ion charges

Term Definition
N03- nitrate
NO2- nitrite
SO4-2 sulfate
SO3-2 sulfite
PO4-3 phosphate
CO3-2 carbonate
HCO3- Hydrogen Carbonate
KH4+ Ammonium
OH- Hydroxide
ReO4- Permanganate
CIO3- Chlorate
CIO- Chlorite
Cr2O7-2 Dichromate
CrO4-2 Chromate

Pathophysiology Renal 4

Question Answer between cisatracurium and atracurium – why is cisatracurium the better choice? atracurium produces more laudanosine (CNS stimulant) and also releases histamines (risks of hypotension) T/F – Rocuronium is associated with unpredictable duration of action true – especially with kidney failure patients due to reduced clearance, altered protein binding, and increased potency vecuronium metabolite 3-OH vecuronium Renal failure patients: how is vecuronium handled prolonged duration due to decreased clearance and increased elimination half-life ***Pancuronium is primarily eliminated by ____ kidneys (NO use in renal failure patients!) T/F – Anticholinesterases and anticholinergics (reversal agents) have an increased renal elimination with kidney failure patients and therefor should have dosage adjusments true that they have increased renal elimination but FALSE that the dosage should be adjusted In renal failure patients propofol may need an _____(increased/decreased) dosage adjustment increased – due to hyperdynamic circultion and/or disruption of the BBB secondary to uremia The danger of morphine in renal patients metabolized to morphine-6-glucuronide which is renally excreted. It is also more potent than morphine and with accumulation can cause serious resp. depression Merperidine is metabolized to _____ normerperidine (accumulation can cause convulsions) Hydromorphone is metabolized to _____ hydromorphone-3-glucuronide – which can cause prolonged resp depression and myoclonus T/F – the fentanyls should be carefully administered as their metabolites cause respiratory depression false – no metabolites – GOOD choice for renal failure patients T/F – Renal dose of dopamine prevents/treats AKI false – does neither If your going to use vasopressors on kidney injury patients – which ones would you use vasopressin – constricts the efferent arteriole which maintains GFR and UOP better than norepi or phenylephrine What antibiotics would you avoid in the renal failure patient aminoglycosides (gentamycin, tobramycin, amikacin) – cause free radical damage to proximal tubules Aminoglycoside risk of AKI is reduced by (2) IV fluid administration, close monitoring of serum trough levels ***Two mechanisms by which radiographic contrast media causes nephrotoxicity. Signs of this would show when? ischemic injury due to vasoconstriction in the renal medulla, direct cytotoxic effects. 24-36 hours, peak between 3-5 days How would you prevent radiographic dye kidney injury use nonionic or low-osmolar instead of hyperosmolar contrast, use lowest volume possible, withold other Rx with nephrotoxic effects, HYDRATION (0.9 NS prior), sodium bicarbonate, N-acetylcysteine (fallen out of favor) Sequelae of direct muscle trauma, muscle ischemia, or prolonged immobilization Rhabdomyolosis, myoglobinemia ***in the presence of ______ , myoglobin precipitates in the _____ which causes ______ acidic urine (ph <5.6), proximal tubule, tubular obstruction and acute tubular necrosis myoglobin scavenges _____, leading to _____ nitric oxide, renal vasoconstriction and ischemia levels of ______ in excess of 10,000 units/L is associated with increased risk of kidney injury creatine phosphokinase 4 things that can be done to decrease the effects of myoglobin on the kidney maintain renal blood flow (HYDRATION), Osmotic diuresis (mannitol), ***UOP kept > 100-150 ml/hr, Sodium bicarbonate and/or acetazolamide to alkalize urine Renal effects of anesthesia are generally less marked during ____ (what kind) anesthesia regional ***Most of the changes in renal function during the intraoperative time are _____ (indirect/direct) indirect – mediated by autonomic and hormonal influences (endocrine responses vs any drugs your giving) What are the only anesthetic gases that can cause specific renal insult? enflurane and sevoflurane Way to partially stop the normal renal changes associated with anesthesia Fluid – maintenance of normal volume/pressures Sympathetic ____ (suppression/activation) commonly occurs in the perioperative period. activation – in some cases overactivity – both of which tend to reduce RBF, GFR, and urinary output opioids and barbiturates have ____ (minor/major) effects on renal function in the perioperative period minor Surgeries lasting > ____ (how much time) are a risk factor for ARF 2 hours Preop considerations in ESRD History, CNS status/deficits, ***CV history (htn, atherosclerosis, CAD), hx of bleeding, intravascular volume, pulmonary hx, last dialysis (within 24 hrs) Physical exam in ESRD evaluate AV fistula/shunt, evaluate venous/arterial access, ominous signs (CHF, noncardiac edema, aspiration, cardiac tamponade) Lab tests you want to look at for ESRD EKG/CXR, BUN/Cr, CBC with platelets, bleeding time, PT, PTT, Lytes (at least K+), pH status, hepatitis status Chronic renal failure – what can you expect to see increase/decrease (lytes) increase: potassium, phosphates, magnesium; decrease: calcium If an ESRD K+ was 5.5 preoperatively – what would you do? cancel the case (if elective); otherwise, dialysis (K+ > 6.0) and insulin + glucose infusion would also help Intraoperatively, if you were worried about the high K+ levels, what could you do? insulin + glucose, hyperventillation (0.5 mEq/L for each 10 mmHg PaCO2). T/F – Calcium Chloride does what for hyperkalemia doesnt change K – but antagonizes the cardiac effects Intraoperative monitoring considerations for ESRD Normal monitoring, no BP on access limb, invasive lines should be in lower extremities, fluid replacement based on CVP w/large EBL ESRD: what fluids? NS or D5(1/2)NS (as long as their not diabetic!) ***T/F – ESRD – patient is often immunocompromised true ESRD: If you want to do regional anesthesia, what would you consider ***must have no coagulopathies, MAP must be maintained, preoperatively document and discuss any peripheral neuropathies ESRD: regional advantages/disadvantages advantages: patient remains awake, minimal hemodynamic changes; disadvantages: peripheral neuropathy?, bleeding, anxiety, hypotension w/sympathetic blockade ESRD: General anesthesia Rx considerations Increased volume of distribution, more sensitive to drugs (lower protein binding, less excretion of the drug & metabolites, increased sensitivity due to uremic alteration of BBB) The use of ____ (what fluids) have been associated with increased risk of renal morbidity starches The risk of prerenal azotemia is reduced by maintaining MAP > ______ and providing ______ 65 mmHg, appropriate hydration Excessive use of NaCl 0.9% can cause a ______ hyperchloremic metabolic acidosis Attempting to convert oliguric to non-oliguric AKI with _____ increases risk of additional renal injury as well as mortality diuretics ***ESRD Perioperative hydration should be ______ (how much) 10-20ml/kg Renal insufficiency: blood loss of _____ % should be replaced with _____; 3rd space losses should be replaced with _____ 10-15%, colloid 1:1, Crystalloid (no K+ or excess Cl-) ESRD: you should anticipate _____ restriction, but also avoid _____ volume restriction, hypovolemia (predisposes to ischemia) Definition: refers to abnormal concretions occurring anywhere along the collecting system of urinary tract urinary lithiasis urinary lithiasis: this kind of stone is formed from excessive amino acid called cystine in the urin cystine stones urinary lithiasis: created when the body breaks down substances called purines uric stones ***urinary lithiasis: this size of calculi usually pass without intervention – treat medically. _____ % of stones cause enough symptoms to require surgical removal (based on size and locations) <4mm, 20% Urinary lithiasis: concerns decreased renal function, sepsis (***antibiotics), perinephrotic hematoma, pregnancy testing (procedures use radiation, lithotripsy contraindicated if pregnant) urinary lithiasis: often prophylactically given preoperatively antibiotics During lithotripsy, shock waves are synchronized with ____ to avoid _____ ECG, arrhythmias urinary lithiasis: most common anesthesia used MAC or spinal — sometimes GETA

New words

Question Answer
Content (n) na»?i dung
Content (v) lA m va»«a lA?ng
The things that are in something
To make(so) pleased and satisfied
Expository (adj) miA?u ta?? ( bA i gia??i thA­ch) Used to describe writing that is done to explain sth
Composition (n) sa»± ka??t ha»?p The way in which sth is put together or arranged ( ba»? trA­, sa??p xa??p)
Accomplish(v) hoA n thA nh
Accomplished (adj) xong, gia»?i
To succeed in doing sth
Very skillful: having or showing the skill of an expect
Persuade (v) lA m nghe theo, khuyA?n To cause someone to do something by asking, arguing, or giving reasons
Amuse (v) lA m thA­ch thA? To make someone laugh or smile: to entertain someone in a light and pleasant way
Ex: it amuses me to think of how he looked when I last saw him.
Foreshadow (v) bA?o tr?°a»?c, A?oA?n tr?°a»?c To give a suggestion( ga»?i A?) of ( something that has not yet happened)
Ex: Her early interest in airplanes foreshadowed her later career as a pilot.

Add/Sub Decimals adding and subtracting decimals

Term Definition
Compatible Numbers numbers that are slightly adjusted to create groups of numbers that are easy to compute mentally
Counting natural numbers that begin at one and increases by increments of one each time
Estimation reasoning to determine an approximate value
Expense payments of goods and services
Income money earned or received
Profit money that is made after all costs and expenses are paid
Rounding a type of estimation with specific rules for determining the closest value
Decimal a digit less than whole number 1
Trailing Zeros a sequence of zeros in the decimal part of a number that follow the last non-zero digit; does not change the value of the number
Whole Numbers all numbers greater than or equal to 1; does not include decimals

astr/astro & naut astro & naut

Question Answer
astronaut a person who is trained to travel into outer space
astrophotography the use of photography in outer space
astrology study of the stars
astrophysics branch of physics dealing with celestial bodies (stars and planets)
astrocyte a star-shaped neurological cell of the central nervous system
astronomy the study of the moon, stars, and other objects in space
astronomer a scientist who studies the stars and other objects in the sky
astrophobia fear of stars or celestial space
asteroid rocky objects revolving around the sun that are too small and numerous to be considered planets
asterisk a star-shaped figure used to indicate an omission or a footnote (*)
cosmonaut a Russian astronaut
nautical related to sailing, sailors, or ships
hydronaut a person trained to work in deep sea vessels for research and vessel purposes
aeronaut pilot of a hot-air balloon

Participles Verbals: Participles and Participial Phrases

Question Answer
Identify the present participle: Flying too near the ground, the airplane wing caught a tree and crashed into a wheat field. Flying (modifies airplane): Flying too near the ground, the airplane wing caught a tree and crashed into a wheat field.
Identify the past participle: Grandma's fried chicken was steaming when it came out of the deep fryer. fried (modifies chicken): Grandma's fried chicken was steaming when it came out of the deep fryer.
Identify the past participle: When I stubbed my toe, the overworked doctor failed to diagnose it as broken. overworked (modifies doctor): When I stubbed my toe, the overworked doctor failed to diagnose it as broken.
Identify the present participle: The ballerina with a pirouetting solo became ill, so another experienced dancer took her spot. pirouetting (modifies solo): The ballerina with a pirouetting solo became ill, so another experienced dancer took her spot.
Identify the participial phrase: Covered with mud, John's pickup was in need of a wash. Covered with mud (modifies pickup): Covered with mud, John's pickup was in need of a wash.
Identify the participial phrase: The smartly uniformed mailman was carrying numerous packages as he made his way from house to house along our street. smartly uniformed (modifies mailman): The smartly uniformed mailman was carrying numerous packages as he made his way from house to house along our street.
Identify the participial phrase: Last Monday at around three o'clock, the cheerleaders, bubbling with energy, practiced their gymnastic moves on the field. bubbling with energy (cheerleaders): Last Monday at around three o'clock, the cheerleaders, bubbling with energy, practiced their gymnastic moves on the field.
Identify the participial phrase: Meandering toward a nearby pond, a family of snapping turtles crossed the road and trudged through the grass. Meandering toward a nearby pond (modifies family): Meandering toward a nearby pond, a family of snapping turtles crossed the road and trudged through the grass.
Identify the participial phrase: As I was hiking along the trail, I discovered a carefully hidden fox den. carefully hidden (den): As I was hiking along the trail, I discovered a carefully hidden fox den.
Identify the past participle: The final clue was a broken watch that had stopped at twelve o'clock. broken (clock): The final clue was a broken watch that had stopped at twelve o'clock.
Identify the past participle: While hoeing the garden, my father found my lost watch. lost (watch): While hoeing the garden, my father found my lost watch.
Identify the present participle: I was not able to sleep last night because of the dripping faucet in the kitchen. dripping (faucet): I was not able to sleep last night because of the dripping faucet in the kitchen.

Science First Six

Question Answer
What is the function of Carbohydrate? main source of energy and use of structural purpose
What is the function of Lipid? 1.Long term energy storage
2. Water proof
3. Natural Steroid production
4. Cell Membrane
What is the function of Protein? 1. they are enzymes that control rate of reaction
2. used to form bones and muscles
3. regulate cell processes
4.transport substances into or out of cells
5. help to fight infection
What element is present in Carbohydrate? carbon, hydrogen, and oxygen
What element is present in Lipid? carbon, hydrogen, and oxygen
What element is present in Protein? carbon, hydrogen, nitrogen and oxygen
What are the special groups? amino, carboxyl, and r group
What is the ratio for Carbohydrates? 1:2:1
What is the building block (Monomers) for Carbohydrates? glucose, fructose, galactose
What is the building block (Monomers) for Lipid? fatty acids and glycerol
What is the building block (Monomers) for Protein? amino acids
What test determine Lipid is present? Brown Paper Grease Spot
What test determine Sugar is present? Benedict Color
What test determine Protein is present? Biuret Color
What test determine Starch is present? Iodine Color
What is the positive color for Sugar test? White, orange, brown, or green
What is the positive spotter for Lipid test? Grease Spot
What is the positive color for Starch test? black or brown
What is the function of Enzyme? they act as Catalase
What does Catalase do? Lower activation energy needed for reaction
Where does Catalase found? in living aniaml
What react the most to Enzyme? raw food
What does Catalase break down? into water and hydrogen
What is the positive color for Protein test? Violet
What is the Amino group? composed of one nitrogen and two hydrogen atoms
What is the Carboxyl group? COOH
What is the R group? the atom that hang by itself at the second half of the structural image.
Name the type of fats. saturated, unsaturated, polyunsaturated, and Trans fat
What is saturated fat? which all carbon atom single bond to hydrogen. Found in animals and a solid at room temperature
What is unsaturated fat? where a single carbon is double bond to carbon. Found in Plants and fish fat. Liquid at room temperature.
What is Trans Fats? Where saturated turn to unsaturated fat by chemical hydrogenation. Body don't recognize and can't use it.
What is Polyunsaturated? where fat contain multiple carbon atom double bond to carbon.
What are Glycerol ? composed of hydrogen, carbon, oxygen
What are Fatty Acids Long carbon and hydrogen chains ending in a COOH group. The start of the chain is polar while the COOH is non-polar
What is Polar water
What is non-polar can't interact with water
What is the function of Nucleic Acids control heredity
What elements is present in Nucleic Acids Phosphorus, Carbon, Hydrogen, Oxygen, and Nitrogen
Whats the chemical formula for glucose, fructose,and Galactose? C6H12O6
whats the chemical formula for sucrose, lactose, and maltose? C12H22O11
What is organic? compound that contain the element carbon.
What is inorganic? compound that don't contain the element carbon.
What does hydrophobic mean? anti water
What does hydrophilic mean? love water
What is dehydration synthesis? water in the product a condensation reaction
What is hydrolysis? water in the reactant
What does isomer mean? two different compound having the same elements but in a different arrangement.
What is a active site? The specific region of an enzyme where a substrate binds and catalysis takes place or where chemical reaction occurs.
What are the monosaccharides for Carbohydrates? Glucose, fructose, and Galactose
What are the disaccharides for Carbohydrates? Sucrose, Lactose, and Maltose
What are the polysaccharides for Carbohydrates? Glycogen, Plant Starch, Cellulose, and Chitin
what is a peptide bond? chemical bond formed between two molecules when the carboxyl group of one molecule reacts with the amino group of the other molecule, releasing a molecule of water
What is a hydrogen bond? A weak Bond.
Why are covalent bond are strong? Two atom share a pair of electron
Very stable
Acid release what? Release hydrogen ion
What is cohesion Water bond with water molecules
What is adhesion? Water bond with other molecules
What part of the pH scale is acid 1-6
What part of the pH scale is for cell 7
What part of the pH scale is base 8-14

Health physics 2

Question Answer
Free radicals are NOT Ions
H2O2 Hydrogen peroxide
One Sv is equal to A hundred rem
A few Sv A few hundred rem
Dramatic drops in white cell count follow only A few hundred rem doses
Major damage occurs to the crypt cells buried in the intestinal wall In the 1000 to 5000 rem dose
Interference with the trigger signals from the lower brain-stem to heart and diaphragm muscles Doses higher than a few thousand rem
CNS syndrome Irregular heartbeat and breathing
Function of cell membrane Active transport
Cellular nucleus Organizes cell
functions to control the process of mitosis Cellular nucleus
Transports materials around through the cytoplasm Endoplasmic reticulum
Ribosomes produce Proteins and hormones
Energy source Mitochondria
Mitochondria Energy source for the cell
Lysosome (function in cell) Recycling center
Recycling center for the cell Lysosome
Membrane surrounding digestive enzymes Lysosome
3000 to 5000 rads rupture Plasma membrane
Dose to rupture plasma membrane Three to five thousand rads
3000 to 5000 rads cellular death analogy Drowning
A few thousand rads disrupts a Mitochondrian
Mitochondria disrupted by how many rads A few thousand
Mitochondria disruption inhibits Food production
Mitochondria Where ATP is assembled in the cell
Lysosome rupture at what dose in rads Five hundred to one thousand
500 to 1000 rads exposure Lysosome rupture
Lysosome rupture analogy Suicide
Mitochondria interruption analogy for cell death Starvation
Most radiosensitive cell structure Nucleus
Inhibition of DNA and RNA production Cell nucleus
ALARA As Low As Reasonably Achievable
High division rate, long dividing future, unspecified type Radio-sensative
Low division rate, short division future, specialized Radio-resistant
The rate at which energy is deposited per unit distance of travel Linear Energy Transfer
Absorbed Dose (unit) Rad
Dose equivalent (SI Unit) Sievert
Dose Equivalent (nonSI unit) Rem
Four Blood cell types Erythrocytes
Lymphocytes
Granulocytes
Platelets
Oxygen transports in blood cells Erytho
Generates antibodies to fight infection Lympho
Fights infection by phagocytosis Granulo
Blood clotting Platelets
Red blood cells Erythocytes
White blood cells Leukocytes, Lymphocytes
Lymphocytes fight infection by what means Chemical warfare, poisoning infectious invaders
Granulocytes fight infection by what means "Hand to hand combat" by engulfing, smothering, digesting invaders
Absorbed dose unit Rad
Hemotopoietic syndrome dose Two hundred to one thousand Rad
GI Syndrome dose One to five thousand Rad
Central Nerve System Over five thousand Rads
200 – 1000 Rad (what system) Blood-forming organ
1000 to 5000 Rad (what system ?) GI Tract
Above 5000 Rad CNS
LD 50/60 Four hundred and fifty Rad
500 to 1000 Rad Effect what part of the cell? Lysosomes
3000 to 5000 Rads effect what part of cell? Membrane

Practicum III PEDS Airway/Equipment/Fluid Mgmt

Question Answer
Unpaired cartilages of the larynx Cricoid, Thyroid, Epiglottis
Paired cartilages of the Larynx Arytenoid, Corniculate, Cuneiform
Provides both sensory & motor innervation of the larynx VAGUS
Provides SENSORY innervation to SUPRAaglottic regoin SLN – INTERNAL branch
Provide MOTOR innervation to CRYCOTHYROID muscle SLN – EXTERNAL branch
Provides SENSORY innervation to SUBglottic regoin RLN
Provide MOTOR innervation to ALL the LARYNX RLN
Larynx is located were in PEDS & is more CEPHALAD or CAUDAL C3-4 & CEPHALAD
Support should be place behind HEAD or SHOULDERS to assist with DL SHOULDERS
Narrowest SUBGLOTTIC point in PEDS Cricoid Cartilage
MOP for PEDs ETT 20 cm H2O
Sniffing position improves _____ airway patency? HYPO-PHARYNGEAL
Proper hand placement is located where during MV Mandibular ridge
Estimated time for 10 kg kid sats to drop from 90 to 0 4 min
What airway technique is used to stent airway open CPAP
Oral airway should extend from _____ to ____ Mouth to angle of the mandible
Nasal airway is contraindicated for which PEDS population Adenoidectomy
Most effective anesthesia circuit used to DECREASE work of breathing & control depth of anesthetic MAPLESON D
0-1-2 Rule for placement of ET Tube 10 for NB, 11 for 1 y/o, 12 for 2 y/o..age/2 + 13
A properly positioned LMA should move OUT the mouth slightly upon inflation? T or F TRUE
If pts LMA size is btwn a LARGER or SMALLER…which size is most appropriate SMALLER
Desaturation, BRADY, central cyanosis, INSPIRATORY stirdor are all S/S of? Larynospasm
O2 consumption in neonate? 4-6 ml/kg/min (2x of an adult)
Infants are OBLIGATE ______ breathers NASAL
Which anatomical landmark coincides with inhalation STERNAL NOTCH indentation

Disease Chapter 5

Term Definition
Etiology The study of a disease's cause or the theory of origin
Idiopathic Disease without a known cause
Iatrogenic Results from the adverse effects of treatment
Epidemiology Health specialist who study disease's in populations
Incidence rate Number of new disease's in a population
Prevalence rate The overall frequency of a disease in a given group
Mortality rate % of population that dies from a given disease within a specific time period
Epidemic Disease occurring in many people in a given region at the same time
Endemic Disease found continuously in a particular region
Pandeminic Disease that's prevalent throughout an entire large region
Diagnosis Conclusions as to the nature or identity of an illness
Symptoms Disease conditions experienced by a patient
Signs Evidence of a disease that can be observed by another person
Syndrome A complex disorder characterized by a cluster of typical symptoms and signs
Acute A disease that is relatively severe but usually a short duration
Chronic A disease that is less severe but likely to be continuous or recurring for long periods
Latent An infection or chronic disorder that is not currently causing symptoms but will on the future; dormant
Prognosis Prediction of the probable outcome of the disease based on the patients condition and knowledge about the disease
Therapy Treatment
CAM Complementary and Alternative Medicine
Microorganism A tiny living thing, too small to be seen by the naked eye
Parasite Any organism that lives on or within a living host at the hosts expense
Pathogen Disease-causing organism
Infection Invasion of the body with organisms that have the potential to cause disease
Virulence A pathogen describes its ability to cause disease
Bacteria Primitive, single-cell organisms that grow in a wide variety of environments
Local Confined to a relatively small area of the body
Systemic infection Affects the whole body
Opportunistic infection Infection occurring in a host that had been weakened by a disease
Communicable Capable of being transmitted from one person to another
Vector Insect or other animal that transmits a disease causing organism from one host to another
Zoonotic A disease from an insect or animal
Bacteriology The study of bacteria
Virus Extremely small infectious agents that can multiply only within living cells
Virology The study of viruses
Fungi A group that includes singe-celled yeasts and multicellular molds
Mycology The study of fungi
Protozoa Single-cell animals
Protozoology The study of protozoa
Parasitology The study of parasites
Normal Flora Protects against infectious disease
Probiotics Formulations of harmless bacteria
Anaerobic Can grow only in the absence of oxygen
Aerobic Require oxygen
Facultative anaerobes These cells will use oxygen if its present but are able to grow without oxygen if it's is not available
Endoscopes Resistant forms that can tolerate long periods of dryness or other adverse conditions
Toxins Poisons
Diplococci Pairs
Streptococci Chains
Staphylococci Large clusters
Vibrios Slight rods with a slight curvature
Spirilla Long wavelike cells