What is acromegaly?
syndrome resulting when the anterior pituitary produces excess growth hormone after closure of puberty state….often associated with gigantism
Why is it important to provide a stress dose of corticosteroids for patients with autoimmune disorders on chronic therapy?
b\c they are susceptible to cardiovascular collapse b\c they cannot release endogenous cortisol in response to stress
What age group does acromegaly most affect?
middle aged men and women
Acromegaly is a ________ disorder.
metabolic
Acromegaly causes an increase of the production of what hormone?
growth hormone
What are common signs and symptoms of acromegaly?
enlargement of hands, feet, head, forehead, jaw, and tongue
Do patients with acromegaly always require a larger ETT?
No
What is the affinity of carbon monoxides for Hgb compared to oxygen?
200x greater
What portion of the pediatric body in the rule of nine is greater compared to adults?
head
In a burn patient, at what point should you avoid succinylcholine?
after 24 hours
T/F? You can assume that a burn patient with a pulse oximetry reading of 100% is adequately oxygenated.
FALSE
What is the first line treatment for HTN in the phechromocytoma patient prior to surgery?
alpha blocker
Is bradycardia indicative of a thyroid storm?
no; but hyperthermia, metabolic acidosis, abnormal LFT’s, and atrial fibrillation is
T/F? Careful airway assessment is vital in hypothyroid, but not as important in hyperthyroid.
FALSE
Which endocrine disorders are associated with sensitivity to paralytics?
cushings, addisons, hypothyroid, hyperthyroid
What 2 hormones are secreted from the posterior pituitary (neurohypophysis)?
vasopressin (ADH), oxytocin
What is SIADH?
syndrome of inappropriate anti diuretic hormone secretion; characterized by excessive release of ADH from the posterior pituitary; often results in dilutional hyponatremia
What are some common causes of SIADH?
intracranial tumor, porphyria, lung cancer, hypothyroid
Is hyperthyroidism a known cause of SIADH?
no!! hypothyroidism is
What anesthetic technique is inadvisable in patients with multiple sclerosis?
spinals
What is the gold standard for diagnosing MH?
caffeine halothane contracture test (CHCT)
What is the earliest sign of MH?
increased ETCO2 >55mmHg
Why is cardizem not an appropriate drug choice for dysrhythmias associated with MH?
b\c it is a CCB
What is the correct classification for MH?
channelopathy
Injury is the leading cause of death between ages 1 and 45 in US. (T/F)
TRUE
Tertiary survey occurs prior to discharge to reassess and confirm known injuries and identify occult ones. (T/F)
TRUE
What drugs should be avoided in a chest trauma patient in hypovolemic shock?
N2O, atracurium, mivacurium; KETAMINE IS OK
T/F? CPP=MAP-ICP
TRUE
What antiemetic is safe for use in a Parkinsons patient?
zofran
Which drug alleviates exacerbations of Parkinsons disease?
Benadryl d\t its anticholinergic properties
What drug is used to lower the seizure threshold?
methohexital
IBS can be associated with what type of disease process?
chronic pain
What pain intervention is contraindicated in patients with pain associated with ulcerative colitis (megacolon)?
opioids
What increases the risk for colorectal cancer?
high fat and meat protein
What is the most common type of porphyria in the US?
acute intermittent porphyria
The anesthetic medication to avoid in patient with AIP is:
Barbiturates
Porphyrias are most commonly found in _____.
females from puberty to menopause
