Boot Camp Week 3

Question 1

What are risk factors for an epidural abscess?

Answer 1

Diabetes
ETOH
Cancer
Immunosuppression
Active infection elsewhere
IVDU

Question 2

Describe the tonic phase of ECT

Answer 2

15 seconds of increased parasympathetic activity

Question 3

Describe the clonic phase of ECT

Answer 3

Several minutes of increased SNS activity

Question 4

What respiratory pattern is ideal for ECT?

Answer 4

Hyperventilation leads to a more prolonged/better seizure

Question 5

What are RELATIVE contraindications to ECT?

Answer 5

Pregnancy
Pacemaker
CHF
Glaucoma

Question 6

What is the MOA of intralipid?

Answer 6

creates an expanded lipid phase, which drives toxic drugs from the tissue to the plasma and therefore toward metabolism

Question 7

What are BG goals in CT surgery patients?

Answer 7

less than 180 during CPB
Less than 150 in ICU

Question 8

What is the FIRST thing you should do when a surgeon gets ready to enter the trachea?

Answer 8

Remind them to switch to scalpel instead of cautery

Question 9

What are the most sensitive leads during CARDIAC surgery?

Answer 9

Lead II
V5 (because V4 usually is moved for surgical purposes)

Question 10

What is the most serious complication of DBS placement?

Answer 10

Intracerebral hemorrhage

Question 11

What does most blood loss occur in spinal surgery?

Answer 11

During Decortication

Question 12

What should be avoided during OLV in COPD patients?

Answer 12

No PEEP! in everybody else, PEEP is helpful

Question 13

CRAO is caused by:
ION is caused by:

Answer 13

CRAO: external compression of the globe

ION: loss of watershed perfusion

Question 14

What are risk factors for ION?

Answer 14

Male Sex
obesity
Long procedure
Wilson Frame

Question 15

What are risk factors for CRAO?

Answer 15

Horseshoe headrest

Question 16

When do serum levels from tumescent lidocaine peak?

Answer 16

12-14 hours

Question 17

When is the patient with CAD at HIGHEST risk for MI?

Answer 17

It’s usually within 48 hours

Question 18

What are the indications for Cryo?

Answer 18

Fibrinogen Deficiency
vWD
Hemophilia

Question 19

Which phase of ECT is associated with skeletal muscle rigidity?

Answer 19

Tonic

Clonic is convulsions

Question 20

List each heat loss mechanism in order of importance

Answer 20

Radiation
Convection
Evaporation
Conduction

Question 21

What is the effect of hypocapnea on coronary arteries?

Answer 21

Vasoconstriction

Question 22

What four conditions increases the risk of HOCM exacerbation?

Answer 22

Decreased Preload
Decreased Afterload
Increased HR
Increased Contractility

Question 23

What is lusitropy?

Answer 23

Relaxation

Question 24

What is dromotropy?

Answer 24

Conduction

Question 25

What are the four categories of antiarrhythmic drugs?

Answer 25

Question 26

The RCA gives rise to which arteries?

Answer 26

Posterior Right Marginal

Question 27

The LCA gives rise to which arteries?

Answer 27

Cflx Ant. Interventricular

Question 28

Which drugs undergo plasma hydrolysis?

Answer 28

Anything metabolized by pseudocholinesterase or nonspecific esterases

Question 29

List all of the drugs that antagonize NMDA

Answer 29

Nitrous Xenon Ketamine Dextromethorphan Methadone Magnesium

Question 30

FiO2 and Nasal Cannula

Answer 30

Question 31

What is the acceptable level of halogenated agents alone and with nitrous?

Answer 31

Alone 2ppm With Nitrous 0.5ppm

Question 32

What is the most common valve disease in ankylosing spondylitis?

Answer 32

Aortic Regurg

Question 33

Which pain med is contraindicated in thyroid storm

Answer 33

Aspirin. It can dislodge T4 from albumin

Question 34

Compared to the general population, geriatric patients have a _______ IV induction and a ______ inhalation induction

Answer 34

Slower IV Faster Inhalation

Question 35

In terms of body composition, geriatrics have increased ______ and decreased _______

Answer 35

Increased fat decreased lean body mass

Question 36

In geriatric patients the Vd for hydrophilic drugs is _______

Answer 36

smaller

Question 37

Less muscle mass causes:

Answer 37

Decreased BMR Decreased TB water Decreased blood volume Decreased plasma volume

Question 38

In geriatric patients the Vd for lipophilic drugs is _____

Answer 38

Larger May prolong elimination

Question 39

How are drug plasma concentrations altered in the elderly?

Answer 39

Albumin is lower, so acidic drugs will have a higher free fraction Alpha 1 is higher, so basic drugs will have a lower free fraction

Question 40

Which lung parameters increase in the elderly?

Answer 40

MV Lung Compliance RV FRC Closing Capacity

Question 41

Which lung parameters decrease in the elderly?

Answer 41

Lung elasticity Chest wall compliance VC IRV ERV FVC & FEV1

Question 42

At what age does closing capacity occur during tidal breathing while standing?

Answer 42

65

Question 43

At what age does closing capacity occur during tidal breathing while supine?

Answer 43

45

Question 44

Which cardiac parameters are decreased in the elderly?

Answer 44

CO HR SV Diastolic Function

Question 45

How do geriatrics respond to neuraxial anesthetics?

Answer 45

Smaller epidural and spinal spaces, requiring dose reduction

Question 46

How is GFR impacted by age?

Answer 46

Approximately 125ml/min in the adult male Reduces by 1 ml/min/year after age 40

Question 47

How is hepatocellular function impacted by age

Answer 47

It isn't. Hepatic function remains intact, but blood flow to the liver decreases

Question 48

What are the indications for FFP?

Answer 48

Coagulopathy Warfarin Reversal Antithrombin Deficiency Mass Transfusion DIC Hereditary Angioedema