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*My APEX > Boards Dump > Flashcards

Boards Dump Flashcards

1
Q

Symptom of Baroreceptor activation post carotid endarterectomy? what else can activate it?

A

bradycardia

mediastinoscopy and phenylephrine

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2
Q

Drugs to give for carcinoid syndrome?

If hypotensive?

A
  • Octreotide/Lanreotide
  • antihistamines (H1 and H2 blockers)
  • 5-HT3 antagonists
  • steroids
  • Phenylephrine or Vasopressin
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3
Q

In pregnancy in respect to coagulation? What increases and what decreases?

A

Increases:

  • Clotting factors (1,7-10,12)
  • Fibrinolytic system

Decreases:

  • Protein C & S
  • Antifibinolytic system (XI and XIII)
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4
Q

What controls Renal vascular resistance to Glomerulus?

A

Afferent arteriole (this is controlled by the myogenic mechanism)

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5
Q

Osmolarity of TURP syndrome? S/S?

A

Hypo-osmolar

Triple H-BANS

  • HTN (fluid overload)
  • Hyponatremia
  • hemolysis
  • Bradycardia
  • AMS
  • N/V
  • Seizures
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6
Q

What is mixed with cell saver?

A

heparin

Citrate

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7
Q

What is blocked in retrobulbar block?

A
  • CN II
  • CN III
  • CN VI ?
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8
Q

Landmarks for TAP block

A
  • External Oblique
  • Latissimus Dorsi
  • Illiac Crest
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9
Q

Valve off hanger yoke?

A

Check valve

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10
Q

Neonatal abstinence syndrome

A
  • Defined as post-birth drug withdrawal from maternal exposure during utero
  • Can only be prevented if mom stops using before or directly when finds out pregnant
  • symptoms as soon as 24-48h after birth or as late as 5-10 days after birth
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11
Q

qTC at risk for arrhythmias?

A

>500

“Prolonged” per Apex:

Men > 0.45

Women > 0.47

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12
Q

Decreases cardiac contractility:

A
  • ischemia
  • hypoxia
  • acidosis
  • hypercapnia (hypercarbia)
  • hyperkalemia
  • hypocalcemia
  • volatile anesthetics
  • propofol
  • B.blockers
  • CCB
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13
Q

Hypokalemia:

Presentation?

EKG?

A

Presentation

  • muscle cramps
  • weakness
  • paralysis
  • worsens dig toxicity

EKG

  • Long PR, QT
  • Flat T wave
  • U wave present
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14
Q

Hyperkalemia:

Presentation?

EKG?

A

Presentation

  • Cardiac rhythm disturbances
  • decrease contractility

EKG

  • 5.5-6.5: peaked T waves
  • 6.5-7.5 P flat and prolonged PR
  • 7-8: Wide QRS (antidromic)
  • >8.5: sine wave, VF
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15
Q

EKG findings for hypo and hypercalcemia

A

Hypo - long QT

Hyper - Short QT

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16
Q

Hypercalcemia

A

H-NAPS

  • HTN
  • Nausea
  • abd pain
  • psychosis
  • Seizures
17
Q

Hypocalcemia

A

​LPM-CT

  • Laryngospasm
  • parasthesias and tetany (nerve irritability)
  • muscle cramps
  • Chvosteks
  • Troussseaus
18
Q

MH Labs:

A
  • Mixed metabolic and respiratory acidosis (mostly respiratory acidosis)
  • Hyperkalemia
  • Elevated CK (creatinine Kinase)
  • Myoglobinuria
  • DIC (late) (increased PT, PTT, Ddimer - decreased: Fibrinogen, platelets)
19
Q

1: 200,000 Epi per mL
1: 100,000 ?

A

5 mcg per ml (0.005mg)

10 mcg/ml (0.010mg)

20
Q

What nerves blocked by popliteal block?

A
  • Peroneal
  • Tibial
21
Q

Wiggers diagram:

  • Note Valve opening and closures
  • Note location of PR, QRS, QT
A
22
Q

what tests to be done if pt taking statin?

Lasix?

if over 50?

A

LFTs

Electrolytes

EKG

23
Q

NDNMB vs Succ on receptors and fade:

A

NDNMB

  • Antagonize presynaptic Nn receptor - this produces fade

Succ

  • Agonizes presynaptic Nn receptor
24
Q

NMB recover criteria, list 50% criteria? 60%?

A
25
Q

Which vessel is at risk of occlusion during mediastinoscopy (both names)?

A
  • Innominate artery
  • brachiocephalic
26
Q

Most common side effects of mediastinoscopy

A

1 hemmorhage

Others:

  • innominate artery compression
  • RLN (left side) injury
  • Phrenic nerve injury
  • Chylothorax
  • VAE
27
Q

Equipment placement for Mediastinoscopy

A

Right upper:

  • A-line
  • Pulse ox

Left Upper:

  • NIBP
28
Q

Blood returned from RV by?

LV by?

A

RV: Anterior cardiac veins

LV: Coronary sinus

29
Q

Preload Increased by?

A

Increased:

  • CVP
  • atrial contractility
  • afterload

Decreased:

  • HR
30
Q

Preload decreased by?

A
  • Increased HR
  • Decreased CVP, Afterload
  • A fib
  • Mitral or tricuspid stenosis
  • Diastolic heart failure
31
Q

What fluids have anticoagulant properties?

A

Dextran > Hetastarch > Hextend

(also pentastarch)

32
Q

Class III mallampati can still see?

A

Soft Palate, Hard Palate, and Base of uvula

33
Q

mask ventilation in addition to BONES?

A
  • stiff lungs
  • mallampati III/IV
  • sleep apnea
34
Q

Obesity lung volumes, what drops, what stays same, increases?

A

decreased:

  • ERV
  • FRC
  • VC
  • TLC

Same:

  • RV

Increases:

  • CC
35
Q

Elderly lung volumes - drops, same, increases?

A

Decreases:

  • ERV
  • VC
  • IRV

Same:

  • TLC

Increases: (Remember increased FRC)

  • FRC
  • RV
  • CC
36
Q

Pregnancy lung volumes - drops, same, increases?

A

Decreases:

  • RV
  • ERV
  • FRC
  • TLC (5%)

Same: (Remember VC)

  • VC
  • CC

Increases:

  • IRV
37
Q

Inceases PVR (what decreases?)

A

HE-SLAPP-VH

HE SLAPP Very Hard

  • Hypoxia
  • Elevated airway pressures
  • Surgical stress (deep anesthesia)
  • Low Fio2
  • Acidosis
  • PEEP
  • Polycythemia (anemia)
  • Vasoconstrictors
  • Hypercarbia

Decreased PVR is opposite - in parenthases if not obvious

38
Q

Name and uses:

A

*My APEX (10 decks)

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