General anesthesia

Question 1

What are some normal physiological responses to being pregnant?

Answer 1

Decreased serum albumin, increased alpha and beta globulins, increased fibrinogen and factor VII, transferrin and TIBC increases, Fe decreases

Question 2

Which of the following is NOT affected by volatile anesthetics? SSEPs, MEPs, AEPs, VEPs

Answer 2

Auditory evoked potentials

Question 3

Describe the mechanism of action of PTH

Answer 3

PTH is activated when calcium is low. It stimulates osteoclast activity to cause bone reabsorption, it activates calcitriol to create vitamin D which stimulates Ca reabsorption in the gut, it increases ca reabsorption in the DISTAL tubule of the kidney

Question 4

What electrolyte abnormality is seen in respiratory alkalosis?

Answer 4

Hypocalcemia: negatively charged ions are bound to H+. When the body becomes alkalotic, the H+ ions leave the negatively charged proteins and Ca2+ binds instead. This then leads to hypocalcemia

Question 5

What types of gases will increased MV have the largest effect on?

Answer 5

More soluble gases (in order of most soluble to least: Halothane, isoflurane, sevoflurane, N20, desflurane)

Question 6

What artery are you at risk for inecting local anesthetic when you are doing an inter scalene block?

Answer 6

The vertebral artery

Question 7

Define an acid and base in chemistry terms

Answer 7

Acids donate protons and bases receive protons

Question 8

What is CBF directly related to?

Answer 8

PaCO2, not H+, therefore respiratory acidosis increases CBF more than metabolic acidosis

Question 9

What metabolic change is seen with TPN?

Answer 9

Hypophosphatemia, this is caused by increased insulin 2/2 increased glucose. This leads to an intracellular shift of phosphate into the cell. This is the principle of re-feeding syndrome and why you cannot give TPN to malnourished people who already have low P