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Pathophysiology CVP 622 > Test 1 content-Quizzes > Flashcards

Flashcards in Test 1 content-Quizzes Deck (32)
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1

The American Diabetic Association and the American College of Endocrinology classify pre diabetics as those individual with fasting blood glucose levels within the ________ mg/DL range, while those with fasting blood glucose levels greater than_______mg/DL are considered to have diabetes mellitus.

(1) 100-125 mg/dl

(2)-126 mg/dl

2

2) Type I, or juvenile diabetes, represents _______% of all patients diagnosed with diabetes.

5-10%

3

3) Type II diabetes represents ______% of all patients with the diagnosis of diabetes

90-95%

4

4) What percentage of patients with diabetes will undergo coronary bypass grafting surgery?

28%

5

5) There is an increased risk of which of the following for diabetic patients following cardiac surgery?
a. Morbidity and mortality
b. Stroke
c. Renal Failure
d. Sternal wound infections
e. All of the above

All of the above

6

6) In the study done by Bhamidipati et al he stratified the diabetics into 3 management groups. Which group had the lowest mortality?

Moderate group

7

In the 1980’s a body of evidence was developed that linked poor glucose control in diabetics to __________?

Poor wound healing and increased rates of infection

8

8) In the Leuven surgical trial reduced 12 month mortality among critically ill patients with diabetes was demonstrated when blood glucose levels were maintained in what range?

80-110 mg/dL

9

9) TRUE or FALSE: The NICE-SUGAR study found that the intensive control group actually experienced a greater incidence of all cause mortality at 90 days after surgery.

True

10

The 2009 Society of Thoracic Surgeons Class I recommendations suggest that all patients with diabetes undergoing cardiac surgical procedures should maintain serum glucose levels below ______ mg/dL.

180

11

Renal function is adversely affected in _____% of patients undergoing CABG surgery?

30-40

12

2) What percentage of CABG patients develops acute renal failure?

1-3%

13

Allows maintenance of glomerular capillary pressure by preventing tubular obstruction

Mannitol

14

Increases cardiac output

Dopamine

15

Decreases renal perfusion

Dopamine

16

Reduces plasma levels of hydrogen peroxide free oxygen radicals

Mannitol

17

Lowers ischemia associated protein leakage from renal vasculature

Mannitol

18

Maintains renal perfusion

Dopamine

19

Results in diuresis

Dopamine

20

Prevents renal injury_

Mannitol

21

TRUE or FALSE. The etiology of kidney dysfunction occurring after cardiac surgery is multi-factorial and is generally explained on the basis of perioperative low cardiac output or effects of CPB.

True

22

List 4 of the 5 listed bypass related risk factors frequently referred to in the literature according to this article(added all 5):

1. CPB exceeding 70 minutes
2. Normothermic vs hypothermic bypass
3. Bypass surgery without a pump
4. Cross clamp time
5.pulsatile vs. non-pulsatile bypass flow

23

A recent survey of perfusionists found that in more than ____ % of centers, mildly hypothermic perfusion of 32 degrees Celsius to 34 degrees Celsius is routinely used.

90

24

What temperature measurement location is recognized as being the gold standard for cerebral temperature?

Jugular Bulb

25

The study by Nussmeier et al. demonstrated that all body sites _____________ jugular bulb temperature during cooling and _____________ jugular bulb temperature during rewarming.

Overestimated / underestimated

26

The study by Newland et al. found that when they reviewed 4 different oxygenator’s arterial outlet ports the temperature measurement from the oxygenator’s __________ the reference temperature probe that they had placed distal to the oxygenator in the circuit.

Underestimated

27

It is recommended in the article that the following temperature recordings are reasonable for core temperature measurement:

Pulmonary artery and nasopharyngeal

28

True or False: Newland et al. found that an arterial outlet temperature higher than 37 degrees Celsius is an independent predictor of acute kidney injury.

True

29

Temperature gradients between the arterial outlet and venous inflow on the oxygenator during CPB cooling should not exceed ____ degrees Celsius to avoid generation of gaseous emboli.

10 degrees

30

Scheffer and Sanders findings support slow rewarming because:
a. It helps avoid excess cerebral oxygen extraction and jugular venous desaturation
b. It increases time for better distribution of heat
c. It improved maintenance of the relationship between cerebral blood flow and the cerebral metabolic rate of oxygen
d. All of the above

All the above