BMore Flashcards
- A patient with penicillin allergy. What do you give?
a. Clindamycin
- Wolff-Parkinson-White Syndrome question discussing re-entry.
a. Generally due to atrioventricular (AV) reentry
- Bulimia patient findings?
a. Metabolic alkalosis
Think throwing up all of the acid
- Trigeminal neuralgia patient. Which distribution is more common for trigger points?
a. CN V1 and V2
b. CN V2 and V3
b. CN V2 and V3
- What condition/disease is associated with trigeminal neuralgia in patient under 40?
a. Multiple Sclerosis [Rvw p320]
- Acetaminophen toxicity can be exacerbated by:
a. Phenytoin
- Glucose content for CSF vs serum vs nasal
a. CSF (2.5 - 4.4 mmol/L) < serum (7.8 mmol/L) < nasal in glucose content
- Diabetic ketoacidosis. What do you see in this pt?
( 11 symptoms)
b. Tachypnea – my pick
[Rvw p29] Symptoms include:
-ab pain,
-n/v,
-Kussmaul resp,
-ketone breath,
-anion gap metabolic acidosis,
-marked dehydration,
-tachycardia,
-polydpisia,
-polyuria,
-weakness,
-altered consciousness
Kussmaul resp
Kussmaul respirations are fast, deep breaths that occur in response to metabolic acidosis
- Questions on PFT. Which measurement is the same for obstructive vs restrictive lung disease?
a. Tidal volume (TV)
- Know about FRC, FEV1 and how to tell whether they have restrictive or obstructive disease
a. FEV1 is the volume of air expired in 1 second after maximum inspiration.
FVC is the forced vital capacity and is the maximum volume of air forcibly expired after maximum inspiration.
The FEV1:FVC ratio is <80% in obstructive lung disorders (asthma, COPD, etc.). In restrictive disorders (pulmonary fibrosis, sarcoid, etc), the ratio will be normal or >1 since the FVC will be markedly decreased while the FEV1 should be normal. If the ratio is <1, and FEV1 is also decreased, then a mixed disorder is present. In obstructive disease, there is increased FRC and TV
- A patient has developed pulmonary hypertension, which is most likely cause?
a. Mitral stenosis
- A patient with known Aortic Stenosis becomes hypotensive, how do you treat?
a. Phenylephrine in small doses
- ECG leads is best for monitoring P-wave abnormalities?
a. Lead II
- What rhythm least likely to show on EKG after unstable paroxysmal supraventricular tachycardia (PSVT)?
a. Persistent PSVT
b. Sinus tachycardia
c. Ventricular tachycardia
d. Sinus bradycardia
d. Sinus bradycardia
- What is the first line drug for SVT according to ACLS protocol?
Adenosine-Confirmed
Adenosine is the first-line medical treatment for the termination of paroxysmal SVT. It is a short-acting agent that alters potassium conductance into cells and results in hyperpolarization of nodal cells
Adenosine has a role in slowing down the heart rate enough to assist in diagnosis.
- PE suspected. What’s the most accurate test to confirm?
a. D-dimer
b. CT Angiogram Chest
c. Ultrasound
b. CT Angiogram Chest-Confirmed
- Hylar lymphadenopathy
a. Sarcoidosis
- A patient in renal failure needs emergent surgery and anesthesia, what’s the most important lab value?
a. Potassium
- Cystic Fibrosis (CF) patients overtime develop - understand the disease and what are consequences long term Cystic Fibrosis patients overtime (look up what lung problems this patient will have)
a. Some other lung problems as answer choice
b. Develop pulmonary hypertension
Respiratory (7)
GI (9)
Osteoporosis (3)
b. Develop pulmonary hypertension – frequently found in CF
Respiratory: bronchiectasis, chronic lung infection, nasal polyps, hemoptysis, pneumothorax, respiratory failure, acute exacerbations
GI: nutritional deficiencies, diabetes, jaundice, fatty liver disease, cirrhosis, intestinal blockage, intussusception, distal intestinal obstruction syndrome (DIOS)
Reproductive: infertility (men), reduced fertility (women)
Other: osteoporosis, electrolyte imbalances, dehydration, fear
- KNOW all different types of fentanyl and their half life, onset time, metabolism rate.
a. Fentanyl
b. Remifentanyl – this has the shortest half-life & elimination time
c. Sufentanyl
Coinciding with this trend was the introduction of fentanyl analogues with faster and faster elimination. Fentanyl (8–10 hr elimination half-life) was followed by sufentanil (6–9 hr), alfentanil (2 hr), and remifentanil 0.6 hr.
- Question about what pain med to take post-op in someone with GI issues
a. Naproxen
b. Celebrax
c. Diclofenac
d. Ibuprofen
They are all NSAIDs so they all has side effect of stomach ulcers, bleeding, holes, etc. Ibuprofen is known to have the least GI side effect amongst all the NSAIDs.
- Duration of local anesthesia is related to?
a. Degree of protein binding ability
- Onset of local anesthetic depends on
a. Dissociative constant (pKa)