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*My APEX > From practice tests #2 > Flashcards

From practice tests #2 Flashcards

1
Q

Technique to decrease local anesthetic from opthalmic to systemic

A
  • Keep eye shut for 1 min
  • avoid blinking
  • press medial canthus
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2
Q

WBC function:

  • T lymphocytes
  • B lymphocytes
  • Neutrophils
  • Basophils
  • Eosinophils
A
  • Cell mediated (no antibodies)
  • Humoral immunity (antibodies)
  • Bacterial/Fungal (most abundant)
  • Histamine, serotonin, heparin, bradykinin (hypersensitivity)
  • Parasites
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3
Q

Disease caused by a prion? Leads to?

A

Creutzfelt-Jakob

  • Leads to Dementia and encephalopathy
  • Caught from animal protein, implants, cadavar pituitary hormones
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4
Q

Vanco must be started within how long of incision?

A

120 mins

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5
Q

Rigid bronchoscope: 4 ways to ventilate, EtCO2, Airway

A

Ventilate

  • Spontaneous
  • Apneic
  • PPV (requires ventilating bronchoscope)
  • Jet ventilation (best with TIVA)

innacurate EtCO2

Airway not secure

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6
Q

Greatest risk of VAE during mediastinoscopy when?

A

During spont. breathing

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7
Q

What is the “Hold up” sign?

A

When using a bougie, its when hitting the carina (35-40cm)

Confirms placement

-Bougies are also good for NT intubation, or through supraglottic airway

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8
Q

Giving “chest rigidity” causing opioids, the difficult ventilation is actually from? Due to?

A

Laryngeal muscle contraction

From increased dopamine or decreased GABA

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9
Q

Sniffing position alignment

A

Cervical flexion - aligns pharyngeal/Laryngeal

A-O extention - aligns Pharyngeal/Oral

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10
Q

Most potent glucocorticoid? the rest that are glucocorticoid only?

A
  • Dexamethasone
  • Betamethasone
  • Triamcolone
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11
Q

Has = glucocorticoid/mineralocorticoid effects

A
  • Cortisol
  • Cortisone
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12
Q

Drugs with Glucorticoid > mineralocorticoid effects

A
  • Prednisone
  • Methylprednisone
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13
Q

Drug with mineralacorticoid > glucocorticoid effects

A
  • Fludricortisone
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14
Q

Post-op tonsil bleed timing

A

75% < 6 hours

25% < 24 hours

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15
Q

Loading dose for Mg for seizure prophylaxis (eclampsia)?

Target Mg levels?

A

4-6 Grams over 10 mins, then 1-2 G/hr

Target plasma: 2-3.5

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16
Q

Cells of the GI tract:

  • Gastrin
  • Cholecystokinin
  • Secretin
  • Gastric inhibitory peptide
A
  • G cells
  • I cells
  • S cells
  • K cells
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17
Q

Lasers: Shortwave vs Longwave

A

Shortwave:

  • Deeper
  • Retina
  • RAN - Ruby, Argon, ND:YaG lasers

Longwave:

  • Shallow
  • More H20
  • Cornea/sclera
  • CO2 laser
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18
Q

1 site of metastasis in Breast Cancer

A

Bone

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19
Q

Mastectomy

A
  • hypercalcemia
  • possible low spo2 if isosulfan blue is injected into sentinal node
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20
Q

Effects of bone cement:

A
  • First sign: decreased EtCO2
  • Hypotension
  • Hypoxemia (air/fat emboli)
  • Increased PVR
  • Cardiac Arrest
  • LOC during regional
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21
Q

Superior Hypogastric plexus

A
  • Innervates pelvic organs
  • Block helps in Cancer pain
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22
Q

ASA chance of mortality per 10,000

A
  1. 0.04
  2. 0.5
  3. 2.7
  4. 5.5
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23
Q

Nerve injured when arms pronated in supine position

A

Ulnar

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24
Q

most to least common closed claims cases (categories of anatomic/anesthetic fault)

A
  1. Regional
  2. Respiratory
  3. Cardiac
  4. Equipment
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25
Q

Neurotransmitter and their target receptor:

  • Substance P
  • Glutamate
  • Serotonin
  • Glycine

Which are excitatory/inhibitory?

A

Excitatory

  • Substance P - Neurokinin 1 (NK1)
  • Glutamate - NMDA

Inhibitory

  • Serotonin - 5HT
  • Glycine - Chloride linked GlyR
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26
Q

Grey matter lamina dorsal/ventral?

A

1-6 Dorsal

7-9 Ventral

27
Q

Drugs metabolized by Pseudocholinesterase

A
  • Ester anesthetics (cocaine is Pseudocholinesterase + liver)
  • Mivacurium/Succinylcholine
28
Q

Tumescent local anesthetic contains:

A
  • Dilutent (NaCl)
  • Lidocaine (0.05-0.1%)
  • Epi
  • Bicarb (sometimes)

Peaks 12 hours

DOA 36 hours

29
Q

Oxybarbiturates and Thiobarbiturates? Best anticonvulsant?

A

Oxybarbs:

  • Methohexital
  • Phenobarbital (best anticonvulsant)
  • Socobarbital

Thiobarbs:

  • Thiopental
  • Thiamylal
30
Q

Reduces gas pressure between O2 tank and intermediate system?

A

Regulator

31
Q

Bourdin gauge can calculate which gases? Why?

A
  • Nitrogen
  • Helium

Liquid in canister

32
Q

Axis deviation

A

Leads Leaving each other L axis deviation

  • Normal: -30 to +90
  • Left: < -30 (extreme is -90 or less)
  • Right: > +90
33
Q

Semi-open Circuits

A
  • Bain
  • Mapleson
  • Jackson-Reese
34
Q

Name circuits

A
35
Q

Antiarrhythmics action

  • Class I
  • Class II
  • Class III
  • Class IV
A
  • Decrease phase 0 (NA channel blockers)
  • decrease rate depolarization through SA, phase 4 (Beta blockers)
  • prolongs repolarization, phase 3 (K channel blockers)
  • decrease action potential (Ca channel blocker)
36
Q

Multiple Sclerosis

A
  • avoid spinal (epidural/PNB ok)
  • Avoid hyperthermia, Succ, stress
  • pt on long term steroids (may need stress dose)
37
Q

disease of abnormal calcium sequestration

A

Myotonic Dystrophy

38
Q

Hyper/Hypo-K periodic paralysis, what Ion channels?

A

HyperK - Na channel

HypoK - Ca channel

39
Q

Cyclosporins effect which organ the most?

A

Kidney

40
Q

Diseases causing kyphosis secondarily cause what?

A

Aortic Regurg

*Think ankylosing spondylitis, RA, spina bifida, osteoporosis, muscular dsytrophy, Ehlers-Danlos, Marfans

41
Q

Disruption of _____ in which LeFort fractures?

A
  • Cribiform plate
  • Lefort II, III
42
Q

5 and dime reflex (oculocardiac) effects which receptors?

A

M2 on SA/AV nodes

43
Q

Which reflex still intact in heart transplant?

A

Bainbridge

44
Q

Herbal alpha 2 blocker?

Treats what?

A

Yohimbe

treats orthostatic hypotension

45
Q

RMP and TP of SA node?

Another name for SA node?

A

RMP -60

TP -45

Keith-Flack node

46
Q

Supplies SA node?

A

RCA (in 50-60% ppl)

Cx (in 40-50% ppl)

47
Q

Decreases supply and increases demand of heart?

A

Increased

  • HR
  • Preload

Decreased

  • Aortic diastolic BP
48
Q

Most common cause of mitral stenosis?

Others?

A

Endocarditis

RA, SLE, Carcinoid syndrome

49
Q

Where do Cranial nerves originate from?

A

Midbrain

  • 3-4

Brain stem

  • Pons: 5-8
  • Medulla: 9-12
50
Q

Hypercarbia effects

A

Direct effects:

  • Myocaridial depressant
  • local vasodilation

SNS effects:

  • Vasoconstriction
  • Increased contractility
  • increasesed serum K+
51
Q

Secretion: Adrenal medulla vs adrenal cortex

A

Medulla

  • Epinephrine
  • Norepinephrine

Cortex (zona glomerulas, fasciculata, reticularis)

  • Aldosterone
  • Glucocorticoids
  • Androgens
52
Q

Thyroarytenoids

A

They relax

But also ADDuct the VC, closing airway

53
Q

Additives to Bier block to extend sensory block?

A
  • Toradol
  • Tramadol
  • Clonidine
54
Q

Match to area of anatomy:

  • Lower motor neuron
  • Upper motor neuron
  • 2nd order neuron, medial lemniscal
  • 2nd order neuron, spinothalamic
A
  • Ventral horn
  • precentral gyrus in Cerebral cortex
  • gracilis nucleus in Medulla/brainstem (think medial medulla)
  • Dorsal horn (think spinothalamic - 1st and 2nd neuron in spinal cord)
55
Q

ETT cuff pressures less than? in what unit of measure?

A

<25 cmH2O

56
Q

C and K temp conversions

C and F conversions

A

C = K - 273.15

K = C + 273.15

C = (F-32) x 5/9

F = (Cx1.8) + 32

57
Q

Measurement conversions

mmHg to cmH20

1 atm and others

A

1 mmhg = 1.36 cmH2O

1 atm = 100 kpa, 1033 cmH2O, 14.7 lbs/inch²

58
Q

FRC and atelectasis?

A

an increased FRC is protective against atelectasis (COPD, elderly)

Doesnt mean it cant be caused by other means…

59
Q

Cricoid pressure is known to?

A

Decrease LES sphincter tone

60
Q

Where are M2 receptors?

A

Cardiac

61
Q

Increased risk of LAST

A
  • Hypercarbia
  • Hyperkalemia
  • Resp/Metabolic acidosis
62
Q

Soda lime: Exhaustion vs dessication

A

Exhaustion:

  • Color change (Change in pH <10.3)
  • ability to absorb CO2

Dessication

  • dried out (no H2O, typically 13-20% saturated)
  • Risk of Compound A and Carbon monoxide
63
Q

CSF vs Blood

A

CSF

  • More acidic (due to lower protein levels decrease H+ buffer)
  • less Glucose, K+
64
Q

Which volatile attenuates baroreceptor reflex the least?

A

Isoflurane

*My APEX (10 decks)

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