Anesthesiology VV - ARDS Overview
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Questions and Answers

Which of the following correctly describes the effects of Digoxin concerning renal impairment?

  • It has no effect regardless of renal function.
  • It could accumulate in renal impairment. (correct)
  • It should be increased in renal impairment.
  • It is contraindicated in renal impairment.

What is the primary action of Dalteparin in the context of coagulation?

  • It acts primarily on platelets.
  • It inactivates thrombin exclusively.
  • It acts mainly on factor Xa. (correct)
  • It acts only on factor IIa.

For which of the following conditions is Labetalol NOT indicated?

  • Preventing bronchospasms.
  • Managing hypertension in pre-eclampsia.
  • Controlling blood pressure in acute situations.
  • As a first-line treatment for atrial fibrillation. (correct)

What is the most common adverse effect associated with Dantrolene?

<p>Diarrhea. (B)</p> Signup and view all the answers

Which of the following statements about the administration of Potassium during acute Digoxin intoxication is correct?

<p>Potassium administration can help stabilize cardiac function. (C)</p> Signup and view all the answers

Which patient condition indicates the use of Dantrolene?

<p>Malignant hyperthermia. (A)</p> Signup and view all the answers

What is a significant consideration when using Labetalol for blood pressure control?

<p>Route of administration affects beta and alpha receptor actions. (B)</p> Signup and view all the answers

Which of the following statements about Dalteparin is inaccurate?

<p>It has a longer duration of action when administered by oral route. (A)</p> Signup and view all the answers

Which of the following statements about Dobutamine is correct?

<p>Dobutamine is metabolized primarily by COMT. (D)</p> Signup and view all the answers

Which condition is contraindicated for the use of Lepirudin?

<p>Pregnancy and lactation (A)</p> Signup and view all the answers

What is a significant adverse effect of Mannitol?

<p>Crystallization at low temperatures (A)</p> Signup and view all the answers

Which statement about Diazepam is true?

<p>Diazepam acts as an agonist on GABA-A receptors. (D)</p> Signup and view all the answers

Which of the following is NOT a correct statement about Aminophylline?

<p>It acts as an agonist on beta-2 receptors. (C)</p> Signup and view all the answers

What is a major characteristic of Leupirudin's mechanism of action?

<p>It is a direct irreversible thrombin activator. (D)</p> Signup and view all the answers

In which situation is Mannitol indicated?

<p>Acute renal failure (A)</p> Signup and view all the answers

Which of the following statements about Dobutamine and beta blockers is accurate?

<p>Beta blockers could reduce the effects of Dobutamine. (C)</p> Signup and view all the answers

What is the current ESC guidelines recommended algorithm for rule-in and rule-out of ACS-NSTEMI with high sensitivity cardiac troponins?

<p>0-6 h (D)</p> Signup and view all the answers

Which of the following are differential diagnoses for ACS in the setting of acute chest pain?

<p>All the above (B)</p> Signup and view all the answers

Which is the recommended time for invasive evaluation with coronary angiography in established NSTEMI diagnosis?

<p>As soon as possible (A)</p> Signup and view all the answers

Which of the following statements regarding haloperidol is incorrect?

<p>It is a mild alpha blocker (B)</p> Signup and view all the answers

Which of the following statements about Vasopressin is correct?

<p>It controls water excretion in kidneys by V1 receptors (A)</p> Signup and view all the answers

What is a correct statement regarding lidocaine?

<p>It is classified as anti-arrhythmic agent Class IA (B)</p> Signup and view all the answers

Which statement regarding aminophylline is incorrect?

<p>It induces severe hypotension (B)</p> Signup and view all the answers

Which statement regarding acetylcysteine is incorrect?

<p>It can be administered only intravenously (D)</p> Signup and view all the answers

Flashcards

Digoxin adverse effect

Digoxin can cause gastrointestinal issues like nausea, vomiting, and diarrhea.

Digoxin accumulation

Digoxin can accumulate in the body with kidney problems.

Labetalol mechanism

Labetalol affects both beta and alpha receptors, and the specific impact depends on administration method.

Labetalol use

Labetalol is used to treat high blood pressure conditions like pre-eclampsia.

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Dantrolene use

Dantrolene is a treatment for malignant hyperthermia.

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Dantrolene adverse effect

Dantrolene can sometimes cause diarrhea as a side effect.

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Dalteparin mechanism

Dalteparin primarily targets factor Xa and has less protein binding than unfractionated heparin.

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Dalteparin use

Dalteparin is used to prevent blood clots, such as in extracorporeal circuits and pulmonary embolism.

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High Sensitivity Troponin Algorithm

The algorithm used to rule in or rule out Non-ST Elevation Myocardial Infarction (NSTEMI) with high sensitivity cardiac troponins. It involves specific timeframes for troponin levels to be assessed.

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ACS Differential Diagnoses

Other conditions that present with similar symptoms to Acute Coronary Syndrome (ACS), requiring careful consideration during diagnosis.

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Invasive Evaluation Timing

The recommended timeframe for performing coronary angiography in established NSTEMI cases, to assess coronary artery structure and potential blockages.

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Haloperidol: Incorrect Statement

Haloperidol is a butyrophenone antipsychotic with distinct characteristics, but it has limitations including contraindications in certain conditions.

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Vasopressin: Correct Statement

Vasopressin is a hormone with diverse actions, including its involvement in water regulation and its potential interactions with other medications.

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Lidocaine: Correct Statements

Lidocaine is a local anesthetic and anti-arrhythmic agent used for specific medical purposes.

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Aminophylline: Incorrect Statements

Aminophylline is a medication with specific pharmacological actions, but it has limitations and possible adverse effects.

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Acetylcysteine: Incorrect Statements

Acetylcysteine is a medication used for specific purposes, but it has limitations and potential adverse effects.

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Lactulose

A synthetic sugar used orally for constipation and hepatic encephalopathy. It draws water into the gut, promoting bowel movements and reducing ammonia levels in the blood.

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Mannitol

A sugar-like compound used in various ways, including lowering intraocular pressure (eye drops), treating acute renal failure, and preventing blood clots. It's not to be combined with furosemide and can crystallize in low temperatures.

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Lepirudin

A natural anticoagulant obtained from leeches, used to prevent blood clots. It's a direct thrombin activator, meaning it directly inhibits thrombin, preventing blood clotting.

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Dobutamine

A medication that primarily stimulates beta1 receptors, increasing heart rate and contractility. It is used to treat heart failure and low blood pressure.

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Diazepam (Valium)

A benzodiazepine drug that enhances the effects of GABA, an inhibitory neurotransmitter, reducing anxiety, muscle spasms, and seizure activity. It does not have the same action as barbiturates.

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Aminophylline

A methylxanthine used to treat asthma and other respiratory conditions by relaxing the muscles in the airways. It acts through multiple mechanisms, including bronchodilation, vasoconstriction, and stimulation of the central nervous system.

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Osmotic Diarrhea

Diarrhea caused by the presence of substances in the intestines that draw water into the gut, leading to increased stool volume and frequency. This can happen due to the absence of a specific enzyme in the colon.

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Beta-galactose-glucose Synthetic Disaccharide

A type of sugar molecule created by linking galactose and glucose subunits. This type of disaccharide is often used in food and medicine for its specific properties.

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Study Notes

Anesthesiology VV - ARDS

  • ARDS timing: within 2 weeks of a known clinical insult (1 week)
  • Abdominal sepsis can be a cause of ARDS (true)
  • Tidal volume adjustment: based on patient weight (5ml/kg) is true
  • ARDS includes lung edema and increased permeability of alveolar capillary membrane (true)
  • COVID-19 pneumonia pathophysiology is somewhat similar to ARDS, but not identical (false)
  • ARDS reduces respiratory system compliance (true)
  • Lung edema due to increased capillary hydrostatic pressure is generally not a feature of ARDS (true)
  • Prone position:
    • Not effective only in COVID-19 pneumonia (false)
    • Not typically considered for PaO2/FiO2 values > 150 mmHg (false)
    • Can often improve hypoxemia, though mechanism isn't fully understood (true)
    • Widely used worldwide (true)
    • Redistributes lung densities toward dependent lung regions (true)
  • PEЕР application in severe ARDS:
    • Always indicated (generally, but specifics depend on the patient) (true)
    • Dependent on lung density distribution (true)
    • Should ideally be based on potential for lung recruitment (true)
    • Should not exceed 10cmH2O (false)
    • May correct hypoxemia by reducing right-to-left shunting (true)

Acid-base Equilibrium

  • Stewart's approach: pH is independently regulated by pCO2, A-, and SID (false. pCO2, strong acids/bases, and SID are related)
  • SID (strong ion difference) is the difference between strong cations and strong anions (true)
  • Hypoalbuminemia doesn't cause metabolic acidosis. Instead, it can cause metabolic alkalosis. (false)
  • Saline solution per se can lead to hyperchloremic metabolic acidosis (true)
  • Chloride excretion is higher in respiratory acidosis. (false)
  • Chloride excretion may increase to compensate for increased bicarbonate reabsorption (true)
  • pH is independent of volatile acids, PCO2, and bicarbonate. (false. It is inter-dependent)
  • SID is equal to the difference between anions and cations (false)
  • High pCO2 alone doesn't decrease bicarbonate (false. Increases it to compensate)
  • Ketoacidosis is not due to increased chloride. (false)
  • In respiratory acidosis: increased PaCO2 leads to increased bicarbonate to compensate
  • Kidneys increase chloride excretion in chronic respiratory acidosis. (true)
  • pH is not generally higher than 7.45 (false)

Potassium Metabolism and Balance

  • Daily potassium requirement is about 2-4 mmol/kg (true)
  • Plasma K+ level > 5.5 mmol/L may not always show ECG alterations (false)
  • K+ supplementation in DKA patients should start only when K+ concentration is > 3.5 mmol/L (false)
  • Rhabdomyolysis is associated with severe hyperkalemia (true)

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Description

Test your knowledge on Acute Respiratory Distress Syndrome (ARDS) in the context of anesthesiology. This quiz covers factors such as timing, causes, and management strategies including prone positioning and respiratory compliance. It's essential for medical professionals dealing with critical care cases.

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