Exam4 Flashcards
sole anesthesia dose:
- sufentanil (mcg/kg)
- fentanyl (mcg/kg)
- 10-20 mcg/kg
2. 50-100 mcg/kg
pump flows of what mL/kg range keep MAP 50-60 mmHg?
50-60 mL/kg
what is protamine dose for every 100 units of heparin?
1 mg
total CO percent and mL/min:
- coronary BF
- brain
- 5%, 250 mL/min
2. 15%, 750 mL/min
C/V disease is the leading cause of death at what %?
30%
myocardial O2 extraction is what %?
70%
cerebral vasodilation or constriction?
- increase O2
- decrease O2
- increase CO2
- decrease CO2
- constriction
- dilation
- dilation
- constriction
CSF:
- total mL
- mLs made per hour
- ICP normal range
- 150 mL
- 30 mL/hr
- 5-15 mmHg
what is cerebral BF fraction?
perfusion pressure/vascular resistance
cerebral BF decrease what % with each degrees celsius?
7%
diuretics:
- lasix mg/kg range
- lasix mg/kg range with mannitol
- mannitol mg/kg range
- .5 to 1 mg/kg
- .15 to .3 mg/kg
- .5 to 1 g/kg
VA’s cause vasoconstriction or vasodilation resulting in increase or decrease cerebral BF and ICP?
vasodilation, increases
what is order of VA effect on ICP?
HIS, D
halothane, iso, sevo, dex
VAs:
- increase or decrease CMRO2?
- increase or decrease CPP?
- decrease
2. decrease
barbiturates cause the name of what effect?
robin hood effect
what is flumazenil dose? (mcg)
200 mcg
what 2 IV meds increase ICP and CMRO2?
ketamine, succs
ketamine increase cerebral BF what % range?
60-80%
what is drug of choice for these vasospasms?
- coronary
- cerebral
- nitroglycerine
2. nimodipine
put these in order of most sensitive to anesthesia to least sensitive: SSEP, visual, brainstem auditory
- visual
- somatosensory
- brainstem auditory
in one word, how does fentanyl decrease amplitude and increase latency? (S)
slightly
does propofol effect latency?
no
what cerebral BF amount for these (mL/100g/min):
- EEG slow
- isoelectric EEG
- 20-25 mL/100g/min
2. 18 mL/100g/min
what % range of neurosurgery cases have an VAE?
5-50%
what are the 9 indicators of VAE from most sensitive to least sensitive? (TD eric prays corrupt christians, elevate blood pressure)
- TEE
- doppler
- ETCO2
- PA catheter
- CO
- CVP
- ECG changes
- BP
- precordial stethoscope
avoid what vent setting for pituitary surgery? (H)
hyperventilation
how many million ppl in north america have aneurysms?
5 million
what % of SAH pts?
- transient loss of consciousness
- severe HA
- 45%
2. 85%
transmural pressure is the difference between what 2 pressures?
MAP and ICP
most neurosurgeons like to keep SBP between what mmHg range before aneurysm clipping?
120-150 mmHg
SAH:
- what % of these pts have a rebleed?
- rebleeding has what % of mortality?
- 50%
2. 80%
cerebral vasospasm peaks at what 2 days after SAH?
4 and 9
triple H therapy for cerebral vasospasm:
- what are the 3 Hs?
- keep CVP > what?
- keep HCT at what %?
- keep SBP between what range?
- HTN, hypervolemic, hemodilution
- > 10 mmHg
- 32%
- 160-200 mmHg
avoid what lab state when treating vasospasm? (H)
hyponatremia
SAH anesthesia concerns:
- intraop controlled hypotension or hypertension?
- if proximal occlusion of a parent vessel is done, keep BP what % range above baseline to maximize collateral flow?
- hypotension
2. 20-30%
Epilepsy:
- what % range of general population?
- what % range of ppl with epilepsy have intractable seizures?
- what % range of pts with intractable seizures are surgery candidates?
- 0.5-2%
- 10-20%
- 20-30%
Wada test:
- what is purpose of the test?
- what drug type is injected? (B)
- this test is done before surgery for what condition? (E)
- determine which side of the brain is responsible for certain vital cognitive functions (speech and memory)
- barbiturates
- epilepsy
smoking:
- stopping what hour range before surgery decreases carboxyhemoglobin and shifts curve to the right?
- stop what week range before surgery?
- 12-24 hours
2. 4-8 weeks
thoracic surgery pts:
- atelectasis, PNH and resp failure occurs in what % range of pts?
- these account for what % range of mortality?
- 15-20%
2. 3-4%
Bed results for these tests warrant split lung function tests:
- PaO2 < what?
- PaCO2 > what?
- FVC < what %?
- FEV1 < what number of liters?
- FEV1/FVC ratio < %?
- DLCO < what %?
- 50
- 45
- 50%
- 2L
- 50%
- 40%
PPO FEV1:
- > what % are safe?
- < what % have a 50% chance of mortality?
- < what % will need postop ventilation?
- > 40%
- < 40%
- < 30%
PPO DLCO < what % is associated with hi M&M?
< 40%
PPO FEV1 x DLCO < what number is associated with hi mortality?
< 1650
PPO FEV1 x DLCO < 1650 is associated with what % mortality rate?
75%
what test is the only true significant independent predictor of complications?
PPO FEV1
inoperability using single lung function tests:
- mean PAP of > what mmHg after balloon occlusion?
- PaO2 of < what mmHg after balloon occlusion?
- PaCO2 > what mmHg?
- 35 mmHg
- 45 mmHg
- 60 mmHg