General Fundamentals Flashcards by Corinne Pittman

Drugs causing Malignant Hyperthemria:
“SHAPE.”

S - succinylcholine (most common)
H - alothane
A - all Fluranes
P - phenothiazines
E - ether

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Pronounced elevation of ETCO2 + Tachycardia after induction of general anesthesia.

Diagnosis?

Malignant Hyperthermia

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Myocardial depression/suppression of action potentials (APs) occurs b/c of its effect on ___ channels.

Voltage-gated Na+ channels

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__ivacaine has a safer cardiovascular toxicity profile than __ivacaine.

Ropivacaine has a safer cardiovascular toxicity profile than Bupivacaine.

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Local anesthetics act on voltage gated ___ channels, and thus their effect is most pronounced during depolarization of Atria.

Na+ channels

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Local anesthetics act on voltage gated Na+ channels, and thus their effect is most pronounced during ___.

Depolarization of Atria.

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Erb’s point (punctuation nervous) is located at the ___, and is the site where several cutaneous sensory nerves from the cervical plexus emerge.

Midpoint of the posterior border of the SCM.

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The cervical plexus consists of:
C2: ___
C2-3: Greater auricular
C2-3: Transverse cervical
C3-4: Supraclavicular

The cervical plexus consists of:
C2: Lesser occipital
C2-3: Greater auricular
C2-3: Transverse cervical
C3-4: Supraclavicular

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The cervical plexus consists of:
C2: Lesser occipital
C2-3: ___
C2-3: Transverse cervical
C3-4: Supraclavicular

The cervical plexus consists of:
C2: Lesser occipital
C2-3: Greater auricular (ear lobe, skin over parotid/mastoid)

C2-3: Transverse cervical
C3-4: Supraclavicular

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The cervical plexus consists of:
C2: Lesser occipital
C2-3: Greater auricular
C2-3: ___
C3-4: Supraclavicular

The cervical plexus consists of:
C2: Lesser occipital
C2-3: Greater auricular
C2-3: Transverse cervical (skin over ant neck)

C3-4: Supraclavicular

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The cervical plexus consists of:
C2: Lesser occipital
C2-3: Greater auricular
C2-3: Transverse cervical
C3-4: ___

The cervical plexus consists of:
C2: Lesser occipital
C2-3: Greater auricular
C2-3: Transverse cervical
C3-4: Supraclavicular (skin of upper chest/shoulder)

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A ___ study looks at similar groups w/and w/o a disease/disorder and assess both groups for a previous exposure.

Case-control study

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A __ study looks at a current condition in a “section” of a population at a given time, and assesses exposures or risk factors.

Cross-sectional study.

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Kaposi sarcoma is associated with __ virus.

HSV-8

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HIPAA addresses the right to patient privacy of health information, AND:
1. ___
2. Patient right to continued health insurance if employment is changed

HIPAA addresses the right to patient privacy of health information, AND:
1. National requirements for electronic health records
2. Patient right to continued health insurance if employment is changed

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HIPAA addresses the right to patient privacy of health information, AND:
1. National requirements for electronic health records
2. ___

HIPAA addresses the right to patient privacy of health information, AND:
1. National requirements for electronic health records
2. Patient right to continued health insurance if employment is changed

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A CD4 count < _ is consistent with AIDS.

CD4 <200

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___(infxn) and CMV infection are both AIDS defining illnesses.

Tracheal/Esophageal candidiasis and CMV infection are both AIDS defining illnesses.

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Tracheal/Esophageal candidiasis and ___ are both AIDS defining illnesses.

Tracheal/Esophageal candidiasis and** CMV infection** are both AIDS defining illnesses.

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Lidocaine toxicity occurs when >__mg/kg of plain lidocaine OR 7mg/kg of lido w/epi is injected

Lidocaine toxicity occurse when >3-5mg/kg of plain lidocaine OR 7mg/kg of lido w/epi is injected

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Lidocaine toxicity occurse when >3-5mg/kg of plain lidocaine OR __mg/kg of lido w/epi is injected

Lidocaine toxicity occurse when >3-5mg/kg of plain lidocaine OR **7mg/kg of lido w/epi **is injected

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After __ anesthesia induction, patient begins uttering nonsensical speech w/HR of 123/min and bp 160/89.

Lidocaine induction
(manifests as cardiace/neuro sx)

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The __ nerve innervates the cornea, and thus initiates the blink reflex.

Nasocilliary nerve (branch of trigeminal nerve)

Direct electrical stimulation of the __ nerve will initiate a blink reflex.

Supraorbital n.

The toxic dose of lidocaine is ____.

4-4.5mg/kg

The **only** muscles that lie deep to the plane of the FN are the: 1. __ 2. buccinator 3. mentalis

The **only** muscles that lie deep to the plane of the FN are the: 1. **levator anguli oris** 2. buccinator 3. mentalis

The **only** muscles that lie deep to the plane of the FN are the: 1. levator anguli oris 2. ___ 3. mentalis

The **only** muscles that lie deep to the plane of the FN are the: 1. levator anguli oris 2. **buccinator** 3. mentalis

The **only** muscles that lie deep to the plane of the FN are the: 1. levator anguli oris 2. buccinator 3. ___

The **only** muscles that lie deep to the plane of the FN are the: 1. levator anguli oris 2. buccinator 3. **mentalis**

Testing for penetrating neck injuries in Zone 1 should include ___.

CXR CTA Gastrografin swallow study

Sturge-Weber syndrome is caused by a: *genetic inheritance* or *somatic mosaic mutation*?

Sturge-Weber syndrome is caused by a **somatic mosaic mutation** in the GNAQ gene.

Which 5 muscles of the soft palate play an important role in swallowing and breathing?

1. palatoglossus 2. palatopharyngeus 3. levator veli palatine 4. musculus uvulae 5. tensor veli palatinei

Which muscle of the soft palate is *not* innervated by the vagus n.?

Tensor veli palatini (innervation = trigeminal n.)

Patients w/methemoglobinemia display a ___ (VS measure), which may lead to dyspnea, headache, and AMS.

"False" drop in pulse ox to (~85%) - *Methemoglobinemia is a state in which the ferrous (Fe2+) irons of heme within Hb are oxidized to the ferric (Fe3+) state. These ferric hemes are then unable to bind O2. As a result, the oxygen-dissociation curve is shifted toward the left, making it more difficult to release O2*

Local anesthetics can cause aquired methemoglobinemia in high doses, and should be treated with ___.

Oxygen + methylene blue

Histamine-mediated angioedema may be treated with _____, while this Tx is not effective against Bradykinin-mediated (non-allergic) angioedema.

Corticosteroids/Epi

Bradykinin-mediated (non-allergic) angioedema is treated with ___.

Beta2 receptor antagonist (icatibant) and kallikrein inhibitor (ecallantide)

The Sx of Bradykinin-mediated (non-allergic) angio differes from Histamine-mediated angio, in that there is no ___?

No urticaria

Dose of 1:1000 epi for Tx of anaphylaxis in children is ___ and can be repeated q__mins

0.01 mg/kg IM and can be repeated q5-15mins.

In a 1:1000 epi solution, there is _mg/_ml of epi

**1mg/1ml of epi**

The number of patients you need to treat in order to prevent ***1*** bad outcome is the ___.

**NNT** (Number Needed to Treat) = **1/ARR**

The **ARR** = the difference btwn. the

Experimental event rate - Control rate

Patient complains of *metallic taste* + *tinnitus* + *numbness around the mouth* + *n/v* after receiving 3cc of which local anesthetic?

**Lidocaine toxicity**

A resident concludes a result leads to higher survival rates, when it actually does not exist. Type of error?

Type 1 error *reject the null H when it should not be*

Failure to reject a false null hypothesis (failing to detect a true relationship) Type of error?

Type II error

Which local anesthetics are metabolized in the plasma by cholinesterase?

Amino-esterase local anesthetics: - cocaine - procaine - tetracaine

Professional competence means ___.

lifelong learning + maintianing most up-to-date medical knowledge

__ is effective in mgmt of anaphylaxis in patients taking beta-blockers, w/sx refractory to epi.

Glucagon

Although Abx have been shown to reduce the incidence of rheumatic fever following a Strep infxn, it does not affect the natural hx of ___.

post-streptococcal **glomerulonephritis**

What patients cannot get Methylene blue?

patients w/G6PD deficiency

Longest to shortest mechanism of action of "aines."

bupivicane (420mins) >plain lidocaine (30mins)

Binds the enzyme thymidylate synthetase

5-FU

Alkylating agent that prevents DNA synthesis and fibroblast proliferation

Mitomycin

Bacteriostatic antibiotics: "**ECST**a**T**i**C** about bacteriostatic"

**Bacteriostatic antibiotics:** **E** - erythromycin (all macrolides) **C** - clinda **S** - sulfonamides **T** - trimethoprin a **T** - tetracycline c **C** - chloramphenicol

Vitamin K dependent factors are:

2, 7, 9, and 10

Urokinase binds ___ to create plasmin

plasminogen