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*My APEX > From practice tests #4 > Flashcards

From practice tests #4 Flashcards

1
Q

Interventions for a L-R shunt?

A
  • Decrease SVR
  • Increase PVR
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2
Q

Drugs and their % plasma protein binding:

A

PDMEK

Propofol 98%

Dexmedetomidine 94%

Midazolam 94%

Etomidate 75%

Ketamine 12%

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3
Q

Bohr vs Haldane effect

A

Bohr is the effect of CO2 on the oxyhemoglobin dissociation curve

Haldane is the effect of O2 on the CO2 response curve

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4
Q

What twitches do you see using stim on Interscalene confirming correct location?

Too shallow?

Too deep?

A
  • Bicep contraction
  • inward shoulder rotation

Shallow;

  • phrenic nerve stimulation (Hiccuping)

Deep/Lateral:

  • Contraction of Trapezius
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5
Q

Factors that increase risk of hypoglycemia in newborn

A
  • Prematurity
  • small for gestational age
  • maternal diabetes
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6
Q

term for excess saliva

A

sialorrhea

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7
Q

High frequency vs low frequency ultrasound transducers

A

High - shallow penetration

Low - deep penetration

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8
Q

What response is still impaired even at 0.1 MAC?

Etiology?

A

Ventilatory response to hypoxia

  • Type I glomus cells in carotid sinus are impaired by reactive oxygen species (ROS), a byproduct of Volatile anesthetic metabolism. Greatest to least efffect Sevo > Iso > Des
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9
Q

Match TURP fluid with complication:

  • Distilled H2O
  • Glycine
  • Sorbitol
  • NaCl
A
  • Distilled H2O - Hyponatremia, hemolysis, hemoglobinuria
  • Glycine - Transient vision loss, increased ammonia (decreased LOC)
  • Sorbitol - Hyperglycemia, Osmotic Diuresis (similar to mannitol so can cause LV HF in susceptible pt)
  • NaCl - monopolar cautery can cause electrical current
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10
Q

Equation for static compliance?

Dynamic compliance?

A

Tidal volume/ (plateau pressure - PEEP)

Tidal volume/(PIP - PEEP)

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11
Q

Most common comorbidity in pt with sickle cell disease?

A

Asthma - its presence significantly increases M&M

Also:

  • Acute chest syndrome can occur in abdominal surgeries
  • Pulm HTN
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12
Q

SLE vs RA

A

SLE:

  • HTN
  • Thrombocytopenia

RA

  • Platelet dysfunction but not decrease
  • Sjogrens syndrom (dry eye/mouth)

Both

  • Anemia
  • Peripheral neuropathy
  • Restrictive lung disease
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13
Q
A

Top (Beta wave)

2nd: Theta - GA, sleeping kid
3rd: Delta - GA, deep sleep, brain injury
4th: Burst suppression(looks like Barbed wire) - GA, hypothermia, CPB, cerebral ischemia

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14
Q

Area where pulmonic stenosis will be heard

A
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15
Q

Criteria for severe pre-eclampsia?

A

BP:

  • syst > 160
  • Diastolic >110
  • Headache/blurred vision
  • RUQ/epigastric pain
  • Pulmonary edema
  • HELLP
  • 24h Urine <500ml
  • Impaired fetal growth

(Mild just HTN, Edema, proteinuria)

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16
Q

Areas of brain?

  • Learning and storing info?
  • Strong emotion, pain, stress?
  • Regulate fine control of movement?
A
  • Hippocampus
  • Amygdala
  • Basal ganglia (Substantia nigra dopamine deficiency in parkinsons)
17
Q

Blocks and their uses:

  • Thoracic paravertebral block
  • Celiac plexus block
  • Superior hypogastric plexus block
  • Sphenopalatine block
A

Thoracic paravertebral block (need one block per dermatome)

  • breast
  • thoracotomy
  • rib

Celiac plexus

  • Cancer pain of upper abdominal organs: distal esophagus, stomach, liver, pancreas, small intestines, all but descending colon

Superior hypogastric plexus block

  • Cancer pain of pelvic organs: uterus, ovaries, prostate, descending colon

Shenopalatine block

  • PDPH
18
Q

samples of K sparing diuretics

A

SAT

  • Spironolactone
  • Amiloride
  • Triamterene
19
Q

Examples and S/S of Loop diuretics

A

Examples:

  • Lasix
  • Bumex
  • Etharcrynic acid

S/S:

  • Hypo
  • K, Na, Cl, Ca, Mg
  • volemia
  • Rarely: tinnitis, vertigo, hearing loss
20
Q

S/S of Thiazide diuretices. Examples?

A

S/S:

  • Hyper:
  • Glycemia
  • calcemia

Examples: (HIC)

  • Hydrochlorothiazide
  • Indapamide
  • Chlorthalidone
21
Q

What depresses SSEPs the most?

A

Nitrous oxide

22
Q

PNB contraindicated in an anticoagulated patient?

A

Lumbar plexus block (psoas block)

23
Q

Neurons of spinothalamic tract (pain and temperature)

  • 1st order
  • 2nd order
  • 3rd order
A
  • Dorsal root ganglion
  • Dorsal horn
  • RAS + Thalamus
24
Q

aPTT measures events that occur when?

Also called?

A

during intrinsic and final common pathway

also called contact activation pathway

25
Q

Low albumin will alter what type of drugs? List them:

A

Low hepatic clearance drugs ( <0.3 )

  • Diazepam/lorazepam
  • Roc
  • Dilantin
  • Methadone
  • Theophyline
  • Thiopental
26
Q

Pts who have undergone bariatric surgery may have deficiencies in which vitamins/minerals?

A
  • B9 (folic acid)
  • B12 (Colabamin)
  • ADEK (fat soluble)
  • Iron
27
Q

Vaporizer leaks tested how?

Low pressure system tested how?

A

Negative pressure leak test with machine off, vaporizor on. tested individually

High pressure leak test

28
Q

Glossopharyngeal block will anesthetize what structures:

A

POST VA

  • Posterior 1/3 of tongue
  • Oropharynx
  • Soft palate
  • Tonsils
  • Vallecula
  • Anterior epiglottis
29
Q
A
30
Q

Which Muscarinic targets are part of SNS?

A
  • Sweat glands
  • Piloerector muscles
31
Q

TEG deficiencies:

  • R time
  • K time
  • Alpha angle
  • MA
  • A60
A
  • Factors - tx with FFP (6-8min)
  • Fibrinogen - tx with Cryo (3-7min)
  • Fibrinogen - tx with Cryo (50-60°)
  • Platelets - tx with Plts +/- DDAVP (50-60mm)
  • Excess fibrinolysis - TXA or Amicar (MA - 5)

*My APEX (10 decks)

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