From practice tests #3 Flashcards
Jet ventilation
- Max 60 psi
- can be used above glottis
- can cause pneumo
Bronchial blockers used for:
- suctioning of isolated lung (suction air or insufflate with O2)
- nasally intubated
- a trach
- a single lumen ETT in place
- < 8 years old
- EZ, Cohen, Arndt, Uniblocker
known difficult airway, avoid?
RSI
Each Hgb molecule can carry how many O2 atoms?
Can carry 4 O2 molecules > so 8 O2 atoms
Aortic valve dimensions: Normal and severe AS
- Normal 2.5-3.5 cm²
- Severe AS < 0.8 (some books say < 1.0 cm²)
Candidates for CEA vs CAS
CEA better for pts with:
- Dont tolerate antiplatelets
- severe renal
CAS better for pts with:
- CHF < 30%
- CAD w/unstable angina
- abnormal stress test or MI < 1 month
- Valve disease
- Severe obesity
- Contralateral RLN injury
Aortic aneurysm least likely to cause aortic insufficiency
Crawford 1
Descending AAs only?
D3.SB.C
- Debaky 3
- Stanford B
- All Crawford
Ascending AAs only?
D2.SA
- Debakey 2
- sometimes Standford A
Nitric oxide pathway
O2 + arginine → Nitric oxide → cGMP → Protein kinase
Halflife 6 seconds
Recall of anesthesia exam?
Modified Brice exam:
- Remember before going to sleep?
- 1st thing waking up?
- anything between going to sleep/waking up?
- did you dream?
- what was the worst thing about your procedure?
closes glottic opening
aryepiglottic folds
Pancreatitis S/S
- Pericardial effusion
- myocardial depression
- Dysrhthmias
- MI
- DIC
- ARF
- THrombophlebitits
- vasodilation
- hypovolemia
Autonomic Hyperreflexia S/S
- HTN
- Bradycardia
- Pulm edema
- Seizures
*most common in bold
when to redose antacids?
60 mins
Antibodies
O has anti AB
AB has none
B has A
A has B
Most common arrhythmia with WPW syndrom
AVNRT
Name for wide/narrow QRS
Wide - Antidromic
Narrow - Orthodromic
Gout treatment
- Hydration
- Alkalize urine with bicarb
- Allopurinol (inhibits purine →uric acid)
- Colchacine (decreases inflammation)
Levadopa does what
decreases prolactin
increases growth hormone
30 day mortality risk of elderly, in order
- ASA 4
- > 90yo
- ARF
- unplanned ICU admit
- ASA 3
LMA + laparoscopic procedure guidelines
“15” rule:
- < 15º tilt
- < 15 cmH20
- < 15 min
Use gastric draining LMA - proseal, supreme
FGF coupled ventilators equation
3 L/min = 3000 ml/min.
I:E ratio 1:3 → 3000 x 1/3 = 1000
1000ml/10 RR = 100 ml
Vt = 450ml, so 100 ml + 450 ml = 550ml total volume to pt
TURP fluids
- 10-30 ml/min retained
- EBL 2-5 ml/min
N20 activates SNS causing:
Increased
- HR
- BP
- SVR
but also myocardial depressant
Elevated level in hemophelia A?
PTT
Vent modes
AC - spontaneuos ventilation with preset Vt
CMV - best in apneic pts
IMV - traditional weaning
Hormone stimulation causes?
- Gastrin
- CHolecystokinin
- Secretin
- Molitin
- pepsinogen secretion
- gallbladder contraction
- bile flow
- upper GI motility
Structures to align for intubation
Oral
Pharyngeal
Laryngeal
TOF monitoring on a hemiparitic limb results in?
- falsely elevated result
EEG suggestions of neural damage?
- 50% decrease in amplitute
- 10% increase in latency
Neuropathic pain with autonomic involvement?
Complex regional pain syndrome
- Type 1 + 2: risks are female, prev. trauma or surgery
- Type 2: always preceded by nerve injury
Treatment is same for both:
- Ketamin
- Menantine (NMDA antagonist)
- Gabapentin
- Sympathetic block
- PT
- minimize spina bifida pt exposure to?
- Latex - severe allergery later on in life
Most potent benzo for amnesia
Lorazepam (ativan)
Obesity drug dosages: Induction/Maintenence
- LBW/TBW
- TBW/LBW
- LBW
- TBW
- Propofol
- Fent/Sufent
- Roc/Vec/Remi
- Midaz/Succ/Atra/Cis
Dorsolateral aspect of humerus nerve
Radial
Nerve injuries:
- Lateral stirrup injury
- Medial stirrup injury
- excess flexion/traction/forceps delivery
- Lithotomy
- Excess traction
- Legs crossed
- Sitting position
- Common peroneal - foot drop
- Saphenous - decreased sensation
- Obturator - innability to adduct legs
- Sciatic - foot drop
- Femoral - impair knee extention/hip flexion/anterior sensation
- Top - Sural. Bottom - superficial peroneal
- Midcervical tetraplegia, VAE
Anatomic sites matched with laser
- Argon - vascular
- Ruby - retina
- Nd:YaG - tumor, trachea
- CO2 - oropharyngeal, VC
Lithium prolongs:
NMBs
NMS causative agents:
- Reglan
- Haldol
- Choropromazine/prochlorperazine (phenergan/compazine)
- Risperidone
- Droperidol
Avoid in Parkinsons as well
Serotonin syndrome from:
Treatment?
- MAOI + Meperidine (demerol) or Ephedrine
- SSRI + Demerol or Fentanyl
Cyproheptadine
SSRIs
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Fluvoxamine (Luvox)
- Citalopram (Celexa)
- Escitalopram (Lexapro)
- St Johns Wart
MAOIs
- Phenelzine (Nardil)
- Trancyclypromine (Parnate)
- Selegine (Emsam)
Aqueous Humor Produced and reabsorbed by?
- Ciliary Process
- Canal of Schlemm
Eye Bubbles + N2O
Silicone oil
Air
PF propane
- Silicone Oil - 0
- Air - 5 days
- PF propane - 30 days
Most common side effect of antibiotics
Pseudomembranous colitis
Antibiotics that act by disruptinng cell wall synthesis?
Called?
- Cephalosporins (Cef- or Ceph-)
- Vanco
- Beta-Lactams (-cilins)
Called Peptidoglycans
Abx to avoid in OB
- Erythromycin
- Flourinoquinilones (-oxacins)
- Tetras
Antiemetics that hit Vestibular apparatus
Anticholinergics (scopolamine)
Antihistamines
Samters Triad
Aspirin (also NSAIDS) exacerbated respiratory disease
- Asthma
- Allergic rhinitis
- Nasal polyps
Can cause bronchospasm
Drugs that cause Hypokalemia
BITE
- Beta 2 agonists
- Insulin
- Theophyline
- Epi
Drugs that inhibit baroreceptor reflex
- Volatiles
- Propofol
- B. Blockers
B.Blockers that block both A+B:
- Carvedilol (10:1)
- Labetalol (7:1)
Horners syndrome
Blockade of Stellate ganglion (C7)
- Ptosis (drooping eyelid)
- Miosis
- Anhidrosis (inability to sweat)
- Enopthalmos (posterior displacement of eyeball)
Both PNS/SNS: Preganglion/postganglion fibers
Pre: Myelinated B
Post: Unmyelinated C
