Anästhesie (Fach) / Krankheitsbilder (Lektion)

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  • Epiglottitis Bakterium: H. influenzae Typ B Alter: 2-5 Jahre Symptome: Fieber, Dyspnoe, Stridor. KEIN Husten im Ggs zu Tracheobronchitis (Croup) Therapie: Beruhigung. Epinephrin vernebelt. Atemwegssicherung am besten ...
  • Aldosteron: Steuerung Sekretionsreiz: Hyperkaliämie, Hyponatriämie, Volumenmangel, Hypotonie Stimulation durch ACTH, beta-Stimulation Hemmung durch ANP, Dopamin  
  • Schlafapnoe Assoziation mit Art HT, DM, Reflux, schwieriger Intubation
  • Phäochromozytom siehe essential clinical anaesthesia ... 90% in Nebenniere, 10% bilateral Symptome: Schwitzen, Herzklopfen, Kopfschmerzen, Synkope Urin: Vanillinmandelsäure, Metanephrin. Heute: freies Metanephrin Plasmalevel, ggf. Clonidinsupressionstest ...
  • Gastrektomie Spätkomplikationen perniziöse Anämie (Vit b12 Mangel wegen fehlendem intrinsic factor) Frühdumping: Reservoir Magen fehlt--> Kohlenhydrate im Dünndarm entziehen Wasser + Parasympatishe Aktivität --> Volumenmangelschock ...
  • Sichelzellanämie HbS. Präzipiert in desoxygeniertem Zustand -> Sichelform der Erys -> Verstopfung der Mikrozirkulation. Hämolyse Komplikation: Autosplenektomie Diagnostik: Hämoglobinelektrophorese Erbgang: autosomal ...
  • Glucose-6-Phosphatdehydrogenasemangel (Flavismus) x chromosomal rezessiv Auslöser: ASS, Metamizol, Sulfonamide, Vit K, Malariamittel u.v.m.                           Infekte, Stress, metabolische Azidose Cave: Hämoglobinurie mit Nierenversagen ...
  • Post punctional Headache: blood patch Relief of headache may occur immediately or within 24 hours.  Epidural blood patch performed around 48 hours postpartum has a 60-90% cure rate at first attempt.   Geb's Handbuch S34
  • Long-QT-Syndrom > Torsade de Pointes a) genetisch: Kalium- oder Natriumkanal-Veränderungen b) medikamenten induziert Tricyclic antidepressants (Imipramine) Major tranquilisers Amiodarone Antihistamines Erythromycin  ...
  • Post partale Blutung Ergometrin: Cave: System. Vasokonstriktion. KI: Präeklampsie! Carboprost (Prostaglandin): Cave: Bronchospasmus, bes. bei Asthmatikern
  • Renal tubuläre Azidose   Renal-tubuläre Azidose Typ I (distal-tubuläre Sekretionsstörung für Protonen). Als Kompensation werden mit Kalium und Natrium Kationen ausgeschieden. Renal-tubuläre Azidose Typ II (proximal-tubuläre ...
  • Trigeminus Neuralgie u.a. Kopfschmerzen Trigeminal neuralgia is neuropathic pain in the distribution of the trigeminal nerve. Episodes of paroxysmal shooting or sharp natured pain occur typically provoked by stimuli such as light touch, eating, ...
  • Kryoglobulinämische Vaskulitis Kryoglobuline sind in der Kälte präzipitierende lmmunglobulinkomplexe (reversibel, < 10 °C), meist lgM-IgG-Komplexe (wobei monoklonales lgM als Autoantikörper mit polyklonalem lgG reagiert) 3 Typen: ...
  • Child-Pugh classification Within the Child-Pugh classification the following five elements are assessed or measured in order: Ascites Grade of encephalopathy Serum bilirubin (μmol/L) Serum albumin  (g/L) Prothrombin time or ...
  • Porphyrie Pathogenese: excess production and excretion of porphyrins and their precursors Ursache: Enzymdefekt im Hämstoffwechsel Auslöser: Stress, infection, pregnancy, menstruation, starvation and certain ...
  • autonomic neuropathy Features of an autonomic neuropathy include: Postural hypotension Cardiac conduction defects Bladder dysfunction Gastrointestinal disturbances including delayed gastric emptying pupils constrict or dilate ...
  • COPD Patients with mild COPD (60 - 79% of the predicted FEV1) are often unknown to their GP. Those with moderate COPD (40 - 59% predicted) are seen intermittently seen by the GP, whilst those with severe ...
  • Laktatazidose characterised by an elevated arterial blood lactate level and an increased anion gap ([Na + K] - [Cl + HCO3]) of > 20 mmol.  It can be a consequence of overproduction and/or reduced metabolism of lactic ...
  • Metabolische Alkalose Metabolic alkalosis is a primary increase in serum bicarbonate (HCO3-) concentration which occurs as a consequence of a loss of H+ from the body or a gain in HCO3-. There are many causes of metabolic ...
  • Transfusionsreaktion: ABO incompatibility. Antibodies bound to red cells in the body can cause red cell destruction by two major mechanisms: intravascular and extravascular. Intravascular: Red cells are destroyed in the bloodstream ...
  • Prolaktinom A prolactinoma may present with Amenorrhoea Bitemporal hemianopia due to chiasmal compression Reduced bone mineral density (BMD) associated with longstanding hypo-oestrogenism and Hypopituitarism (zB ...
  • Horner Syndrom Horner's syndrome results from interruption of the sympathetic innervation to the head. It was originally described with cervical lesions causing damage to the T1 contribution to the cervical sympathetic ...
  • Serotonerges Syndrom Symptome: excitation, hyperpyrexia, hypertension, profuse sweating, and rigidity. This may progress to seizures, coma, and death.   Auslösende Medikament:  Monoamine oxidase inhibitors (MAOIs) Pethidine ...
  • Lungenfibrose It can be caused by chemical agents including: Paraquat Antimitotic drugs  MTX Busulphan Amiodaron Asbestos Aspiration of gastric contents Fumes.
  • Hypoxic pulmonary vasoconstriction Hypoxic pulmonary vasoconstriction (HPV) is the reflex constriction of pulmonary arterioles in response to low a PO2 (below 80 - 100 mmHg; 11 - 13 kPa) in adjacent alveoli. It is independent of the innervation ...
  • E. coli Infekt- Antibiose? Escherichia coli is a Gram negative bacillus which produces penicillinases, but it remains sensitive to numerous antibiotics. Bacterial resistance to antibiotics is a major problem and where possible ...
  • hyperprolactinaemia is associated with the following... ... ...Acromegaly is associated with hyperprolactinaemia either through stalk compression or co-secretion of prolactin with growth hormone. Dopamine agonists, for example, bromocriptine, suppress prolactin ...
  • Le-Fort-Frakturen Le-Fort-I : horizontaler Oberkieferbruch. Das Knochenfragment erinnert an eine Oberkiefer-Totalprothese Le-Fort-II: pyramidenförmigen Oberkieferabsprengung Le-Fort-III: vollständiger Abriss des Mittelgesichts ...
  • M. Bechterew Assoziiert mit: Herz: Asociated with a higher risk for cardiovascular diseases: ischemic heart disease, peripheral vascular disease, congestive heart failure aortic regurgitation and conduction disturbances, ...
  • Fallot-Tetralogie Right ventricular outflow tract obstruction (pulmonary stenosis) Ventricular septal defect (VSD) Deviation of the origin of the aorta to the right so that it overrides the VSD Concentric right ventricular ...
  • Hypophysenadenom The pituitary gland is an important part of the neuro-endocrine axis. It is found in the sella turcica of the sphenoid bone at the base of the skull. Superiorly it is related to the hypothalamus, third ...
  • Mydriasis Mydriasis/pupillary dilatation is associated with Third nerve palsy Mydriatics such as anticholinergics and Tricyclics due to their anticholinergic effect. It is not associated with SSRIs.
  • hereditäres Angioödem C1-Esterase-Inhibitor-Mangel (quantitativ oder qualitativ). Autosomal dominant. C1-Esterase-Inhibitor: Kontrolle der Aktivierung des Komplementfaktors C1
  • Lagerungsschäden  The length of time spent in an abnormal position will increase the likelihood of problems and possible litigation. The eyes and optic nerves are at risk from direct pressure from surgical instruments, ...
  • Central cord syndrome   Mögliche Ursache: Hyperextension bei Intubation. Is the most common incomplete spinal cord lesion. The spinal cord is injured in central grey matter and results in proportionally greater loss of motor ...
  • Anterior spinal artery infarction The anterior spinal artery is a single long anastomotic channel that lies at the mouth of the anterior central sulcus and supplies the circulation to the anterior two thirds of the spinal cord. Eight ...
  • Brown-Sequard syndrome   Ursache: halbseitige Läsion des Rückenmarks durch trauma, neoplasm and multiple sclerosis. Teilweise Kreuzung der Bahnen resultiert in:   ipsilateral upper motor neurone paralysis and loss of ...
  • Cauda equina syndrome The spinal cord ends at L1 and L2 at which point a bundle of nerves travel downwards through the lumbar and sacral vertebrae (L1-5 and S1-4). Injury to these nerves will cause partial or complete loss ...
  • Karzinoid/ Neuroendokrine Tumoren Spezielle NET-Formen sind z. B. VIPome, Gastrinome, Insulinome oder Phäochromozytome.    Karzinoid-Syndrom (durch Serotonin): Trias Diarrhoe (Durchfall), Flush (Erröten) und Hedinger-Syndrom (kardiale ...
  • Kurzdarmsyndrom nach Resektion von Dünndarm Symptome Durchfällen  Fettstühle  Mangelversorgung mit Wasser, Makro- und Mikro-Nährstoffen (Eiweiß, Fett, Elektrolyte, Calcium, Magnesium, wasser- und fettlösliche Vitamine, ...
  • Hypertroph-obstruktive Kardiomyopathie genetisch bedingte Hypertrophie des Myokards im linken Ventrikel (meist Septum) > Obstruktion des linksventrikulären Ausflusstrakts und verminderte Auswurfleistung.   Ausserdem eingeschränkte Dehnbarkeit ...
  • Thalassämie meist Mutation des ß-Giobingens -+ verminderte Produktion von ß-Ketten -+ kompensatorisch gamma-oder delta-Ketten vermehrt. Ineffektive Erythropoese mit intra-und extramedullärer Hämolyse.  Heterozygot ...
  • Dystrophia myotonica: Anästhesieprobleme wenig cardiopulmonale Reserve (Cardiomyopathie, Schwäche Atemmuskeln) Risiko für Aspiration erhöht (verzögerte Magenentleerung) übermässige Wirkung von Iv Anästhetika, nicht depolarisierenden Mm. ...
  • SIADH associated with: Pneumonia Bronchial small cell carcinoma Haferzell-lungen-CA Pulmonary tuberculosis Subarachnoid haemorrhage Head injuries Meningitis, etc. medikamentös-induziert (Thiazid-Diuretika, ...
  • Addison-Krise   M. Addison:   = primärer NNR-Insuffizienz. Versiegen sämtlicher Kortikosteroide; (hingegen ist die Aldosteronproduktion bei den sekundären Formen infolge ACTH-Mangel nur wenig betroffen)    Symptome: ...
  • CUSHING-SYNDROM = HYPERKORTISOLISMUS Symptome: 1. Fettstoffwechsel: Umverteilung der Depotfette: Vollmondgesicht, Stiernacken, Stammfett-sucht; supraklavikuläre Gruben durch Fettpolster verstrichen; Hypercholesterinämie 2. Eiweißstoffwechsel: ...
  • Hypocalcämie With hypocalcaemia, neuromuscular, neural and cardiovascular abnormalities predominate. Neural hyperexcitability causes smooth and skeletal muscle contractions. Neural findings include: Dementia or overt ...
  • Awareness The main risk factors are: 1. Use of neuromuscular blocking agents. 2.Light planes of anaesthesia: Caesarean section (1 in 250) Cardiac anaesthesia (1 in 100) Major trauma (1 in 20) Impaired CVS function ...
  • Occulomotoriuslähmung In surgical third nerve palsy, ptosis and mydriasis are evident and the eye looks 'down and out'. These features reflect loss of innervation to all the major structures supplied by the oculomotor nerve. ...
  • Emphysem, LuFu In bullous emphysema the air spaces are > 1 cm in diameter. If the bullae are not significantly ventilated then lung mechanics and carbon monoxide transfer reflect properties of non-bullous lung. The ...