Flashcard review
Highest risk groups for latex allergy? Which condition?
- Spina bifida/myelomeningocele
- Atopy
- Health care workers
- Food allergy to banana, kiwi, pineapple, tomato, mango
Does the higher the barrier pressure mean more or less likelihood of reflux?
The higher the pressure, the less likely to cause reflux
What decreases gastric barrier pressure?
What increases gastric barrier pressure?
What is Samter’s triad?
Aspirin exacerbated respiratory disease
- Asthma
- Allergic rhinitis
- Nasal polyps
Which two supplements reduce mac?
Kava Kava
Valerian
Which supplement can mimic Conn’s?
Licorice
Metabolic syndrome
How can you reduce atelectasis in obese people?
Keep FiO2 less than 80%
Valsalva breath 40cm H20 for 10 seconds
PEEP or CPAP for 5-10
In obesity, HTN is the result of?
Activated RAAS and SNS
Hyperinsulinemia
Elevated cytokine
How does CO, SV, HR, and blood volume change in obesity?
Increased CO, SV, and blood volume to feed fat
HR stays the same
Which valvular defect is highly suggestive of Pulmonary HTN in the obese population?
Tricuspid regurgitation on TEE
Is MAC changed in obesity?
No
How are propofol and narcotics dosed?
Propofol
Loading - LBW
Maintenance - TBW
Narcotic
Loading - TBW
Maintenance - LBW
How is remifent dosed?
LBW
How are succ/cis/atracurium dosed?
TBW
How are roc/vec dosed?
LBW
Define hypopnea
50% reduction in airflow for 10 seconds, 15 or more times per hour
Define OSA
100% reduction in airflow for 10 seconds 5 or more times and a reduction of 4% in SaO2
Definitive test for OSA?
Polysomnography
Mild = 5-15 episodes
Moderate = 15-30 episodes
Severe = >30 episodes
What tool is used for undiagnosed OSA? What score?
STOPBANG
> 3 means high risk
What is obesity hypoventilation syndrome?
Longterm consequence of untreated OSA
APNEA WITHOUT RESPIRATORY EFFORT
Which drug should be avoided with an anastomotic leak repair?
Ketorolac - increases the incidence
What is Ma Huang?
Natural source of Ephedrine
What is orlistat? Complications?
Lipase binder - hinders absorption of fat
Impairs Vit D, A, K, E absorption
Without Vit K, factors 2,7,9,10 are impaired and may cause bleeding
Venous air embolism vs paradoxical air embolism, which one affects the lungs? Which would cause a stroke?
Venous - pulmonary vasculature
Paradoxical - stroke
What is the best table for a prone patient?
Jackson
Which three factors worsen tracheobronchial compression with an anterior mediastinal mass?
- Supine
- Induction of GA
- PPV
What happens if an airway is lost in a patient with a anterior mediastinal mass?
Turn them lateral or prone
Use a bronchoscope
Crash on to fem-fem bypass
What is autonomy?
Patient has the right to make their own decisions
What s nonmaleficence?
Hippocratic oath-
do not inflict harm
What is beneficence?
Prevent harm and help the patient
6 elements to informed consent?
-Competence
-Decision-making capacity
-Disclosure of information
-Understanding of disclosed information
-Voluntary consent
-Documentation
What four things must be proven in a lawsuit for malpractice?
Duty
Breach of duty
Causation
Damages
What is res Ipsa loquitur
Things peak for itself
Shifts burden of proof from the plaintiff to defendant
Assault vs battery.
Assault - attempt to touch another person
Battery - touching someone without consent
What is vicarious liability?
Respondeat superior
Hospital is responsible for the CRNA
Are there currently any schedule 1 drugs in anesthesia? Examples?
No
Are there currently any schedule 2 drugs in anesthesia? Examples?
Cocaine
Opioids
Meth
Phencyclidine
First thing to do in a lawsuit?
Contact insurance immediately
Do not discuss the case with anyone
How does someone become an emancipated minor?
-Married
-Pregnant or parent
-In the military
-Economically independent
In an emergency situation, can you give a Jehovah’s Witness blood without a court order?
Yes
Being awake for 24 hours is equal to what BAC?
0.1%
When is sleep-related behavior most common?
After 16 hours of a shift
Night shifts
OSHA limits for noise levels? 8 hour span?
Single - 115dB
8 hour span - 90 dB
How long must an addict be out of work for? How long is probation?
1 year
5 year probation
First steps if suspect a coworker is using?
Do not let them out of your sight
Have a bed available
Do not let them decide their treatment
Last step, call the police
6 steps of high-level care?
Patient centered
Safe
Effective
Timely
Efficient
Equitable
