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Flashcards in PreTest Deck (18):
1

Earliest clinical sign of hypermagnesemia

Loss of deep tendon reflexes

2

Initial mgmt of asx hyponatremia

Free water restriction

3

Which pts are at risk for developing hyperoxaluria?

Pt who has lost a lot of ileum.
Usu, FA are absorbed by the terminal ileum, and calcium and oxalate combine in the ileum to form an insoluble cmpd that is excreted. W/o ileum, FAs aren't absorbed and go to the colon, where they combine with calcium- so there is a lot of free oxalate, and it gets absorbed. Excess oxalate is excreted by the kidneys and promotes calcium oxalate stone formation.

4

Where there is post-op oliguria, what is the first thing you need to determine?

If it's due to a prenrenal cause (physiological response to hypovolemia) or if it is due to acute tubular necrosis

5

How do you know if oliguria is dt tubular injury or to hypovolemia?

Look at FE-Na.
1 means there is a problem with the tubules.

6

When should you give abx to prevent surgical site infections? And what abx?

Single dose, Within 1 hr before surgery
Cefazolin (against aerobes and anerobes)

7

Biochemical profile of salicylate ingestion (aspirin)?

metabolic acidosis
respi alkalosis
(mixed)
anion gap.

8

Rx for HIT heparin induced thrombocytopenia

Cessation of heparin
Start a non-heparin anticoagulant like lepirudin
Start oral warfarin when appropriate (when platelets are back to at least 100k

9

Significant bleeding in early post-op period is most probably dt what?

Bleeding vessel in the surgical field

10

What is the dx test of choice of acute mesenteric ischemia?

Angiography

11

Dx eval and Rx for DVT in prego

Duplex and heparin (does not cross the placenta. don't give warfarin to prego)

12

What blood test values show you that someone has vWD?

Prolonged aPTT
Failure to aggregate in presence of risocetin

13

Transfusion of what product can provide vWF?

Cryoprecipitate

14

What drugs can be given to polycythemia vera pts to bring down their Hct and platelets

Busulfan
Chlorambucil
(alkylating agents)

15

When a pt gets a large amt of blood transfusions, what factors do they become deficient in?

V and VIII (the labile factors)
banked blood is also deficient in platelets, so they may become throbocytopenic.
Give them FFP (it replaces the Vit-K dep factors) and give them platelets if they are thrombocytopenic.

16

Rx for heparinized pt w significant hemorrhage

Give protamine sulfate to reverse the heparin anticoagulation
Also place vena cava filter

17

Complications of starting TPN in a malnourished pt

Refeeding syndrome (malnourished pts who are given IV glucose)- can get hypophosphatemia, hypokalemia, hypomagnesemia
Start TPN slowly and replenish Mg, K, P
(can also get hyperglycemia, hyperchloremic acidosis)

18

Pt w tapering of steroids and
nausea, vom, hypotension, hypoglycemia, abd pain

mental status chgs, increased temp, CV collapse

acute adrenal insufficiency