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19 Cards in this Set
- Front
- Back
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Standard Preop workup for men older than 40, women older than 50, and those with history or symptoms suggestive of cardiac dz INCLUDES:
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CXR, ECG, Electrolytes
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Possible complication of spinal anesthesia
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hypotension due to loss of ability to vasoconstrict
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Possible complications of general anesthesia
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increased incidence of pulmonary complications and mild cardiodepression
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How long should you stop ASA or NSAIDS before a procedure?
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ASA: 7-10 days
NSAIDS: 2 days |
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Contradictions to stop metformin treatment (i.e. because of lactic acidosis)?
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Stop if serum concentration of creatinine is elevated significantly;
Withdraw during periods of suspected tissue hypoxia (for example, due to myocardial infarction, sepsis); Withdraw for three days after contrast medium containing iodine has been given, and start treatment with metformin only after renal function has been checked; Withdraw two days before general anaesthesia and reinstate when renal function is stable. |
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Obesity Hypoventilation Syndrome (aka Pickwickian Syndrome) Describe:
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The combination of obesity (body mass index above 30 kg/m2), falling oxygen levels in blood (hypoxia) during sleep and increasing carbon dioxide levels (hypercapnia); this is the result of hypoventilation during sleep (often due to OSA). The main treatments are weight loss and nocturnal ventilation (CPAP). The exact cause is unknown.
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What are the appropriate perioperative blood glucose levels:
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100-250 mg/dL
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DBP greater than _ is a RF for malignant HTN, AMI, CHF
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110 mm Hg
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When does improvement in postop respiratory morbidity imrpove after smoking abstience?
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6-8 weeks
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Simple test to determine pulmonary status preoperatively
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ABG
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The effect of Laparoscopy on patient's pulmonary status
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increased CO2 absorption into the blood increases pulmonary work and is contraindicated in those with decreased pulmonary function.
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Define the Ankle Brachial Index.
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measure of the fall in blood pressure in the arteries supplying the legs and as such is used to detect evidence of blockages (PVD). It is calculated by dividing the systolic blood pressure in the ankle by the higher of the two systolic blood pressures in the arms. A reduced ABPI (less than 0.9) is consistent with peripheral artery occlusive disease, with values below 0.8 indicating moderate diseased and below 0.5 severe disease.
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5 factors used to predict risk for cardiac complications after vascular surgery.
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1. Q waves on ECG, H/o ventricular ectopy, h/o angina, DM with medicines, Age >70
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# of PVC's that should initiate a cardiology workup for possible ventricular dysfunction
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6
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Child's Classification Criteria to measure hepatic reserve to determine operative mortality risk.
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Bilirubin, Albumin, Ascites, Encephalopathy, Nutrition, (sometimes PT or INR)
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A patient presents with CLF and ascitic fluid leaking from his umbilical hernia. He is at increased risk for?
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bacterial peritonitis, should receive surgical repair urgently
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The surgical description of "capillary ooze" in a uremic patient is a description of? What can be done?
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platelet dysfunction due to uremia leading to intraop bleeding. Transfusion of platelets WILL NOT help, but you can use Desmopressin.
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What bowel prep is contraindicated in diabetics and salt restricted diets?
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fleets phospho-soda (can lose bicarb and predispose to metabolic acidosis)
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What bowel prep should be avoided in chronic renal failure?
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magnesium citrate, if become hypermagnesmic use calcium gluconate
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