brain dump for 1st comprehensive exam Flashcards by Felicia Woodall

Most lipid soluble opioid?

Morphine

How well did you know this?

Not at all

Perfectly

Marfan syndrome and a Bentall procedure includes all except:

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

descending aorta

How well did you know this?

Not at all

Perfectly

TOF: how many HZ?

2 Hz

How well did you know this?

Not at all

Perfectly

Most likely to cause an allergy with orthopedic surgery?

Bone cement

How well did you know this?

Not at all

Perfectly

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

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

How well did you know this?

Not at all

Perfectly

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

5l/min

How well did you know this?

Not at all

Perfectly

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

2 week abstinence from ETOH

4 week cessation from smoking

(what I assume is the right answer)

How well did you know this?

Not at all

Perfectly

What is an independent risk factor for infection?

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

DM (poorly controlled)

How well did you know this?

Not at all

Perfectly

What is NOT an inhibitor HPV?

Pneumonia

How well did you know this?

Not at all

Perfectly

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

FEV1

How well did you know this?

Not at all

Perfectly

Which is not a risk with Mediastinoscopy?

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

I do not know if this is correct?

How well did you know this?

Not at all

Perfectly

Lateral position dependent lung?

Pa > Pv > PA

How well did you know this?

Not at all

Perfectly

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

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

Spina Bifida Patient

OR personnel

(fruit allergy, multiple previous operations)

How well did you know this?

Not at all

Perfectly

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

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

HYPOthyroidism

How well did you know this?

Not at all

Perfectly

Name the three endogenous catecholamines we typically have to know?

Epi
Norepi
dopamine

How well did you know this?

Not at all

Perfectly

Rank Volatile anesthetics greatest to least for allergic hepatitis?

Halothane>enflurance>isoflurance>desflurance

How well did you know this?

Not at all

Perfectly

Cause of epiglottitis?

H. Influenzae type B

How well did you know this?

Not at all

Perfectly

Obese patients have what?

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

Increased LV wall stress

How well did you know this?

Not at all

Perfectly

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

Fat emboli

assumed correct answer

How well did you know this?

Not at all

Perfectly

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

10-20 units of blood

assumed correct answer

How well did you know this?

Not at all

Perfectly

Associated with TURP? Choose 2

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

Hemolysis

hyponatremia

How well did you know this?

Not at all

Perfectly

To decrease OR fires what should the O2 be at?

Less than 30%

not equal to or less… just less than

How well did you know this?

Not at all

Perfectly

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

PEEP

How well did you know this?

Not at all

Perfectly

Problems with Left sided DLT except ?

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

Upper lobe occlusion?

I currently do not know the correct answer.

How well did you know this?

Not at all

Perfectly

Biggest concern with an anaphylactic reaction?

Circulatory collapse

When NOT to do a fiberoptic? a. Full stomach b. Lack of time c. Basilar skull fracture d. Pharyngeal abscess

Pharyngeal abscess

Cause of metabolic alkalosis? a. Cystic fibrosis b. High altitude c. Sepsis d. Hypoxia

Cystic Fibrosis

Major differences when comparing epidural to spinal (2)

a. Dose is 10 fold more than what would be used for a spinal | b. Slower onset than spinal

Tell me what the second gas effect definition is?

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.

Obese people lose how much FRC in the supine position?

50% decrease in FRC

What causes increased cell permeability, vasodilation, and bronchoconstriction? a. IgE b. Basophils c. mast cells d. kinins

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

What group of people have a higher incidence of MH?

Young males | almost none in infants and fewer reported in elderly

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

NPH insulin users | also men who have been fixed

Seizure causes include all except? a. Increased glutamate b. Decreased GABA c. Increased neuronal firing d. Autosomal genetic disorder

Autosomal genetic disorder

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

Mast cells

Treatment for angioedema? a. FFP b. PRBC c. Benadryl d. Platelets

FFP

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

ASA 5 (V)

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

ASA III

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

10 kg

Pronation of the forearm will cause damage to what nerve?

Ulnar

What cardiac condition is a high risk of endocarditis? a. TOF b. Congestive heart failure c. Hypertrophic cardiomyopathy d. Myocardial ischemia

TOF

Nerve damage associated with trendelenburg position?

Brachial plexus

Lithotomy position associated with all the following nerve damages except? a. Obturator nerve b. Sciatic nerve c. Lumbosacrial d. Sural nerve

Sural nerve

Name some Left to Right shunts?

PDA | ASD

Prolonged tourniquet inflation will cause all of the following except? a. Transient muscle dysfunction b. Permanent nerve damage c. Hypothermia in pediatrics? d. Rhabdomyolysis

Hypothermia in pediatrics

Airway algorithm after failed intubation?

Mask ventilation

Hyperbaric local anesthetic in supine position will accumulate where? a. T10 - L1 b. L2-L5 c. T4-T8

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

Formula to find cut length of a tube for a kid? find the length for a 4 year old

age / 2 then add 14 (cm) Thus a 4 year old = 16cm

Formula for tube size (mm)? What would it be for a 4 year old?

age / 4 then add 4 4 /4 = 1 +4 = 5 (mm)

Infant formula fasting time?

6 hours

Formula for allowable blood loss?

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

Definitive diagnosis of OSA is by?

POLYSOMNOGRAPHY

Oxygen device able to achieve 100% FiO2?

Non Rebreather mask

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

Masseter spasm tripling of CO2 increasing temp

Tell me the procedure that is not out patient appropriate? bladder biopsy breast biopsy UPPP toe amputation

UPPP

OCR treatment?

parasympathOLYTIC

pathophysiology of OCR?

Trigeminal afferent vagal efferent

Nerve BELOW the epiglottis?

Vagus

Nerve responsible for laryngospasm?

sensory innervation of the superior laryngeal nerve (ILN)

innervates the Larynx below the vocal folds?

Recurrent laryngeal nerve

What nerve supplies below the epiglottis?

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

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

III

Shivering can cause what? (3)

MI Decreased 02 consumption increased risk of infection

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

Tidal volume based on ideal body mass

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

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

MAC blade goes where? Miller blade goes where?

MAC= vallecula Miller = epiglottis

Decreased protein binding in the elderly causes?

increased free level of the drug

Tell me about cricoid pressure (3)

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

Low risk DVT (choose 2) a. Open prostatectomy b. Robotic prostatectomy c. Laparoscopic something d. Advanced age

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

Who can get an office based procedure? a. Diabetes b. Substance abuse c. Seizure disorder d. Allergy to several ABX

diabetes

Allergy reaction give? Choose 3 a. Epinephrine b. 2-4 L fluids for hypotension? c. 100% FI02 d. Benadryl

Epi 2-4 L 100% O2

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

decrease pressure in abdomen

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

2 weeks

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

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

How many cartilages does the larynx have?

How to assess for airway edema in the PACU setting?

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

Superior thyroid artery runs? Choose 2

Along the lateral edge of the cricothyroid membrane Crossing the upper cricothyroid membrane

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

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

Most likely to produce anaphylactic reaction? a. Protamine b. Vecuronium c. Heparin d. Fentanyl

Protamine

Who is at increased risk for an anaphylactic reaction? (2) a. DM pt b. person with atopy c. asthma pt d. Cosmetologist

atopy | asthma

Know what the definition for anaphylaxis is.. pick two

prior exposure to the antigen idk the 2nd choice

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

partially compensated metabolic alkalosis

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

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

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

surgical time over 200 min. 7 surgical ports