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*ACE's > ACE 2012-9b > Flashcards

ACE 2012-9b Flashcards

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1
Q

Pt is on daily oral naltrexone, what should he do about this drug in preparation for surgery?

A

Naltrexone should be stopped immediately

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2
Q

Opioid requirements for a patient undergoing surgery that has been taking an oral combo drug of extended release morphine and naltrexone (Embeda)

A

Unchanged if pill is used correctly.

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3
Q

T-test is what type of analytical test?

A

Parametric test that can be used to determine if there is a significant difference between the means of 2 groups

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4
Q

2 types of analysis most commonly used for survival analysis

A

Kaplan-Meier analysis and Cox proportional hazards regression model

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5
Q

Jaw necrosis is a well documented complication of what drug?

A

Bisphosphonates

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6
Q

Chronic pain drugs associated with development of osteoporosis

A

First generation anticonvulsants like phenytoin

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7
Q

Common drawbacks of gabapentin

A

Sedation, weight gain, peripheral edema, cognitive effects

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8
Q

Cardiac abnormality associated with hyperthyroidism

A

Atrial fibrillation

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9
Q

Cardiac abnormality associated with hypothyroidism

A

Pericardial effusion

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10
Q

Management of pt with mediastinal mass causing tracheal compression

A
  • Secure airway while awake if possible
  • maintain spontaneous ventilation
  • monitor airway compromise postop
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11
Q

RIFLE criteria for AKI

A

1 of the following criteria within 48 hrs

  • absolute increase in Cr of 0.3
  • 50% or more increase in Cr
  • UOP < 0.5 mL/kg/hr for > 6 hrs
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12
Q

Standard stimulation site for SEP

A

Median nerve

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13
Q

Standard response site for MEP

A

Abductor pollicis brevis

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14
Q

Drug dosing based on Ideal body weight or lean body weight in a morbid obese pt would result in too small of a dose

A

Ideal body weight

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15
Q

Dose of propofol for induction and fentanyl and remifentanil should be based on what type of weight for obese pts?

A

Lean body weight (LBW)

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16
Q

Dose of succinylcholine for induction should be based on what type of weight for obese pts?

A

TBW (total body weight)

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17
Q

Dose of vecuronium and rocuronium for induction should be based on what type of weight for obese pts?

A

IBW (ideal body weight)

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18
Q

Larynx of neonate is located at what vertebral level?

A

C3-4

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19
Q

Larynx of adult is located at what vertebral level?

A

C4-5

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20
Q

Anterior attachment of neonate vocal cords in relation to posterior attachment

A

More caudad. “Anterior = away”

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21
Q

Larynx of preterm neonate is located at what vertebral level?

A

C3

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22
Q

Mechanism of action of dabigatran (pradaxa)

A

Direct thrombin inhibitor

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23
Q

Half life of dabigatran (pradaxa)

A

12 hrs

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24
Q

Peak effect of dabigatran (pradaxa)

A

2-3 hrs

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25
Q

Mechanism of action of clopidogrel and ticlopidine

A

Platelet inhibitors, ADP receptor inhibitor

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26
Q

Mechanism of action of tirofiban

A

Platelet inhibitor, 2b-3a receptor inhibitor

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27
Q

Wrist drop and diminished brachioradialis reflex is injury of what nerve?

A

Radial nerve

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28
Q

Loss of thumb abduction is injury of what nerve?

A

Median nerve

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29
Q

Baroreceptors are part of carotid body or sinus?

A

Carotid sinus

30
Q

Chemoreceptors are part of carotid sinus or body?

A

Carotid body

31
Q

Propofol’s effect on QT interval

A

Little effect

32
Q

Combo of glycopyrrolate and reversal agent’s effect on QT interval

A

Prolongs QT interval

33
Q

Carboxyhemoglobin level less than what percent does not require supplemental O2 therapy

A

Less than 10%

34
Q

Carboxyhemoglobin level greater than what percent is an indication for hyperbaric oxygen therapy

A

Greater than 25%

35
Q

Carbon monoxide’s affinity to hemoglobin is how many times greater than oxygen

A

250 times

36
Q

American academy of pediatrics recommends lateral X-rays for all Down’s syndrome kids between what ages?

A

3-5 years of age

37
Q

How does cervical instability compare between adults and children with Down’s syndrome

A

Same

38
Q

Endotracheal tubes opened and checked can be stored and used within how many hours?

A

48 hrs

39
Q

Osler-Weber-Rendu syndrome or hereditary hemorrhagic telangiectasia is characterized by formation of multiple…

A

Arteriovenous malformations, with life threatening locations such as pulmonary, hepatic, and cerebral circulations

40
Q

Most common symptom associated with post dural puncture headache

A

Nausea, followed by neck stiffness, vomiting, visual, auditory

41
Q

Drugs that increase serum level of lithium

A

ACE inhibitors, NSAIDS, loop diuretics, metronidazole

42
Q

Drugs that decrease serum levels of lithium

A

Acetazolamide, theophylline

43
Q

First manifestation of oxygen toxicity

A

Retrosternal tightness

44
Q

Decrease in vital capacity caused by oxygen toxicity can be detected after how many hours?

A

24 hrs

45
Q

When does supplemental oxygen cause seizures?

A

The partial pressure of oxygen is in excess of 2 atmospheres

46
Q

Odds of renal failure and mortality with use of hetastarch compared to crystalloids

A

Increase

47
Q

How does cessation of smoking 24 hrs prior to surgery affect risk of postop pulmonary complications

A

Increase in pulmonary complications when smoking cessation began less than 8 weeks prior to surgery

48
Q

Primary sign of autonomic dysfunction

A

Orthostatic hypotension

49
Q

Drug used to keep autonomic dysfunction patient euvolemic in preparation of surgery

A

Fludrocortisone, mineralocorticoid that causes sodium retention and increases intravascular volume

50
Q

Why should aspiration prophylaxis be given to Parkinson’s patient with severe autonomic dysfunction?

A

Possible vocal cord dysfunction

51
Q

Main advantage of retrobulbar block compared with peribulbar block

A

Reduced block onset time

52
Q

Train of four response in a paraplegic patient’s normal limb compared to paretic limb

A

Response is exaggerated in paretic limb compared to normal limb

53
Q

Does a negative molecular genetic test for a patient with family history of MH exclude susceptibility to MH?

A

NO!!!! Gold standard is muscle biopsy for caffeine halothane contracture test, only 4 testing centers in the US

54
Q

How is rocuronium excreted?

A

Bile

55
Q

Aminosteroid neuromuscular blockers

A

Rocuronium, vecuronium, pancuronium

56
Q

Mechanism of action of tapentadol (Nucynta)

A

Mu opioid receptor agonist, also like tramadol, it prevents neuronal reuptake of norepinephrine and serotonin

57
Q

Why are thiazides contraindicated for treatment of hypercalcemia

A

Thiazides increase tubular reabsorption of calcium

58
Q

Cardiac output for a parturient is highest when?

A

Immediately postpartum, up to 75% above prelabor values

59
Q

When does cardiac output postpartum return to prelabor values?

A

48 hrs postpartum

60
Q

Time to peak analgesia for fentanyl

A

6.8 min

61
Q

Time to peak analgesia for sufentanil

A

6.2 min

62
Q

Time to peak analgesia for alfentanil

A

1.4 min

63
Q

Time to peak analgesia for remifentanil

A

1.1 min

64
Q

pKa of fentanyl

A

8.4

65
Q

pKa of sufentanil

A

8.0

66
Q

pKa of alfentanil

A

6.5

67
Q

pKa of remifentanil

A

7.2

68
Q

How does 3 degree decrease in body temp affect plasma propofol concentration

A

Increase by 30%

69
Q

How does each degree drop in body temp affect MAC of isoflurane?

A

Decrease by 5%

70
Q

Risk of aortic dissection in a patient with asymptomatic bicuspid aortic valve

A

Increased

71
Q

Occurrence of neurologic consequences with identifiable embolic events in patients undergoing carotid endarterectomy

A

Most do not develop a stroke

72
Q

Stage of labor that can be prolonged by neuraxial analgesia

A

2nd stage when cervical dilation is complete

*ACE's (27 decks)

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