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Apex Pt 2 > Chem Phys, Misc > Flashcards

Chem Phys, Misc Flashcards

1
Q

Molecular bonds in order of strongest to weakest

A

Covalent, ionic, polar covalent, van der waals

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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

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3
Q

How temperature effects solubility of a gas

A

Inc temp= dec solubility

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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

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5
Q

Charles’s law

A

V1/t1= v2/t2

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6
Q

Gay lussacs law

A

P1/t1= p2/t2

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7
Q

How to memorize what is constant in each relationship w each law

A

PTV (paid tv) CBG (can be great)

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8
Q

Ohms law

A

Current= voltage difference or pressure gradient/resistance

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9
Q

Poiseuille’s law

A

Blood flow= pixradius^4 xpressure gradient / 8xviscosityxlength of tube

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10
Q

Laminar or turbulent: airflow through term bronchioles, med sized airway, glottis, carina

A

All turbulent except term bronchioles is laminar

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11
Q

Reynolds number calc

A

Densityx diameter x velocity / viscosity

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12
Q

Which Renolds number laminar v turbulent

A

Laminar= <2000, turbulent >4000

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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

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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

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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

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16
Q

Law of Laplace

A

Relationship b/w wall tension, internal p, and radius. Sphere= t=(pxr) / 2. Cylinder= tension= pxr

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17
Q

How exposure to radiation is quantified

A

Roentgen (R)

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18
Q

Yearly max radiation exposure

A

5 rem

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19
Q

Yearly mex exposure for fetus of a pregnant woman

A

0.5 rem or 0.05 rem/month

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20
Q

Safe distance from radiation

A

6 feet or 0.25mm of lead

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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

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22
Q

How to calc radiation exposure at 2 diff locations

A

Intensity 1/intensity 2= distance 2 ^2 / distance 1 ^2

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23
Q

Boiling point

A

Temp at which a liquids vapor pressure= atmospheric pressure

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24
Q

Specific heat

A

Amt heat required to inc the temp of 1g of a substance by 1 degree c

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25
Q

Heat of vaporization

A

Number of calories requires to vaporize 1 ml of liquid

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26
Q

Latent heat of vaporization

A

Number or calories required to convert 1g of liquid to vapor without a temp change in the liquid

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27
Q

How to convert between Celsius and kelvin

A

C= k-273.15. K= C+273.15

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28
Q

How to convert between Celsius and Fahrenheit

A

C= (F-32) X 5/9. F= (cx1.8) + 32

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29
Q

Boiling point of water

A

212 F or 100c

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30
Q

Freezing pt water

A

32 f or 0c

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31
Q

1 mmHg= ____ cm h20

A

1.36

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32
Q

1 cmh20= ___ mmHg

A

0.74

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33
Q

1 atm= ___ mmhg= ___torr= ___ bar

A

760, 760, 1

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34
Q

1 atm= ___kPa= ____cmh20 = ____psi

A

100, 1033, 14.7

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35
Q

How to calc volumes percent

A

Vol percent= (partial p/total p) x 100

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36
Q

Overpressurizing a vaporizer is an ex of which law

A

Henrys law

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37
Q

Mechanisms of heat transfer in order of importance

A

Radiation, convection, eval, conduction

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38
Q

Number one source of heat loss, where it is lost, how to prevent

A

Radiation (infrared). Skin. Cover pt

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39
Q

Convection: number of source of heat loss, how it happens

A

2nd. Wind chill

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40
Q

3 stages of heat transfer in OR

A

1= redist from core to periphery. II= heat transfer > production. III= transfer= production

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41
Q

Drugs that treat postop shivering

A

Demerol, clonidine, precedex

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42
Q

Best tube if co2 laser used

A

Laserflex

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43
Q

Best tube if nd yag laser used

A

Lasertubus

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44
Q

CO2 laser: structure damaged and color eye protection

A

Cornea, clear

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45
Q

Structures damaged/color eye protection: nd yag, ruby, argon

A

All damage retina. Nd yag= green. Ruby= red. Argon= amber

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46
Q

Rule of 9s adults

A

Head= 10. Each arm 9. Each side of torso is 18. Perineum is 1. Each leg is 18

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47
Q

Rule of 9s peds, age range it sapplies to

A

19% head. Each side of torso is 16. Each arm is 9.5. Each leg is 15. 1-4 years old

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48
Q

Rule of 9s: how it changes as child grows up

A

> 1 year, each year of age until 10: decrease head surface by 1% and inc each leg by 0.5%

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49
Q

Why avoid albumin in burns, for how long

A

First 24 hrs, lost to interstitial space

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50
Q

When to consider transfusion in burn pt

A

If hct <20 in healthy pt or <30 in cardiac pt

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51
Q

Parkland formula

A

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

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52
Q

Modified Brooke formula

A

2ml Lr x%tbsa x kg. 1/2 over 8 hr 1/2 over 16 hr. 2nd day same as parkland

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53
Q

CO poisoning consid

A

Pulse ox not accurate. Spo2 may be falsely high. Shifts curve left. Tx is 100%fio2

54
Q

Absolute contraindications to ect

A

<6 mo MI, recent brain surgery <3 mo, <3 mo stroke, brain tumor, unstable cervical spine, pheo

55
Q

Relative contra to ect

A

Preg, pacer, PVD, chf, glaucoma, retinal detachment, severe pulm disease

56
Q

Which drugs/things inc seizure duration, what do u want length to be

A

> 25 sec. etomidate, ketamine, alfent and prop, aminophylline

57
Q

Which drugs decrease sz duration

A

Prop, midaz, ativan, fentanyl, lido

58
Q

Lithium does what to muscle relaxants

A

Prolongs doa of sux and ndmrs

59
Q

Neuroleptic malignant syndrome: what happens, what causes it

A

Dopamine depletion in basal ganglia and hypothalamus. Dopamine antagonists or withdrawal from dopamine agonists

60
Q

NMS: drugs that cause it

A

Reglan, haldol, chlorpromazine, risperdal

61
Q

NMS: manifestations and tx

A

Muscle rigidity and necrosis, rhabdo, ANS instab, pupils normal. Tx: bromocroptine, dantrolene, ect (sux is ok)

62
Q

Serotonin syndrome: what happens and what causes it

A

Excess 5 ht activity in cns and pns. Ssri and demerol or fentanyl. Maoi and demerol or ephedrine

63
Q

Serotonin syndrome: features and tx

A

Akathisia (inner restlessness), agitation to coma, tremor, muscle rigidity, mydriasis. Rx cyproheptadine

64
Q

Intraocular perfusion pressure=

A

Map - IOP

65
Q

Normal IOP

A

10-20

66
Q

3 key consid in strabismus surgery

A

Inc risk MH and PONV. Oculocardiac reflex

67
Q

Nitrous w SF6 bubble: when to avoid

A

15 min before bubble and for 7-10 days after bubble is placed

68
Q

Eye sx how long to avoid nitrous after silicone oil, air bubble, perfluoropropane

A

0 days, 5d, 30 days

69
Q

Aminoglycosides SE

A

Ear and kidney toxic, skel muscle weakness (caution w nmbs)

70
Q

Tetracycline se

A

Liver and kidney toxic

71
Q

Antibiotics contraindicated in pregnancy

A

Chloramphenicol, emycin, fluoroquinolones, tetracyclines

72
Q

SE isoniazid

A

Liver toxic and periph neurop

73
Q

Se rifampin

A

Low plt/wbc/rbc, kidney failure

74
Q

Anaphylaxis causes degranulation of what 2 things, what degranulation can be stopped by

A

Mast cells and basophils. Epi

75
Q

Type I hypersensitivity: mediated by what, ex

A

IgE. Requires prev sensitization. Anaphylaxis and extrinsic asthma

76
Q

Type II hypersensitivity: mediated by what, ex

A

Antibodies, IgG and IgM. Activates complement. ABO incompatibility and HIT

77
Q

Type III hypersensitivity: mediated by what, ex

A

Immune complex. Activates complement. Snake venom, protamine induced vasoconstriction

78
Q

Type IV hypersensitivity: type, ex

A

Delayed. 12 hours after exposure. Contact dermatitis, GVHD, tissue rejection

79
Q

Two main chemos that cause BM suppression, one that doesnt

A

5 fu and methotrexate. Bleomycin

80
Q

Gastrin: where its made, stimulus, func

A

Stomach g cells. Food in tummy. Inc gastric acid and pepsinogen secretion

81
Q

Secretin: where made, stimulus, func

A

S cells in SI. Acid in duodenum. Inc pancreatic bicarb sec and dec gastrin sec

82
Q

CCK: where made, stimulus, func

A

I cells in SI. Food in duodenum. Inc gallbladder contrac (bile release) and panc enzyme sec. dec gastric emptying

83
Q

Gastric inhib peptide: where made, stim, func

A

SI. Food in duodenum. Inc insulin release. Dec acid sec and motility in stomach

84
Q

Somatostatin: where made, stim, func

A

Pancreatic islet cells/stomach/SI. Food in gut, gastrin, cck. Dec all GI func

85
Q

Which GI enzyme inc in zollinger Ellison syndrome, implication

A

Gastrin. Ulcers

86
Q

Tx for carcinoid tumor

A

Somatostatin

87
Q

Gerd determined by _____ pressure. The _____ it is, the lower the likelihood of reflux

A

Barrier. Higher.

88
Q

Barrier pressure= what minus what

A

LES pressure- IG pressure

89
Q

What 3 things decrease barrier pressure

A

Anticholinergics, cricoid pressure, pregnancy

90
Q

What drug increases barrier pressure

A

Reglan

91
Q

Where vomiting center is in brain

A

Nucleus tractus solitarus

92
Q

Zofran: moa, ligand

A

5ht3 antagonist, serotonin

93
Q

NK1 antagonist: ligand, ex

A

Substance p, arepitant

94
Q

Dopamine antagonist: receptor target, ligand, ex, what they are

A

D2, dopamine, antiemetic. Haldol, reglanm prochlorperazine

95
Q

Antihistamine: receptor, ligand, ex, they decrease ____ postop

A

H1 and m1. Histamine and ach. Benadryl, hydroxyzine, promethazine. PONV

96
Q

Anticholinergics: receptor, ligand, antiemetic ex

A

M1, ach, scopolamine

97
Q

Pt risk factors for PONV

A

Female, not smoker, motion sickness, previous PONV, age slightly (younger have inc risk)

98
Q

Surgical RF for PONV

A

> 1 hr, gyn, laparoscopic, breast, plastics, peds: strabismus, orchiopexy, t+a

99
Q

Anesthesia RF for PONV

A

Halogenated anes, nitrous, etomidate, opioids, neostigmine

100
Q

Zofran: when it should be given, se

A

30 min pre emergence. HA and diarrhea

101
Q

First sign of bone cement implantation syndrome if awake vs if under GA

A

Awake: alt LOC and dyspnea. GA: dec end tidal

102
Q

Triad of fat embolism syndrome

A

Resp insuff, neuro involvement, petechial rash

103
Q

Tourniquet: max time, upper extrem pressure, lower extrem pressure

A

2 hrs. Upper= 90 over SBP. Lower= 2x over SBP

104
Q

Bier block: how long tourniquet needs to be up for, pressure if upper v lower

A

20 min after local injected. 300 upper, lower= 300 or 2xsbp

105
Q

Herbals that inc bleeding risk

A

Garlic, ginger, gingko, ginseng, saw palmetto

106
Q

Herbals that decrease mac

A

Kava kava and valerian

107
Q

Agency that sets standards req on anesthesia machine

A

American society for testing and materials

108
Q

Agency that created anes machine checkout procedures

A

FDA

109
Q

Agency that sets standards for acceptable exposure to VAs

A

OSHA

110
Q

Safe metals in MRI, not safe

A

Safe= stainless steel, titanium, aluminum, copper. Not safe= iron

111
Q

MRI safe cylinder color

A

Silver w a color code at top

112
Q

Areas assessed by modified aldrete scoring system

A

Activity, resp, circulation, consciousness, 02 sat

113
Q

tidal vol should be based on

A

Ideal body weight

114
Q

Control paco2 by what and not what

A

By rate not vol

115
Q

Cv changes in obese: inc

A

Cardiac output, blood vol, stroke vol

116
Q

Cv changes obese: what is unchanged. How heart fails first then eventually

A

Heart rate same. Diastolic dysfunc then eventually systolic

117
Q

How Vd of lipophilic and hydrohpilic drugs changes if obese

A

Vd increases in both

118
Q

H20 sol drugs calc w what vs lipid sol drugs

A

H20= ideal body wt. lipid= TBW

119
Q

How to calc lean body wt

A

IBW X 1.3

120
Q

Dosing: prop induc, maint

A

Induc LBW maint TBW

121
Q

Sux dosing for ett

A

TBW

122
Q

Roc and vec dosing induc and maint

A

Both LBW

123
Q

Cis and atra dosing induc and maint

A

TBW

124
Q

Epidural dosing of LA if obese

A

75% of normal dose

125
Q

OSA episodes per hr: mild, mod, severe

A

Mild 5-15, mod <30, severe >30

126
Q

Dx criteria for obesity hypoventilation syndrome

A

BMI >30, awake paco2 >45, dysfunc breathing while sleeping

127
Q

How OHS diff from OSA

A

W OHS there isn’t any effort to breathe during apnea

128
Q

Most sensitive sign for anastamotic leak after gastric bypass

A

Unexplained tachycardia

129
Q

Frank starling curve: which pos put you lower on curve, higher on curve, too high on curve

A

Lower= reverse tburg. Higher= steep tburg. Too high= steep tburg and myo dysfunc

130
Q

Presentation of radial nerve injury

A

Wrist drop

131
Q

Common peroneal injury presentation

A

Foot drop, cant evert, cant extend toes dorsally

Apex Pt 2 (5 decks)

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