Chem Phys, Misc Flashcards
1
Q
Molecular bonds in order of strongest to weakest
A
Covalent, ionic, polar covalent, van der waals
2
Q
Henrys law
A
At a constant temp the amt of gas dissolved in a sol is proportional to the partial pressure of a gas over the solution
3
Q
How temperature effects solubility of a gas
A
Inc temp= dec solubility
4
Q
What is ficks law
A
Law of diffusion, transfer rate of gas through a tissue. Directly prop to partial pressure diff, diff coefficient/solubility, and membrane SA. Inv prop to membrane thickness and molecular weight
5
Q
Charles’s law
A
V1/t1= v2/t2
6
Q
Gay lussacs law
A
P1/t1= p2/t2
7
Q
How to memorize what is constant in each relationship w each law
A
PTV (paid tv) CBG (can be great)
8
Q
Ohms law
A
Current= voltage difference or pressure gradient/resistance
9
Q
Poiseuille’s law
A
Blood flow= pixradius^4 xpressure gradient / 8xviscosityxlength of tube
10
Q
Laminar or turbulent: airflow through term bronchioles, med sized airway, glottis, carina
A
All turbulent except term bronchioles is laminar
11
Q
Reynolds number calc
A
Densityx diameter x velocity / viscosity
12
Q
Which Renolds number laminar v turbulent
A
Laminar= <2000, turbulent >4000
13
Q
Bernoulli’s principle
A
Relationship b/w pressure and velocity of a moving fluid or gas. If fluids velocity is high then pressure on walls is low. If velocity is low then pressure is high
14
Q
Venturi effect
A
As air flow moves past a narrowed point the pressure at the point decreases. If the pressure dec below atmospheric p then air is entrained into the tube
15
Q
Chanda effect
A
How jet flow attaches itself to a nearby surface and continues to flow along surface even when surface curves away
16
Q
Law of Laplace
A
Relationship b/w wall tension, internal p, and radius. Sphere= t=(pxr) / 2. Cylinder= tension= pxr
17
Q
How exposure to radiation is quantified
A
Roentgen (R)
18
Q
Yearly max radiation exposure
A
5 rem
19
Q
Yearly mex exposure for fetus of a pregnant woman
A
0.5 rem or 0.05 rem/month
20
Q
Safe distance from radiation
A
6 feet or 0.25mm of lead
21
Q
Radiation exposure obeys which law
A
Amt of exposure is inversely prop to the square of the distance of the source. Intensity= 1/distance^2
22
Q
How to calc radiation exposure at 2 diff locations
A
Intensity 1/intensity 2= distance 2 ^2 / distance 1 ^2
23
Q
Boiling point
A
Temp at which a liquids vapor pressure= atmospheric pressure
24
Q
Specific heat
A
Amt heat required to inc the temp of 1g of a substance by 1 degree c
25
Heat of vaporization
Number of calories requires to vaporize 1 ml of liquid
26
Latent heat of vaporization
Number or calories required to convert 1g of liquid to vapor without a temp change in the liquid
27
How to convert between Celsius and kelvin
C= k-273.15. K= C+273.15
28
How to convert between Celsius and Fahrenheit
C= (F-32) X 5/9. F= (cx1.8) + 32
29
Boiling point of water
212 F or 100c
30
Freezing pt water
32 f or 0c
31
1 mmHg= ____ cm h20
1.36
32
1 cmh20= ___ mmHg
0.74
33
1 atm= ___ mmhg= ___torr= ___ bar
760, 760, 1
34
1 atm= ___kPa= ____cmh20 = ____psi
100, 1033, 14.7
35
How to calc volumes percent
Vol percent= (partial p/total p) x 100
36
Overpressurizing a vaporizer is an ex of which law
Henrys law
37
Mechanisms of heat transfer in order of importance
Radiation, convection, eval, conduction
38
Number one source of heat loss, where it is lost, how to prevent
Radiation (infrared). Skin. Cover pt
39
Convection: number of source of heat loss, how it happens
2nd. Wind chill
40
3 stages of heat transfer in OR
1= redist from core to periphery. II= heat transfer > production. III= transfer= production
41
Drugs that treat postop shivering
Demerol, clonidine, precedex
42
Best tube if co2 laser used
Laserflex
43
Best tube if nd yag laser used
Lasertubus
44
CO2 laser: structure damaged and color eye protection
Cornea, clear
45
Structures damaged/color eye protection: nd yag, ruby, argon
All damage retina. Nd yag= green. Ruby= red. Argon= amber
46
Rule of 9s adults
Head= 10. Each arm 9. Each side of torso is 18. Perineum is 1. Each leg is 18
47
Rule of 9s peds, age range it sapplies to
19% head. Each side of torso is 16. Each arm is 9.5. Each leg is 15. 1-4 years old
48
Rule of 9s: how it changes as child grows up
>1 year, each year of age until 10: decrease head surface by 1% and inc each leg by 0.5%
49
Why avoid albumin in burns, for how long
First 24 hrs, lost to interstitial space
50
When to consider transfusion in burn pt
If hct <20 in healthy pt or <30 in cardiac pt
51
Parkland formula
1st day: 4 ml LR x % Tbsa burned x kg. 1/2 first 8 hrs 1/2 over 16 hrs. 2nd day: d5w maintenance rate, 0.5 ml x %tbsa burn x kg for albumin
52
Modified Brooke formula
2ml Lr x%tbsa x kg. 1/2 over 8 hr 1/2 over 16 hr. 2nd day same as parkland
53
CO poisoning consid
Pulse ox not accurate. Spo2 may be falsely high. Shifts curve left. Tx is 100%fio2
54
Absolute contraindications to ect
<6 mo MI, recent brain surgery <3 mo, <3 mo stroke, brain tumor, unstable cervical spine, pheo
55
Relative contra to ect
Preg, pacer, PVD, chf, glaucoma, retinal detachment, severe pulm disease
56
Which drugs/things inc seizure duration, what do u want length to be
>25 sec. etomidate, ketamine, alfent and prop, aminophylline
57
Which drugs decrease sz duration
Prop, midaz, ativan, fentanyl, lido
58
Lithium does what to muscle relaxants
Prolongs doa of sux and ndmrs
59
Neuroleptic malignant syndrome: what happens, what causes it
Dopamine depletion in basal ganglia and hypothalamus. Dopamine antagonists or withdrawal from dopamine agonists
60
NMS: drugs that cause it
Reglan, haldol, chlorpromazine, risperdal
61
NMS: manifestations and tx
Muscle rigidity and necrosis, rhabdo, ANS instab, pupils normal. Tx: bromocroptine, dantrolene, ect (sux is ok)
62
Serotonin syndrome: what happens and what causes it
Excess 5 ht activity in cns and pns. Ssri and demerol or fentanyl. Maoi and demerol or ephedrine
63
Serotonin syndrome: features and tx
Akathisia (inner restlessness), agitation to coma, tremor, muscle rigidity, mydriasis. Rx cyproheptadine
64
Intraocular perfusion pressure=
Map - IOP
65
Normal IOP
10-20
66
3 key consid in strabismus surgery
Inc risk MH and PONV. Oculocardiac reflex
67
Nitrous w SF6 bubble: when to avoid
15 min before bubble and for 7-10 days after bubble is placed
68
Eye sx how long to avoid nitrous after silicone oil, air bubble, perfluoropropane
0 days, 5d, 30 days
69
Aminoglycosides SE
Ear and kidney toxic, skel muscle weakness (caution w nmbs)
70
Tetracycline se
Liver and kidney toxic
71
Antibiotics contraindicated in pregnancy
Chloramphenicol, emycin, fluoroquinolones, tetracyclines
72
SE isoniazid
Liver toxic and periph neurop
73
Se rifampin
Low plt/wbc/rbc, kidney failure
74
Anaphylaxis causes degranulation of what 2 things, what degranulation can be stopped by
Mast cells and basophils. Epi
75
Type I hypersensitivity: mediated by what, ex
IgE. Requires prev sensitization. Anaphylaxis and extrinsic asthma
76
Type II hypersensitivity: mediated by what, ex
Antibodies, IgG and IgM. Activates complement. ABO incompatibility and HIT
77
Type III hypersensitivity: mediated by what, ex
Immune complex. Activates complement. Snake venom, protamine induced vasoconstriction
78
Type IV hypersensitivity: type, ex
Delayed. 12 hours after exposure. Contact dermatitis, GVHD, tissue rejection
79
Two main chemos that cause BM suppression, one that doesnt
5 fu and methotrexate. Bleomycin
80
Gastrin: where its made, stimulus, func
Stomach g cells. Food in tummy. Inc gastric acid and pepsinogen secretion
81
Secretin: where made, stimulus, func
S cells in SI. Acid in duodenum. Inc pancreatic bicarb sec and dec gastrin sec
82
CCK: where made, stimulus, func
I cells in SI. Food in duodenum. Inc gallbladder contrac (bile release) and panc enzyme sec. dec gastric emptying
83
Gastric inhib peptide: where made, stim, func
SI. Food in duodenum. Inc insulin release. Dec acid sec and motility in stomach
84
Somatostatin: where made, stim, func
Pancreatic islet cells/stomach/SI. Food in gut, gastrin, cck. Dec all GI func
85
Which GI enzyme inc in zollinger Ellison syndrome, implication
Gastrin. Ulcers
86
Tx for carcinoid tumor
Somatostatin
87
Gerd determined by _____ pressure. The _____ it is, the lower the likelihood of reflux
Barrier. Higher.
88
Barrier pressure= what minus what
LES pressure- IG pressure
89
What 3 things decrease barrier pressure
Anticholinergics, cricoid pressure, pregnancy
90
What drug increases barrier pressure
Reglan
91
Where vomiting center is in brain
Nucleus tractus solitarus
92
Zofran: moa, ligand
5ht3 antagonist, serotonin
93
NK1 antagonist: ligand, ex
Substance p, arepitant
94
Dopamine antagonist: receptor target, ligand, ex, what they are
D2, dopamine, antiemetic. Haldol, reglanm prochlorperazine
95
Antihistamine: receptor, ligand, ex, they decrease ____ postop
H1 and m1. Histamine and ach. Benadryl, hydroxyzine, promethazine. PONV
96
Anticholinergics: receptor, ligand, antiemetic ex
M1, ach, scopolamine
97
Pt risk factors for PONV
Female, not smoker, motion sickness, previous PONV, age slightly (younger have inc risk)
98
Surgical RF for PONV
>1 hr, gyn, laparoscopic, breast, plastics, peds: strabismus, orchiopexy, t+a
99
Anesthesia RF for PONV
Halogenated anes, nitrous, etomidate, opioids, neostigmine
100
Zofran: when it should be given, se
30 min pre emergence. HA and diarrhea
101
First sign of bone cement implantation syndrome if awake vs if under GA
Awake: alt LOC and dyspnea. GA: dec end tidal
102
Triad of fat embolism syndrome
Resp insuff, neuro involvement, petechial rash
103
Tourniquet: max time, upper extrem pressure, lower extrem pressure
2 hrs. Upper= 90 over SBP. Lower= 2x over SBP
104
Bier block: how long tourniquet needs to be up for, pressure if upper v lower
20 min after local injected. 300 upper, lower= 300 or 2xsbp
105
Herbals that inc bleeding risk
Garlic, ginger, gingko, ginseng, saw palmetto
106
Herbals that decrease mac
Kava kava and valerian
107
Agency that sets standards req on anesthesia machine
American society for testing and materials
108
Agency that created anes machine checkout procedures
FDA
109
Agency that sets standards for acceptable exposure to VAs
OSHA
110
Safe metals in MRI, not safe
Safe= stainless steel, titanium, aluminum, copper. Not safe= iron
111
MRI safe cylinder color
Silver w a color code at top
112
Areas assessed by modified aldrete scoring system
Activity, resp, circulation, consciousness, 02 sat
113
tidal vol should be based on
Ideal body weight
114
Control paco2 by what and not what
By rate not vol
115
Cv changes in obese: inc
Cardiac output, blood vol, stroke vol
116
Cv changes obese: what is unchanged. How heart fails first then eventually
Heart rate same. Diastolic dysfunc then eventually systolic
117
How Vd of lipophilic and hydrohpilic drugs changes if obese
Vd increases in both
118
H20 sol drugs calc w what vs lipid sol drugs
H20= ideal body wt. lipid= TBW
119
How to calc lean body wt
IBW X 1.3
120
Dosing: prop induc, maint
Induc LBW maint TBW
121
Sux dosing for ett
TBW
122
Roc and vec dosing induc and maint
Both LBW
123
Cis and atra dosing induc and maint
TBW
124
Epidural dosing of LA if obese
75% of normal dose
125
OSA episodes per hr: mild, mod, severe
Mild 5-15, mod <30, severe >30
126
Dx criteria for obesity hypoventilation syndrome
BMI >30, awake paco2 >45, dysfunc breathing while sleeping
127
How OHS diff from OSA
W OHS there isn’t any effort to breathe during apnea
128
Most sensitive sign for anastamotic leak after gastric bypass
Unexplained tachycardia
129
Frank starling curve: which pos put you lower on curve, higher on curve, too high on curve
Lower= reverse tburg. Higher= steep tburg. Too high= steep tburg and myo dysfunc
130
Presentation of radial nerve injury
Wrist drop
131
Common peroneal injury presentation
Foot drop, cant evert, cant extend toes dorsally
