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Flashcards in surgery Deck (115)
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1

what lab measuring renal function should be done for preop patients over 40?

creatinine

2

who should have their blood glucose tested preop?

family hx, personal hx of DM and patient undergoing grafting for peripheral vascular disease

3

do routine prep labs show a reduction in mortality and morbidy?

no, do not do for otherwise healthy individuals

4

warfarin and dig are known for causing what electrolyte abnormality?

K

5

ECHO are recommended in all patients older than?

40

6

silent MI is most common in what population?

elderly and DM

7

spirometry is recommend to who?

thoracic and upper abdominal surgery, smokers and dyspnea

8

pregnancy test?

for all women of child bearing years

9

H&P identify previous?

MI, heart failure, chronic pulmonary dz, dm, peripheral vascular disorders, hepatic or renal impairment

10

index used to measure cardiac risk?

detsky's modified cardiac risk index or Lee's

11

what does Lee's index look at

high risk surgery, coronary artery dz, congestive heart failure, cerebrovascular dz, insulin dependent DM, and elevated serum creatinine >2

12

what is the best prophylactic blood thinner to use?

unfractionated heparin 5,000 units subcutaneouly every 8-12 hours, stop once pt is ambulatory

13

Enoxaparin is also used what is it?

low molecular weight heparin

14

can warfarin be used

yes, once the initial use of heparin has been completed, but dosing is measured via INR (therapeutic dose ranging between 2-3)

15

what is fondaparinux

anticoagulant, good for hip surgery

16

Greenfield filter prevents clots formed in the lower extremities to migrate, patient who are candidates include?

allergic to anticoagulants, trauma (risk of further bleeding), central nervous system procedures

17

malnourished criteria is

lost more than 10% of lean body mass, or has not has adequate intake in 7 days

18

malnourishment effects many systems including

GI atrophy, slow cardiac output, decreased vital capacity, immune system and skin healing

19

what labs may be abnormal of malnourishment

increased creatinine, high lymphocyte count, albumin, transferrin

20

what is refeeding syndrome?

abnormal glucose, lipid metabolism, thiamine deficiency, hypophosphatemia, hypomag, hypo k

21

how do you avoid refeeding syndrome?

limit initial feedings to no more than 20kcal/kg during the first week of feedings

22

basal energy expenditure

harris benedict equation

23

what is the preferred route of nurtrient replacement

enteral route (tube feeding)

24

are naso or gastro tube better at preventing aspiration

gastro

25

best tube to avoid aspiration and great for pancreatits

jejunostomy

26

what is hyperalimentation

Intravenous nutrition

27

what are the complications of hyperalimentation

catheter related problems, hyperglycemia, electrolyte abnormalities

28

leading cause of death between the age of 1-44

unintentional and violence related injuries

29

leading cause of accidental death

MVA (Etoh is involved in over 1/2)

30

what does the FAST exam look at

abdominal cavity for fluid or air, perihepatic, perisplenic, pelvic and pericardial regions