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Basic > basic 2 > Flashcards

basic 2 Flashcards

1
Q

when calculating minute ventilation in vent that has non compensating pnuematic bellows what do u have to take into consideration

A

add the FGF so its TV x RR + FGR

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2
Q

name 3 conditions associated with atlantoaxial instaiblity

A
  1. dwarfs
  2. rhematiod arthritis
  3. downs syndrome
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3
Q

what immunosuppresent can prolong Neuromuscular blocking agents

A

cyclosporin

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4
Q

mechanism of IV regional anesthesia

A

local anesthetic block of nerve endings via vascular beds

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5
Q

most common blood product that will lead to tranfusion assocaited sepsis

A

platelets bc stored at room temp

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6
Q

what opioid needs to be metabolized to have any effect

A

codeine to morphine via CYP2D6

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7
Q

spinal cord inhibiton is mediated by what transmitters/moleculres

A

opioids
GABA
glycine

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8
Q

list volatiles from most to least soluble

A

halothane > iso > sevo> N > des

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9
Q

nalbuphine MOA

A

mu antagonist
kappa agonist

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10
Q

haldane effect

A

hgb binding to O2 decreases hgb affinity for CO2

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11
Q

why are desflurane vapors heating

A

to prevent drastic changes in vapor pressure, since it vaoprizes at room temp

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12
Q

how is the binding ratio anti Xa: IIa ratio different betwen heparin and low molecular weight heparin

A

LMWH has smaller fragments and doesnt inhbiti thrombin IIa, as much as standard heparin so the anti Xa:IIa ratio is increased in LMWH

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13
Q

parameters in which PPV is most accurately predicted

A

-no peep
- tidal voluems > than 7-8cc/kg
-norma sinus rhythm
-positive pressure ventilation

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14
Q

why is edrophonium paired w atropine for reversal

A

bc similar onset and duration of action

think if u wanna reverse ur mistakes get AT (atropine) your PHONE (edrophonium)

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15
Q

mechanism of phenytoin

A

blockade of voltage gated sodium channels
whihv id why it can be anti epilectic and anti arythemic

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16
Q

when is pulmonary vasculate resistance the lowest

A

at FRC

volume less than FRC has decreased vessel radius, and kinked vessels
volume greater than FRC expands the alveoli and compresses the vessels

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17
Q

why is hypothermia in neonates lethal

A

hypothermia leads to nonshivering thermogenesis aka brown fat metabolism in neonates, this causes metabolic acidosis which is deleterious for neonates

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18
Q

whats the greatest risk factor for bradycardia when using succ

A

repeat doses of succ wtihin 5 minutes of each other can restumulate muscarinic receptor in cardiac

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19
Q

which opioid does not cause biliary spasm

A

butorphanol which is a synthetic my agonist-antagoinst and partial kappa agonsit

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20
Q

pathologies in what part of the heart may result in large R waves in v1 on EKG

A

right heart/artia/ ventricle strain etc. muscular dystrophy

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21
Q

name what artieries the anterior cardiac vein, middle cardiac vein and great cardiac vein are associated with

A

great –> left anterior descending
middle –> PDA(think ur in the middle of everyone when doing PDA)
anterior–> RCA think the ANTERIOR car is a RACE car (RCA)

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22
Q

what is poiselles law for flow

A

change in pressre *^4 * constant / length * viscosity * 8)

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23
Q

what happens to HR with 1.0 MAC of iso

A

HR icreases like ~15 BMP

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24
Q

symptoms of propopfol infusion syndrom

A

lactic acidosis
pancreatitis
high triglycerides
high K
renal failure/rhabo
cardiac failure
hepatomegaly

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25
Q

what determines the function of nitric oxide

A

the location that its produced

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26
Q

what paralytic has the least increase in dose for burn patients

A

mivacurium bc esterase metabolism

atrcurium is only partially metabolized by esterases

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27
Q

what number do u multiple by to convert to dynes

A

multiply by 80

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28
Q

transfusion realted immunomodulation causes benefit in what scenario (TRIM) R for renal survival

A

renal allograft survival rate

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29
Q

recovery of muscles after paralytics from first to last

A

diaphargm
laryngeal msucles
corrugator supercili
abdominal msucles
obicularies occuli
glenohyoid
adductor policus

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30
Q

odds ratio

A

AD/BC

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31
Q

how does liver disease affect nicardipine

A

liver onsuffiiency prolongs halflife of nicardiipine since its metabolized by ;iver and exccreted through GI

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32
Q

what clotting factors are decreased in prenancy

A

factors 11 and 13

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33
Q

what is the shape of a bobbin rotameter

A

wider at the top than the bottom so as flow increases cross secitonal area increases

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34
Q

what physiologic changes happen w bicarb

A

increased preload bc increased intravascular volume
decreased LV contractility
increased hgb afinity for O2 (left shift)
increased LA produciton
intracranial hemorrhage

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35
Q

what part of the leg is least likely to get parasthesias in lithotomy position

A

posterior thigh (think its hiding behind)

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36
Q

when used alone whats the most effective lead for detecting myocardial ischemia

A

v5

think 5 fingers on one hand ~~ 5 is an essential number and all u need ~~

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37
Q

how is anaphylaxsis vs anaphyloid reaction different

A

they are clinically the same
anyphylaxsis invles igE whereas anaphyloid is not igE but still has histamine release

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38
Q

the most effieicny mapleson circuits for spont and controlled ventilation

A

spont vent: all Dogs Can Bite

cntrolled vent: Dead Bodies Cant Argue

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39
Q

what are the least stable facotrs in fpp

A

factor 5 and 8

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40
Q

what gases have highest risk fo floride nephrotoxicity

A

sevo and enflursnce

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41
Q

what corresponds to closing of the mitral valve on ekg

A

the R wzve

42
Q

what does the R wave on EKG correspond to

A

mitral valve closing

remember electricity is temporally a little ahead than the pressure in cardiac cycle

43
Q

what is the mechanism of nitroprusside toxicity

A

cyandide ions binding to cytochome c oxidase
cyanomethemglobinemia
thiocynate production which causes the CNS side effects

44
Q

how does glyco affect LES tone

A

causes decreased LES tone think its anti parasympathetic so anti digestion and lower tone may keep food from moving forward

45
Q

how does end state liver disease affect metabolism of vec

A

vec is metabolized by the liver so clearance will be decreased

46
Q

how does hypervolemia affect drug doses like for roc (cirrohsis etc).

A

increase volume of distribution so increase dose of roc required at induction

47
Q

what LA has the lowest cardiac to cns dose toxicity

A

bupi

48
Q

does IO or central access have faster insertion time/technically easier

A

IO is easier and quicker to place

49
Q

what eye drug can cause convulsions if systemic absorption

A

cyclopentolate

50
Q

what electrolyte abnormality potentiates the affects of digoxin toxicity

A

hypokalemia
eat bananas to avoid digoxin toxicity

51
Q

why is nitrous oxide d/c’d when theres concern for co2 embolus

A

because u want to turn to 100% oxygen, turning of N20 itself doesnt help

52
Q

do u get more allergic rxn from esteres or amides

A

usually from esters because they have PABA derivatives

think easter Eggs are ALLERGic

methyparaben is a perservative in esters and amides

53
Q

if u ahve a ppower outage on ur machine what will not work

A

monitoring requires eletricity,

capanography wont work

54
Q

what qualifies a patient to be at high risk of adrenal insufficiency

A

I they are getting 20mg or more of prednisone daily for 3 weeks

55
Q

what has a stronger affect on BP venous or arterial dilation

A

venous dilation because majority of blood is in the veins

56
Q

what is bayes theorem used for

A

to help develop preop testing alogirthms based on conditional probability

57
Q

how is cerebral autoregulation affected by barbituates

A

unaffaceted

uncoupling of cerebral autoregulation happens with mac > 1

58
Q

first sign of CNS toxicity w local adminsitration

A

numbness around the lips

59
Q

how does chronic opioid use affect cortisol

A

will decrease cortisol

increase prolactin
increase testosterone and estrogen

60
Q

what will contribute the most to CO production in co2 absorbent

A

presence of strong bases
barium/sodium/potassium hydroxide

61
Q

what does adding bicarb to LA do

A

increases speed of onset because increases the unionized form

this can cause percipitant to form in certain LAs

62
Q

how does PA-Pv gradient affect Fa/Fi rate of rise

A

higher gradient will slow down the rate of rise

63
Q

how does ACEI affect bradykinin

A

increases bradykinin which increases AA metabolites increasing vasodilation and kidney natruesis affects

64
Q

what is the dose amount of roc to give a patient to prevent fasciculations before succ

A

10% of ED95

which for paralytics dose that will cause 95% of twitched suppression

65
Q

what is the afferent of the carotid body and what can inhibit it

A

glossopharyngeal nerve (hering nerve)

impaired y opiods, benzos, volatile anesthetics, b/l carotid surgery

66
Q

why are peds more likely to have bradycardia on intubvation and DL

A

because peds have a over prominence of paraysympathetic NS

67
Q

to pass through BBB molecules need to be 3 things

A

small < 500 daltons
unionized
liphophilic

68
Q

only thing that causes decreased 2,3 BPG

A

stored RBCs

69
Q

how should u adjust the dose if epi for LAST

A

decreased epi dose less than 1mcg/kg of epi

70
Q

what who benzos undergo phase 2 glucuronidation without phase 1 metabolism

A

lorazepam
oxazepam

the LOR AX loves SUGAR

71
Q

if someone w hemophilia a has antibiodies how do u treat

A

factor VII or factor II

intiail step is demopressin and cryo for minor bleeding bc this has fibrinogen and factor 8

72
Q

how do CCB affect paralytics

A

mild augmentation of both depolarizing and non depolarizing

think it keeps the ca in the muscles so none of it can be used for contraction

73
Q

how does hypoalbumin affect opioid and benzo dose

A

decrease benzo dose bc u have hella free benzo

increase opioid dose bc the hella free opoids will lead to tolerance development faster.

74
Q

what is the function of renin

A

turn angiotensinigen to angiotensin 1

75
Q

what are the indications for ffp transfusion

A
  1. warfarin reversal
  2. TTP
  3. heparin resistance bc no anti thrombin 3
  4. correct of certain coagulation deficiencies
76
Q

why does morphine help w tet spells

A

decreases HR, anixety, RR but mostly decreases pullmonary vascular resistance

77
Q

is stage 2 seen with inhalational induction

A

no

78
Q

what happens if u use succ to reinduce a patient after reversing w neostigmine

A

prolonged succ during

79
Q

what phase of diastole contributes the most blood

A

early RAPID filling ~~ flowing in like the rapids

80
Q

how does going from upright to supine affect FRC and CC

A

FRC is decreased (think heart is compressing lungs )

closing capacity is unchanged

81
Q

whats the most reliable sign for uterine rupture

A

non reassuring fetal heart tones

82
Q

how long does it take for fent patch to onset and how long till peak affect

A

6-8 hours for onset
30 hours for peak affect

83
Q

when cross typing blood what blood types do u mix w

A

anti A and anti B and anti d (rh) u dont test with anti O antibodies

84
Q

what does vasopressin do to platlets

A

mild decrease
increases aggregation

85
Q

standard error equation

A

SD/ sqare root of N

86
Q

what pressor can u not give IM

A

norepi

think no no for norepi shot

87
Q

how many mg of fibinrogen are in 1 unit of cry

A

200 mg

think 2 eyes and they are 2 circles

88
Q

how is respiration affected w benzos

A

decreased tidal volume

think opooids affect RR more and benzos affect Tv more

89
Q

sites for IO access

A

sternum
proximal humerus
proximal tibia
distal tibia

90
Q

fasted onset opioid and why

A

alfentanil think A if first because its fast
its fast bc it has low pka

91
Q

why does chlorprocaine have rapid onset of action

A

concentration

think c and c

92
Q

what herbal meds are associated w increased bleeding

A

garlic
ginger
ginklo
vitamin E

93
Q

nesiritide mechanism

A

recombinant form of BNP

94
Q

when is p50 of oxygen highest and lowest

A

its highest in infants/kids till 10. year of age

lowest in new borns

95
Q

what is the adult O2 consumption
whats the equation for FRC

A

3-4 cc/kg/min

FRC is 30 cc/ kg in healkthy adult

96
Q

antiplatelet drug w longest duration of action

A

ticlopidine

97
Q

second messenger for NMDA receptor

A

intracellular calcium

98
Q

does oxymorphone work at the NMDA receptor

A

no

99
Q

what does cryo contain

A

vWF
factor VIII
factor XIII
fibrinogen
fibronectin

100
Q

urine osmolarity: plasma osmolarity ratio > 1.5 suggests what

A

prerenal injury

Basic (9 decks)

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