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Comprehensive exam Spring 21 (retake) > brain dump for 1st comprehensive exam > Flashcards

brain dump for 1st comprehensive exam Flashcards

1
Q

Most lipid soluble opioid?

A

Morphine

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2
Q

Marfan syndrome and a Bentall procedure includes all except:

a. Re-implant coronary arteries
b. Aortic valve
c. Descending aorta
d. Ascending aorta

A

descending aorta

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3
Q

TOF: how many HZ?

A

2 Hz

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4
Q

Most likely to cause an allergy with orthopedic surgery?

A

Bone cement

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5
Q

When you have a obese patient what happens to the chest wall compliance/ lung compliance/ and elastic resistance?

A

increased elastic resistance and decrease in chest wall compliance and lung compliance

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6
Q

You do not need a CO2 absorber if your flows are above?

A

5l/min

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7
Q

Best way to reduce chances of infection (how long from smoking/ETOH).

A

2 week abstinence from ETOH

4 week cessation from smoking

(what I assume is the right answer)

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8
Q

What is an independent risk factor for infection?

a. Smoking
b. DM
c. Alcohol
d. Hypothyroid

A

DM (poorly controlled)

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9
Q

What is NOT an inhibitor HPV?

A

Pneumonia

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10
Q

Most predictive of respiratory complication(?) after lung resection (respiratory mechanics)

A

FEV1

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11
Q

Which is not a risk with Mediastinoscopy?

a. Cerebral ischemia
b. Air embolism
c. MI
d. Massive hemorrhage

A

MI

I do not know if this is correct?

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12
Q

Lateral position dependent lung?

A

Pa > Pv > PA

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13
Q

Who is at most risk for latex allergy? (2)

a. Spina bifida patient
b. Asthma
c. OR personnel
d. Factory worker

A

Spina Bifida Patient

OR personnel

(fruit allergy, multiple previous operations)

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14
Q

Patient has very low blood glucose, low sodium, and impaired hepatic function. What is your diagnosis?

a. Hypothyroidism
b. Hyperthyroidism
c. Hyperparathyroidism
d. Hyperkalemia

A

HYPOthyroidism

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15
Q

Name the three endogenous catecholamines we typically have to know?

A

Epi
Norepi
dopamine

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16
Q

Rank Volatile anesthetics greatest to least for allergic hepatitis?

A

Halothane>enflurance>isoflurance>desflurance

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17
Q

Cause of epiglottitis?

A

H. Influenzae type B

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18
Q

Obese patients have what?

a. Increased LV wall stress
b. Decreased LVEDP
c. Diastolic dysfunction
d. Decreased LVED pressure

A

Increased LV wall stress

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19
Q

24 hour post trauma surgery with multiple blood transfusion. Patient has florid skin rash, tachycardia, and dyspnea? What do you think?

a. TRALI
b. ARDS
c. Transfusion reaction
d. Fat Emboli

A

Fat emboli

assumed correct answer

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20
Q

How much blood has to be given in order to be called Massive Transfusion?

a. 1 to 2 times blood volume
b. 3 to 4 times blood volume
c. 10-20 units of blood
d. 30-40 units of blood

A

10-20 units of blood

assumed correct answer

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21
Q

Associated with TURP? Choose 2

a. Hemolysis
b. Hyponatremia
c. Hypertension
d. Hyperosmolarity

A

Hemolysis

hyponatremia

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22
Q

To decrease OR fires what should the O2 be at?

A

Less than 30%

not equal to or less… just less than

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23
Q

What is the only Vent. parameter to improve obese people’s respiratory function?

A

PEEP

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24
Q

Problems with Left sided DLT except ?

a. Tube too deep
b. Not deep enough
c. Right main stem intubation
d. Upper lobe occlusion

A

Upper lobe occlusion?

I currently do not know the correct answer.

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25
Q

Biggest concern with an anaphylactic reaction?

A

Circulatory collapse

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26
Q

When NOT to do a fiberoptic?

a. Full stomach
b. Lack of time
c. Basilar skull fracture
d. Pharyngeal abscess

A

Pharyngeal abscess

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27
Q

Cause of metabolic alkalosis?

a. Cystic fibrosis
b. High altitude
c. Sepsis
d. Hypoxia

A

Cystic Fibrosis

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28
Q

Major differences when comparing epidural to spinal (2)

A

a. Dose is 10 fold more than what would be used for a spinal

b. Slower onset than spinal

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29
Q

Tell me what the second gas effect definition is?

A

The ability of the large-volume uptake of one gas (first gas) to accelerate the rate of (increase) the PA of a concurrently administered companion gas (second gas) is known as the second gas effect.

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30
Q

Obese people lose how much FRC in the supine position?

A

50% decrease in FRC

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31
Q

What causes increased cell permeability, vasodilation, and bronchoconstriction?

a. IgE
b. Basophils
c. mast cells
d. kinins

A

KININS

kinins are synthesized in mast cells and basophils to produce vasodilation, increased capillary permeability and bronchoconstriction.

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32
Q

What group of people have a higher incidence of MH?

A

Young males

almost none in infants and fewer reported in elderly

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33
Q

What group of people are more likely to have a protamine allergy?

A

NPH insulin users

also men who have been fixed

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34
Q

Seizure causes include all except?

a. Increased glutamate
b. Decreased GABA
c. Increased neuronal firing
d. Autosomal genetic disorder

A

Autosomal genetic disorder

35
Q

IgE receptors that are on the surface of THIS CELL and bind to specific antigens and located in skin, lung, and intestine?

A

Mast cells

36
Q

Treatment for angioedema?

a. FFP
b. PRBC
c. Benadryl
d. Platelets

A

FFP

37
Q

A moribund patient who is not expected to live without the operation?

A

ASA 5 (V)

38
Q

HTN and sob on exertion with 1 flight of stairs has an ASA of?

A

ASA III

39
Q

3-4 mmhg increase in SBP and 2mmhg increase in DBP for every ____ of weight gain?

A

10 kg

40
Q

Pronation of the forearm will cause damage to what nerve?

A

Ulnar

41
Q

What cardiac condition is a high risk of endocarditis?

a. TOF
b. Congestive heart failure
c. Hypertrophic cardiomyopathy
d. Myocardial ischemia

A

TOF

42
Q

Nerve damage associated with trendelenburg position?

A

Brachial plexus

43
Q

Lithotomy position associated with all the following nerve damages except?

a. Obturator nerve
b. Sciatic nerve
c. Lumbosacrial
d. Sural nerve

A

Sural nerve

44
Q

Name some Left to Right shunts?

A

PDA

ASD

45
Q

Prolonged tourniquet inflation will cause all of the following except?

a. Transient muscle dysfunction
b. Permanent nerve damage
c. Hypothermia in pediatrics?
d. Rhabdomyolysis

A

Hypothermia in pediatrics

46
Q

Airway algorithm after failed intubation?

A

Mask ventilation

47
Q

Hyperbaric local anesthetic in supine position will accumulate where?

a. T10 - L1
b. L2-L5
c. T4-T8

A

As of right now I do not know for sure the correct answer.
hyperbaric solutions are ones that sink in spinal fluid but the brain dump is saying in supine position they will rise …. I still have to look this one up…. will update as I find the answer

48
Q

Formula to find cut length of a tube for a kid?

find the length for a 4 year old

A

age / 2 then add 14 (cm)

Thus a 4 year old = 16cm

49
Q

Formula for tube size (mm)?

What would it be for a 4 year old?

A

age / 4 then add 4

4 /4 = 1 +4 = 5 (mm)

50
Q

Infant formula fasting time?

A

6 hours

51
Q

Formula for allowable blood loss?

A

EBV X (starting hct - target hct) / starting hct

52
Q

Definitive diagnosis of OSA is by?

A

POLYSOMNOGRAPHY

53
Q

Oxygen device able to achieve 100% FiO2?

A

Non Rebreather mask

54
Q

The order you would see presenting S/S with MH?

A

Masseter spasm
tripling of CO2
increasing temp

55
Q

Tell me the procedure that is not out patient appropriate?

bladder biopsy
breast biopsy
UPPP
toe amputation

A

UPPP

56
Q

OCR treatment?

A

parasympathOLYTIC

57
Q

pathophysiology of OCR?

A

Trigeminal afferent vagal efferent

58
Q

Nerve BELOW the epiglottis?

A

Vagus

59
Q

Nerve responsible for laryngospasm?

A

sensory innervation of the superior laryngeal nerve (ILN)

60
Q

innervates the Larynx below the vocal folds?

A

Recurrent laryngeal nerve

61
Q

What nerve supplies below the epiglottis?

A

below the epiglottis could be the SLN or RLN depending on what answer is available and what is being asked.

SLN = below epiglottis and above vocal cords

RLN is below Vocal cords and trachea which is still below the epiglottis

62
Q

If you can see the epiglottis what grade view is this?

A

III

63
Q

Shivering can cause what? (3)

A

MI

Decreased 02 consumption

increased risk of infection

64
Q

Protective mechanical ventilation setting you can use for pneumonia would be?

A

Tidal volume based on ideal body mass

65
Q

Patient has sever rheumatoid arthritis, what type of intubation should you use?

A

Inline stabilization with fiber optic (keep the neck as still as possible)

66
Q

MAC blade goes where? Miller blade goes where?

A

MAC= vallecula

Miller = epiglottis

67
Q

Decreased protein binding in the elderly causes?

A

increased free level of the drug

68
Q

Tell me about cricoid pressure (3)

A

a. 5kg
b. 30 newtons
c. Finger and thumb upper esophagus posteriorly against the cervical vertebrae

69
Q

Low risk DVT (choose 2)

a. Open prostatectomy
b. Robotic prostatectomy
c. Laparoscopic something
d. Advanced age

A

I do not know for sure the answer here will update when I am sure

70
Q

Who can get an office based procedure?

a. Diabetes
b. Substance abuse
c. Seizure disorder
d. Allergy to several ABX

A

diabetes

71
Q

Allergy reaction give? Choose 3

a. Epinephrine
b. 2-4 L fluids for hypotension?
c. 100% FI02
d. Benadryl

A

Epi
2-4 L
100% O2

72
Q

Laparoscopic procedure and patients BP drops to 65/30 and HR increases to 115…what do you do?

a. Increase pressure 15mmhg
b. Ephedrine
c. Epinephrine
d. Decrease pressure in abdomen

A

decrease pressure in abdomen

73
Q

A child previously had an URI and is now asymptomatic, how long after this URI should you wait to do surgery?

A

2 weeks

74
Q

question about a patient who is going to have surgery and has stopped smoking, how long should you wait?

A

I would want to say 6-8 weeks but the best answer on the exam was 4 weeks? IDK

75
Q

How many cartilages does the larynx have?

A

9

76
Q

How to assess for airway edema in the PACU setting?

A

deflate the cuff was the answer, but in real life you will suction then deflate the cuff to check.

77
Q

Superior thyroid artery runs? Choose 2

A

Along the lateral edge of the cricothyroid membrane

Crossing the upper cricothyroid membrane

78
Q

correct spinal structure order (what the needle passes through in a midline approach)

A

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

79
Q

Most likely to produce anaphylactic reaction?

a. Protamine
b. Vecuronium
c. Heparin
d. Fentanyl

A

Protamine

80
Q

Who is at increased risk for an anaphylactic reaction? (2)

a. DM pt
b. person with atopy
c. asthma pt
d. Cosmetologist

A

atopy

asthma

81
Q

Know what the definition for anaphylaxis is.. pick two

A

prior exposure to the antigen

idk the 2nd choice

82
Q

pH7.48 CO2-60 HCO3 - 35 BE +1?

A

partially compensated metabolic alkalosis

83
Q

question about histamine that was a choose 2 (look up all you can about histamine)
I will fill it in when I look this up

A

idk all the choices or the answers, something to do with requires mu receptor and does not require mu receptor… then something else.. idk

84
Q

Who is at risk for incidence of sub q emphysema? (2)

a. surgical time less than 200 min.
b surgical time more than 200 min.
c. 5 surgical ports
d. 7 surgical ports

A

surgical time over 200 min.

7 surgical ports

Comprehensive exam Spring 21 (retake) (5 decks)

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