causes liver disease in children?
B
119
Which hepatitis usually develops into chronic liver disease?
C
120
What is the most common cause of cirrhosis?
Alcoholic liver disease (ALD)
121
A platelet count of less than what requires transfusion in ALD patients?
< 50,000
122
Symptoms of ETOH withdrawal will occur how long after stopping?
24-72
123
How much fat do hepatocytes contain?
> 5%
124
What is the gold standard in distinguishing NAFLD from other liver diseases?
liver biopsy
125
What is the cause of drug induced liver injury?
Acetaminophen OD
126
What is Wilson's disease?
Hepatolenticular degeneration that is characterized by impaired copper metabolism
127
What is the #1 genetic cause of liver transplantation in children?
a-1 antitrypsin deficiency
128
What is hemochromatosis?
Disorder associated with excess iron in the body, leading to MODs. Likely cause is repetitive blood transfusions or high dose iron infusions
129
Who does autoimmune hepatitis primarily affect?
Women
130
What is primary biliary cholangitis (PBC)?
Autoimmune progressive destruction of bile ducts with periportal inflammation & cholestasis
131
What is primary sclerosing Cholangitis (PSC)?
Autoimmune chronic inflammation of the larger bile ducts
132
What is cirrhosis?
The final stage of liver disease where normal liver parenchyma is replaced with scar tissue
133
What is the most common complication of cirrhosis?
Ascites
| Varices are present in 50% of cirrhosis patients
134
What causes hepatic encephalopathy?
A build up of nitrogenous waste
135
What is hepatorenal syndrome?
Excess endogenous vasodilators
136
What is hepatopulmonary syndrome?
Triad of chronic liver diseases:
1. Hypoxemia
2. Intrapulmonary vascular dilation
3. Platypnea (hypoxia when upright)
137
What is portopulmonary HTN?
pulmonary HTN accompanied by portal HTN
138
What are points in the Child Turcotte Pugh (CTP) scale based on?
1. Bilirubin
2. Albumin
3. PT
4. Encephalopathy
5. Ascites
139
What is the model for end stage liver disease (MELD) score based on?
1. Bilirubin
2. INR
3. Creatinine
4. Na+
140
What is used for fluid resesitation in liver patients?
Colloids
141
What NMB drugs are recommended for liver patients?
Succs and Cisatracurium
142
What is a TIPS procedure?
Stent or graft placed between hepatic vein and portal vein to allow portal flow into systemic circulation
143
Why do we maintain a low CVP by fluid restriction for partial hepatectomy?
To reduce blood loss
144
How do you calculate cerebral perfusion pressure (CPP)?
MAP - ICP
145
What is normal CBF and how much CO does it recieve?
750 mL/min; 15% of CO
146
How do you calculate CBF?
50 mL/100g brain tissue per minute
147
What is a normal ICP?
5-15 mmHg
148
What is the monroe-kellie hypothesis?
Any increase in one component of intracranial volume must be offset by a decrease in another component to prevent an elevated ICP
149
A reflection of dura that separates the two cerebreal hemispheres
Falx Cerebri
150
A reflection of dura that lies rostral to the cerebellum
Tentorium cerebelli
151
How are hernation syndromes categorized?
based on the region of brain affected
152
Herniation: Subfalcine
Herniation of the contents under the falx cerebri resulting in a midline shift
153
Herniation: Uncal
A subtype of transtentorial herniation where the uncus herniates over the tentorium cerebelli. This results in ipsilateral oculomotor nerve dysfunction.
154
How can we decrease ICP?
| Long list, just review it
1. Elevate the head
2. Hyperventilation - lowers PaCO2
3. CSF drainage - EVD
4. Hyperosmotic drugs - mannitol
5. Diuretics - induce systemic hypovolemia
6. Corticosteroids - decrease swelling and ehance the integrity of the BBB
7. Propofol - decrease CRMO2 and CBF
8. Surgical decompression
155
156
Progressive autoimmune demyelination of cental nerve fibers
MS
Primarily affects women and is characterized by periods of exacerbations and remissions.
157
What are two of the major preanesthetic considerations for MS patients?
1. **Temperature** - any increase in body temp can precipitate an exacerbation of MS
2. Avoid succynilcholine as it may induce hyperkalemia - upregulated nACh receptors
158
Autoimmune disorder where antibodies are generated against nAChRs at skeletal motor endplate
MG
Treat with pyridostimmine
AChE inhibitors may prolong succs and Ester LA's
159
Disorder causing the development of autoantibodies against VG-Ca2+ channels
Eaton Lamber Syndrome
| Tx: 3-4 diaminopyridine (selective K+ channel blocker
160
What is the cause of Eaton-Lambert Syndrome?
Small Cell Lung CA
161
Hereditary disorder of muscle fiber degeneration complicated by breakdown of the dystrophin-glycoprotein
Duchenne MD
162
What are Eaton Lambert patients really sensitive to?
NMB both ND and D
163
Prolonged contraction after muscle stimulation
Myotonia
164
What are myotonias triggered by?
Stress and cold temps
165
What is central core disease?
core muscle cells lack mitochondrial enzymes
166
What causes a hypermetabolic syndrome in patients with muscular dystrophy?
Succs and volatile anesthetics like MH
167
What are the three major types of dementia?
1. Alzheimers (70%)
2. Vascular dementia (25%)
2. Parkinsons (5%)
168
Degeneration of dopaminergic fibers of basal ganglia
Parkinson's Disease
169
What system does dopamine regulate?
regulates extrapyramidal motor system by inhibiting excess stimulation
170
What medications may affect your anesthetic for dementia patients?
AChE-I, MAOIs, psych meds
171
What is the leading cause of death and disability globally?
Stroke
172
What is the recommended initial treatment for acute ischemic stroke?
PO ASA
173
What the CV risk factors related to ischemic stroke?
1. HTN
2. DM
3. CAD
4. Afib
5. Vascular disease
174
New anticoaglant for thrombus =
no elective cases within 3 months
175
How quickly do anerysms need to be intervened?
within 72 hours
176
What is a risk post SAH? For how long?
vasospasm for 3-15 days post op
177
What is the aim for anerysms pre anesthesia?
BP control to avoid rupture
178
Anerysm Grading
| Long just read
1. Unruptured
2. Ruptured, no deficits
3. Moderate to severe HA
4. Drowsiness, confusion
5. Stupor, hemiparesis
6. Deep coma, decerbrate rigidity
179
What are the major symptoms of an anerysm?
1. HA
2. Photophobia
3. Confusion
4. Hemiparesis
5. Coma
180
What is triple H therapy?
1. Hypertension
2. Hypervolemia
3. Hemodilution
181
Arterial to venous connection without intervening capillaries creating an area of how flow to low resistance shunting
AV malformations
182
What is chiari malformation?
Congenital displacement of the cerebellum
Type 1: Downward displacement
Type 2: downward displacement of cerebellar vermis
Type 3: Occipital encephalocele
Type 4: non compatible with life
183
What is Bourneville Disease (Tubular Sclerosis)?
Disease causing benign hematomas, angiofibromas, and other malformations that can occur anywhere
| Can present with retardation and seizure disorders
184
Benign tumors of the CNS, eyes, adrenals, pancreas, and kidneys
Von Hippel-Lindau Disease
| May present with pheochromocytoma
185
A disorder of CSF accumulation causing increase ICP that results in ventricular dilation
Hydrocephalus
186
Primary Injury
Occurs at the time of insult
187
Secondary injuries
| Long list, read
1. Neuroinflammation
2. Hypoxia
3. Anemia
4. Cerebral edema
5. Electrolyte imbalances
6. Neurogenic shock
188
Transient, paroxysmal, synchronous discharge of neurons in the brain
Seizure
189
How do you intubate post seizure?
RSI with cricoid pressure
190
When is surgery indicated for an aortic anerysm?
> 5.5 cm
191
Uniform dilation along entire circumference of arterial wall
Fusiform
192
Berry-shaped bulge to one side
Saccular
193
What is the safest/fastest measure of obtaining a diagnosis of a dissected aneurysm?
Doppler echocardiogram
194
What needs to be on board before surgeries on seizure patients?
anti-seizure medications
195
Tear in the intimal layer of the vessel causing blood to enter the medial layer
Dissection
196
Which type of dissection is "catastrophic"?
Ascending
197
What is the major complication of a Stanford A dissection?
Neurological deficits
198
What two types of dissection are part of Stanford A?
Ascending aorta & aortic arch
199
What type of dissections are type B?
Descending thoracic aorta
200
What dissections are treated with medical therapy?
Stanford B
| unless they have signs of impending rupture
201
What are signs of impending rupture?
1. Persistent pain
2. Hypotension
3. Left-sided hemothorax
202
Which dissection is an emergency?
Ascending arch
| Uncomplicated type B rarely treated with urgent surgery
203
What can cause a dissection?
1. **Cocaine**
2. Blunt trauma
3. Iatrogenic causes
204
What is iatrogenic?
Cardiac catheterization, aortic manipulation, cross clamping, and arterial incision
205
What is the aortic aneurysm triad?
1. Hypotension
2. Back pain
3. A pulsatile abdominal mass
206
Where do most abdominal aortic aneurysms rupture?
left retroperitoneum
207
What can euvolemic resuscitation lead to in an aneurysm?
Retroperitoneal tamponade
208
Caused by a lack of blood flow to the anterior spinal artery
Anterior spinal artery syndrome
209
The anterior spinal artery is responsible for perfusing the anterior ______ of the spinal cord
2/3
210
What can cause anterior spinal artery syndrome?
1. Aortic aneurysms
2. Aortic dissection
3. Atherosclerosis
4. Trauma
211
What is the number 1 leading cause of disability in the US?
Stroke
| It's also the 3rd leading cause of death in the US
212
How quickly does TPA need to be given?
Within 4.5 hours
213
When is a cartoid endarectomy indicated?
Lumen diameter 1.5mm or >70% blockage
214
What affects cerebral oxygenation?
1. MAP
2. CO
3. SaO2
4. Hgb
5. PaCO2
215
What defines PAD?
ABI < 0.9
216
What are two of the primary signs of PAD?
1. **Intermittent claudation**
2. **Resting extremity pain**
3. Coolness
4. Hairloss
217
Why do patients with PAD get relief when hanging their LE over the side of the bed?
Increases hydrostatic pressure
218
What causes subclavian steal syndrome?
occluded SCA proximal to vertebral artery
219
What will the SBP of the affected arm in subclavian steal syndrome me?
20 mmHg lower
220
What does a doppler US show?
Pulse volume waveform that can identify arterial stenosis
221
What does duplex US show us?
Can identify areas of plaque formation and calcification
222
What are 3 examples of PVD?
1. Superficial thrombophlebitis
2. DVT
3. Chronic venous insufficiency
223
What is virchow's triad?
1. Venous stasis
2. Hypercoaguability
3. Distrupted vascular endothelium
224
LMWH advantages and disadvantages
| Just read
A
1. Longer Half-Life
2. Less risk of bleeding
DA
1. Higher cost
2. Lack of reversal agent
225
Who is high risk for DVT?
| long list
1. **Age > 40**
2. **Operation > 60 minutes**
3. Previous Hx of stroke, DVT, embolism
4. Knee or hip replacement
5. Major fractures
6. Extensive trauma
226
What may be observed frequently during and after carotid endarterectomy?
Hypo and hypertension
227
An inflammatory vasculitis leading to occlusion of small and medium-sized arteries and veins in the extremities
Thromboangitis
228
What complications are the leading cause of perioperative morbidity and mortality?
Cardiac complications
229
What typically causes an acute arterial occlusion?
Cardiogenic embolism
230
Large Artery vasculitis
Takayasu artheritis
Temporal artheritis
231
Medium to small-artery vasculitis
Thromoboangiitis obliterans
Wegener granulomatosis
Polyartheritis nodosa
232
Medium-artery vasculitis
Kawasaki disease
233
Inflammation of arteries of the head and neck
Temporal (giant cell) arteritis
234
An inflammatory vasculitis leading to small & medium vessel occlusions in the extremities caused by an autoimmune response that was triggered by nicotine
Thromboangiitis Obliterans "Buerger Disease"
235
What happens in 50% of total hip placements?
Superficial thrombophelbitis and DVT
236
What can greatly improve post op ambulation and decrease DVT?
Regional anesthesia
237
Antineutrophyl cytoplasmic antibody negative vasculitis
Polyarteritis nodosa
238
What is the primary cause of death for patients polyarteritis nodosa?
Renal failure
239
What is indicated by a retrograde blood flow > 0.5 seconds?
Lower extremity chronic venous insufficiency
