Good facts

Question 1

Adenosine:

Answer 1

SA node slowing and AV node conduction delay.

First line paroxysmal SVT

Question 2

WPW tachycardia treatment:

Answer 2

Procainamide

Question 3

Preoperative ecg in what patients?

Answer 3

Hx of: CVA, CAD, significant arrhythmia, PAD, structural heart disease

Not. Diabetes, renal insufficiency

Question 4

Intrinsic, common, vs extrinsic

Answer 4

Intrinsic: 12, 11, 9, 8
Common: 10, 5, 2
Extrinsic: 3, 7

Question 5

Vitamin K dependent factors

Answer 5

1972

• 10
• 9
• 7
• 2

Question 6

Conditions with Increased Sv02

Answer 6

Cirrhosis
Septic shock
AV fistula
Hypothermia
Hypoxia.

Question 7

Tca overdose initial treatment:

Answer 7

ABC’s

Sodium bicarbonate changes pH so less able to bind fast sodium channels.

Question 8

APGAR

Answer 8

Skin color: cyanotic, blue at extremities
Heart rate: absent, <100, >100
Reflex irritability
Muscle tone: absent/limp, some flexion, active
Breathing: absent, weak/irregular

Max 10

Question 9

Differential for hypoxemia: expected A-a gradient.

Answer 9

Normal:

• Low Fi02
• hypoventilation

Elevated:

• shunt
• V/Q mismatch
• impaired diffusion

Question 10

When gage drops in nitrogen tank how much is left?

Answer 10

16%

253 Liters

Question 11

Coronary perfusion pressure

Answer 11

CPP= AoDP - LVEDP

Question 12

Uterotonics contraindicated meds for medical conditions:

Answer 12

• carboprost tromethamine—asthma

- methergine— hypertension (pre/eclampsia)

Question 13

Fetal monitoring, acceleration and decked:

Answer 13

Increase 15HR for 15 seconds

Early: 20 simultaneously w/ contraction
Late: 10-30 decrease delayed by 10-30 seconds

Question 14

Medications that Cross placenta:

Answer 14

Morphine, fentanyl, benzodiazepines, ephedrine, local anesthetic, atropine and beta-blockers

Question 15

Need for post op ventilation in Myesthenia gravia patients.

Answer 15

Preop vital capacity < 2.9 or<40ml/kg

Pyridostigmene dose: >750mg/day

Question 16

Definition of fetal acedemia:

Answer 16

pH: 7.2 or lower
Lactate: 4.8 or higher… less than 4.2=nml

Question 17

Expected pCO2 in metabolic acidosis:

Answer 17

Winters formula, PaCO2=(1.5 * [Hco3]) + 8 +_ 2

Question 18

Dexamethasone antiinflammatory mechanism of action

Answer 18

Agonizes NRC31 to upregulate antiinflammatory proteins

Question 19

Autonomic hyperreflexia

Answer 19

Typically at T12 or above especially T5

Acute hypertension, vasoconstriction below level of injury and vasodilation above

• reflex bradycardia
• arrhythmia
• myocardial infarction

Question 20

qSOFA

Answer 20

RR >22
Altered mental status
SBP < 100

Question 21

Glycopyrrolate

Answer 21

Blocks peripheral muscarinic receptors.

Question 22

Omalizumab mechanism

Answer 22

Stabilize mast cells. IgE blocker.

Question 23

Montelukast mechanism

Answer 23

Beta agonist. Long acting

Question 24

Mepolizumab mechanism and use

Answer 24

Asthma, blocks Interleukin 5

Question 25

Law of Laplace

Answer 25

Pressure=2*T/r ``` T= surface tension r= radius ```

Question 26

Pka

Answer 26

Lower pka= more unionized, faster transfer across placenta.

Question 27

Adductor block under ultrasound

Answer 27

``` ALABAMa Cross section lateral to medial AL- adductor longus AB- adductor brevis AM-adductor magnus ``` Obturator nervebwtween AL and AB

Question 28

Pebtology of Cantrell

Answer 28

1. Omphalocele 2. Ectopic cordially (heart completely or partially outside thorax) 3. VSD, ventricular diverticula 4. Sternal cleft 5. Anterior diaphragmatic hernia

Question 29

Post hepatic jaundice

Answer 29

Elevated direct bilirubin (conjugated)

Question 30

Leukocyte reduction

Answer 30

Cancer patient, reduce risk of trim (transfusion related immunomodulation)

Question 31

Wash rbcs

Answer 31

Remove proteins and reduce risk of allergic reaction and reduce potassium. Used for igA deficiency patients also.

Question 32

Severe OSA

Answer 32

>30 apnic events in an hour.