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42 Cards in this Set

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peaked T waves, hyperkalemia.

next step?
calcium
(stabilize cardiac membranes)
uremia --> platelet dysfxn --> intraop bleeding.

next step?
desmopressin (ddAVP)
or
FFP
most common cause of early postop death after LE revascularization
MI
LBBB indicative of...
underlying IHD (never nl)
general anesthesia drawbacks
1.pulmonary complications
2.mild cardiodepression
ASA = reversible/irreversible?
irreversible (7-10 days)
poorly controlled diabetics have increased risk of post-op...
infections!
cardiomyopathy pts at risk for...
1.arrhythmias
2.CHF
3.outflow obstruction
4.sudden death
golytely
(polyethylene glycol electrolyte solution) causes NO NET secretion/absorption of ions
fleets phospho-soda:
contraindicated in...
1.diabetics
2.salt-restricted diets
high magnesium levels.

next step?
calcium gluconate
bacterial endocarditis prophylaxis:
dental/oral/respiratory tract/esophageal procedures
1.amoxicillin (1 hr prior)
or
2.clinda/ceph/clarith (1 hr prior)
bacterial endocarditis prophylaxis: GI/GU procedures in high-risk pts
high-risk = ampicillin + genta (30 min prior), ampicillin (6 hrs post)
or
vanco + genta (30 min prior)
bacterial endocarditis prophylaxis: GI/GU procedures in moderate-risk pts
mod-risk =
1.amoxicillin/amp (1 hr prior)
or
2.vanco (1-2 hr prior)
bowel "prep" purpose
decrease fecal mass & bacterial content in colon
most important of bowel preps...
mechanical removal:
1.cathartics
2.enemas
abx decreasing bacterial load in gut?
1.neomycin
2.erythromycin
bacterial endocarditis prophylaxis - not needed for...
1.s/p CABG
2.s/p ASD/VSD
3.MVP w/o regurg
4.murmurs
5.pacemakers
bacterial endocarditis prophylaxis - high risk...
1.prosthetic heart valves
2.endocarditis Hx
3.complex congenital HD
4.prosthetic vascular grafts
severe liver failure signs
1.jaundice, ascites
2.muscle wasting
3.asterixis, advanced encephalopathy
4.caput medusa
5.splenomegaly
6.gastric/esophag varices
Child's classification
liver failure
Child's classification - categories
1.bili
2.alb
3.ascites
4.enceph
5.nutrition
6.mortality
cardiac complications - 5 factors assessed
1.Q waves
2.Hx ventricular ectopy
3.Hx angina
4.DM
5.age>70
laparoscopy may increase...
CO2 in blood
RR post-op complications in smokers
2-6x
nl urine output
0.5-1 ml/kg/hr
NS [Na+]
154
D5W [glucose]
50
D10W [glucose]
100
lactated Ringer's [Na+]
130
72 y.o. w/a-fib c/o severe abdominal pain out of proportion to exam
mesenteric ischemia
75 y.o. Hx MI c/o gnawing abdominal pain after eating. 15 lb wt loss in past month
chronic mesenteric ischemia
increased lactate
metabolic acidosis
hypercoagulable state
mesenteric ischemia
mesenteric ischemia - causes
1.atherosclerosis
2.a-fib
3.low-flow state
4.hypercoagulable state
mesenteric ischemia - Tx
1.tissue perfusion w/fluids
2.surgery!!! (bypass w/saphenous vein)
AAA - risk factors
1.atherosclerosis
2.>5cm (20-40% risk in 5 yrs)
abdominal/back pain
pulsatile mass in abdomen
hypotension
Hx vascular dz/atherosclerosis
AAA
AAA Dx
A) MRI or CT w/contrast
B) angiogram
AAA Tx
1.good IV access, type & cross
2.surgery (if rupture in suspected)
63 y.o. male
pain in "kidney" for 3 days
Hx MI x2
no back tenderness
AAA
elderly pts w/abdominal pain - always consider...
vascular causes
1.AAA
2.mesenteric ischemia
3.MI
most common cause of post-op fever
atelectasis