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Grab bag from TrueLearn > Grab bag > Flashcards

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1
Q

Patients that need prophylactic antibiotics against Infective Endocarditis?

A
  1. Prosthetic Cardiac Valves
    • including Transcatheter valves
  2. Implanted prosthetic material (annuloplasty rings)
  3. H/o Infective Endocarditis
  4. Unrepaired Cyanotic heart Disease
    • repair w/ residual shunt
  5. Patients w/ h/o cardiac transplant who have regurgitant lesion
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2
Q

Intraoperative fluid management for infant?

A

20-40 cc/kg of isotonic crystalloid if otherwise healthy infant

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3
Q

Sensitivity?

A

TP/(TP+FN)

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4
Q

Specificity?

A

TN/(FP+TN)

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5
Q

Pulmonary function in neonate?

A

Pliable rib cage –> retractions –> leads to less efficient gas exchange

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6
Q

Thyrotoxic Cardiomyopathy?

A

T3 exerts direct effects on myocardium –> fibrotic and fatty changes with eosinophilic infiltration

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7
Q

FiO2 strategy with amiodarone?

A

Limit FiO2 as much as possible given the concern of pulmonary fibrosis with chronic amiodarone usage

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8
Q

Amiodarone class?

A

Class III antiarrhythmic

- affects phase 3 of cardiac cycle

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9
Q

Amiodarone pharmacokinetics?

A

LONG half-life

- very lipid soluble

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10
Q

Amiodarone MOA

A

Blocks K+ channels, Ca+, Na+ channels

- affects beta-adrenergic receptors –> decreases automaticity of fibers

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11
Q

Least accurate of core temps?

A
  • Bladder = subject to urine flow and prolonged response time
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12
Q

4 best temp monitoring sites

A
  1. Distal Esophagus
  2. Nasopharynx
  3. TM
  4. PA
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13
Q

Nitrous flammability

A

N20 is flammable and should be avoided during airway/laser surgery

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14
Q

Hypopharynx anatomical borders

A

level of epiglottis to level of cricoid cartilage

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15
Q

Larynx

A

base of epiglottis to cricoid cartilage

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16
Q

Nasopharynx

A

base of skull to soft palate

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17
Q

oropharynx

A

soft palate to epiglottis

18
Q

West Zone with greatest amount of dead space to alveolar ventilation ratio?

A

West Zone 1

19
Q

Hallmark features of lumbar vertebrae

A
  1. Vertebral bodies are large and wide
  2. Spinous processes are broad and extend posterior
  3. Nerve roots exit below pedicle
  4. SP are not super angulated
20
Q

Benefits of leukoreduction

A
  1. Lower febrile reactions
  2. Less viral transmission
  3. Less bacterial infection
  4. Reduced inflammatory accumulation during storage
21
Q

What is leukoreduction?

A

decrease or complete elimination of donor leukocytes in the blood
- special filters applied

22
Q

Why is radioactive iodine alone bad for sole treatment of hyperthyroid?

A

Uptake of iodine will destroy overactive thyroid cells –> release of thyroid hormone into blood stream –> hyperthyroid (thyroid storm)

23
Q

How to ensure adequate brain cooling during hypothermic arrest?

A

Maintain CPB for 20 mins once target temp is achieved –> ensures proper cooling of neural tissues

24
Q

When are transplumonary pressures the highest during normal breathing?

A

Restrictive lung disease –> IPF

- this is due to a reduction in the lung compliance

25
Q

Medication of choice for acute mountain sickness ppx?

A

Acetazolamide –> augments hypoxic ventilatory response promoting urinary bicarb loss

26
Q

CSF compensation for acute mountain sickness

A

Decrease CSF HCO3 to restore CSF pH in setting of respiratory alkalosis

27
Q

Reverse Bainbridge Reflex

A

Decreased cardiac preload —> bradycardia

* decreased cardiac stretch fibers

28
Q

Sympathectomy level for spinal compared to where injected?

A

2 spinal levels higher than injection

29
Q

Factors affecting neuraxial block?

A

Position
Baricity of Local
Dose of Local

30
Q

Bainbridge Reflex

A

Increased preload —> stretching heart —> increased HR

31
Q

First line uterine relaxant for shoulder dystocia?

A

Nitro!

32
Q

Symptoms of myotonic dystrophy

A
  1. Muscle degeneration
  2. Cataracts
  3. Premature balding
  4. DM
  5. Thyroid dysfunction
  6. Adrenal insufficiency
  7. Gonadal atrophy
  8. Cardiac abnormalities
  9. Respiratory muscle weakness
  10. Gastric atony
33
Q

SIADH

A
  • euvolemia
  • hypotonic plasma
  • hypertonic urine
  • high urine sodium
34
Q

Botulism

A
  • neurotoxin causes inhibition of exocytosis of ACh at peripheral nerve
  • -> chemical paralysis
35
Q

Tx of Botulism

A

supportive therapy and antitoxin

  • equine serum for >1 year
  • human Ig for <1 year
36
Q

what can cause beta-1 receptor down-regulation?

A

Aging
CHF
chronic albuterol

*basically anything with chronic stimulation of the beta-1 receptor!

37
Q

what can cause beta-1 receptor up-regulation?

A

BETA-BLOCKERS!!!
myocardial ischemia
hyperthyroidism

*basically anything were there isn’t chronic stimulation

38
Q

Cardiomyopathy from repeated transfusions for blood disorder?

A

Iron overload and hemosiderosis

39
Q

Most common metabolic changes with TPN initiation?

A
  1. Hepatic Steatosis
  2. Hyperglycemia
  3. Hypercarbia
  4. Hypophosphatemia
  5. Hypokalemia
  6. Hypomagnesemia
40
Q

Most sensitive test for MH?

A

Halothane-caffeine contracture test! –> gold standard test

*97% sensitivity

41
Q

Brain death exam

A
  1. Irreversible causes
  2. Absent brain stem reflexes
  3. Reversible causes excluded
  4. GCS of 3
  5. No fever
42
Q

Brainstem reflexes

A
  1. Light reflex
  2. Oculocephalic reflex
  3. Caloric reflex
  4. Corneal reflex
  5. Pharyngeal reflex
  6. Tracheal reflex

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