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10 Cards in this Set
- Front
- Back
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What is the best measure of the anticoagulant effect of Dabigatran? OR The diluted thrombin time measures the anticoagulant activity of A apixaban B rivaroxaban C dabigatran D warfarin E heparin
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B - Dilute Thrombin Time
Dabigatran, an oral direct thrombin inhibitor,does not require routine monitoring;however, it is readily measured by many available coagulation assays. The partial thromboplastin time (APTT) gives an approximation of dabigatran activity but is not linear over dabigatran concentrations used clinically. The prothrombin time should not be used to determine dabigatran concentrations because it is insensitive to its effects. The thrombin time (TT) is overly sensitive for dabigatran but useful to identify low levels of the drug. The diluted thrombin time (dTT) is a sensitive method to measure the anticoagulation ef- fect of dabigatran and is increasingly used to determine its effect when needed.
Clin Lab Med 34 (2014) 479–501 |
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Small air bubbles in the arterial line system will reduce
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E Resonant Frequency A small air bubble markedly dampens the system but lowers natural frequency and causes an artifactual 25 mm Hg increase in systolic pressure. Air bubble in system Increases damping, reduces natural frequency and may therebyparadoxically increase resonance in system causing systolic overshoot.( lower naturalresonant frequency means more resonance) ( graphs given) http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/anesthesia/site/content/v03/030263r00.HTM |
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Term neonate, noted to have intermittent stridor few days after birth, then parents also notice stridor during feeding and sleep. Otherwise normal and healthy. Most likely condition is
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B - Laryngomalacia Laryngomalacia stridor is strictly inspiratory, and generally intermittent, worse during feeding and sleeping, but abating during crying.
Tracheomalacia is characterized by abnormal tracheal collapse secondary to inadequate cartilaginous and myoelastic elements supporting the trachea. Tracheal narrowing occurs with expiration and causes stridor. The stridor may not be present at birth but appears insidiously after the first weeks of life. The stridor is usually aggravated by respiratory tract infections and agitation.
* Infants present after a few weeks of life with expiratory stridor (also called laryngeal crow). |
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Cryoprecipate, once thawed must use within
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D - 6 hours CRYOPRECIPITATE (CRYO)When FFP is thawed slowly at 4o C, a white precipitate forms at the bottom of the bag, whichcan then be separated from the supernatant plasma. This “Cryoprecipitated Anti-Hemophilic Factor” is 15-20 ml in volume and contains: 150-250 ml of fibrinogen, 80-100units of Factor VIII, von Willebrand’s Factor, Factor XIII, and fibronectin. It is stored frozenand must be transfused within 6 hours of thawing or 4 hours of pooling. ( transfusionmedicine updates) |
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Glycine 1.5% used for TURP, osmolality is
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A - 200 mosm/L
hypotonic |
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Blue urticaria is a complication of
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C
PB V injection or isosulfan blue Patent blue V/ isosulphan blue is the dye used for sentinel nodemapping and has caused urticaria/ anaphylaxis |
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In patients with inoperable AS, compared to medical treatment TAVI has significantly lower incidence in 30 days of
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PARTNER A Trial TAVI vs SAVR PARTNER B Trial TAVI vs maximal medical therapy Patients with TAVI vs medical therapy have higher mortality, higher stroke and same risk MI. But they have lower AF onset and lower AKI - however, neither of these was statistically significant!! Maybe pick AF??? By 1 year though mortality less with TAVI though still higher incidence TIA/Stroke 30 day mortality - SAVR > TAVI > Medical TAVI 3.4% vs Surgery 6.5% TAVI 5% vs Medical 2.8% 1 year mortality TAVI 24.2% vs Surgery 26.8% TAVI 30.7% vs Medical 49.7% Major stroke - 30 days TAVI > SAVR > Medical TAVI 3.8% vs Surgery 2.1% TAVI 6.7% vs Medical 1.7% Major stroke - 1 year TAVI 5.1% vs Surgery 2.4% TAVI 10.6% vs Medical 4.5% New onset AF TAVI 8.6% vs Surgery 16% New AF at 30 days TAVI 0.6% vs Medical 1.1% New AF at 1 year TAVI 0.6% vs Medical 1.7% MI - exactly the same in both arms 30 days 0% 1 year 0.6% AKI - 30 days TAVI 0% vs Medical 0.6% AKI - 1 year TAVI 1.1% Medical 7.3% D - AF
The incidence of new onset AF after TAVI is 10% within the first 30 days. This risk is 70% lower in patients undergoing TAVI compared to SAVR.
CVA, AKI are higher in TAVI Check - whether compared with surgical or maximal medical therapy??????? |
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EVAR, best method to reduce risk of renal impairment 2011A: 75 year old male with normal renal function for an endoluminal aortic repair. What is the best protection to prevent the development of renal dysfunction? A: NaCl B: NAC C: mannitol D: dopamine E: dialysis
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N/Saline to maintain renal perfusion and decrease contrast nephropathy. |
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EVAR is preferred over open AAA repair because
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A - no has higher cost B - lower operative mortality at 30 days but not long term C - need more follow up as more surveillance due to higher risk endoleak D - More re-intervention due to endoleaks E - True - as shorter ICU stay
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Laser flex tube with double cuffs - how to inflate cuff(s)?
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B - Distal then Proximal |
