ACE 2010 Flashcards

1
Q

Only nerve required to be anesthetized in order to perform awake tracheostomy

A

Recurrent laryngeal nerve

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2
Q

3 main nerves that innervate the airway

A

Trigeminal, glossopharyngeal, vagus nerves

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3
Q

Occupational exposure to ionizing radiation mostly occurs from what type of X-rays?

A

Scattered x-rays

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4
Q

Lesion of which nerve root causes pain in index finger and thumb

A

C6

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5
Q

Lesion of which nerve root causes pain in shoulder and proximal arm with deltoid weakness and loss of biceps reflex

A

C5

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6
Q

Circle system test checks the machine between what 2 points?

A

Common gas outlet and Y piece

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7
Q

How is SVR and cardiac output affected by liver cirrhosis?

A

Decreased SVR, increased CO

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8
Q

Side effect of narcotics that is increased in patients who were chronically on narcotics preoperatively

A

Respiratory depression

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9
Q

Most reliable method to diagnose facet joint pain

A

Diagnostic nerve block

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10
Q

Celiac plexus block results in blockade of which types of nerves?

A

Sympathetic efferents and visceral sensory afferents

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11
Q

Median nerve’s relation to axillary artery

A

Superior to axillary a.

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12
Q

Ulnar nerve’s relation to axillary artery

A

Inferior to axillary a.

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13
Q

Radial nerve’s relation to axillary artery

A

Posterior to axillary a.

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14
Q

Musculocutaneous nerve’s relation to axillary artery

A

Superiolateral to axillary a.

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15
Q

FFP may be administered up to how many hrs after thawing?

A

24 hrs

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16
Q

ASA task force recommendation for monitoring after single injection of neuraxial fentanyl

A

2 hrs

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17
Q

ASA task force recommendation for monitoring after single injection of neuraxial morphine

A

24 hrs

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18
Q

ASA task force recommendation for monitoring after single injection of neuraxial extended release morphine

A

48 hrs, monitoring after 1st 24 hrs should be every 4 hrs

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19
Q

Aprepitant is a drug used to treat what?

A

PONV

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20
Q

Aprepitant is administered via what route?

A

PO

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21
Q

Mechanism of action of aprepitant

A

Blocking action of substance P in the CNS

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22
Q

Reaction to protamine administration can result in what symptoms?

A

Allergic reaction, pulmonary hypertension, RV failure, hypotension

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23
Q

Step to take if on initiation of CPB, patient is hypotensive and there is high pressure in outflow to aorta with flow of 1L/min

A

Separate from CPB

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24
Q

Absolute indications for one lung ventilation

A
  • Isolation of healthy lung to prevent contamination with infection or hemorrhage.
  • Control of ventilation for a bronchopleural fistula, bullae.
  • VATS
  • Unilateral lung lavage
25
Anesthetic drugs that should be avoided in patients with porphyria
Etomidate, thiopental, methohexital, nifedipine
26
Most common adverse reaction to protamine
Hypotension
27
Level of 2,3-DPG in banked blood after 96 hrs of storage
Essentially zero
28
Percent of normal level of 2,3-DPG 7 hrs after blood transfusion.
50%
29
How many hrs after blood transfusion will levels of 2,3-DPG return to normal?
48 hrs
30
Factor that is the most predictive of hypoxemia during one lung ventilation
Right side thoractomy because left lung has 2 lobes and right lung has 3 lobes
31
How does magnesium affect local anesthetic and neuromuscular blocker administration
Potentiate them
32
What is metoclopramide's effect on lower esophageal sphincter?
Increase tone of lower esophageal sphincter
33
Absolute contraindication to ECT
- Pheochromocytoma | - Intracranial hypertension
34
Pectus excavatum is associated with what congenital heart disease.
Mitral valve prolapse.
35
Treatment for methemoglobinemia
Methylene blue
36
Treatment for cyanide toxicity
Sodium thiosulfate which converts cyanide to thiocyanate. Amyl and sodium nitrite which induce methemoglobin which binds to cyanide. Hydroxycobalamin binds to cyanide to form cyanocobalamin (vit b12) which is cleared by kidneys
37
Capsaicin in use for treatment of postherpetic neuralgia
Poorly tolerated
38
Acute fatty liver of pregnancy often coexists with what pregnancy related diseases
Preeclampsia, HELLP syndrome
39
Sickling of RBCs in a pt with sickle cell disease can be precipitated by what conditions?
Hypoxemia, hypothermia, acidosis, dehydration, vascular stasis, infection
40
How does rapid administration of mannitol affect ICP?
Increase ICP because intravascular volume is expanded
41
Full E-cylinder of nitrous oxide contains how many liters?
1600L
42
Pressure of full E-cylinder nitrous oxide tank
750 psi
43
How much nitrous oxide is left in E-cylinder tank when pressure starts dropping?
25% or approx 400L
44
Severe hemophilia A is associated with factor VIII activity that is what percent of normal?
Less than 1% of normal
45
FDA has approved use of what coagulation factor for treatment of bleeding and prophylaxis in hemophilia A patients with antibody inhibitors to factor VIII
Recombinant factor VIIa
46
Half life of argatroban
45 min
47
Mechanism of action of argatroban
Synthetic direct thrombin inhibitor
48
Early goal directed therapy for sepsis
CVP 8-12 mmHg MAP 65-90 mmHg SvO2 >= 70% Hct >= 30% (if SvO2 < 70%)
49
Aldrete score required for hospital discharge
> 8
50
GI procedure most frequently associated with cardiopulmonary complications
ERCP
51
Pain in nondependent shoulder occurs in how many patients undergoing thoracotomy
85%
52
Axilla and inner arm pain is caused by injury to what nerve?
Intercostobrachial nerve, which arises from T2
53
MCC of sudden cardiac death in young competitive athletes
Hypertrophic cardiomyopathy
54
Prevalence of HCM in general adult population
0.2% (1/500)
55
Myasthenia gravis affect on nondepolarizing neuromuscular blocking agent
Increased sensitivity to nondepolarizing nmbs due to decrease in functional acetylcholine receptors
56
Myasthenia gravis affect on succinylcholine
Resistance to succinylcholine
57
Percent of deaths from amniotic fluid embolism that occur within 5 hrs of initial presentation
2/3
58
Specific lab test for diagnosis of amniotic fluid embolism
None!