Lange Q&A Surgery

Def high-output renal failure
BUN continues to rise with urine output >1000-1500

Mild-to-moderate renal insufficiency

Severe renal failure
Oliguric renal failure

How long can the kidneys tolerate ischemia?
30-90 minutes

Do vasopressors help with shock?
No, they aggravate the deleterious effects of shock

Hyperkalemia manifests with ____ or ____ signs
GI or cardiovascular

What are the GI signs and symptoms of hyperkalemia
Nausea, vomiting, intestinal colic, and diarrhea

T/F abdominal distension as a result of paralytic ileus is due to hypokalemia?

What are the CV signs and symptoms of hyperkalemia
ECG is useful to monitor potassium levels.

Hyperkalemia = peaked T waves, ST segment depression, widened QRS complex, and heart block

When would you see Osborne (J) waves?
Seen in hypothermia

What is given to counteract the effect of potassium on the myocardium?
Calcium gluconate

How do you get metabolic acidosis with normal anion gap?
Loss of bicarbonate (e.g. small bowel fistula, pancreatic fistula, or diarrhea) and gain of chloride

What are some causes of SIADH?
Head injury
CNS disorders
Neoplastic diseases

What are some signs of SIADH?
Impaired water excretion, oliguria, hyponatremia, significantly decreased serum osmolality, and increased urinary osmolality

When does hyponatremia cause CNS symptoms?
When serum sodium <130 mEq/L

What are some of the signs/symptoms of moderate hyponatremia?
Muscle twitching and increased tendon reflexes

What are some signs/symptoms of severe hyponatremia?
Convulsions, loss of reflexes, and hypertension

What is the sodium deficit?
(normal serum sodium − observed serum
sodium) × 0.6 × (total body weight)

How should the sodium deficit be corrected?
Half of the sodium deficit should be administered over 12-18 hours

The composition of intestinal fluid is closest to that of ____

What ions does normal saline, 3% saline, and half normal saline have?
Na, Cl

How do you calculate pH based on changes in CO2?
Every change of 10 mmHg from 40 mmHg changes pH by 0.08 from 7.4.

What are the most common signs of zinc deficiency?
Skin lesions (scaly, hyperpigmented lesions)
Diminished wound healing

What are the effects of toxic megacolon?
Massive dilatation
Fecal peritonitis

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