Anesthesia

Question 1

Which Benzo is hepatically cleared? Which Benzo isn’t?

Answer 1

Is: Versed.
Isn’t: Ativan

Question 2

How do you reverse Benzo?

Answer 2

Flumazenil

Question 3

What’s risk of Meperidine?

Answer 3

Lower seizure threshold

Question 4

What’s propofol infusion syndrome?

Answer 4

Hyperkalemia, arrythmia, acidosis

Question 5

What’s contraindication for Ketamine?

Answer 5

Ischemic heart disease (sympathomimetic)

Question 6

What’s maximum dose of lidocaine?

Answer 6

1% lido = 10 mg/mL
1% w/o epi: 4 mg/kg
1% w/o epi: 7 mg/kg

Question 7

What’s risk of bupivacaine?

Answer 7

arryhthmia/hypotension

Question 8

What’s symptoms of lidocaine tox? How do you treat it?

Answer 8

Tinnitus/perioral numbness->anxiety->tremor/seizure/coma->cardiac arrest
Tx: IV 10% intralipid emulsion

Question 9

How do you treat malignant hyperthermia?

Answer 9

Dantrolene

Question 10

How do you reverse muscle relaxants?

Answer 10

Roc, Vecuronium: Sugammadex or neostigmine+glycopyrrolate

Cisatracurim, atracurium: Neo + Glyco

Question 11

How do you interpret train of four technique?

Answer 11

Number of twitches in response to pulsed stimuli:
0: 95+% blocked
1: 90% blocked
2: 80% blocked (ideal level)
3: 75% blocked
4: <65% blocked. Not paralyzed

Question 12

What’s dose of naloxone? How do you titrate?

Answer 12

Breathing spontaneously: 0.05 mg naloxone
Not breathing: 0.2-1 mg naloxone

Aim for goal RR >12