Brainscape's Knowledge GenomeTM

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


See full index

Anesthesiology > ACE 2013 10B > Flashcards

ACE 2013 10B Flashcards

1
Q

How do NSAIDs affect the kidneys?

A

They inhibit production of prostaglandins which cause afferent arterial vasodilation which can cause acute renal failure

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

Which is a side effect seen with NSAIDs: obstructive uropathy, elevated BP, renal vasodilation, hypokalemia

A

Elevated BP - thought to be secondary to Na retention and volume expansion

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

What is the treatment for neurogenic diabetes insipidus?

A

Infusion of isotonic fluids (use hypotonic fluids if plasma osmolarity reaches 290 mOsm/L or higher) + desmopressin (DDAVP)

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

What is the treatment for nephrogenic diabetes insipidus?

A

Infusion of isotonic or hypotonic solutions + chlorpropamide or clofibrate (potentiate effects of arginine vasopressin on renal tubules)

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

What is the treatment for nephrogenic diabetes insipidus?

A

Infusion of isotonic or hypotonic solutions + chlorpropamide or clofibrate (potentiate effects of arginine vasopressin on renal tubules)

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

Which of the following increases risk of postop apnea in a ex-32 weeker: post-conceptual age 60 weeks, intraop caffeine, anemia, hx of necrotizing enterocolitis

A

Anemia

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

What is the Modified Aldrete Scoring System and what does it consist of?

A

PACU discharge criteria

Consists of Respiration, oximetry, BP, level of consciousness, and activity

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

What is the Post-Anesthetic Discharge Scoring System and what does it consist of?

A

PACU discharge criteria

Consists of pain, bleeding, nausea, CV changes, activity

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

What is the Post-Anesthetic Discharge Scoring System and what does it consist of?

A

PACU discharge criteria

Consists of pain, bleeding, nausea, CV changes, activity

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

Which of the following is an absolute contraindication for ECT: pregnancy, AICD, pheochromocytoma, neuroleptic malignant syndrome

A

Pheochromocytoma

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

Which of the following is an absolute contraindication for ECT: pregnancy, AICD, pheochromocytoma, neuroleptic malignant syndrome

A

Pheochromocytoma

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

What level are the cardiac accelerator fibers located?

A

Sympathetic fibers from T1-T4

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

Why might you see bradycardia following spinal anesthesia to T10?

A

Reverse Bainbridge reflex: normally, increased venous return causes increased HR (via SNS and inhibition of vagal outflow); this is the opposite where decreased venous return (from spinal) causes bradycardia

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

Why might you see bradycardia following spinal anesthesia to T10?

A

Reverse Bainbridge reflex: normally, increased venous return causes increased HR (via SNS and inhibition of vagal outflow); this is the opposite where decreased venous return (from spinal) causes bradycardia

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

Name some medications that are given intraoperatively that should be avoided in patients with Parkinson Disease

A

Promezathine, droperidol, metoclopramide (any medication that decreases the effects of dopamine)

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

How long after cosmetic liposuction via the tumescent technique do you expect peak serum levels of lidocaine?

A

12-14 hours after injection

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

How long after cosmetic liposuction via the tumescent technique do you expect peak serum levels of lidocaine?

A

12-14 hours after injection

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

What do you worry about in a neonate with generalized cyanosis and a concave abdomen?

A

Congenital diaphragmatic hernia

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

What congenital abnormalities are most commonly associated with congenital diaphragmatic hernias?

A

CVS (50%): ASD/VSD, ToF, Coarctation
GI (40%): malrotation
CNS (20%): spina bifida, hydrocephalus, microcephaly

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

What side effects do you worry about in patients taking cyclosporine?

A

Acute kidney injury

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

What side effects do you worry about in patients taking bleomycin?

A

Pulmonary fibrosis

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

What side effects do you worry about in patients taking bleomycin?

A

Pulmonary fibrosis

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

What are the classic characteristics of obesity hypoventilation syndrome?

A
  1. Obesity (BMI >30)
  2. Daytime awake hypercapnia and hypoxia
  3. Sleep-disordered breathing without another known cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the classic characteristics of obesity hypoventilation syndrome?

A
  1. Obesity (BMI >30)
  2. Daytime awake hypercapnia and hypoxia
  3. Sleep-disordered breathing without another known cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What medications are capable of producing burst suppression?

A

Volatile anesthetic gases (~2 MAC), etomidate, propofol, and barbiturates

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

Which is least likely to cause airway obstruction 1 hour after total thyroidectomy: neck hematoma, recurrent laryngeal nerve injury, tracheomalacia, hypercalcemia

A

Hypercalcemia (total thyroidectomies lead to hypocalcemia from parathyroid removal)

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

Which is least likely to cause airway obstruction 1 hour after total thyroidectomy: neck hematoma, recurrent laryngeal nerve injury, tracheomalacia, hypercalcemia

A

Hypercalcemia (total thyroidectomies lead to hypocalcemia from parathyroid removal)

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

What do you worry about in chronic methamphetamine users?

A
  1. Depletion of neurotransmitters (NE and epi) - hypotension

2. Cardiomyopathy (40% of patients)

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

PEEP of 10 cm H2O will decrease which of the following: FRC, airway resistance, dead space, arterial oxygen sat

A

Airway resistance (from increase in lung volume)

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

What does the addition of sodium bicarbonate to lidocaine do?

A

Decreases pain on subcutaneous infiltration; although there are more non-ionized forms from the decreased pH, studies have not shown decreases in onset time or block intensity

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

Which is most associated with increased risk of worsening neurologic function in MS: epidural, peripheral nerve block, GA, hyperthermia

A

Hyperthermia - Uhthoff phenomenon (body temp elevation of 0.5C or more will exacerbate MS symptoms)

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

Which is most associated with increased risk of worsening neurologic function in MS: epidural, peripheral nerve block, GA, hyperthermia

A

Hyperthermia - Uhthoff phenomenon (body temp elevation of 0.5C or more will exacerbate MS symptoms)

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

What are some ECG findings for hypercalcemia? Hypocalcemia?

A

Hyper: shortened PR and QTc intervals
Hypo: prolonged QTc interval

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

What medication should you try to avoid in hypercalcemia?

A

Thiazide diurectics - they will induce hypercalcemia

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

What are common findings for critical illness polyneuropathy?

A

Respiratory muscle weakness (slow to wean off vent) and distal weaknesses (mostly lower extremity); you do NOT see cranial nerve or facial abnormalities

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

Which is least likely to occur after femoral nerve block: loss of skin sensation over anterior thigh, loss of sartorius muscle function, loss of sensation over medial leg and foot, loss of adductor longus function

A

Loss of adductor longus function (innervated by the obturator nerve)

37
Q

What nerves make up the femoral nerve? Obturator nerve?

A

Femoral: Posterior division of L2-L4
Obturator: Anterior division of L2-L4

38
Q

What pain medication can worsen opioid-induced constipation?

A

TCAs

39
Q

Vacuum-assisted devices in OB increase the risk of what to the infant?

A

Cephalohematomas and subgaleal hemorrhages

40
Q

Forceps-assisted deliveries in OB increase the risk of what to the infant?

A

Cephalohematomas and intracranial hemorrhages

41
Q

Forceps-assisted deliveries in OB increase the risk of what to the infant?

A

Cephalohematomas and intracranial hemorrhages

42
Q

Why doesn’t succinylcholine readily cross the placenta?

A

It is highly ionized and has a low lipid solubility

43
Q

What is the mechanism of action of dexmedetomidine and what hemodynamic effects do you see from it?

A

Alpha-2 agonist

Bradycardia and hypotension

44
Q

How is dexmedetomidine metabolized?

A

Liver (conjugation and methylation)

45
Q

How is dexmedetomidine metabolized?

A

Liver (conjugation and methylation)

46
Q

What are the conditions listed in the Revised Cardiac Risk Index?

A
  1. Hx of ischemic heart disease
  2. Hx of CHF
  3. Hx of CVA
  4. Renal insufficiency
  5. DM
47
Q

What are the major cardiac risk factors that should be treated prior to elective surgery?

A
  1. Unstable coronary disease (angina, recent MI)
  2. Decompensated heart failure
  3. Severe valvular disease
  4. Significant dysrhythmias
48
Q

What are the major cardiac risk factors that should be treated prior to elective surgery?

A
  1. Unstable coronary disease (angina, recent MI)
  2. Decompensated heart failure
  3. Severe valvular disease
  4. Significant dysrhythmias
49
Q

How is remifentanil metabolized?

A

Nonspecific blood and tissue esterases (NOT plasma cholinesterase)

50
Q

How is remifentanil metabolized?

A

Nonspecific blood and tissue esterases (NOT plasma cholinesterase)

51
Q

What is the first-line therapy for bony metastatic pain?

A

NSAIDs, then opioids

52
Q

What is the first-line therapy for bony metastatic pain?

A

NSAIDs, then opioids

53
Q

During a laparoscopic procedure, what do you suspect if you see hypercapnia increase by 25% after 30 minutes of pneumoperitoneum? What if you see hypoxemia after 15 min?

A
  1. Subcutaneous emphysema

2. Bronchial intubation (diaphragm pushed up)

54
Q

During a laparoscopic procedure, what do you suspect if you see hypercapnia increase by 25% after 30 minutes of pneumoperitoneum? What if you see hypoxemia after 15 min?

A
  1. Subcutaneous emphysema

2. Bronchial intubation (diaphragm pushed up)

55
Q

What changes in the respiratory function of a patient who has a spinal to a level of T3?

A

Abdominal and intercostal muscles involved in active exhalation are affected, causing decreased ERV and thus vital capacity

56
Q

What changes in the respiratory function of a patient who has a spinal to a level of T3?

A

Abdominal and intercostal muscles involved in active exhalation are affected, causing decreased ERV and thus vital capacity

57
Q

What are some risk factors for developing post-operative ulnar neuropathy?

A
  1. Male (thicker flexor retinaculum and bony protuberance is more prominent with less adipose protection)
  2. Obesity or very thin body habitus
  3. Prolonged immobilization
  4. Older age
58
Q

What are some risk factors for developing post-operative ulnar neuropathy?

A
  1. Male (thicker flexor retinaculum and bony protuberance is more prominent with less adipose protection)
  2. Obesity or very thin body habitus
  3. Prolonged immobilization
  4. Older age
59
Q

How does progesterone affect respiration in pregnancy?

A

Shifts the CO2 response curve to the left (direct respiratory stimulant) so you have a higher tidal volume
Also is a bronchodilator (increased dead space)

60
Q

How does progesterone affect respiration in pregnancy?

A

Shifts the CO2 response curve to the left (direct respiratory stimulant) so you have a higher tidal volume
Also is a bronchodilator (increased dead space)

61
Q

What nerve is injured if you have a foot drop with decrease sensation of the lateral calf and foot?

A

Lumbosacral trunk

62
Q

What nerve is injured if you have weak quadriceps, decrease sensation of the medial calf, and loss of the patellar reflex?

A

Femoral nerve

63
Q

What nerve is injured if you have decreased sensation of the medial aspect of the thigh and inability to adduct the thighs?

A

Obturator nerve

64
Q

What is the mechanism of action of gabapentin: agonism of GABA-A receptors, agonism of GABA-B receptors, NMDA antagonist, or calcium channel modulation

A

Calcium channel modulation (gabapentin increases release of GABA but is not an agonist)

65
Q

What is the mechanism of action of gabapentin: agonism of GABA-A receptors, agonism of GABA-B receptors, NMDA antagonist, or calcium channel modulation

A

Calcium channel modulation (gabapentin increases release of GABA but is not an agonist)

66
Q

What does the posterior tibial nerve provide sensation to in the foot? Saphenous? Sural? Superficial peroneal? Deep peroneal?

A

PT: plantar surface of foot
Saphenous: medial ankle and foot
Sural: lateral foot
Superficial peroneal: dorsal surface of foot
Deep peroneal: web space between first and second toes

67
Q

What does the posterior tibial nerve provide sensation to in the foot? Saphenous? Sural? Superficial peroneal? Deep peroneal?

A

PT: plantar surface of foot
Saphenous: medial ankle and foot
Sural: lateral foot
Superficial peroneal: dorsal surface of foot
Deep peroneal: web space between first and second toes

68
Q

What is first indicator of hypovolemia in a 3 year old patient with trauma?

A

Tachycardia (given the underlying SNS tone of children)

69
Q

What TEE view gives you simultaneous information about all 3 major coronary arteries?

A

Transgastric mid-papillary short axis view

70
Q

What is the landmark used when performing a stellate ganglion block?

A

Chassaignac tubercle (transverse process of C6)

71
Q

Why do we use leukocyte reduced pRBCs?

A

Decrease in febrile non-hemolytic transfusion reactions, decreased transmission of CMV, decreased alloimmunization

72
Q

What is more noxious: surgical skin incision or laryngoscopy with intubation? Without intubation?

A

Laryngoscopy without intubation is less noxious but with intubation is more noxious

73
Q

What are the symptoms of serotonin syndrome?

A
  1. AMS (agitation/delirium/confusion)
  2. Autonomic nervous system hyperactivity (hyperthermia, sweating, tachycardia, flushing)
  3. Neuromuscular abnormalities (rigidity, tremor, shivering)
74
Q

What is the mechanism of action for tramadol?

A

Weak mu opioid receptor agonist and wean SNRI

75
Q

What should you worry about if you have immediate bilateral lower extremity numbness and weakness progressing to paraplegia in a patient who had a left-sided TFESI with methylprednisolone?

A

Spinal cord infarct secondary to arterial injury or intraarterial injection of particular steroid (not likely nerve trauma since it is bilateral)

76
Q

What is the first-line treatment for trigeminal neuralgia?

A

Carbamazepine

77
Q

What are some more serious side effects of carbamazepine?

A

SJS, toxic epidermal necrolysis, hyponatremia due to SIADH, aplastic anemia, agranulocytosis, abnormal LFTs, and pancytopenia

78
Q

Which chemotherapeutic agents are associated with cardiomyopathies?

A

Doxorubicin and danorubicin

79
Q

What chemotherapeutic agent is associated with pulmonary fibrosis?

A

Bleomycin

80
Q

What is the first thing you do when there is an airway fire?

A

Call for help and remove the ETT

81
Q

Patient has allergies to fish, soy beans, shellfish, and avocados; which drug(s) might cause an allergic reaction: protamine, propofol, povidone iodine, latex

A

Latex; the others are associated with but have not been shown to cause an allergic reaction

82
Q

What is supine hypotensive syndrome in the mother and what hemodynamic signs does it present with?

A

During late pregnancy, nausea/dyspnea, cyanosis and LOC after assuming the supine position (compression of IVC)
Hypotension + bradycardia

83
Q

What is the main advantage of using liposome-encapsulated morphine rather than standard morphine?

A

Increased duration of action

84
Q

Which medication increases the risk of pediatric emergence agitation: isoflurane, sevoflurane, propofol, dexmedetomidine

A

Isoflurane (more so than sevoflurane because it is less soluble), the other two are used to treat emergence agitation

85
Q

What is the oculocardiac reflex and what can increase the likelihood of provoking the reflex?

A

OCR: pressure on the globe, traction on EOM, or manipulation of the conjunctiva which causes bradycardia
Hypoxia and hypercapnia increases likelihood

86
Q

Can the oculocardiac reflex occur with enucleated orbits? In the presence of a retrobulbar block?

A

Yes for both

87
Q

What is the purpose of the dispersive pad (bovie pad)?

A

Reduce current density

88
Q

With a double lumen tube, what do you suspect if you have a sudden increase in peak airway pressures and decreased expiratory tidal volumes with elevated HR and BP?

A

Malpositioning of the DLT; deflate the bronchial cuff and evaluate with a fiberoptic

Anesthesiology (21 decks)

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