Brainscape's Knowledge GenomeTM

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


See full index

Truelearn Advanced Exam > ACE Exam 4 > Flashcards

ACE Exam 4 Flashcards

1
Q

Hyperaldo lytes

A

hyperNa
met alk
HypoK

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

Spontaneous ventilation, which Mapleson limits rebreathing?

A

A!
-FGF as far from pt as possible

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

Mechnical ventilation, which uses least FGF w/ no rebreathing?

A

D or F, where FGF right next to pt

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

What happens when you quit smoking for 48 hours?

A

-dec carboxyHg
-R shift of O2 dissoc curve
-dec CN levels -> better oxidative phosphorylation
-dec nicotine levels -> improves vasodilation and clearance of toxic substances that may impair wound healing

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

n most commonly injured in OB deliveries

A

LFCN

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

obturator n damage symptoms

A

dec sensation on inner thigh
weakness of internal rotation and hip adduction

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

MC drug to cause anaphylaxis in the OR

A

NMBD

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

MCC of unilateral RLN injury

A
  1. Cancer
    (surgery is 2nd)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

To minimize postop blindness

A

-maintain MAP per pts baseline BP
-neck in neutral position
-avoid direct eye compression
-in high risk pts consider doing staging surgical procedures, break into 2 shorter cases
-higher risk w/ male sex and obesity

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

what n injury: dec knee extension, dec hip abduction, numnbess on anteromedial thigh and calf, dec patellar reflex

A

femoral n

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

to minimize work of breathing in an asthmatic

A

put them sitting up or semirecumbant (inc FRC)
-bigger ETT
-slower than normal RR

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

which trachs are MRI safe?

A

Shiley
-Bivona trachs need to be replaced before MRI

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

Number of days on mechanical ventilation to have it be considered ventilator assoc PNA

A

2 days
48 hours

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

only drug to tx asthma that has bronchodilator effects AND anti-inflammatory

A

Aminophylline
-filing it in b/c it has 2 purposes

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

Benzocaine topilization and then dec SpO2, dx?

A

Met-Hg

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

When you take a bribe from a vendor thats considered?

A

Fraud

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

If you steal supplies to go on a mission trip thats considered?

A

abuse

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

Giving sevo and noticing a prolonged QT fix?

A

switch to TIVA w/ prop
-other meds that prolong QT and to avoid: epi, zofran, amiodaron

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

hypoxic pulm vasoconstriction and temp

A

decreases w/ hypothermia
-increases w/ hyperthermia

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

ppx dose of enoxaparin, how long after can you remove a catheter?

A

12 hours

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

RF for spinal hematoma

A

female
> 65 years old
-spinal cord or vertebral abnormalities
-renal insuff

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

How long after catheter removal can you give LMWH ppx dose?

A

4 hours

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

therapeutic LMWH dose, how long do you have to wait to put in catheter?

A

24 hours

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

what type of vWD will not respond to DDAVP?

A

type 3 b/c they make none

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Treacher Collins syndrome
-glossoptosis (tongue posteriorly placed) -micrognathia -cleft palate -cardiac abnormalities -auricular malformationn and deafness -slanting of palpebral fissure
26
immunosuppressant causing renal issues
tacrolimus cyclosporine
27
compared to typical epidural, what does a DPE do better?
Better sacral analgesia =less need for top-up doses than either epidural or CSE -DPE was assoc w/ less motor blockade than conventional epidural dosing
28
Best PFT at predicting postop outcomes w/ lobectomies
FEV1
29
black box warning for hyroxyethyl starch
inc risk of bleeding and renal injury in pts w/ sepsis
30
type of rsolution determines u/s machine ability to discriminate structures at different depths
axial
31
u/s ability to distinguish 2 objects at the same depth
lateral resolution
32
u/s ability to distinguishb/w events of rapidly moving structures
temporal resolution
33
what do you use a CHADS-VASc to assess?
RF for stroke w/ a fib
34
early v last burn phases
early: hypovolemic, hypodynamic cardiac late: hyperdynamic, hypermetabolic state
35
MC complication w/ TAVR
damage to the conduction system requiring a pacemaker
36
specificity
TN/TN+FP
37
GFR and renal arterial pressure
GFR inc w/ inc renal arterial pressure, but then plateaus at ~80
38
What opioid should be avoided in lactating/breastfeeding?
codeine -> dep on enzymes can lead to high conc of morphine in breast milkd
39
Def of adequate preoxygenation
EtO2 > 90% EtNitrogen < 5%
40
cirrhotic cardiomyopathy
hyperdyamic dec SVR -inability to compensate w/ stress or exercise -biventricular systolic and diastolic dysfxn -dec circulating volume (max dilated splanchnics) -resistance to beta symp stimulation -electrophysiological abnormalities, prolonged QT
41
which is higher: radial art line or NIBP cuff during HTN?
radial art line
42
which is higher rad art line or NIBP cuff during hypoTN?
NIBP
43
what type of regurge is abnormal in pregnancy?
AR -due to inc in LV size and dilation, MR, TR, and PR are all normal
44
common metabolic derrangement after brain death
Diabetes Insipidus!
45
MCC of preop anemia
iron def anemia
46
SAH and recent surgical femur fracture now gets PE, what to do next?
Catheter directed therapy -> direct clot removal or dissolution
47
pt having cataracts surgery, has a hx of controlled HTN and hypothyroidism, preop testing?
none indicated
48
risk of hyperthermic intraperitoneal chemotherapy w/ cisplatin
-given in dextrose solution -> hyperglycemia -hypoNa can occur -must cool pt, see inc HR, CO, O2 consumption, dec SVR (pressure compresses IVC)
49
how does neonate switch from fetal to neonatal circulation?
dec in PVR -inc LA pressure closes PFO
50
what anesthetic drugs dec immune response
opioids
51
Goals for spinal drains
-MAP 80-100 -CSF pressure 8-12 -draining less than 15-25 cc/hr
52
What drug abuse will screw w/ your teeth?
Methamphetamines
53
perk of robotic surgery over laparoscopic
more degrees of freedom w/ manipulation of surgical instruments
54
Airway pressure release ventilation
basically CPAP, allows pt to breath spontaneously -ARDS
55
Delayed hemolytic transfusion rxns
-minor antigens: Kidd, Duffy, Kell, MNS, RH
56
34 YOM healthy no prev medical problems, MVA rib fx splenic lac, ST elevations in V5 cause?
cardiac contusion
57
motor n most likely to be anesthetized w/ adductor canal block
n to vastus medialis
58
Methylenetetrahydrofolate reductase def, what to avoid?
nitrous oxide
59
which DOAC is most renally excreted?
Dabigatran ran out of the renals -rivaroxaban and apixaban liver metabolism
60
intrathecal ziconotide complications
hallucinations
61
why less resp depression w/ midaz than prop?
ceiling effect -> benzos can only potentiate effects of endogenous GABA -> after a certain dose no more
62
most common operations for pts w/ multiple myeloma
ortho ones! bone tractures
63
treatment for hepatorenal syndrome
-renal hypoperfusion and inc Na absorption -splanchnic vasodilation and inc in nitric oxide -> dec in BP -> RAA aldo -tx: vasopressin, somatostatin, and alpha agonists (NE, midodrine) w/ volume resuscitation
64
biggest predictor of CNS dysfxn after cardiac surgery
age
65
ACh and succ at NMJ
competitve!
66
minimize fatigue on night shifts
-quick 20-60 min naps -keep overhead lights bright -strategic caffeine -limiting night shifts -short rest breaks -keeping regular sleep schedule -work < 16 hrs
67
myotonia dystrophy and cardiac
conduction delays are common and can be resistant to atropine, have external pacing readily available
68
if n block and procedure
2 time outs
69
ratio of compressions to breaths in neonate
3:1 -in 1 minute goal is 90 compressions 30 breaths
70
dose of neonatal epi
10 microg/kg
71
HIT but needs CPB what to give?
Bival **only if normal renal fxn
72
cardiac issue w/ highest maternal mortality
pulm HTN EF < 30% severe MS, AS -aortic dilation
73
NSAIDs more commonly cause GI bleeding
Ketorolac Piroxicam (cam, need GI cam b/c bleeding) Sulindac Indomethadone
74
weird assoc w/ SFLT2 inh: flozins
euglycemic ketoacidosis
75
what to avoid in pts who have been scuba diving/
nitrous oxide
76
prone positioning helps pts in ARDS why?
aeration! improve V/Q
77
how to get pain w/ facet issues?
lumbar extension
78
what u/s factor determines lateral resolution?
frequency
79
why give gabapentin preop?
dec opioid req post op
80
best way to minimize surgical site infxn w/ c/s
give ppx abx
81
when to do a preop stress test?
risk of inducible ischemia during intraop course
82
when using heliox recommended %
30% O2, 70% Helium
83
Oliceridine
mu opioid receptor 400x more selection for mu compared to other opioid receptor subtypes, so less resp depression and GI issues
84
New onset a fib after noncardiac surgery tx
BB or Verapamil, Diltiazem
85
After quench of MRI what happens
-helium floods the room -> can make the environment hypoxic -makes the room cold can get frostbite
86
Amisulpride MOA
Dopamina antagonist -schizophrenia and PONV
87
What meds are EEG reliable indicators of consciousness?
Propofol
88
what meds are unreliable EEG?
ketamine (falsely excited) precedex (falsely deep)
89
What is caffeine used for?
PDPH, and preventing apnea and bradycardia in infants -prolonging sz in ECT
90
MC anti-HTN in preeclampsia used
labetalol hydralazine if IV not available: nifedipine
91
MC issues w/ VV ECMO
renal failure cannula site bleeding oxygenator failure
92
Concern for pts w/ neurofibromatosis
AIRWAY! can get neurofibromas in airways
93
if someone is a ultrametabolizer of codeine, what pain meds to give and what to avoid
give: morphine, fentanyl, methadone, hydromorphone don't give: hydrocodone, oxycodone
94
HFNC how much PEEP for 10L of flow?
1 PEEP
95
RF for QT prolongation
age > 65 female sex hypoK, hypoMg
96
over 3 c/s risk of placenta accreta?
60%
97
risk of accreta w/ 1 c/s
3%
98
risk of accreta w/ 2nd c/s
11%
99
Ruex en Y, what is connected to small gastric pouch?
jejunum

Truelearn Advanced Exam (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions