Basic Flashcards
What is the pressure of a full tank of N2O? What is the volume? When does the pressure start to fall?
Full: 745 PSI and 1650L
Pressure will fall when the liquid is used up at approx 17%
Loop diuretics:
- MOA:
- Location
- Metabolic changes
- MOA: NaK 2Cl
- Location: ascending loop of henle
- Metabolic derrangements: hypokalemic, hypochloremic metabolic alkalosis
Thiazide diuretics:
- MOA
- Location
- Metabolic changes
- MOA: NaCl transporter
- DCT
- Hypokalemic, hypochloremic metabolic alkalosis
What does calcium do when the body is either acidotic or alkalotic?
- Acidotic: If the body is acidotic, then more H ions occupy binding sites on albumin and the concentration of free ionized calcium increases
- Alkalotic: if the body is alkalotic, then less H ions occupy binding sites on the albumin and the ionized calcium is decreased d/t Ca binding albumin
At what level does the conus medullaris and the dural sac terminate? In kids?
- Adults: Conus L1, Dural Sac S1
2. Kids: Conus: L3, Dural Sac: S3
What nerve does the saphenous nerve branch from?
Femoral nerve
Describe VCV
The breaths are triggered by the RR interval. A constant flow of gas is delivered to achieve a set TV. The pressure will depend upon lung compliance
What two factors determine acoustic impedance for ultrasound?
- Density
2. Speed of sound
Where does the Artery of Adamciewicz usually supply?
T9-T12 of the ASA
Where does the Artery of Adamkiewicz usually supply?
T9-T12 of the ASA
What lead is best to look at for atrial activity?
Lead II
What is the primary determinant of myocardial oxygen supply?
Heart rate
What three classes of drugs can decrease emergence delirium caused by ketamine?
Barbiturates, Benzos, propofol
What class of antibiotics perpetuates the action of neuromuscular blockade?
Aminoglycosides
What compound is formed by the gasses and a desiccated absorbent?
CO (Desflurane makes the most)
Which renal arteriole (afferent/efferent) does Toradol effect? Lisinopril?
- PG inhibition (NSAIDs): prevents renal afferent arter vasodilation
- AceInh prevent renal efferent artery vasoconstriction
What are the effects of acute and chronic phenytoin usage on NDMB?
- Acute: potentiates the block
2. Chronic: Increased resistance to blockade and increased ED95
What effect does ventricular hypertrophy have on wall tension?
T: (P*r)/2h
P: pressure
r: radius of the ventricle
h: thickness of the ventricle
therefore, as the ventricle thickens, the tension of the wall decreases
What is the MOA of Amiodarone?
Class III Na channel blocker
What is a common side effect seen after injection of large amounts of 2-Chlorprocaine for a labor epidural?
Muscle spasms: the EDTA in the drug binds out nearby calcium. It is self limiting and there is no need for concern
How does chronic opioid use affect prolactin, FSH, LH, estrogen, testosterone, and cortisol?
Increases PRL
Decreased everything else
How are ester LA metabolized? Amides?
Ester: plasma cholinesterases
Amide: hepatic
What surgeries should you hold ASA 5-10 days prior?
- Neuro surgeries: cranes and spine
- posterior eye surgeries
- middle ear surgeries
What are the two cases of liver metabolism?
- Phase 1: oxidation-reduction
2. Phase 2: Glucuronidation
How are benzodiazepines metabolized?
Lorazepam vs. midazolam/diazepam
Liver
1. Lorazepam specifically only undergoes phase II of liver metabolism, aka glucuronidation. This means that the main metabolite is water soluble and inactive, so it is quickly cleared by the kidneys. If a patient has ESRD, this does not affect the drug
- Midazolam/diazepam both undergo Phase I of liver metabolism, aka oxidation and reduction. Both of these form ACTIVE metabolites leading to accumulation in ESRD patients and the elderly
ALL benzos can be affected by severe liver disease. They are protein bound, so in liver deficiency, they can present with increased amount of free and active drug.
What is the MOA of metoclopromide? What are
effects on gastric volume, the gastric pH, and the LES?
Dopamine antagonist
Increases LES tone, decreases gastric volume, and has NO effect on gastric pH
It has WEAK anti-emetic properties
What part of the capnogram is affected in an obstructive lung disease?
B –> C ( not C–>D)
- A–> B is the beginning of expiration and where CO2 fills the deadspace
- B –> C is the the exhalation of CO2 that should rise rapidly. In acute or chronic obstructive disease, there is a shunt, making this a slow rise in CO2
- C–>D is the expiatory plateau, this may have a sharper upstroke due to the change in B –> C but it is not the main characteristic seen with COPD
- D –> E is inspiration
