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Hall Ch6 Flashcards

1
Q

Normal tracheal capillary arteriolar pressure is

A

25-35 mmHg

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2
Q

You should wait how many hrs after last dose of BID dosing of lovenox before giving neuraxial anesthesia?

A

24 hrs

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3
Q

Fluoride toxicity anesthesia most closely resembles what type of renal failure

A

Nephrogenic diabetes insipidus

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4
Q

Best prophylaxis against deep vein thrombosis

A

Early ambulation

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5
Q

MCC of postop hypoxemia

A

V/Q mismatch

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6
Q

Symptoms of hypocalcemia usually occur how many hours after inadvertent resection of parathyroid glands?

A

24-72 hrs

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7
Q

Damage to which nerve leads to wrist drop

A

Radial n.

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8
Q

MCC of bronchiectasis

A

Recurrent bronchial infections

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9
Q

Treatment of acute dystonic reaction following administration of an anti-dopaminergic drug

A

Anti-cholinergic drug that crosses blood brain barrier like diphenhydramine or benztropine

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10
Q

Nerve most frequently injured at antecubital fossa by extravasation of IV

A

Median n.

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11
Q

Onset of delirium tremens usually occurs how long after alcohol abstinence

A

2-4 days

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12
Q

Why is postop mechanical ventilation a relative contraindication for tracheal resection?

A

Risk of wound dehiscence because of positive airway pressure

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13
Q

Average 1 yr old weighs how much?

A

10 kg, triple the birthweight.

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14
Q

From age 1-6, children gain how much kg per yr?

A

2 kg

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15
Q

From age 6-10, children gain how much kg per yr?

A

3 kg

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16
Q

Acute threshold changes of a pacemaker are almost always associated with what electrolyte imbalance

A

Potassium

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17
Q

First signs of cerebral ischemia appear on EEG when cerebral blood flow (CBF) falls below what value?

A

22 mL/100 g/min

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18
Q

EEG becomes isoelectric when CBF falls to what value?

A

15 mL/ 100 g / min

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19
Q

Irreversible membrane damage and cellular death occur when CBF falls to what value?

A

6 mL / 100 g / min

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20
Q

Duration of action of anticholinesterase drugs from fast to slow

A

Edrophonium < neostigmine < pyridostigmine

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21
Q

Glycopyrrolate or atropine has longer duration of action?

A

Glycopyrrolate

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22
Q

Which partition coefficient is most closely associate with minimum alveolar concentration?

A

Oil/gas partition coefficient

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23
Q

Succinylcholine is hydrolyzed by?

A

Pseudocholinesterase

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24
Q

Conditions associated with increased DLCO (Diffusing capacity of carbon monoxide)

A

Obesity, asthma, exercise, supine position, left to right shunt, polycythemia

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25
Most reliable early sign of MH
Increased end expiratory CO2 (PECO2)
26
Components of PADSS (post anesthetic discharge scoring system)
vital signs, ambulation, pain, nausea/vomiting, surgical bleeding
27
Does history of uncomplicated general anesthesia reassure that a malignant hyperthermia suspect can be ruled out?
No, it is not uncommon for MH-susceptible patients to not trigger initially and then develop fulminant MH with a subsequent anesthetic
28
Mechanism of action for montelukast (singulair)
Leukotriene receptor antagonist. Leukotrienes are inflammatory mediators.
29
Trismus after giving succinylcholine signals onset of MH in what percentage of patients?
Less than 50%
30
Head flexion can advance the ETT by how much?
1.9 cm toward carina
31
How many days after gas bubble is injected into vitreous for retinal detachment can nitrous oxide be used?
10 days
32
Myocardial oxygen demand
HR wall tension Contractility Basal metabolic
33
Myocardial oxygen supply
HR Oxygen content Anatomy Coronary perfusion pressure
34
Normal oxygen consumption of heart
8 mL/100 g/ min
35
Oxygen consumption of heart on CPB
2 mL/100g/min
36
Cardiac conditions to treat SAM (systolic anterior motion)
Big slow heart, decrease contractility, increase afterload
37
Several days after a thermal injury, how does a patient's sensitivity to depolarizing and nondepolarizing muscle relaxants change?
Increased sensitivity to depolarizing agent | Decreased sensitivity to nondepolarizing agent
38
Greater than 60% of all drug-induced allergic reactions during perioperative period is attributable to...
Muscle relaxants
39
Succinylcholine should be used cautiously with patients with Huntington's chorea because of
Decreased levels of pseudocholinesterase, therefore prolonging effects of succinylcholine
40
PaO2 is decreased by how much for each degree that body temperature is cooler than 37C?
6%
41
2 main causes of central cyanosis
1) Decreased arterial oxygen saturation | 2) Hemoglobin abnormalities (eg. methemoglobinemia and sufhemoglobinemia)
42
Classic signs of fat embolism
Tachycardia, dyspnea, mental confusion, fever, petechial rash on upper part of the body
43
Remifentanil is metabolized primarily by
Nonspecific esterases
44
MC reason for unexpected hospital admission after outpatient general anesthesia
Nausea and vomiting
45
MC reason for prolonged recovery room stay
Nausea and vomiting
46
Elimination half life time of factor VIII
12 hrs
47
Factor VIII level for a hemophiliac should be raised to what before elective surgery
100%
48
What is the best screening test for hemophilia A?
PTT because hemophilia A is associated with decreased levels of factor VIII so PTT tests intrinsic coagulation cascade
49
90% of patients have blood to the AV node supplied by which coronary artery?
right coronary artery
50
Severe CAD of which coronary artery can lead to complete heart block
Right coronary artery
51
How does hypernatremia affect MAC?
Increase
52
How does abnormal thyroid function affect MAC?
No change
53
Minimum dermatomal level that must be achieved for testicular surgery
T10
54
Peak effect of neostigmine
10 min
55
Peak effect of glycopyrrolate
3 min
56
Long term lithium therapy may be associated with what conditions?
Nephrogenic diabetes insipidus, hypothyroidism, decrease MAC, prolong duration of action of pancuronium and succinylcholine. Diuretics increase lithium levels.
57
Best medication to treat hypotension in a patient with metastatic carcinoid
Octreotide, a synthetic somatostatin
58
How is insulin metabolized?
Liver and kidney, so diabetic with renal disease can have prolonged effects of insulin
59
Why does carboxyhemoglobin not decrease the pulse oximetry reading?
Because it has absorbable at 660 nm, which is similar to oxygen rich hemoglobin
60
Mechanism of action of gabapentin
Unknown but it involves inhibition of voltage dependent calcium channels
61
Perioperative visual loss is most commonly due to
Ischemic optic neuropathy, with associated factors of: prolonged hypotension, anemia, large blood loss, facial edema
62
Drugs used to treat postop shivering other than meperidine
Clonidine, droperidol, magnesium, calcium, chlorpromazine
63
For every 10 cm of H2O, how much change in mmHg?
7.5 mmHg
64
Specific cytochrome P450 enzyme that facilitates metabolism of codeine, oxycodone, and hydrocodone.
CYP2D6
65
Specific cytochrome P450 enzyme that facilitates metabolism of fentanyl, sufentanil, alfentanil.
CYP3A4
66
One of the most potent inhibitors of CYP3A4 and CYP2D6, which help metabolize narcotics.
Fluoxetine
67
Phase of liver transplantation where greatest degree of hemodynamic instability is expected
Reperfusion phase
68
Metabolic and physiologic conditions that prolong duration of action of nondepolarizing neuromuscular blockade.
Respiratory acidosis, myasthenia syndromes, hepatic/renal failure, hypocalcemia, hypothermia, hypermagnesemia.
69
Drugs that prolong duration of action of nondepolarizing neuromuscular blockade.
Inhaled and local anesthetics, corticosteroids, antibiotics like clinda and flagyl and aminoglycosides, calcium channel blockers, dantrolene, lasix
70
Why is it better to reverse muscle relaxants in pregnant patients with neostigmine and atropine instead of neostigmine and glycopyrrolate?
Because glycopyrrolate does not cross into placenta
71
NSAIDSs are contraindicated in patients undergoing spinal fusion because?
NSAIDs may impair bone healing
72
Leading causes of malpractice claims against anesthesiologists
Death (22%), nerve damage (21%), brain damage (10%)
73
Retinopathy of prematurity is caused by?
O2 administration to neonates up to 44 weeks, especially a hazard in extremely premature neonates
74
Greater auricular nerve arises from branches of what nerves?
C2 and C3 spinal nerves
75
4-12 days after evacuation of intracerebral hemorrhage, pt develops progressive mental deterioration over several hours
Cerebral vasospasm.
76
Why is aspirin contraindicated for thyrotoxicosis?
It displaces thyroid hormones from thyroglobin and can aggravate disease
77
The last of the classic signs of compartment syndrome to appear
Pulselessness
78
How is dose and duration of spinal anesthetics different in infants compared to adults?
Greater dose and shorter duration, infants have more CSF volume per kg
79
If a patient is trapped in MRI machine, what is the greatest hazard patient is in when the MRI machine is shutdown (quenched)
Cold
80
Treatment for anthrax
Ciprofloxacin (anthrax is gram positive bacillus)
81
Treatment for plague
Streptomycin (plague is gram negative coccobacillus)
82
Injury to what nerve causes impaired ankle dorsiflexion, loss of foot eversion and toe extension
Common peroneal nerve

Anesthesia Boards (27 decks)

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