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64 Cards in this Set
- Front
- Back
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What is the most painful part of the D+C
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beginning- dilation esp in missed AB
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After 12 weeks a woman who is pregnant or has been pregnant will have what kind of induction and anesthesia
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RSI with GETA
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What type of AB can MAC usually be used on
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Incomplete
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What are the SE of prostaglandin derivative drugs that are used to dilate the cervix
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pain, NV, fever, diarrhea, bronchoconstriction*
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What drug would you not give to relieve methergine related HTN
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esmolol- BBs
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SE and contraindications of hemabate
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bronchospasm
reactive airway disease |
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What kind of induction and anesthesia will be used on a hyditaform mole
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RSI with propofol and GETA
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How can you differentiate b/w thyroid storm and PIH
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PIH elevated SBP and DBP
Thyrotoxicosis elevated SBP and decreased DBP |
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What drugs should you not give to a fertility patient
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reglan
droperidol NSAIDS |
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When does a missed AB normally occur
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less than 12 weeks
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What are the diagnostic signs of Hydatiform mole
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elevated Hcg
no fetal heart tones early vaginal bleeding |
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What are four conditions that may be caused by hydatiform mole
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Hyperemesis and n/v (dehydration/lyte)
High blood loss PIH thyrotoxicosis |
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What are some of the complications of the lithotomy position
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masked hypovolemia
peroneal nerve damage femoral nerve damage(xtreme flexion) Increased IAP Over flexion of hip |
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What are operations for gyn malignancies associated with
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DVTs
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What is the rate limiting step of NE production
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tyrosine hydroxylase
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stimulation of these receptors stimulates glcyogenolysis and lipolysis
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a1
b2 |
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receptor that when activated suppresses insulin production and inhibits lipolysis
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a2
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What are the B2 doses for epi
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1-2 mcg/min
0.01-0.03 mcg/kg/min |
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What are the doses for b1 and b2 effects of epi
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2-10 mcg/min
0.1-0.3 mcg/kg/min |
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What drugs should epi not be administered with
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MAOi
Ketamine TCA Cocaine |
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Infusion rate for norepi
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4-12 mcg/min
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What does 0.5-2 ug/kg/min dopamine do
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increase natriuresis
renal artery dilation |
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What is the best dopamine dose range for the patient with CHF
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2-5 ug/kg/min
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Clinical uses of dobutamine (3)
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CHF
Cardiogenic shock MI |
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Dose of dobutamine
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2-15 ug/kg/min
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Rescue drug that may cause coronary steal syndrome
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dobutamine
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2 rescue drugs that inhibit HPV
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dobutamine
dopexamine |
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What are the effects of dopexamine
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decreased SVR
reflex increase in HR |
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How is ephedrine metabolized
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MAO
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What receptor does ephedrine directly affect
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B2
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Bolus and infusion rate of vasopressin
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0.2 units
0.04 units/min |
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Drug that should be used for clonidine withdrawal syndrome
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labetalol
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SE of amrione
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thrombocytopenia
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Which phosphodiesterase inhibitor has the strongest vasodilatory effect?
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Amrione
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Which phosphodiesterase inhibitor has the strongest inotropic effect?
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milrinone
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4-8 hours postprandial where does 25% of glucose come from
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gluconeogenesis
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How long does the action of insulin work
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20-60 minutes
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First sign of diabetic renal disease
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albuminuria
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When do kidneys lose their ability to filter K and acids
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when glomerular filtration falls below 15-20 ml/min
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Drug that can counteract the development of proteinuria
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ACE inhibitors
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When is vascular access obtained for renal patients
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cr level 4-5
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When is dialysis started
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cr level 6
or creatinine clearance 10-12 ml/min |
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Most common cause of death in diabetics
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MI
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What does autonomic neuropathy correlate with
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nothing
ie not age or duration of disease |
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3 ways to test for autonomic neuropathy
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no increase in HR with deep inhalation
no increase in HR with valsalva orthostatic hypotension > 30 mmHg |
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What are 3 causes of impaired ventricular function in diabetics
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microangiopathy
nephropathy hypertrophic myopcardiopathy |
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What is impaired ventricular dysfunction in diabetics associated with
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duration of disease and HTN
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What is the initiating event in sudden MI in diabetics
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hypoxia
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How do beta blockers worsen hypoglycemia
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b1 mask- loss of tachycardia
b2 decreased glucogenolysis gluconeogenesis |
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What does DKA cause a loss of
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water
K P |
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How much will hydration decrease plasma glucose in the DKA patient
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30-50%
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Insulin tx for DKA
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0.1 u/kg bolus
0.1 u/kg/hr |
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Fluid tx of HDS
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1-1.5 L 1/2 NS an hour until 320mOsm
NS and 15 units insulin |
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Preop insulin
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2/3 NPH night before
1/2 NPH morning of Full dose lispro night before 0 regular night before or day of |
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What problems can sulfonlyureas cause intraoperatively
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HTN
preconditioning |
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What is the insulin infusion protocol
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0.02 u/kg/hr
0.04 u/kg/hr hyperal or steroids 0.06 u/kg/hr heart |
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D5 1/2 NS with BG of less than 100
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150
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D5 1/2 NS with BG of 150
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75
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D5 1/2 NS with BG of 150-200
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50
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D5 1/2 NS with BG of >200
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KVO
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Minor surgery insulin protocol
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1/2 normal intermediate acting insulin
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How much will 1 unit of insulin lower BG
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25-30
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How much will 10 g of glucose raise BG
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30-40
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Serum oSm formula
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2 X (Na + CL) + (BUN/2.8) + (gluc/18)
normal 285-295 |
