Asa Standards

Question 1

Standard monitors

Answer 1

Pulse ox, capnography, o2 analyzer, disconnect alarm, ecg sbp hr temp

Question 2

Lead 1/2/3

Answer 2

Lead 1 - on R + on l arms
Lead 2 - on Ra +on LL
Lead 3 - on la + on LL

Question 3

Dinamap -device for noninvasive automatic mean art press compared to art line

Answer 3

Systolic and mean usually same, diastolic is 10 mmhg higher with automated

Question 4

Map equation

Answer 4

Map = co x svr
Map = pressure dias + 1/3(p sys - p dias)

Question 5

Kroktof sounds

Answer 5

Phase 1 = systolic bp

Phase 5 = diastolic

Question 6

Ischemia with art line

Answer 6

Less then .1%

Question 7

Arterial blood flow hand

Answer 7

Majority is ulnar

Question 8

Brachial artery cannulization

Answer 8

Can injure median nerve

Question 9

Subclavian vein cannulization

Answer 9

Cannulated between middle third and latereal third clavicle
At the scalenea the subclavian vein goes anterior to ant scalene while artery goes between ant and mid
Both go over first rib
Advantages include shorter distance and more comfort and less infection

Question 10

Chylothorax

Answer 10

Most common with left subclavian

Question 11

Median nerve to brachial artery in ac

Answer 11

Median nerve is medial

Question 12

Facet joint intervention for block

Answer 12

Medial branch of posterior division of spinal nerve

Question 13

Stellate ganglion

Answer 13

Found c6/c7
Sympathetic innervation for hand neck arm head
Blocking causes unopposed parasympathetic and horners syndrome
Includes vasodilation of arm head neck, stuffiness, miosis, ptosos and anhydrosis. No sweat

Question 14

Celiac plexus

Answer 14

Located l1
Lateral to aorta near celiac artery takeoff
Mediates innervation to small intestine, ascending and transverse colon, liver kidney spleen gallbladder
Blocking it blocks visceral pain, leads to inc parasympathetic including diarrhea

Question 15

Changes in blood pressure as you move farther away from heart

Answer 15

Increase in systolic, decrease in diastolic, same map

Question 16

Change in bp every 1 cm

Answer 16

.74 mmhg

Question 17

A wave

Answer 17

after atrial contraction

Question 18

C wave

Answer 18

Represents bulging of tricuspid valve into atrium during systole (after qrs)

Question 19

X decent

Answer 19

Atrial relaxation as ventricle is contracted

Question 20

V wave

Answer 20

Filling of the atria with tricuspid closed

Question 21

Y decent

Answer 21

Tricuspid opens and blood passively flows into ventricle

Question 22

Afib on cvp

Answer 22

No a wave and increaeed c wave for increased filling pressures

Question 23

Av disassociation for cvp

Answer 23

Cannon a wave, atrial contraction against closed tricuspid valve

Question 24

Cardiac tamponade cvp

Answer 24

Elevated filling pressures with no y decent

Question 25

Normal mvO2

Answer 25

40 mmhg correspondes to 75% sat

Question 26

Pulm art cathter enters pulm artery at

Answer 26

35-45 cm

Question 27

Normal svr pulm art cathter

Answer 27

900-1500 dynes

Question 28

Normal pulm vasc resistance

Answer 28

50-150 dynes

Question 29

Normal cardiac index

Answer 29

2.2 to 4.2

Question 30

Wave lengths of pulse ox

Answer 30

660 oxygenated 940 deoxy

Question 31

Meth hgb / methelyne blue sat

Answer 31

85 for methhemoglobenemia, 65% for methelene blue

Question 32

Heat loss in first hour

Answer 32

Redistribution from core to periphery

Question 33

Best core temps

Answer 33

Typanic > bladder > axillary /skin

Question 34

Men 1

Answer 34

Pancreas pituitary parathyroid

Question 35

Primary hypothyroidism tsh t3 t4

Answer 35

Increae in tsh, low t3/t4. Primary means at the sight of organ. Secondary means the signaling from head

Question 36

Phenoxybenzamone

Answer 36

Irreversible nonselective alpha adrenergic antagonist

Question 37

Treatment of thyroid storm

Answer 37

Hydration bblocker (esp propanolol blocks conversion of t4-t3) and ptu

Question 38

Refeeding syndrome hallmark

Answer 38

Hypophosphatemia can also have hypokalemia

Question 39

Carcinoid tumor

Answer 39

Releases seretonin and kalkiormkn Causes diarrhea and fushing and palpitation Causes rhf from tricuspid and pulm vslve sclerosis

Question 40

Normal cortisol in a day

Answer 40

20-30 mg normal | 300 at times of stress

Question 41

Maximal blood loss formula

Answer 41

MBL= hgb - allowed hgb / (avg of two hgb) x ebv (Initial - final (allowed) / avg ) * ebv

Question 42

Sirs criteria

Answer 42

``` Need 2: Temp 38 Hr > 90 Rr > 20 Paco2 12k ``` Sepsis is with confirmed or suspected infxn Septic shock is hypotension

Question 43

``` Cvc normal Cvp Possitive pressure airway Pcwp Co ```

Answer 43

``` Cvp normal 2-6, decreased is hypovolemia Pa pressure 25/10 Pawp normal 8-12 reflects lvedp Ci normal 2.4-4.2 Co normal 4-8L/min ```

Question 44

Dopamine receptor

Answer 44

Alpha 1 beta 1 da1

Question 45

Definition of acute renal failure

Answer 45

Urine output

Question 46

Autonomy

Answer 46

Right of the individual to self determination

Question 47

Benificence

Answer 47

The principle of taking the action that best serves the patient

Question 48

Peak vs pleatue pressure

Answer 48

Peak large airways. Pleatu is small airways and alveoli Large increase in pip with no chance in pleatue means bronchospasm or biting of tubes

Question 49

Ards cc/ pip

Answer 49

6cc/kg | Pleatue

Question 50

Mcc lawsuit

Answer 50

Respiratory intubation amywhere

Question 51

Npo

Answer 51

Clear liquids 2 Breast milk 4 All others six