ACE Exam 2022 Flashcards
When doing TOF on foot, what n are you assessing?
posterior tibial
***ONLY motor n in foot, the remainder are sensory
TOF at foot v hand
foot takes longer to onset and recovers faster
STOP BANG, BMI to inc risk of OSA
> 35
STOP BANG, neck circumfrence to inc risk of OSA?
40 cm (16 incchs)
STOP BANG, age to inc risk of OSA?
> 50
abrupt dec in SpO2, what dye given?
Methylene Blue -> absorbs at the same wavelength as deoxy Hg
Indigo carmine SpO2
little/no change
Indocynanine Green SpO2
slight dec 5-8%
Drugs that cross placenta easily
-lipophilic
-not protein bound
-nonionized
-small
-higher proportin of unionized drug in maternal plasma
RF for post herpetic neuralgia
-limited physical activity due to severe prodromal symptoms
-inc pain severity during infxn
-comorbid dx states incl resp dx and DM
What meds take the longest to infuse in?
Vancomycin
Fluoroquinolones: Ciprofloxacin
b/l blockages of superior laryngeal nerves cause
numbness above VC
what Local anesthetic causese the most pain on injection?
Etidocaine
-most lipid soluble
-Bupivacaine is also highly lipid soluble so 2nd most painful
Least painful local anesthetic on injxn?
Chloroprocaine least lipid soluble
-lidocaine 2nd least
What vasopressor may cause serotonin syndrome?
Methylene Blue
-MAO inh
SE of hydroxocobalamin used as vasopressor
chromaturia
-red colored urine
What herbal meds theoretically impact coagulation?
Garlic
Ginkgo
Ginseng
How long before surgery does garlic need to be d/c for neuraxial?
As long as no other anticoagulant drugs are being taken, does not need to be d/c
MC reason for pediatric liver transplant
biliary atresia
MC genetic cause of childhood liver dx
alpha 1 antitrypsin def
In noncardiac surgery, most common reason for periop stroke?
HypoTN (def as > 30% dec in baseline blood pressure)
Colloid osmotic pressure in preeclampsia
DECREASED
-plasma albumin is reduced due to loss of albumin in the protein and leaking of plasma protein through capillaries
CI to intraaortic balloon pump
-AR
-aortic dissection
-severe PVD
-pts w/ mulitple organ failure w/ no hope of reovery
-aortic stent or grafts
-septic shock
-pt refusal
How to know if pt is adequately alpha blocked for pheo surgery?
After 7-14 days of alpha blockade
-BP < 160/90
-some degree of postural hypoTN
-no ventricular arrythmias or ST or T changes for 2 weeks prior to surgery