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Anesthesia Interview Review > Anesthesia Interview Questions > Flashcards

Anesthesia Interview Questions Flashcards

1
Q

What is the difference between hypoxia and hypoxemia

A

Hypoxemia is the decrease in partial pressure of oxygen in the blood ⬇️PaO2 which will result in hypoxia.

Hypoxia is the reduce level of tissue oxygenation.

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2
Q

What is the normal value and how to calculate?

CO ( cardiac output)

A

HR x SV/1000

4.0 – 8.0 l/min

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3
Q

What is the normal value and how to calculate?

MAP( mean arterial pressure)

A

MAP = SBP + 2 (DBP)
3

Another way to calculate the MAP is to first calculate the pulse pressure (subtract the DBP from the SBP) and divide that by 3, then add the DBP:

MAP = 1/3 (SBP – DBP) + DBP
MAP goal>65

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4
Q

What is the normal value and how to calculate?

SVR (Systemic Vascular Resistance) to

A

80 x (MAP – RAP)/CO

    800 – 1200 dynes · sec/cm5
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5
Q

What is the normal value and how to calculate?

PVR (Pulmonary Vascular Resistance)

A

80 x (MPAP – PAWP)/CO

  < 250 dynes · sec/cm5
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6
Q

What is the normal value and how to calculate?

Cardiac Index (CI)

A

CO/BSA

    2.5 – 4.0 l/min/m2
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7
Q

What is the normal value and how to calculate?

Coronary Artery Perfusion Pressure (CPP)

A

Diastolic BP – PAWP

    60 – 80 mmHg
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8
Q

What is preload?

A

The amount of ventricular stretch at the end of diastole (LVeDP)

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9
Q

What is afterload?

A

The amount of resistance the heart most overcome to open the Arotic Valve and push blood out the LV into the systemic circulation (SVR)

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10
Q

What does contractilty mean?

A

Contractility is the strength of the heart ❤️ ❤️

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11
Q

What is the normal value and how to calculate?

SV (Stroke Volume)

A

CO/HR x 1000

   60 – 100 ml/beat
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12
Q

What makes up SV (Stroke Volume)?

A

Preload

Afterload

Contractility

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13
Q

Cranial Nerve I
👃
(OH)

A

Olfactory (smell) 👃

Sensory

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14
Q

Cranial Nerve II
👁👁
(OH)

A

Optic nerve (vision) 👁👁

Sensory

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15
Q

Cranial Nerve III
👀 👁👁 🙄
(OH)

A

Oculomotor Nerve

eye movement & raising eyelids 🥸

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16
Q

Cranial Nerve (IV)
🙄🥺
(TO)

A

Trochlear
(eye movement up 🙄⬆️ and down 🥺⬇️)

Motor

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17
Q

Cranial Nerve V
🧏🏽‍♀️🧏🏿🧏🏼‍♂️🤧😪 😋

(TOUCH)

A

Trigeminal Nerve
(sensation to face🥵🥶, mucus membrane 😪and chewing)

Both

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18
Q

Cranial Nerve VI
👀🙄
(AND)

A

Abducen Nerve
(lateral eye movement 👀👀& outward gaze🙄)

Motor

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19
Q

Cranial Nerve VII
😜😉😀 👅🥲

(FEEL)

A

Facial Nerve
(facial expressions 😜🤪😆, taste👅 , and secretion gland😭😢🥲)

Both

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20
Q

Cranial Nerve VIII
👂

(VERY)

A

Vestibulocochlear Nerve (Hearing 🦻)

Sensory

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21
Q

Cranial Nerve IX
😝🤤 👅
(GOOD)

A

Glossopharyngeal Nerve (Swallowing,Salivation and taste 👅)

Sensory

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22
Q

Cranial Nerve X
🫁
(Velvet)

A

Vagus Nerve
(Diaphragm movement🫁& parasympathetic supply to visceral organs)

Both

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23
Q

Cranial Nerve XI
🗣👥💁🏽
(such A)

A

Accessory Nerve
(speech🗣, shoulder💁🏽 and head movement 👥)

Motor

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24
Q

Cranial Nerve XII
😋👅😝😛🤑🤑👻🐍
(HEAVEN)

A

Hypoglossal Nerve (tongue movement)😋😝😛👅👻

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25
Q

What is the normal value and how to calculate

Cerebral Perfusion Pressure (CPP)

A

Pressure in cranial department

MAP-ICP=CPP
60-80mmHg
⬆️BP —>⬆️CPP (worsening brain 🧠 edema)
⬇️BP—>⬆️ICP=⬇️CPP (blood flow to brain)

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26
Q

What is the normal value and how to calculate ?

Coronary Artery Perfusion Pressure (CPP)

A

Difference between the diastolic pressure and left ventricle end diastolic pressure
DBP-LeDP-CPP
60 – 80 mmHg

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27
Q

What atmosphere pressure at sea level?

A

760mmHg

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28
Q

What is protamine sulfate made of?

A

Sperm of salmon 🍣

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29
Q

What makes up Cryo?

A

Cryo is prepared from plasma and contains:Fibrinogen, factor 8 & 12 and Von Williebrand

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30
Q

What is Desmopressin (DDaVP)?

A

Vasopressin (antidiuretic) that induce the release of factor 8 and Von Willebrand from the endothelial cells

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31
Q

What is the indication for Protamine

A

Heparin reversal

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32
Q

What will be the indication to give FFP?

A

Bleeding, vitamin K deficiency, DIC

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33
Q

What are the drugs that can be given via ETT

A

N- naloxone

A- atropine

V- vasopressin

E- epi

L- lidocaine

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34
Q

What is the proper dosing when giving medication down ET tube?

A

And the recommended dose saying 2 to 2 1/2 times the IV dose

Dilute 5 to 10 ML sterile water or normal Sailing into the ET tube followed by bag valve ventilation

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35
Q

What are the pain receptors?

A
  1. Mu
  2. Kappa
  3. Delta
  4. nociception
  5. zeta
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36
Q

What is Mu -1 receptor responsible for?

A

The mu-1 receptor is responsible for analgesia and dependence.

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37
Q

What is Mu-2 responsible for?

A

The mu-2 receptor is vital for euphoria, dependence, respiratory depression, miosis, decreased digestive tract motility/constipation

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38
Q

What is Mu-3 responsible for?

A

Mu-3 receptor causes vasodilation

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39
Q

How many Mu

A

3

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40
Q

Where is M you found?

A

Primarily in the brainstem 🧠 the medial thalamus (supra spinal)

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41
Q

Where is kappa receptors found?

A

Found primarily in the limbic, brainstem spinal cord and dienaphic area

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42
Q

What are Kappa receptor responsible for?

A

They provide analgesia, diuresis, and dysphoria.

43
Q

Where is the Delta receptor located

A

🧠 brain

44
Q

What are Delta receptor responsible for?

A

They play a role in analgesia and reduction in gastric motility.

45
Q

What is vitamin K depending clotting factors?

A

Factor 2, 7,9,10, protein C & S

46
Q

How long does vitamin K take before it’s therapeutic?

A

24hrs

47
Q

What medication would vitamin K reverse?

A

To reverse warfarin(Coumadin)

48
Q

How do you monitor heparin?

A

aPTT

49
Q

Normal aPTT?

A

Normal:30-40 sec

50
Q

What is the therapeutic level for aPTT when a person is on a heparin drip?

A

Therapeutic:15-25 sec

51
Q

What is the antidote for heparin?

A

Protamine Sulfate

52
Q

What is heparin induced thrombocytopenia (HIT)?

A

⬇️ PLT it worsen clot

53
Q

What does heparin inhibits?

A

Inhibit thrombin conversion to fibrinogen -> fibrin

54
Q

What lab value is used to measure Coumadin level?

A

PT/INR

55
Q

What is the normal PT/INR level?

A

Normal: 0.75-1.25 sec

56
Q

What is the therapeutic PT/INR level for a person who is on Coumadin?

A

Therapeutic level: 2-3 sec

57
Q

What should you not eat or drink when you are on Coumadin?

A

Green leafy vegetable.

No alcohol

58
Q

What pain receptor does morphine and fentanyl work on?

A

Mu receptor

59
Q

How much more potent fentanyl is then morphine?

A

50-100 times more

60
Q

Which pain receptor provide spinal allergies it and which provides supra spinal anesthesia?

A

Mu: supra-spinal

Kappa: spinal

Delta: spinal

61
Q

What is the reversal for narcotics? What is the proper dosage?

A

Narcan: 0.4-2mg (IV/IM/SC) repeat q 2-3min

NOT EXCEED 10mg (0.01mg/kg)

62
Q

What is the reversal drug for benzodiazepine?

A

Flumazenil: 0.2mg IV 15-30 sec

MAX DOSE 3mg/hr

63
Q

What are the different vent settings?

A

https://rebelem.com/wp-content/uploads/2018/09/Mechanical-Ventilation-Modes-1-1024x755.png

64
Q

What are the percentage of O2 on RA?

A

21%

65
Q

What is the percentage of oxygen in 1 L NC?

A

24%

66
Q

How do you calculate a percentage of oxygen at 2 L, 3 L, 4L…etc?

A

2L add 4 = 28%

3L add 4 = 32%

4L add 4 = 36%

5L add 4 = 40

6L add 4 = 44%

67
Q

What is the percentage of oxygen in a nonrebreather mask?

A

Nonrebreather mask:10-15L (60-90%)

68
Q

What percentage of oxygen is given in simple face mask?

A

6-15L (35-55%)

69
Q

What is the difference between an LMA and ETT?

A

An LMA does not manipulate the Gladys or the trachea like an ETT

70
Q

How does a pulse ox work?

A

The pulse oximeter operates on the principle of absorption of light by the solutes in a solution. The Beer-Lambert law states that the amount of light absorbed by a solute is proportional to the concentration of the solute and the distance the light is transmitted through the solution.

71
Q

What does NPH stands for in insulin?

A

NPH (neutral protamine hagedorn) insulin lowers blood glucose within 1 to 2 hours after administration and exerts a peak effect at 6 to 10 hours.

72
Q

What makes up a bag of Zosyn?

A

ZOSYN is a combination product consisting of a penicillin-class antibacterial, piperacillin, and a beta-lactamase inhibitor, tazobactam.

indicated for the treatment of patients with moderate to severe infections caused by susceptible isolates of the designated bacteria in the condition.

73
Q

What is the difference between NS and LR?

A

They are both isotonic solutions which is similar to the body osmotic pressure. They both are crystalloids. This means that they have small molecules that can easily flow through membranes, such as the cell membranes in your body’s tissues.

The differences in particles mean that LR doesn't last as long in the body as NS does. Lactated ringers contain:
Sodium chloride 
Sodium lactate 
Potassium chloride 
Calcium chloride dihydrate 
Water for injection
74
Q

What is the normal blood flow through the heart?

A

Deoxygenated blood enters the inferior or superior vena cava or coronary sinus and ➡️enters the right atrium blood ⬇️
passes through the tricuspid valve
and enters right ventricle blood moves ➡️through the pulmonic valve and enters the pulmonary arteries were blood is carried to the lungs 🫁
the lungs blow off CO2 and picks up O2 into the blood in the pulmonary capillaries from there the oxygenated blood enter the pulmonary veins from the vein blood 🩸 enter the left atrium ➡️ passes through the mitral valve to enter the left ventricle, the left ventricle contract moving blood through the aortic valve into the aorta and to the systemic arteries and system

75
Q

What does inotropic drugs do?

A

⬆️ contractility

76
Q

What are the effects of chronotropic agents?

A

⬆️ or ⬇️ heart rate and rhythm by affecting rhythm produced by SA node

77
Q

What are the two types of chronotropic?

A

Positive chronotropes ⬆️ increase heart rate. ex: Atropine, milrinone, theophylline

negative chronotropes ⬇️ decrease heart rate.
ex: digoxin, metoprolol, acetylcholine

78
Q

What effect does dromotropic agents?

A

affects the conduction speed (in fact the magnitude of delay) in the AV node, and subsequently the rate of electrical impulses in the heart.

Positive dromotropy increases conduction speed (e.g. epinephrine stimulation) ex: phenytoin

negative dromotropy decreases stimulation(e.g. vagal stimulation) ex:verapamil

79
Q

What are the receptors associated with sympathetic nervous system?

A

Alpha: smooth muscle contraction and vasoconstriction (andrenergic receptor)

Beta1: ❤️ heart. Beta 2: 🫁 lungs (adrenergic receptor)

Dopa: renal,splenic, coronary and brain
Causes vasodilation

80
Q

Dopamine effects on CO?

A

⬆️ HR

⬆️ preload

⬆️ afterload

☑️ vasopressor effects

⬆️ contractility

Beta1 receptor or alpha depends on dose

81
Q

Epi effects on CO ?

A

⬆️ HR

⬆️ preload

⬆️ afterload

☑️ vasopressor effects

⬆️ contractility

Alpha & beta receptors

82
Q

Dobutamin effects on CO ?

A

Slight ⬆️ HR

Slight vasodilator

⬆️ contractility

83
Q

Norepinephrine effects on CO ?

A

⬆️ HR

⬆️ preload

⬆️ afterload

☑️ vasopressor effects

⬆️ contractility

Alpha 1 some beta receptor

84
Q

Phenylephrine effects on CO ?

A

Slight ⬆️ HR

⬆️ preload

⬆️ afterload

☑️ vasopressor effect

⬆️ contractility

Alpha receptor only

85
Q

Vasopressin effects on CO ?

A

Slight ⬆️ HR

⬆️ preload

⬆️ afterload

☑️ vasopressor effect

86
Q

Milrinone effects on CO ?

A

Slight ⬆️ HR

Slight ⬆️ preload

Slight ⬇️ afterload

Slight vasodilator

⬆️ contractility

PDE 3 receptor (Phosphodiesterase 3)

87
Q

Nitroglycerin effects on CO?

A

⬇️ preload

⬇️ afterload

☑️ vasodilator

88
Q

Digoxin effects on CO?

A

⬇️ HR

⬆️ contractility

89
Q

Nipride effects on CO?

A

⬇️ preload

⬇️ afterload

☑️ vasodilator

90
Q

Calcium chloride effects on CO?

A

⬆️ contractility

91
Q

Amiodarone effects on CO?

A

⬇️HR

92
Q

Beta Blocker effects on CO!

A

⬇️ HR

⬇️ then ⬆️ preload

⬇️ afterload

☑️ vasodilator

⬇️ contractility

93
Q

Ace Inhibitors effects on CO?

A

⬇️ preload

⬇️ afterload

☑️ vasodilator

94
Q

Nicardipine effects on CO?

A

⬇️ then ⬆️ preload

⬇️ afterload

☑️ vasodilator

⬇️ contractility

95
Q

Dopamine concentration and dosage?

A

Concentration: 4mg/250

Dosage: 2-20mcq/mcq/min

96
Q

Epi for concentration and dosage?

A

Concentration: 2mg/250

Dosage: 0.05mcq-5mcq
1-10mcq

97
Q

Dobutamin concentration and dosage?

A

Concentration : 500mg/250ml

Dosage: 2.5 mcq-20mcq/kg/min

98
Q

Norepinephrine concentration and dosage?

A

Concentration: 4mg/250

Dosage: 0.5-30mg/min
0.01mcq-3mcq/kg/min

99
Q

Phenylephrine concentration and dosage?

A

Concentration: 40mg/250

Dosage: 50-200mcq/min

100
Q

Vasopressin concentration and dosage?

A

Concentration: 20units/100

Dosage: 0.02-0.04u/min

101
Q

Nitroglycerin concentration and dosage?

A

Concentration: 50mg/250

Dosage: 5mcq-20mcq

102
Q

Amiodarone concentration and dosage?

A

Concentration:150mg/100 over 10 mins

Infusion: 360mg/100
1mg/hr for 6hrs than ⬇️ 0.5mg /hr for 18hrs

103
Q

Digoxin dosage?

A

Dosage:0.0625mg- 0.25mg

Anesthesia Interview Review (5 decks)

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