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Bootcamp > Basic > Flashcards

Basic Flashcards

1
Q

Gold standard temp measurement

A

Pulmonary artery

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2
Q

Not accurate temp reasurements

A

axillary, rectal, skin

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3
Q

why does GA cause heat loss?

A

vasodilation - redistribution from core to periphery (radiation)

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4
Q

how to measure depth of anesthesia

A

BIS/sedline

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5
Q

what to do after intubation

A

The A’s: adjust, a temp probe/air (bair hugger), antibiotics, another a line/access, acid (OG tube)

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6
Q

what positions for sniffing position?

A

cervical vertebral flexion

extension of head at atlanto-occipital joint

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7
Q

predictors of difficult laryngoscopy

A 
high mallampati
short thyromental distance
limited jaw protrusion
inter incisor distance <3 finger breaths
decreased flexion and/or extension
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8
Q

risk factors for PONV

A

female, non-smoker, history of PONV, postoperative opioids

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9
Q

zofran MOA

A

serotonin-receptor antagonist (QT prolongation)

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10
Q

dexamethasone MOA for PONV

A

glucocorticoids (increases glucose)

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11
Q

scopolamine

A

anticholinergic (sedating)

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12
Q

haloperidol

A

antipsychotic (qt prolonging)

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13
Q

ASA class 3

A

severe systemic dz with substative functional limitation, >1 moderate to severe dz

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14
Q

if recent (<3 months)

A

ASA 4

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15
Q

ASA 4

A

severe, systemic dz that is a constant threat to life

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16
Q

ASA 5

A

moribund, not expected to survive without operation

17
Q

aspiration prophylaxis

A

regional anesthesia
premeds (reglan, H2 receptor antagonist, nonparticulare antaacids)
NGT, evacuate gastric contents
RSI (cricoid, rapid induction, avoid PPV, intubate)
extubate awake

18
Q

if bag masking, what hhmg will you preferentially insufflate abdomen?

A

20

19
Q

recommended time to delay surgery after MI

A

balloon angio: 14 days
BMS: 30 days of DAPT (ASA and ADP receptor antagonist) – usually continue ASA perioperatively
DES: 180 days of DAPT
MI without intervention: 60

20
Q

preop smoking cessation

A

increase airway irritability and secretions, decreases mucociliary transport, decreases FVR and FEF 25-75%, increases CO -> oxyhemoglobin curve left ward -> decred tissue oxygen perfusion, increased cyanide -> inhibit MOM -> acidemia, nicotine promotes vasoconstriction and hampers healing and tissue perfusion

21
Q

quitting smoking 48-72hrs

A

oh shit, increase in sputum production, more reactive airway

22
Q

drug dosing in morbid obesity

A

increased CO, TBV, GFR
LBW EXCEPT NMBD (succs = TBW, NDNMW = IBW)
Propofol - induction LBW, maintenance - TBW

23
Q

hypotension after desufflation

A

increased abdomninal pressure -> blood shirts -> can drop preload (careful if preload dependent!)

24
Q

side effects of NS

A

mild hyperchloremic non-anion gap MA
causes renal VC and decreased GFR -> UOP
decrease SVR -> hypotension
swelling and redness at injection site. n/v/abd distension

25
Q

how to reverse NMB

A

T4 ->1mg/kg
T2 -> 2mg/kg
deep -> 4mg/kg

Neo:
deep -> not effective, dont do
T1->70mcg/kg (up to 5mg max)
t2-> 50mcg/kg (up to 5mg max)
T3 or more -> 30mcg/kg (up to 5mg max)
26
Q

how does twitches correspond to % receptor sites blocked

A 
4 <70
3 >70
2 > 80
1 > 90
0 95-100
27
Q

transfusion reactions

A

hemolytic: ABO incompatibility
MCC = misidentification
can occur with only 10-15ml
GA - increaed temp, tachy, hypotensive, hemoglobinuria, oozing surgery field
stop transfusion, tell blood bank; labs; foley and osmotic diuresis (mannitol)

Delayed: kell, duffy, kidd (2-12d)
malaise, jaundice, fever
Coombs test
supportive care

28
Q

non hemolytic transfusion

A

fever (WBC/plt sensitivity), urticarial rxn, anaphylactic

give steroids, epi, H1/H2 blockers), TRALI (MC with plt and FFP

29
Q

what is preload

A

ventricular wall stress at the end of diastole

30
Q

what is afterlaod

A

LV wall stress during systole

31
Q

equation of LV wall stress

A

(LV pressure x radius)/(2xLV thickness)

ventricular hypertrophy is protective mech to decrease wall stress

32
Q

ET gradient increases with

A

age, emphysema, increased alveolar dead space (low CO, hypovolemia, PE)

decreases in pregnancy and with kids

33
Q

coronary blood flow depends on

A

HR, coronary perfusion pressure

=aortic diastolic bp -lvedp / coronary vascular resistance

(resistance increased by CAD)
LVEDP increased by diastolic dysfunction, CM

LV perfused in diastole!
RV perfused throughout cardiac cycle

34
Q

average time for denitrogenation with 100% O2

A

3 min of TV ventilation

8 vital capacity breaths

35
Q

things that decrease FRC will decrease apnea time for intubation

A

ok

36
Q

how much of total cardiac output does liver get?

A

25%

37
Q

liver blood supply

A

hepatic artery and portal vein

hepatic artery - only 25% of livers blood supply, delivers 50% oxygenated blood

portal vein - 75% of blood supply
delivers 50% of oxygenated blood

38
Q

o2 saturation and pao2 relationship

A

arterial o2 content = sao2 x 1.34 x hb + 0.003 (pao2)

fall off curve after 90% SaO2

Bootcamp (4 decks)

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