Friday, July 11, 2014

7/11 ACE 2011 ??????

2. Putting magnet on PM disables antitachycardia pacing but does not change pacing to VOO. It stays teh same.

12. pt with GBS develop SIADH 50% of the time. Hypotension is also common as well as dysautonomia presenting as sinus tachycardia or bradydysrhythmias. However, treatment of tachycardia causes profound brady so don't do it unless CAD. EKG shows giant T waves, prolonged QT, U waves, ST-T wave changes.

13. Risks for PA endobronchial puncture include: female, mitral stenosis, PAH, >60 years, coagulopathy, hyperinflation of balloon and distal placement of PAC.

14. Lithotripsy, esp 1st generation machines, can cause ventricular dysrhythmias. Fire the machine during ventricular refractoriness (right after R) to avoid this.

18. Methylene blue blocks MAO so don't give it with SSRI

24. Treat cocaine induced coronary vasospasm w/ benzo, nitrates, and then aspirin.

24. FFP increase factors by 3-6%. There is 5x more citrate in FFP than pRBC. Remember that citrate also chelates Mag as well

30. Neurofibromas can be in the airway. Be very careful of anyone who complains of airway obstruction or dyspnea when lying flat. Do fiberoptiuc.

31. Zenkers pt can regurg their food and you should ask them to do so before intubation...

32: SLE take azathioprine an immunosuppressive and it increases resistance to NMB. Cyclophosphamide prolongs effect of sux. Also chronic inflammation can cause subglottic stenosis, vocal cord paralysis, and other airway problems. Use LMA if possible to avoid post-extubation airway obstruction from edema. SLE also has atlantoaxial subluxatoin

337. Hemophilia A and B increases PTT. Replace with factor VIII. Normal concentration of VIII or 100% activity is 1U/ml. Plasma volume is weight x 40ml/kg.


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