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A. Spring Quiz/Exam Comp > Basics exam 3 > Flashcards

Basics exam 3 Flashcards

1
Q

5 general principles for improving pt outcomes and experiences (M&P chart):

A 
1. (on exam) Regional -general anesthesia technique to improve pt care
2
3.
4
5
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2
Q

Although a benzodiazepine may be given to prevent anesthesia awareness, little

A

scientific evidence exists that supports such treatment

M&P

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3
Q

Oculocardiac reflex is :

A
  • pressure on the globe

- pressure on the extraocular muscles

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4
Q

Pre-op patient is anxious. what dose of diazepam do you give?

A

2-5mg PO

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5
Q

Type 1 OR fire is located:

A

in or on the patient

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6
Q

BIS monitoring assess:

A

anesthetic depth

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7
Q

Patient can follow commands but has no memory. what kind of memory is this:

A

Implicit memory

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8
Q

Potential risk factors with various types of anesthesia from Chart in M&P.

-Regional anesthesia =

A

seizures is a risk

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9
Q

brainstem anesthesia with regional anesthesia is not associated with:

(chart in m&p)

A

seizures

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10
Q

What medication has alpha, minimal beta, and phentolamine is used for infiltration

A

Phenlephrine

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11
Q

Strabismus surgery associated with higher risks of:

A
  • MH
  • PONV
  • OCR
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12
Q

Maintenance rate for 100lb granny:

A

85ml/hr

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13
Q

LMA size for 68kg

A

size 4

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14
Q

EBV for full term infant with weight of 7.7lbs

A

85x 3.5kg = 297.5ml

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15
Q

Cut length for 4 year old =

A

16cm

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16
Q

ETT size for a 4 year old =

A

4.5, 5.0, 5.5

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17
Q

Decreasing pH means:

A
  • increased hydrogen ions

- increasing acidity

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18
Q

Patient getting a laminectomy with thoracic outlet. How do you position?

A

Prone with hands down by side

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19
Q

Laryngospasm mediated by:

A

SLN of vagus nerve

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20
Q

OCR afferent and efferent (2 questions on this):

A

a. afferent trigeminal; efferent vagal

b. afferent is to CNS; efferent is from the CNS

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21
Q

Epiglottis is most likely caused by what pathogen?

A

Haemophilus influenzae type B

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22
Q

If suspected epiglottitis, what are three things you should do:

A
  1. do NOT attempt to directly visualize the glottis
  2. have surgeon called/in to assist with intubation
  3. do not administer anesthesia until equipment and team are ready
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23
Q

O2 levels should be what percentage to avoid OR fires?

A

< 30%

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24
Q

High CO2, increased inspiratory pressure, decreased O2 may indicate:

A

ETT dislodgement

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25
Q

Concentration of O2 that can cause OR fire in less than 1 sec (cotton huck towel):

A

95%

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26
Q

A patient that would benefit from prolonged post-op monitoring (T&A??):

A

3 year old female

< 4 y/o

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27
Q

Pt is 55 yr old with CHF, insulin dependent DM, and a TIA 1 yr ago. Would this pt be appropriate for a stand alone surgical center?

A

no

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28
Q

How do propofol and remifentanil benefit hypotension intraoperatively?

**need to check wording*

A

Decrease PONV

29
Q

What device could potential increase IOP?

A

face mask

30
Q

Most common cause of post-op eye pain?

A

Corneal abrasions

31
Q

Afferent carries stimulus

A

to CNS

32
Q

Efferent carries stimulus

A

from the CNS

33
Q

OCR can be abated by:

A

parasympatholytics (atropine or glycopyrrolate)

34
Q

Normal IOP pressure is:

A

10-22mmHg

35
Q

What would improve pt satisfaction (from chart on m&p):

A

combined regional and general anesthesia

36
Q

An adult with URI is scheduled for surgery. How long would you delay the surgery?

A

6 weeks

37
Q

A child has a URI. How long would you delay surgery?

A

2 weeks

38
Q

What medication should be stopped 10 hours before surgery?

A

Lisinopril (ACE inhibitors)

39
Q

A patient with a BMI of 42 is supine for surgery. He has hypoxemia, etc. What would you expect to be a contributing factor?

A

Decreased FRC

40
Q

What is true regarding stopping metformin prior to surgery:

A
  • Its controversial

- must be d/c’d 48 hours prior to surgery

41
Q

HgbA1C — eryhrocytes have a life span of:

A

120 days

42
Q

Lidocaine 0.75% is equal to:

A

7.5mg

43
Q

What should you do in regards to an ETT fire:

A

simultaneously stop gases/o2 , remove ETT, and disconnect circuit

44
Q

Type 1 OR fires consist of (2)

A
  1. in or on the pt

2. can include drapes and surgical towels

45
Q

What is true regarding O2 rich atmospheres in the OR (2):

A
  1. decreases temperature at which the fuel will ignite

2. the fire will burn more vigorously

46
Q

Giving a benzodiazepine

A

is recommend but not clinically proven to benefit

47
Q

Ensuring the prep is dry completely before placing drapes will:

A

help to decrease risk of OR fire

48
Q

If a pt has hx of PONV, what anesthetic gas would you consider NOT using:

A

N20

49
Q

A patient with a past experience with PONV that usually requires pain meds 3-7 days post op…

You may consider:

A

triple medication therapy on

50
Q

What will sevoflurane combine with to form an exothermic reaction in the OR? (2)

A
  1. soda lime

2. baralyme

51
Q

An source of ignition is:

A

bovie

52
Q

A patient drank water. how long will you delay surgery?

A

2 hours

53
Q

Patient had a steak dinner one hour ago. How long will you keep NPO?

A

7 hours (8 hours total)

54
Q

in your induction; what medication would you avoid to prevent IOP?

A

succinylcholine

55
Q

A patient should d/c metformin 48hrs preop to decrease incidence of:

A

fatal lactic acidosis

56
Q

Two major side effects of spinal anesthesia:

A
  1. hypotension

2. parasympathetic response

57
Q

What would you give preop to decrease awareness in the OR?

A

Benzodiazepine

58
Q

Unconscious memory =

A

Implicit memory

59
Q

Conscious memory =

A

explicit memory

60
Q

What pt(type of) would you expect to have a greater likelihood of awareness during anesthesia?

A
  • emergent c-section
  • cardiac surgery

*on exam: 35 year old /emergent c-section

61
Q

Name three elements required to perform Sellick maneuver:

A
  1. 5kg
  2. or 30 newtons
  3. push esophagus posteriorly
62
Q

Nerves dealing with anterior 2/3 and posterior 1/3 tongue:

A

Lingual and glossopharyngeal (in order)

63
Q

Something about cocaine pledgets for nasal/sinus surgery?

A

Trigenminal –> opthalmic –> anterior ethmoidal

**need to fix this question?

64
Q

Disadvantage of the peribulbar technique?

A

slower onset

*than the intrabulbar block (think of it as the epidural vs spinal)

65
Q

correct spinal order via midline approach:

A

Skin, subq, supraspinous, interspinous, ligamentum flavum, dura mater, arachnoid space

66
Q

Remifentanil and Propofol combination benefit:

A

a. Remifentanil reduces middle ear blood flow, creating a dry surgical field for tympanoplasty.
b. Propofol may help reduce PONV

67
Q

Propofol may help reduce

A

PONV

68
Q

Remifentanil reduces middle ear blood flow, creating a

A

dry surgical field for tympanoplasty.

69
Q

What type of anesthesia has a decreased risk for PONV?

A

regional

A. Spring Quiz/Exam Comp (9 decks)

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