Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Crozer-Keystone > Medicine > Flashcards

Medicine Flashcards

(96 cards)

Start Studying
1
Q

What are the reasons for post op fever?

A
  1. Wind (12-24 h): atelectasis, post-op hyperthermia
  2. Water (~24 h): UTI
  3. Walk (~48 h): DVT, PE
  4. Wound (72 h): post-op infection
  5. Wonder drug (anytime): drug fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the treatments for post op fever?

A
  1. Wind: incentive spirometer
  2. Water: straight cath; UA with gram stain/culture/sensitivity; abs if necessary
  3. Walk: heparin or lovenox protocol; get patient up and walking; Ted hose
  4. Wound: X-ray; gram stain; culture and sensitivity; blood cultures; begin ab
  5. Wonder drug: d/c drug; give reversal if necessary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When do fever peaks occur?

A

Between 4-8 pm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What part of the brain regulates body temp?

A

Hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is malignant hyperthermia?

A

A side effect of general anesthesia - tachycardia, HTN, acid-base and electrolyte abnormalities, muscular rigidity, hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the treatment for malignant hyperthermia?

A

Dantrolene

2.5 mg/kg IV x 1, then 1 mg/kg IV rapid push q6h until symptoms subside or until max dose of 10 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If a risk of malignant hyperthermia is suspected, what pre-op test may be performed?

A

CPK - elevated in 79% of patients with malignant hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the mechanism of action for local anesthetics?

A

Block Na+ channels and conduction of AP’s along sensory nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the toxic dose of lidocaine?

A

300 mg plain (4.5 mg/kg)

500 mg w/ epi (7.0 mg/kg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the toxic dose of bupivacaine?

A

175 mg plain (2.5 mg/kg)

225 mg w/ epi (3.2 mg/kg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to convert percentage of solution to mg/ml?

A

Move decimal point of percentage one place to the right (ex: 1% solution has 10 mg/ml)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the side effects of lidocaine and bupivacaine associated with systemic exposure?

A
  1. CNS effects: initial excitation (dizziness, blurred vision, tremor, seizures) followed by depression (respiratory depression, depression, LOC)
  2. cardiovascular effects: hypotension, bradycardia, arrhythmias, cardiac arrest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can be given to help reverse local anesthetic-induced cardiovascular collapse?

A

Intravenous fat emulsion (Intralipid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is there a risk with intra-articular injections of bupivacaine?

A

Studies have shown chondrocyte death following prolonged exposure to bupivacaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In what age group should bupivacaine be avoided?

A

Children < 12 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name two amides anesthetics and how they are metabolized.

A

Lidocaine
Bulivicaine

(Amides have two i’s!!)

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name an ester anesthetic. How are they metabolized?

A

Novocain

Plasma pseudocholinesterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the only local anesthetic with vasoconstriction?

A

Cocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is cocaine metabolized?

A

Plasma pseudocholinesterase (like other esters)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Can locals cross the placental barrier?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What does MAC (as in MAC with local) stand for?

A

Monitored anesthesia care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

For anesthesia, what cannot be given to a patient with an egg shell injury?

A

Propofol (Diprivan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mnemonic for pain management with a codeine allergy?

A

STUD-N

S:Stadol
T:Toradol
T:Talwin
U:Ultram
D:Darvon
D:Darvocet
D:Demerol
N:Nubain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

First choice for non-narcotic oral med?

A

Tramadol (ultram)

50 mg 1-2 tabs PO q4-6h prn pain

Max daily dose of 400 mg daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
First choice for non-narcotic IV?
Toradol 30-60 mg IV Resident at Methodist told me that because this drug is an NSAID make sure you check kidney function first so you don't cause AKI as this is a very common error
26
Name two non-narcotic analgesics
Ketoralac (Toradol) | Tramadol (Ultram)
27
What schedule drugs are Percocet, Vicodin, Tylenol #3, and darvocet?
Percocet: II Vicodin: III Tylenol #3: III Darvocet: IV
28
What is Percocet 5/325?
Oxyocodone/acetaminophen 5mg/325mg 1-2 tabs PO q4-6h prn pain
29
What is roxicet?
Oxycodone/acetaminophen (5mg/325mg/5 mL) Essentially a liquid form of Percocet that is good for pediatric patients
30
What is Vicodin 5/500
Hydrocodone/acetaminophen 5mg/500mg 1-2 tabs PO q4-6h prn pain
31
What is Tylenol #3?
Codeine/acetaminophen (30 mg/300mg) 1-2 tabs PO q4-6h
32
What is Darvocet-N 100?
Propoxyphene/acetaminophen 100mg/650mg 1 tab PO q4h prn pain
33
What is Toradol and dosing?
Ketorolac 10 mg PO q4-6 Or 30 mg IV q6h
34
What is OxyContin?
Oxycodone extended release
35
What is MS Contin?
Morphine sulfate extended release 15-30 mg 1 tab PO q8-12h prn pain
36
What is Dilaudid?
Hydromorphone 2-8 mg PO q3-4 hr 1-4 mg IV q4-6 hr For severe pain!
37
What is Demerol?
Meperidine Usually not used due to its side effects
38
What therapeutic effects are seen with acetaminophen?
Analgesic Anti-pyretic NO ANTI-INFLAM
39
What is the max daily dose of acetaminophen?
4 g
40
What are the therapeutic effects seen with most NSAIDS?
Analgesic anti-pyretic anti-inflam
41
What pathway do NSAIDs work on?
nonselectively inhibit Cox-1 and cox-2
42
What is the most common side effect of NSAIDS?
GI disturbance (except with cox-2 inhibitors because cox-1 protects the stomach lining)
43
What is the only FDA-approved Cox-2 inhibitor?
Celecoxib (Celebrex)
44
What two nsaids only have anti-inflam effects?
Indomethacin | Tolmetin
45
Do nsaids decrease joint destruction?
No, they only decease inflammation
46
Do nsaids affect bone healing?
May inhibit Bone healing via their anti-inflammatory effects
47
What nsaids cause irreversible inhibition of platelet aggregation?
Aspirin
48
What NSAID does not inhibit platelet aggregation?
Celebrex
49
What is the only IV NSAID?
Ketorolac (Toradol)
50
Which NSAID is often given during surgery or immediately post-op to decrease pain and inflammation?
Toradol 30 mg IV
51
What is the effect of NSAIDS on asthma?
Can increase symptoms of asthma
52
What two nsaids are not renally clearly?
Indomethacin | Sulindac
53
What are two cardiovascular effects of NSAIDS?
Can cause vasoconstriction and increase BP
54
What two nsaids have the least cardiovascular effects?
Diclofenac | Ketoprofen
55
What three nsaids are the most hepatotoxic?
Ibuprofen Naproxen Diclofenac
56
What should be given for an indomethacin overdose?
Benadryl: decreases 5-HT and histamine release
57
What is arthrotec?
Diclofenac/misoprostol An NSAID with protection for the stomach
58
What is the anti-inflamm dose of ibuprofen?
1200-3200 mg/day
59
What is the difference between cataflam and voltaren?
Cataflam: diclofenac potassium (immediate release) Voltaren: diclofenac sodium (delayed release)
60
What is the only non-acidic NSAID?
Nabumetone
61
What are 4 once a day NSAIds?
Celecoxib (Celebrex) Piroxicam (Feldene) Oxaprozin (Daypro) Nabumetone (Relafen)
62
What are three causes of acute arterial occlusion?
Embolism: detached thrombus, air, fat, or tumor Thrombus: occlusion of vessel by plaque or thickened wall Extrinsic occlusion: traumatic, blunt, penetrating
63
What is the triad of a pulmonary embolism?
Dyspnea Chest pain Hemoptysis (although tachy is more common)
64
What tests can be ordered to diagnose a PE? (3)
Chest x-ray Ventilation perfusion scan Pulmonary angiography
65
What is virchows Triad?
1. Venous stasis: tourniquet, immobilization 2. Endothelial wall damage/abnormality: surgical manipulation, trauma, smoking 3. Hypercoagulability: birth control, coagulopathy, history of DVT
66
What does virchows triad predict?
Risk of DVT | Previous DVT is #1 risk factor for having another DVT
67
What are risk factors for DVT (mnemonic)
I AM CLOTTTED ``` I: immobilization A: arrhythmia (like afib) M: MI (past hx) C: coagulable states L: longevity (old age) O: obesity T: tumor T: trauma T: tobacco E: estrogen D: DVT (past hx) ```
68
How is DVT diagnosed clinically?
1. Pain, heat, swelling, erythema of unilateral limb 2. Positive Pratt sign: squeezing calf causes pain 3. Positive homan sign: abrupt DF of foot causes calf pain 4. PE
69
What 3 tests can be ordered to diagnose DVT?
1. Doppler ultrasound 2. Venogram 3. D-dimer
70
For long term prophylaxis of DVT what two drugs can be ordered?
Heparin | Coumadin
71
What is the treatment for DVT?
Heparin 5000 units IV bolus, then 1000 units IV q1h and monitor PTT
72
How to dose heparin for perioperative DVT prophylaxis?
5000 units SC 2h prior to surgery | 5000 units SC q12h until patient ambulates
73
What is the half life of heparin?
1.5 HR
74
How does heparin work?
Intrinsic pathway Potentials Antithrombin III, which inhibits serine protease in the clotting cascade
75
How to reverse heparin?
Protamine sulfate 1 mg per 100 units of heparin
76
What is enoxaparin (lovenox)
Low molecular weight heparin
77
How to dose lovenox for perioperative DVT prophylaxis?
30 mg SC q12h for 7-10 days
78
What is the Half-life of lovenox?
4.5 hrs
79
What are the advantages of using lovenox vs regular heparin? Disadvantages?
Advantages: lovenox has longer plasma half-life w/ significant antjcoagulation in trough Disadvantages: increased post-op complications when used with spinal/epidural anesthesia
80
How is lovenox reversed?
Recombinant factor VII
81
How to dose Coumadin?
5-10 mg PO daily for 3-4 days then adjust for INR
82
What is the half life of Coumadin?
20-60 hrs
83
How long before Coumadin is therapeutic?
3-5 days
84
How does Coumadin work?
Extrinsic pathway Interferes with clotting factors 2, 7, 9, 10
85
How is Coumadin reversed?
Vit K | Fresh frozen plasma
86
What are normal INR for someone not on anticoagulation and someone who is?
1 Intense anticoagulation: 2-3
87
What are the levels of heparin and Coumadin for DVT/anticoagulation prophylaxis?
Heparin: maintain 2-3 times normal PTT Coumadin: maintain 2 times normal INR
88
What 3 nonpharmacologic measures are used for perioperative DVT prophylaxis?
1. Early ambulation 2. teds: thromboembolic deterrent stockings 3. Sds: sequential compression devices
89
What is a surgical treatment for a patient with prior DVTs or recurrent PEs?
Greenfield filter
90
What level of the body is a greenfield filter inserted?
IVC below the renal veins
91
What is Pletal?
Cilostazol
92
What is trental?
Pentoxifylline
93
What is an indication for pletal or trental?
Intermittent claudication
94
What is CRPS?
Complex regional pain syndrome (previously known as RSD or reflex sympathetic dystrophy) A progressive disease of the ANS causing constant, extreme pain that is out of proportion to the original injury
95
What are the different types of CRPS?
CRPS type 1 (reflex sympathetic dystrophy) CRPS type 2 (causalgia)
96
What is CRPS type 1?
- Nerve injury cannot be immediately identified - spontaneous pain not limited to single nerve distribution - abnormal response in sympathetic nervous system - abnormal reflex leading to vasomotor instability and pain

Crozer-Keystone (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions