Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pass Machine > 1 > Flashcards

1 Flashcards

1
Q

artery that supplies heart conducting system

A

RCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How purkinje fibers depolarize ventricles

A

base to apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

RCA supplies what

A

RA/RV, part of inferior wall LV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

right dominant circulatory means what

A

RCA gives rises to PDA. 85%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PDA supplies what in heart

A

posterior-superior interventricular septum and inferior wall of LV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

LMCA supplies what

A

LA, most of inter ventricular septum, LV(septal, anterior and lateral walls)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what supplies bundle of his

A

PDA and LAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CO to heart

A

5%, 250mL/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

extraction ratio of heart

A

65%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

EKG inferior MI

A

II, III, aVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

EKG lateral MI

A

I, aVL, V5-V6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

EKG anterior MI

A

V3-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

EKG septal MI

A

V1-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

EKG lead most sensitive for ischemia

A

5, 75% sensitivity to detect ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

TEE view to detect ischemia

A

trans gastric short-axis because you can visualize all 3 major coronary territories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

valve w/ 2 flaps

A

mitral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

normal area aortic valve

A

2.5-4.5cm2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

mitral valve normal area

A

4-6cm2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

sympathetic innervation to heart

A

cardioaccelerators T1-4 travel via stellate ganglion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

parasympathetic input to heart

A

from nucleus ambiguous in medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

sidedness of heart ANS

A

R to SA node. L to SV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

transplanted heart connections

A

no parasympathetic(vagus), no cardioaccelerator T1-4 and no baroreceptor reflexes. dependent on SV to change CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what transplanted heart responds to for bp

A

isoproterenol, epi, dopamine and dobutamine aka sympathomimetic amines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

myocyte AP

A

Na voltage gated channel open going in cell. then K open out of cell then Ca open influx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

actions potential length in myocyte

A

200msec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

pacemaker cell action potential channel

A

Ca first not Na

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

intrinsic rate of SA, AV and purkinje

A

SA 70-80, AV 40-60 and P 15-40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

lusitropy

A

rate of relaxation after cardiac contractile. dependent on phospholamban which inhibits reuptake of Ca into sarcoplasmic reticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

heart rate regulation in brain

A

medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

ANS receptor in heart

A

b1-2 sympathetic. M2 parasympathetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

percent atrial kick adds

A

20-30% of ventricular filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

atrial pressure wave a

A

end of Atrial contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

atrial pressure wave c

A

rv Contraction, triCuspid bulge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

atrial pressure x

A

atrial relaXation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

atrial pressure v

A

Venous filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

atrial pressure y

A

rapid emptYing of atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

a fib on atrial pressure wave

A

loss of a wave and prominent c wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

AV dissociation on pressure wave

A

cannon a wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

tricuspid regurg on atrial pressure wave

A

tall c-v wave. no x descent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

RV ischemia on atrial pressure wave

A

tall a and v waves. steep x and y descents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

cardiac tamponade on atrial pressure wave

A

dominant x decent and attenuated y descent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

s1 and s2

A

s1 close AV. s2 close Aortic and pulmonic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

s3

A

reverberation of blood rapidly filling ventricle(benign in youth, athlete or preggo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

S4

A

blood filling stiff ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

normal SVR

A

900-1500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

normal PVR

A

50-150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

which chamber of the heart is more sensitive to dysfunction in increased afterload

A

RV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

E/A ratio

A

early diastole filling to atrial kick phase measured on doppler

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

E/A ratio normal

A

.8-1.2, low= impaired relaxation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

when E/A isn’t predictive of diastolic fxn

A

heart valve problems or operator error

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

primary determinant of myocardial oxygen demand

A

heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

ohm’s law

A

change in pressure = force x resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

parasympathetic receptor on arteries

A

m3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Reynold’s number

A

over 2000 means turbulent flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

blood volume in venous circulation

A

64%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

carotid baroreceptor nerve

A

IX glossopharyngeal nerve called hearing’s nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

aortic baroreceptor nerve

A

vagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

bainbridge reflex

A

increased right atrial pressure from more blood back so then tachycardia. common after baby delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

behold jarisch reflex

A

hypotension, bradycardia and coronary artery dilation in response to sympathetic overactivity causing contraction of an underfilled ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Cushing reflex

A

elevated ICP- hypertension, bradycardia and abnormal breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

coronary blood flow ewquation

A

(art dp-LVEDP)/coronary resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

normal blood flow to brain

A

50cc/100gm /min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what can be used to prevent SVT in WPW

A

droperidol. WPW is pre-excitation abnormality. contraindicated verapamil and digoxin because they suppress normal conduction and enhance abnormal. drop- suppresses antero and retrograde conduction to stabilize HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

digoxin moa

A

blocks Na/K pump so up Ca(contractility), decreases AV node conduction(b/c down K). give for CHF, a-fib.flutt,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

digoxin toxicity

A

tachydysrhythmias, decreased nodal conduction leads to Brady and AV block. potentiated by abnormal K(diuretic). can see hockey stick EKG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

treatment of digoxin toxicity

A

lidocaine to increase AV conductance, phenytoin, amio, K,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

adenosine moa

A

suppress AV nodal conduction used to treat WPW and other supra ventricular tachycardia(narrow complex). antagonized by caffeine, amio and theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

classes of antiarrhythmics

A

I: Na channel blocker. 2 b blockers. 3 K channel blockers and 4 Ca blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

class IV anti-arrhythmics

A

Ca blockers verapamil and diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

amiodarone

A

depresses SA/AV nodal conduction. SE: hypotension, Brady, heart block, depression of contractility, thyrotoxicosis, pulm fibrosis, up LFT, blue skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

QT prolonging meds

A

antiarrhythmics, antipsychotics(haloperidol/reiperidone), anti fungal(ketoconazole, fluconazole), abx(bacterium, erythromycin), antidepressants(TCA), GI(zofran)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

alpha 1 receptor

A

vasoconstriction of bv, smooth muscles and gluconeogenesis. Gq protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

alpha 2 receptor

A

feedback mechanism inhibits insulin release, stimulates glucagon release, inhibits NE release. Gi protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

b1 receptor

A

up chronotropy, dromotropy(impulse conduction), up EF. Gs protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

b2 receptor

A

smooth muscle relaxation of bronchus, uterus, inhibits glucose release, stimulate gluconeogenesis, lipolysis, Gs protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

med to avoid in MAOI

A

ephedrine because indirect sympathetic and can cause exaggerated effect in MAOI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

dobutamine

A

.b1, b2 to up CO good for cariogenic and septic shock. avoid in hypotension, arrhythmogenic and can cause tachyphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

dopamine low dopamine agonist, high a1, a2, b1

A

up CO and mild increase SVR good for neuro, septic and cardiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Epi

A

a1-2, b1-2. up HR, SVR and CO. for hypotension, bronchospasm, anaphylaxis(stabilize mast cells directly), can cause hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

NE

A

a1, b1, b2 agonist. vasoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

phenylephrine

A

a1 agonist to up SVR good for sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

vasopressin

A

V1, V2 agonist. vasoconstriction and water reabsorption for sepic shock. good in setting of acidosis. can cause lactic acidosis, abdominal cramp, bronchoconstriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

isoproterenol

A

synthetic catecholamine to b1-2. up HR, CO, contractility, down after load and PVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

milrinone

A

inhibit PDE so up cAMP. leads to ionotropy, lucitropy, dromotropy, chronotropy. up HR, CO. down SVR and PVR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

nitroglycerine

A

direct vasodilator(v over a).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

nitroprusside

A

decomposes to NO to relax smooth muscle. forms cyanide. give thiosulfate to tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

hydralazine

A

activates K channels on vascular smooth. muscle to cause depolarization/relaxation. causes tachycardia. good for preggo. can cause lupus like syndrome or agranulocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

ca blockers

A

down bp. verapamil/dilt also treat tachyarrhythmias. nifedipine only smoother muscle dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

what not to give with verapamil

A

b blocker. too much hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

ace and arb words

A

ace- pril. arb (sartan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

hypercalcemia signs

A

groans, moans, bones, stones, and psychic undertones. short qt and bradycardia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

which prostaglandin increases GFR

A

E2. also ANP, dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

major function of proximal tubule

A

Na resorption and water follows.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

what molecules enhance Na reabsorption in the pro tubule

A

angiotensin II and NE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

what activates D1 receptor

A

dopamine and fenoldopam which decrease prop reabsorption of Na in kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

what percent does proximal tubule reabsorb

A

75

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

amount of bicarb reabsorbed in kidney

A

90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

cell types in collecting duct

A

principal cells that secrete K and participate in aldosterone-mediated Na reabsorption
Intercalated cells which help w/ acid/base regulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

site of ADH action

A

medullary collecting duct. V2 receptor activation causes open of aquaporin to reabsorb water

100
Q

where is renin

A

juxtaglomerular apparatus

101
Q

renin story

A

renin released to blood and turns angiotensinogen (liver) to angiotensin I. Lung’s ACE makes angiotensin II. it acts in prox tubule to up sodium reabsorption

102
Q

CO of kidney

A

25%

103
Q

part of kidney vulnerable to ischemia

A

medulla

104
Q

GFR percent of renal. plasma flow

A

20%

105
Q

what is a good measure of GFR

A

inulin because completely filtered but not secreted or absorbed

106
Q

normal GFR

A

120 men, 100 cc/min women

107
Q

creatinine clearance and GFR comparision

A

creatinine clearance over estimates GFR because it is also secreted

108
Q

when does GFR stop

A

under 40 MAP

109
Q

adenosine on kidney

A

local release causes dilation of afferent arteriole and inhibits renin release

110
Q

ANP on kidney

A

dilate afferent, maybe constrict efferent so up GFR. inhibits renin and aldosterone too

111
Q

plamsa osmolality equation

A

2Na + BUN/2.8 + glucagon/18

112
Q

osmol gap cause

A

ethanol, mannitol, methanol, ethylene glycol, isopropyl alcohol, glycine(TURP),

113
Q

fluid compartments

A

intracellular 2/3 of TBW. extracellular 1/3—75% interstitial and 25% intravascular

114
Q

diuretic that causes hyper K

A

thiazide

115
Q

osmotic diuretic example and other effects

A

mannitol. it’s also a free radical scavenger, can cause pulm edema

116
Q

loop diuretic MOA and SE

A

inhibit Na and Cl reabsorption in thick ascending loop. reversible hearing loss

117
Q

where thiazides work and SE

A

inhibit Na reabsorption in distal tubule. hypoK. metabolic alkalosis, hyperglycemia

118
Q

where K sparing diuretics work, example and SE

A

collecting tubules. spironolactone(aldosterone receptor blocker). High K and metabolic acidosis, gynecomastia

119
Q

fenoldopam

A

selective Dopamine 1 receptor agonist. decreases PVR, up renal blood flow and diuresis. good for cardiac/aaa repair because of antihypertensive and renal sparing properties

120
Q

extraction ratio equation

A

intrinsic hepatic clearance / hepatic blood flow

121
Q

flow dependent drug elimination characteristics

A

high extraction ratio, most eliminated first pass, rapid metabolism

122
Q

capacity limited drug elimination characteristics

A

dose dependent, zero order, hepatic elimination determined by plasma concentration, when dosing exceeds liver capacity, plasma level rises

123
Q

drugs with poor extraction ratio from liver

A

acetaminophen, asa, clinda, diazepam, digoxin, ethanol, phenytoin, warfarin

124
Q

cup inducers

A

anesthetics, anticonvulsants, insecticide, sedative, steroid, HAART, st John wort

125
Q

crossmatch

A

45min. donor and recipient blood. 1-rechecks ABO/lewis. 2-at 37C in albumin checks Rh

126
Q

most labile coagulation factor

A

7

127
Q

indications for FFP

A

correction of factor deficiency when don’t have recombinant. PT/PTT over 1.5x normal. correction of microvascular bleeding during massive transfusion, urgent reversal of warfarin

128
Q

how long do platelets last

A

5 days

129
Q

indications for platelets

A

under 50 with ongoing bleeding or DIC or needs invasive procedure. if drops under 10

130
Q

platelet change for 1u whole blood, 1 u apheresis,

A

10k, 30-50k

131
Q

blood product most likely to spread virus

A

platelets. short life so can’t test for nucleic acids

132
Q

blood product you don’t need ABO compatibility on

A

platelets. desirable but not absolutely required. need Rh though for female childbearing age. also cryo

133
Q

what blood product not to give through warmer

A

platelets

134
Q

cryo indications

A

fibrinogen under 100, ppx for hemophilia A, vWD, congenital dysfibrinogenemias, bleeding due to uremia not responsive to DDAVP

135
Q

factors in cryo

A

8, 13, vWF, fibrinogen

136
Q

who gets anaphylaxis to blood products

A

IgA deficient patients. reacting to donor IgA.

137
Q

mild allergic run blood most common

A

ffp

138
Q

febrile ran blood

A

pt antibody against donor wbc. 1 degree up in 4 hours

139
Q

when does trali occur and tx

A

6 hours after transfusion. non cariogenic pulmonary edema, fever/chill, b/l infiltrates on CXR. mechanical ventilation, strict fluids, pulm hygiene, nebulizer

140
Q

least common cause of TRALI

A

pRBC (least amount of plasma in it)

141
Q

coagulopathy of blood transfusion

A

1.5x blood volumes, fibrinogen decreases. 2x Factor 2,5 8 down. 2.5 x then platelets decrease

142
Q

stored pRBC pH

A

7.0 secondary to lactate and CO2 accumulation

143
Q

4 platelet steps

A

adhesion via vWF/GP1B. 20 shape change/mediator release(thromboxane, prostaglandin, histamine. 2- aggregation Gp2B-3A. emergence of PF3 on platelet where coagulation cascade starts

144
Q

abciximab moa

A

GP2B3A inhibitor so no platelet aggregation

145
Q

point of coagulation cascade

A

make thrombin which turns fibrinogen to fibrin

146
Q

what protein. and S do

A

degrade factor 5 and 8

147
Q

factor 13 job

A

cross link fibrin together

148
Q

tap moa

A

degrades fibrin

149
Q

txa job. aminocaproic acid

A

promote fibrinogenesis. stabilize clot

150
Q

factors tested in INR

A

extrinsic. 1, 2, 5, 7, 10

151
Q

aPTT normal but long PT means what

A

factor 7 because shortest half life

152
Q

PTT tests what factors

A

1, 2, 5, 8, 9, 10, 11, 12 (not 7 and 13)

153
Q

normal ACT

A

90-120 sec

154
Q

“poor man’s PTT”

A

ACT

155
Q

give heparin and act doesn’t prolong then what

A

antithrombin 3 deficiency so give FFP

156
Q

decreased amplitude on TEG

A

decreased platelet activity

157
Q

end slope of TEG

A

give TPA if goes down fast. too much fibrinolysis

158
Q

asa moa

A

irreversible plt cox inhibitor which prevents txa2 a potent plt pro-coagulant

159
Q

cox2 inhibitor

A

celecoxib to mediate pain/inlammation while not causing gastric damage, decreased renal blood flow and inhibit plt txa2

160
Q

calcium level for tetany/arrhythmia

A

less than o.5

161
Q

high calcium sign

A

over 1.7 is coma. otherwise stones, bones, grones and psychic over tones

162
Q

secreted from adrenal medulla

A

80% epi, 20% ne and little dopamine

163
Q

nicotinic vs muscarinic

A

N: ion channel. receptor is everywhere
M: G protein membrane protein. in parasympathetic system so used to counteract nicotinic side effects of reversal

164
Q

pressure needed for jet ventilation

A

15psi

165
Q

highest pH IVF

A

albumin at 7.4 and plasmalyte

166
Q

T1/2 of NS

A

30min

167
Q

lithium and anesthesia

A

d/c b/c prolongs NMBA

168
Q

valproate and anesthesia

A

interferes with platelet function

169
Q

carbamazepine and anesthesia

A

induces p450

170
Q

why procaine is bad for spinal

A

short(less than hour), more nausea, high anesthetic failure rate, slower recovery time PACU, but better because less back/leg pain than iidocaine

171
Q

spinal w/ lido length

A

1.5 hours

172
Q

adhesive arachnoiditis cause

A

chlorprocaine but because of the preservative so since changed and ok.

173
Q

ropivicaine vs bupivicaine

A

ropi is half as potent but safer cardiac but less motor block

174
Q

why neuraxial neostigmine is bad

A

nausea

175
Q

2 MOA that occur when anticholinesterases are given neuraxial

A

inhibits acetylcholinesterase so more ach around to mitigate nociception. also increase concentration of NO. which is good in spinothalamic tract

176
Q

specific gravity of CSF

A

1.0069

177
Q

what influences peak block height of a spinal

A

patient height, site of injection, csf volume, baricity of med, dose of med, posture of patient

178
Q

2 chloroprocaine onset and duration epidural w/ epi

A

10-15min and lasts 60-90min

179
Q

lido onset and duration epidural w/ epi

A

15min, lasts 120-180min

180
Q

bupivacaine onset and duration epidural w epi

A

20min and 3-4hours

181
Q

ropivacaine onset and duration epidural w/ epi

A

15-20min and 2-3 hours

182
Q

sodium bicarb on epidural

A

1mEq addition to 10 mL 1.5% lido makes significantly faster onset and better spread

183
Q

sympathectomy level w/ neuraxial

A

epidural same level. spinal 2 levels above sensory

184
Q

volume for blood patch

A

20cc

185
Q

why isn’t chlorpromazine used for iV anessthesia

A

causes phlebitis

186
Q

local that causes mehemoglobinemia

A

prilocaine

187
Q

how long does the turniquet have to be up for bier

A

at least 25min

188
Q

protein binding molecules in plasma

A

albumin binds acidic drugs. alpha-1 glycoprotein binds basic drugs

189
Q

meds that can have tachyphylaxis

A

ephedrine, opioids, nitroglycerine, ddavp, hydralazine, reglan, ranitidine, local anesthetics

190
Q

risk factors for ulnar neuropathy

A

head rotation away, excess arm abduction, arm pronation, male, extremes of body habitus

191
Q

saphenous nerve compression surgery location

A

medial tibial condyle from leg holder

192
Q

femoral nerve injury surgery

A

kinked under inguinal ligament from extreme flexion and abduction of thighs

193
Q

foot drop nerve

A

common peroneal

194
Q

when to draw tryptase

A

within 5 hours after anaphylaxis

195
Q

sublingual to core temp

A

sublingual 0.5C under

196
Q

meperidine metabolism

A

to normeperidine in liver. can cause myoclonus and seizures

197
Q

morphine metabolism

A

in liver to m6glucoronide(more potent than morphine) and m3g(inactive)

198
Q

hydromorphone metabolism

A

to hydromorphone3glucuronide may cause cognitive dysfunction and myoclonus

199
Q

where to epidural opioids exert their effect

A

substantia gelatinosa in dorsal horn

200
Q

volatiles on icp and cmro2 and cbf

A

all up cbf and icp. nitrous oxide up cmro2, others down

201
Q

nitrous toxicity things

A

megaloblastic hematopoiesis from marrow failure, subacute combined degeneration of spinal cord(numb/falls/weak), immunosuppression(impaired chemotaxis), teratogenic(skeletal and limb, situs inverus),..prolonged exposure

202
Q

ppm numbers

A

nitrous 25, volatiles are 2

203
Q

most IV anesthetic targets

A

gaba potentiation except ketamine…NMDA block

204
Q

when to avoid barbiturates

A

hemorrhagic shock because significant myocardial depressant

205
Q

ALA synthetase

A

induced by barbiturates so causes acute porphyria attack

206
Q

intra artery inject of what is bad and how to treat

A

barbiturates. treat with papaverine/lidocaine, heparizination and consider regional techniques for pain

207
Q

long acting benzo

A

diazepam

208
Q

intermediate acting benco

A

lorazepam

209
Q

when prolonged propofol infusion

A

over 4mg.kg.hr for 48 hours. metabolic acidosis, fatty liver, rhabdo, mitochondrial dysfunction, refractive bradycardia

210
Q

common SE etomidate

A

pain at injection site/thrombophlebitis and a lot of n/v

211
Q

phobicity of fentanyl vs morphine and why it matters spinal

A

f lipophilic. m hydrophilic. hydro slower onset, stays in csf longer so spreads higher and lasts longer

212
Q

opioid receptor euphoria

A

m1

213
Q

m2 opioid receptor job

A

hypoventilation, constipation, dependence

214
Q

opioids histamine

A

morphine and meperidine most

215
Q

mu receptor where spinal

A

substantia gelatinosa which inhibits release of substance P

216
Q

methadone moa and loa

A

mu agonist and nmda antagonist. T1/2 15-60hours, variable due to cup variation

217
Q

meperidine difference

A

atropine like structure so can have vagolytic effects. good for shivering. can cause serotonin syndrome

218
Q

serotonin syndrome effects

A

headache, agitation, hallucination, coma, shiver, sweat, up T, tachycardia, nausea, myocolus, tremor

219
Q

more allergenic locals

A

esters

220
Q

locals with the “I”

A

amides

221
Q

onset local based on what

A

pKa. lower means higher fraction of neutral drug so faster onset. only de protonated can cross

222
Q

potency of local based on what

A

hydrophobicity. which improves transit across membrane

223
Q

duration of locals based on what

A

protein binding

224
Q

procaine different

A

methemoglobinemia, less likely TNS, high n/v

225
Q

benzocaine different

A

paba allergic, methemoglobinemia

226
Q

chlorprocaine different

A

quick onset, arachnoiditis from EDTA, decreased clearance in hepatic/renal dysfunction

227
Q

tetracaine different

A

longer duration of action and motor, TNS risk

228
Q

percent occupied if TOF

A

up to 70% still

229
Q

nerve stimulator orbicularis occult vs adductor pollicis

A

eye mimics laryngeal mm. adductor pollicis comes back after laryngeal

230
Q

o2. cylinder

A

700L gas at 2200psi

231
Q

n2o cylinder

A

1600 L max pressure 750 psi

232
Q

type of system mapleson is

A

semi closed

233
Q

mapleson spontaneous best

A

All Dingos Can Breathe

234
Q

abg and co2

A

down T then more CO2 dissolved in blood. pH up and pO2 down

235
Q

bp only carotid pulse

A

systolic 60

236
Q

bp carotid and femoral pulse

A

sup 70

237
Q

radial pulse bp

A

80 if feel

238
Q

pulse pressure by body part

A

more farther from heart

239
Q

ohms law

A

V=IR

240
Q

which current is more harmful

A

AC is x3 more dangerous

241
Q

where needle goes for cervical plexus block

A

posterior border of SCM at its midpoint

242
Q

stellate ganglion block location

A

medial to carotid pulse, anterior to c6 transverse process(vertebral artery protected)

243
Q

brachial plexus nerves

A

C5-T1

244
Q

brachial artery canulation can hurt what nerve

A

median

245
Q

what sciatic splits to

A

common peroneal and tibial n

246
Q

ankle block nerves

A

4/5 from sciatic: post tibial, sural, superficial and deep peroneal. other is saphenous from lumbar plexus

247
Q

henry

A

concentration of gas dissolved in a solution is proportional to the partial pressure x solubility

Pass Machine (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions