Brainscape's Knowledge GenomeTM

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


See full index

SEE/NCE Boards CoreConcepts > Anesthesia EFFECTS, COMMONs, Triads, DISSOCIATION CURVES, REFLEXES > Flashcards

Anesthesia EFFECTS, COMMONs, Triads, DISSOCIATION CURVES, REFLEXES Flashcards

1
Q

Carbon dioxide dissociation curve: When blood contains mainly oxygenated hemoglobin , the CO2 dissociation curve shifts to the _______

A

Right

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

When does the CO2 dissociation curve shifts to the Right?

A

When blood contains mainly oxygenated hemoglobin

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

When blood contains mainly oxygenated hemoglobin and the CO2 dissociation curve shifts to the RIGHT what does that do?

A

REDUCE the BLOOD CAPACITY to HOLD CO2

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

When blood contains mostly DEOXYhemoglobin , the CO2 dissociation curve shifts to the _______

A

LEFT

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

When does the CO2 dissociation curve shifts to the LEFT?

A

When blood contains mostly DEOXYhemoglobin

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

When blood contains mainly DEOXYhemoglobin and the CO2 dissociation curve shifts to the LEFT what does that do?

A

Increasing the capacity to carry CO2

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

CO2 dissociation curve mnemonic to remember

A

Right O2

Left

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

Explain the HALDANE EFFECT?

A

Allows the blood to LOAD more CO2 at the tissue level where more deoxyhemoglobin is present
And to UNLOAD CO2 at the lung, where more HgbO2 is present .

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

This effect permits more CO2 to be carried in the form of bicarbonate ions

A

Haldane effect

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

With this effect: The associated of H+ with the amino acids of hemoglobin lowers the affinity of hgb of O2, shifting the HgbO2 dissociation curve to the right at low pH or HIGH CO2

A

Bohr effect

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

The Haldane Effect (along with the Bohr Effect) facilitates the

A

release of O2 at the tissues and the uptake of O2 at the lungs.

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

The Haldane Effect results from the fact that deoxygenated hemoglobin has a

A

higher affinity (~3.5 x) for CO2 than does oxyhemoglobin.

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

HALDANE EFFECT MAINLY states that

A

Deoxygenated blood can carry increasing amounts of carbon dioxide, WHEREAS oxygenated blood has a reduced carbon dioxide capacity.

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

The Haldane Effect describes the effect of

A

oxygen on CO2 transport.

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

Bohr effect describes the effect of

A

carbon dioxide on oxygen transport

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

Central chemoreceptors respond to

A

H+ in the CSF

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

Peripheral chemoreceptors respond to

A

↑ H+, ↑ CO2, and ↓ PaO2

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

What is the primary stimulus for ventilatory response?

A

PaCO2

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

Hamburger shift”

A

Cl- exchange for HCO3- in RBC’s:

HCO3- out, Cl- in; non-pulmonary

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

Occulocardiac Reflex: Afferent and Efferent Pathway

A

Afferent pathway = Trigeminal nerve Efferent pathway = Vagus nerve

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

Cushing’s triad : What is it and what does it tell you?

A

HTN
Bradycardia
Irregular respirations

Increased ICP

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

Triple H Therapy: is used for

A

For treatment of cerebral vasospasm

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

What is the triple H therapy ?

A 
Hypervolemia = CVP > 10 mm Hg PCWP = 12-20 
Hypertension = SBP 160-200 mmHg 
Hemodilution = Hct 33%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Obesity Hypoventilation syndrome triad

A

Obesity
Daytime hypoventilation
Sleep disordered breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does Virchow’s triad tells you?

A

Risk factors for venous thrombosis

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

Virchow’s triad (HIS)

A

Venous stasis
Venous injury (endothelial)
Hypercoagulable State

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

Hepatopulmonary syndrome Triad (PHW)

A

PORTAL HTN
Hypoxemia (Arterial deoxygenation)
Widespread pulmonary vasodilation

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

Cholecystitis triad:

A

Sudden RUQ tenderness
Fever
Leukocytosis

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

Clinical significant Hypoglycemia WHIPPLE TRIAD

A

Hypoglycemia (catecholamine)
Low blood glucose
Relief of symptoms after IV glucose

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

DKA Triad

A

Hyperglycemia
Ketonemia
ACIDEMIA

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

Pheochomocytoma Triad

A

Paroxysmal diaphoresis
Tachycardia
Hypertension

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

Hypothermia TRIAD

A

ACIDOSIS
Hypothermia
COAGULOPATHY

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

SPINAL shock TRIAD

A

Hypotension
Bradycardia
Hypothermia

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

SAMTER syndrome Triad

A

Nasal polyps
Asthma
Aspirin allergy

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

FIRE TRIAD

A

Fuel
Oxidizer
Ignition source

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

Beck’s triad indicates

A

Cardiac Tamponate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is beck’s triad?

A

JVD
Hypotension
Muffled heart sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Aortic stenosis Triad

A

Angina
Syncope
CHF (dyspnea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Ruptured Abdominal Aortic Aneurysm triad

A

Severe abdominal pain radiates to back
Pulsatile abdominal mass
Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Chronic pancreatitis triad

A

Steatorrhea
Pancreatic calcification
Diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Myotonic dystrophy triad in males

A

Frontal baldin
premature ocular cataracts
testicular atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Bezold-Jarish reflex is associated with this triad?

A

hypotension, bradycardia, and coronary vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

The Bezold-Jarisch reflex results in

A

unmyelinated vagal afferent stimulation in response to noxious ventricular stimuli (chemical or mechanical),

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

2 things that are increased with Bezold-Jarisch reflex

A

increased parasympathetic tone

Increased ANP and BNP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Up to 25% of patients undergoing surgery in the beach chair position under general or regional anesthesia can experience hemodynamically significant hypotensive bradycardic events thought to be caused by

A

ventricular underfilling and the Bezold–Jarisch reflex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Bainbridge reflex causes an

A

increase in heart rate when the right atrium or great veins are stretched by increased vascular volume.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Associated with the Bainbridge reflex are the

A

Venous baroreceptors–> are located in the right atrium and great veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

When blood pressure increases which receptors are stimulated?

A

the baroreceptors are stimulated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

When baroreceptor are stimulated, what happens to myocardial contractility, venous tone, heart rate, systemic vascular resistance (SVR), and blood pressure?

A

When stretched, the baroreceptors fire –> inhibit the *sympathetic nervous system outflow resulting in a decrease in myocardial contractility, a decrease in heart rate, a decrease in venous tone, a decrease in SVR, and a decrease in blood pressure. *Parasympathetic outflow is simultaneously increased, which also decreases heart rate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What nerves carry the afferent and efferent signals o f the Bainbridge reflex?

A

When the great veins and right atrium are STRETCHED BY INCREASED vascular volume, stretch receptors send AFFERENT signals to the medulla VIA the VAGUS nerve. The medulla then transmits EFFERENT signals via the sympathetic nerves to increase heart rate (by as much as 75%) and myocardial contractility.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What does the Bainbridge reflex help prevent?

A

prevent damming up of blood in veins, the atria, and the pulmonary circulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

The Bainbridge reflex, in which stimulation of

A

right atrial stretch receptors leads to vagal afferent stimulation of the medulla and subsequent inhibition of parasympathetic activity (increasing the heart rate, or, in the case of decrease atrial pressure, lowering heart rate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What three maneuvers can trigger the

oculocardiac reflex?

A

1) traction on the extraocular mus-
cles, especially the medial rectus
(2) ocular manipulation
(3) manual pressure on the globe of the eye.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What nerves carry the afferent and effer- ent action potentials in the oculocardiac reflex arc?

A

The trigeminal nerve (cranial nerve V) carries afferent (sensory) action potentials and the vagus nerve (cranial nerve X) carries efferent (motor) action potentials. This is the five (V) and dime (X) or nickel (V) and dime (X) reflex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What reflex best explains bradycardia during spinal anesthesia?

A

The Bainbridge reflex relates to the characteristic but paradoxical slowing of the heart rate seen with spinal anesthesia..

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

The usual mechanism given for bradycardia with spinal anesthesia is

A

blockade of the sympathetic efferents from Tl-T4 (cardioaccelerator fibers) with subsequent unopposed parasympathetic stimulation (bradycardia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

However, bradycardia during spinal anesthesia is more clearly related to the development of arterial hypotension than to the height of the block. The primary deficiency in the development of spinal hypotension is a

A

Decrease in venous return.

The reduced venous pressure is sensed by low pressure venous baroreceptors, resulting in a reflex bradycardia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

A decrease in cardiac filling pressures may also stimulate vagally mediated bradycardia via the.

A

Bezold– Jarisch reflex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

A decrease in cardiac filling pressure may stimulate what?

A

A decrease in cardiac filling pressures may also stimulate vagally mediated bradycardia via the Bezold– Jarisch reflex (SLOWS THE HR SO THAT HEART CAN FILL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

An INCREASE in cardiac filling pressure

A

increase HR to get rid of extra fluid
BAINBRIDGE
RA & great veins → Bainbridge reflex, stretch of Right Atrium
Increases HR with inspiration via vagus nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Hering-Breuer reflex:

A

Vagus nerve, prevents over-stretching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

The primary components of this DESCENDING pain inhibition system, but certainly not all-inclusive, is the “triad” of the

A
  • Periaqueductal gray (PAG)
  • Rostral ventral medulla (RVM)
  • Dorsolateral pontine tegmentum (DLPT).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

One of the principal goals during early management of the hemorrhaging trauma victim is to avoid the development of the so-called vicious cycle or lethal triad, consisting of –>

A

Hypothermia
Acidosis
Dilutional coagulopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Signs of cyanide toxicity include the triad of

A

Elevated mixed venous O2 (SVO2)
Increasing requirements for SNP (tachyphylaxis)
metabolic acidosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Preeclampsia is diagnosed by the triad of

A

HEP

hypertension, edema, and proteinuria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Occurs in 15-30% of patients and can be treated by volume, atropine, and ephedrine. what reflex?

A

Bezold -Jarish REFLEX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Treatment for Bainbridge reflex

A

None (per APEX)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

How do you treat Symptoms of Bezold Jarish refelx

A 
Restore preload (IVF, raise legs above heads, EPI)
Increase HR, atropine, ephedrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Full heart –> Increase HR

A

BainBridge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Empty heart –> Decrease HR

A

Bezold-jarisch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Autotransfusion during childbirth is an example of what reflex

A

Bainbridge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Sensors of Bezold Jarisch located in

A

RV
Mechanoreceptors (VR)
Chemoreceptors (Ischemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

1st -3rd treatment step of oculocardiac receptor

A

Surgeon removes stimulus
100 oxygen , proper ventilation, deepen anesthetic
Anticholinergics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Inhalation on intrathoracic pressure/ venous return / HR

A

Decrease intrathoracic pressure
Increase venous return
Increase heart rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Exhalation on intrathoracic presssure/venous return/ HR

A

Increase intrathoracic pressure
decrease venous return
decrease heart rate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

In a patient with a history of a spinal cord lesion higher than T7, ___________ and ________is concerning for autonomic hyperreflexia.

A

marked hypertension and bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

AUTONOMIC DYSREFLEXIA explain

A

Normally, descending inhibitory impulses travel down the spinal cord to block reflex arcs to cutaneous, visceral, or proprioceptive stimuli. This arc is disrupted in spinal cord injury and can lead to autonomic instability, most notably severe hypertension followed by a sustained vagal response including bradycardia, vasodilation, and cutaneous flushing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

AUTONOMIC DYSREFLEXIA Treatment

A

Treatment is supportive, including stopping the inciting stimulus (ask surgeons to pause) and lowering the blood pressure to normal levels via vasodilators and assuring adequate levels of anesthesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Proposed mechanism of bradycardia when doing ISB block?

A

Bezold-Jarisch reflex.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is the most common cause of AKI ?

A

Prolonged renal hypoperfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is the leading cause of transfusion-related fatalities and the most common cause of major morbidity and death after transfusion?

A

TRALI (transfusion-related acute lung injury)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

The most common cause of cholestasis is

A

Obstruction of the biliary tract outside of the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Most common cause of Peptic Ulcer disease is

A

Ingestion of NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Major and most common cause of pancreatic insufficiency

A

Chronic pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Most common cause of Methemoglobin in clinical practice is

A

Medications ( Benzocaine and procaine LAs; dapsone ABT; Nitroglycerin and nitric oxide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Most common cause of drug hypersensitivity reactions during anesthesia

A

Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Still the most common cause of adult valvular disease

A

RHD (rheumatic heart disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Most common cause of Hypercalcemia and 2nd most common cause

A

Primary hyperparathyroidism

Malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

FDA has identified the most common cause of Transfusion related deaths as

A

TRALI followed by hemolytic transfusion reactions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is the most common cause of Central Retinal Artery OcclusioN (CRAO)?

A

Head positioning that result in external pressure on the eye.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is the most common cause of Post operative vision loss associated with prone spine surgery in adult patients?

A

ISCHEMIC OPTIC NEUROPATHY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Most common cause of UNANTICIPATED difficulty with the airway>

A

Lingual tonsil hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Most common cause of acute pericarditis is

A

Viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Chronic constrictive pericarditis CURRENTLY (not in the past)

A

Idiopathic, post cardiac surgery, neoplasia, uremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What is the most common cause of Aortic stenosis

A

CONGENITAL DEFECT resulting in a BICUSPID AORTIC VALVE and as a SEQUELAE of Rheumatic valvular heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Most common dysrhythmias associated with MVP

A

PVCs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Most common cause of sudden death in pediatric young adult populations>

A

Hypertrophic Cardiomyopathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the most common cause of peripheral vascular occlusive disease?

A

Atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is the most common cause of aneurysmal vascular occlusive disease?

A

Atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Most common causes of COPD

A

Chronic Bronchitis

EMPHYSEMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Most common cause of Pulmonary edema due to upper airway obstruction?

A

Laryngospasm after extubation OR GA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What is the most common cause of POSTOP. respiratory dysfunction after or under General anesthesia?

A

Atelectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

In nonsurgical setting, most common cause of death with chronic renal failure is

A

Ischemic heart disease.

104
Q

What is the most common cause of death associated with Acromegaly?

A

Cardiac and respiratory complications

105
Q

The most common cause of Cushing syndrome today is the

A

Administration of glucocorticoids

106
Q

Outside of Glucorticoids, the most common cause of Cushing syndrome is

A

Cushing’s disease.

107
Q

Primary Adrenocortical insufficiency aka

A

Addison’s disease

108
Q

What is the most common cause of acute Stent thrombosis?

A

Premature discontinuation of dual anti platelet therapy.

109
Q

AKI is the most common after 5 days of burn injury and the most common cause is

A

Sepsis.

110
Q

The most common cause of Thyrotoxicosis

A

Hyperthyroidism

111
Q

The most common cause of HYPERTHYROIDISM

A

Grave’s disease (Multinodular diffuse goiter)

112
Q

The most common cause of postoperative mortality after bariatric surgery is

A

Thromboembolism

113
Q

The most common signs and symptoms of a leak and %

A

Tacychardia 72%
Fever 63%
Abdominal pain 54%

114
Q

The most common causes of Anesthesia related maternal mortality in obstetrics include

A

High cephalic spread of neuraxial block.

115
Q

The most common cause of arrest in non cardiac procedures is

A

Hyperkalemia

116
Q

The most common cause of AIRWAY obstruction in the immediate postoperative phase is the

A

loss of pharyngal muscle tone in a sedated/obtunded patient.

117
Q

The most common causes of hypoxemia in the PACU include (6)

A 
Atelectasis (can lead to increase in R-to-L shunt)
Pulmonary edema
Pulmonary embolism
Aspiration
Bronchospasm
Hypoventilation
118
Q

The most common causes of delayed awakening

A

Prolonged action of anesthetic drugs

119
Q

Common causes of delayed awakening other than anesthetic drugs.

A

Metabolic causes

Neurologic injury.

120
Q

Most common causes of pediatric anesthesia adverse events for both therapeutic or diagnostic procedures TOP 3 only

A

Drugs errors
Nitrous oxide in combination with other sedative
Inability to rescue the patient from an adverse anesthetic event.

121
Q

Most common cause of Postoperative arterial hypoxemia

A

Atelectasis.

122
Q

The most common cause of significant anesthetic related morbidity and mortality in Laboring women is

A

Unrecognized intrathecal injection of local anesthetics.

123
Q

The most common cause of upper GI obstruction in the newborn?

A

Pyloric Stenosis.

124
Q

Most common cause of death or CNS injury during MAC cases

A

Excessive sedation leading to respiratory compromise

125
Q

Most common cause of hyperphosphatemia is

A

Renal failure.

126
Q

The most common causes fo the anaphylaxis, IgE mediated events

A

NMBAs (58%), latex, ABT

127
Q

The leading injuries in anesthesia-related malpractice claims

A

Death
Nerve damage,
Permanent brain damage
Airway injury

128
Q

Most common cause of serious bronchiolitis and lower respiratory tract disease in infants and young children>

A

Human RSV

129
Q

Most common cause of ARDS

A

SEPSIS

130
Q

Most common cause of acute increase in dead space in the acute setting?

A

Decreased CO

131
Q

Most common cause of Intraoperative death?

A

Uncontrollable bleeding (80%) f/b brain herniation and air embolism.

132
Q

Most common cause of early trauma mortality

A

CNS injury and hemorrhage.

133
Q

The most common causes of acute transplanted lung failure

A

Acute graft rejection

134
Q

Most common cause of 30-day mortality following liver transplantation ?

A

Cardiovascular disease.

135
Q

The most common cause of AKI

A

Acute Tubular necrosis (ATN)

136
Q

Most common cause of metabolic alkalosis is

A

GI loss due to vomiting or NG suctioning.

137
Q

The most common causes of stridor in infants

A

Laryngomalacia

138
Q

Most common cause of elevated liver enzyme in adults

A

Nonalcoholic fatty liver disease (NAFLD)

139
Q

Most common cause of acute liver disease

A

Drug toxicity AND Infection

140
Q

What is the hallmark of MI and ventricular aneurysm?

A

Dyskinesia (paradoxical movement)

141
Q

What is the hallmark of Asthma? (clinically)

A

Inflammation of the airways

142
Q

In acute parenchymal injury offers the most rapid and reliable hallmark of liver dysfunction ?

A

Prothrombin time

143
Q

Hallmark signs of upper airway obstruction in the unanesthesized patient include

A

Hoarse or muffled voice
Difficult swallowing secretions
stridor and dyspnea.

144
Q

Hallmark of OSA is

A

habitual snoring

Fragmented sleep –> Day time somnolence

145
Q

Hallmark of COPD (symptoms)

A

Chronic productive cough

progressive exercise limitation

146
Q

Hallmark of COPD (signs)

A

Reduction of FEV1

147
Q

What is the hallmark of Asthma? (symptoms)

A

Recurrent wheezing
Dyspnea
cough

148
Q

Traditional hallmark of early pulmonary edema

A

Detection of basilar crackles on auscultation

149
Q

The hallmark sign of aspiration pneumonitis (and is frequently the first sign of aspiration) is

A

Arterial hypoxemia

150
Q

Hallmark finding of ARDS

A

NONCARDIOGENIC pulmonary edema

151
Q

Hallmark of Flail chest is

A

Paradoxical movement of the chest wall.

152
Q

Hallmark sign of tension pneumothroax

A 
Hypotension
hypoxemia
Absent breath sounds on AFFECTED SIDE
Tachycardia
Increased CVP
Increased airway pressure
153
Q

Hallmark clinical signs related to TURP (3)

A

Water intoxicatoion
fluid overload
Hyponatremia

154
Q

Clinical hallmark of Myasthenia Gravis?

A

Generalized muscle weakness that IMPROVES WITH REST

Inability to sustain or repeat muscular contractions.

155
Q

Hallmkar of DI is the

A

Excretion of abnormally large volume of dilute urine (polyuria)

156
Q

Hallmark of initial therapy for burn?

A

Fluid resuscitation

Airway management

157
Q

Minimum UO for burn patients

A

0.5 - 1 ml/kg/hr

158
Q

American Burn consensus formula for fluid resuscitation?

A

2-4 ml x kg body weight x % of TBSA burned

159
Q

Hallmark of burn shock is

A

Reduction in CO

160
Q

May develop within 5 years of post lung transplantation

A

Bronchiolitis obliterans syndrome (BOS)

161
Q

Bronchiolitis obliterans syndrome (BOS) hallmark is

A

Development of airway obstruction with a reduction of FEV1 that does not respond to bronchodilation

162
Q

Hallmark of both primary and secondary immunodeficiency

A

Increased susceptibility to infection

163
Q

Hallmark of quality anesthetic care

A

Evidence-based practice (EBP)

164
Q

During cryoablation, _____% of the CO is lost when the pulmonary artery is occluded

A

25%

165
Q

Coanda Effect explains the

A

tendency of fluid flow to follow a curved surface upon emerging from a constriction

166
Q

With the coanda effect If a constriction occurs at a bifurcation due to

A

due to increase in velocity and reduction of pressure, hence the fluid/air tends to stick to the side of the branch causing maldistribution.

167
Q

Application of Coanda Effect in anesthesia

A
  1. Mucus plug at the branching of tracheo-bronchial tree may cause maldistribution of respiratory gases.
  2. Unequal flow may result because of atherosclerotic plaques in the vascular tree
168
Q

Bernoulli’s principle describes what?

A

Described the effect of fluid flow through a tube containing a constriction

169
Q

Bernoulli’s principle states that as flow pass through a ________, the velocity of flow ________and there is a corresponding _______in pressure

A

narrowing in a tube; decreases; decrease

170
Q

Jet ventilation is based on which effect

A

Venturi effect

171
Q

2 key players in the mechanism of anesthesia

A

neurotransmitter-gated ion channels

K+ Channels

172
Q

What is the approximate blood loss per minute during the resection phase of a transurethral prostate resection?

A

2-4 mL

173
Q

The average amount of fluid absorbed during a TURP is about

A

20 mL/min of resection time.

174
Q

The most commonly used endogenous marker of renal reserve or GFR is

A

Creatinine clearance

175
Q

For trigeminal neuralgia (tic douloureux). What is the MOST appropriate first-line pharmacologic treatment?

A

Carbamazepine

176
Q

What is the most common cause of death in the period following resection of a pheochromocytoma??

A

Hypotension

177
Q

How much of the cardiac output does the kidney receive?

A

15-25%

178
Q

The liver gets its blood supply from the portal vein and the hepatic artery which together receives what % of cardiac output?

A

20-25%

179
Q

% of CO to the brain is

A

20%

180
Q

The most common cause (organism) of epiglottis infection

A

haemophilus influenza

181
Q

The 4Ds of epiglottis are

A

Drooling
Dysphonia
Dysphagia
Dyspnea

182
Q

What is the most common serious complication associated with opioid intrathecal and epidural administration?

A

Respiratory depression

183
Q

All local anesthetics cause vasodilation except for (ROLICO)

A

cocaine, lidocaine, and ropivacaine.

184
Q

LA with low potency and short duration is

A

Procaine

185
Q

Elevated carbon dioxide levels can increase the potential for toxicity for

A

all local anesthetics, including tetracaine.

186
Q

Duration of which local anesthetic is prolonged the most by the addition of the epinephrine?

A

Lidocaine

187
Q

Prevent the euphoric effect of opioids?

A

Naltrexone

188
Q

Butorphanol is different from nalbuphine in that it is a kappa receptor agonist and a weak mu receptor antagonist, but it has ______analgesic qualities, and _______sedative effects

A

greater analgesic qualities

greater sedative effects

189
Q

Opioids and the CO2 responsiveness curve

A

They shift the curve to the right, which represents a decrease in responsiveness to CO2

190
Q

What is the main determinant of the rate at which an amide local anesthetic is metabolized?

A

Hepatic clearance

191
Q

The Cockcroft and Gault equation can be used to estimate based upon__________ (select three) SAW

A

creatinine clearance

Serum Creatinine
Age
Weight (SAW)

192
Q

Creatinine Clearance formula

A

(140-age) x weight / Serum Cr x 72

193
Q

Most drug metabolism is performed by microsomal enzymes in the smooth endoplasmic reticulum of the

A

liver cells

194
Q

Most potent endogenous glucocorticoid produced by the adrenal cortex is

A

cortisol.

195
Q

Hepatic clearance is the product of the 2 things :

A

Hepatic blood flow

Hepatic extraction ratio of the drug.

196
Q

The percent of a drug that the liver can clear as it passes through it is referred to as the

A

hepatic extraction ratio

197
Q

The primary etiologic factor in the development of retinopathy of prematurity (ROP) is the

A

gestational age.

198
Q

Factors such as (3) are also associated with an increased risk of developing ROP.

A

hyperoxia, hypocarbia, and acidemia

199
Q

What layer of skin is the rate-limiting layer for the absorption of eutectic mixture of local anesthetic (EMLA) cream?

A

stratum corneum

200
Q

The only process that does not involve the cytochrome P450 pathway is

A

hydrolysis

201
Q

The most frequent cause of hospitalization in patients older than 65 is

A

heart failure.

202
Q

Glucagon increases the blood glucose concentration by

A

Stimulating glycogenolysis in the liver

203
Q

The primary inhibitory neurotransmitter in the “brain

A

GABA

204
Q

The primary inhibitory neurotransmitter in the :”spinal cord

A

Glycine

205
Q

Which anesthetic agent is most associated with a transient increase in liver enzyme levels?

A

Desflurane

206
Q

Changes in alveolar ventilation affect which agent more? a soluble agent or a non-soluble agent?

A

a soluble agent more than a poorly-soluble agent.

207
Q

Spontaneous ventilation will ______ the uptake of inhalation anesthetics by ________ alveolar ventilation.

A

decrease, decreasing

208
Q

Which volatile agent increases cerebrospinal fluid absorption?

A

Isoflurane

209
Q

Chemotherapy drugs that can produce renal and hepatic dysfunction.

A

Methotrexate

210
Q

Peripheral neuropathies are most common in patients treated with

A

Methotrexate

211
Q

Doxarubicin (Adriamycin) can result in

A

cardiomyopathy and congestive heart failure.

212
Q

Alkylating agent that can produce pulmonary toxicity and pulmonary fibrosis.

A

Cyclophosphamide is an

213
Q

Alkylating agent that can produce pulmonary toxicity and pulmonary fibrosis.

A

Cyclophosphamide

214
Q

The alveolar-arterial difference for oxygen increases from approximately ______-at age 20 and to ___mmHg at age 70

A

8 mm Hg at age 20 to approximately 20 mm Hg at age 70.

215
Q

What are the most common arterial blood gas findings in the presence of asthma?

A

Hypocarbia

Respiratory Alkalosis

216
Q

What is the most common life-threatening manifestation of ventilator-induced barotrauma?

A

Tension Pneumothorax

217
Q

3 that suggests tension pneumothorax

A

Hypotension
Worsening hypoxemia
Increased airway pressure

218
Q

The most common cause of cardigenic shock is

A

acute myocardial infarction involving 40% or more of the Left ventricular mass.

219
Q

What is the Most common etiology of hyper dynamic distributive shock ?

A

Sepsis

220
Q

Obstruction to cardiac outflow is most commonly encountered in patients with a

A

Pulmonary embolism

221
Q

What is the most common preventable cause of hospital death?

A

PE

222
Q

What is the most common in distributive shock?

A

Loss of vascular tone leading to cardiovascular collapse

223
Q

The most common cause of relative adrenal insufficiency ?

A

Septic shock

224
Q

What is an indication for steroid replacement

A

Septic shock refractory to volume resuscitation and vasopressor therapy

225
Q

What are the first line drugs to treat non-neuropathic pain in critically ill patients?

A

IV opioids

226
Q

For management of neuropathic pain what 2 medications?

A

Gabapentin

Carbamezipine

227
Q

What should be considered for postoperative analgesia in patients undoing AAA surgery or management of RIB FRACTURES?

A

Thoracic Epidural anesthesia/analgesia

228
Q

When is nonopioid analgesia indicated?

A

Should only be considered only to decrease the dose of opioids used and decrease the opioid related side effects

229
Q

What is the most common side effect of nitrate treatment

A

Headache.

230
Q

Most common side effect of Beta-blocker therapy

A

Fatigue and insomnia

231
Q

What are contraindications to beta blockers? (less obvious listed first)

A

**Sick Sinus Syndrome
**Uncontrolled CHF
Severe reactive airway disease
2nd- 3rd degree AVB
Severe Bradycardia

232
Q

What are Relative contraindications to beta blockers?

A

DM , may mask s/s of hypoglycemia

233
Q

Pt post cardiac transplantation most common of cause of early death?

A

Opportunistic infection as a result of immunosuppressive therapy

234
Q

2 factors are associated with the development of AS–>

A

First –> process of aging –> Calcification and degeneration of aortic leaflets
Second –> Bicuspid aortic valve.

235
Q

What is the most common form of valvular heart disease?

A

MVP

236
Q

What is the most common metabolic disorder seen in newborns and young infants?

A

Hypoglycemia

237
Q

Dysfunction of the serratus anterior muscle and winging of the scapula are consistent with injury to the

A

long thoracic nerve.

238
Q

What is considered the gold standard in evaluating cardiac function and volume status?

A

Esophageal doppler monitoring

239
Q

According to ASTM standards, what is the minimum FiO2 a self-inflating manual resuscitator should be able to deliver when connected to an oxygen source?

A

40%

240
Q

what 2 parts of the nephron participate in aldosterone-mediated sodium reabsorption?

A

The late, distal convoluted tubule and the cortical portion of the collecting tubule

241
Q

When the amount of sodium chloride passing by the macula densa drops (such as a drop in blood pressure), the macula densa cells produce two major effects:

A
  1. They decrease the resistance to blood flow in the afferent arterioles
  2. They stimulate the JG cells to release renin.
242
Q

What is the role of the macula dense? where does it do the job?

A

The macula densa cells sense the amount of sodium chloride in the DISTAL TUBULE (DenseD)

243
Q

Renin release results in the constriction of the _______ arterioles which helps do what? The feedback mechanism can maintain constant GFR between pressures of _____and ______

A

efferent arterioles which helps increase glomerular filtration. This feedback mechanism can maintain a relatively constant glomerular filtration rate between pressures of 50 and 180 mmHg

244
Q

Correct sequence of vessels as they enter and pass through the renal circulation?

A

Lobar artery, Interlobar artery (LI-Lobar Alobu_

Arcuate artery, interlobular artery

245
Q

What is the most serious complication associated with the withdrawal of barbiturates?

A

Grand mal seizures

246
Q

The normal response to the increased venous return in the Trendelenburg position is ______and ________-why?

A

vasodilation and a decrease in the heart rate due to baroreceptor reflex stimulation.

247
Q

Hyperthyroidism on Hemoglobin and platelet?

A

Anemia AND thrombocytopenia

248
Q

Characteristics of G-protein receptors include

A

Modulation of ligand channels
Activation of adenylyl cyclase
Act. PHOSPHOLIPASE C. (MAPI)
Inhibition of adenylyl cyclase

249
Q

The principal indication for CARDIAC TRANSPLANTATION in adults and children is

A

Dilated cardiomyopathy

250
Q

What are the two major capillary systems in the renal circulation?

A

The glomerular and peritubular capillary systems

251
Q

Depolarizing agents work at the end plate and desensitize the channel to which they bind. At what type of receptor does this occur? On what type of voltage-gated channel does this take place?

A

Nicotinic, potassium voltage-gated channel

252
Q

The most common reason for reintervention following an endovascular aneurysm repair.

A

Endoleak

253
Q

Which calcium channel blocker produces the greatest amount of coronary artery dilation?

A

Nicardipine

254
Q

The most sensitive factor of the effect of obesity on pulmonary function is the.

A

Expiratory reserve volume

255
Q

Those diuretics produce mild hyperchloremic metabolic acidosis.

A

Carbonic anhydrase (Acetazolamide)

256
Q

What are the first substances that begin to accumulate in the plasma as renal failure progresses? (select two)

A

Urea

Creatinine

257
Q

The half-life of morphine is prolonged in neonates (6 to 9 hours). The elimination half-life decreases to adult values by what age?

A

4-6 months. The clearance and elimination of morphine is age-dependent. The clearance of morphine is reduced during the neonatal period and increases with increasing age but there is significant inter-individual variability. Most studies suggest total body morphine clearance is 80% that of adult values by 6 months of age.

SEE/NCE Boards CoreConcepts (49 decks)

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