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Principles I > Harmon Hints for the Final > Flashcards

Harmon Hints for the Final Flashcards

1
Q

What are the 5 goals of General Anesthesia?

A
  • analgesia
  • amnesia
  • immobility
  • unconsciousness
  • attenuation of autonomic reflexes to pain
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2
Q

What are the two main types of amnesia?

A

retrograde and anterograde.

(retrograde - previously formed memories are lost

anterograde - inability to form new memories)

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3
Q

What is the Mallampati class if the hard palate is not visible?

A

Mallampati IV

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4
Q

What is the Mallampati class if only the hard and soft palates are visible?

A

Mallampati III

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5
Q

What is the Mallampati class if you can see the hard palate, the soft palate, the uvula, and the tonsilar pillars?

A

Mallampati I

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6
Q

What is the Mallampati class if you can see the hard palate, the soft palate, and part of the uvula?

A

Mallampati II

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7
Q

At what spinal process does the adult spinal cord terminate?

A

L1-L2

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8
Q

What can provide the best sensitivity and specificity for a patient in regards to their diagnoses?

A

patient history

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9
Q

Define sensitivity.

A

the proportion of actual positives which are correctly identified as such (e.g. the percentage of sick people who are correctly identified as having the condition)

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10
Q

Define specificity.

A

the proportion of negatives which are correctly identified (e.g. the percentage of healthy people who are correctly identified as not having the condition)

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11
Q

Would a patient who previously had endocarditis, but who does not have valve dysfunction, require prophylactic antibiotics?

A

No.

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12
Q

How much air is needed to inflate a size 4 LMA?

A

30mL

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13
Q

What is the definitive way to guarantee placement of a double ETT?

A

fiberoptic scope

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14
Q

One way to assess a decreased volume status.

A

urine output

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15
Q

What is the number of mL/kg used to calculate the estimated blood volume of an adult female?

A

65 mL/kg

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16
Q

What is the number of mL/kg used to calculate the estimated blood volume of an adult male?

A

70 mL/kg

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17
Q

What is the number of mL/kg used to calculate the estimated blood volume of an infant?

A

80 mL/kg

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18
Q

What is the number of mL/kg used to calculate the estimated blood volume of a full-term neonate?

A

80-90 mL/kg

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19
Q

What is the number of mL/kg used to calculate the estimated blood volume of a premature neonate?

A

100-120 mL/kg

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20
Q

How does the 4-2-1 rule work for maintenance fluid calculation?

A

4 mL for each of the first 10kg
2 mL for each of the next 10kg
1 mL for each of the rest.

(or for adults > 30kg, just add 40 to their weight, and there is the maintenance.

80kg = 120mL/hr maintenance)

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21
Q

What do you do if you are unable to ventilate and unable to intubate a patient?

A

create a surgical airway.

especially after 3 intubation attempts

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22
Q

Most nerve injuries are due to these two things.

A

pressure ischemia and overstretching

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23
Q

Which patient position is the worst for V/Q mismatching?

A

lateral decubitus

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24
Q

What potassium level would require rapid treatment?

A

> 5.5

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25
Q

Would ascites be considered an insensible loss?

A

No.

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26
Q

A basal skull fracture is contraindicated in what type of intubation?

A

nasal intubation

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27
Q

Which nerve is responsible for sensation above the vocal cords?

A

internal branch of the superior laryngeal nerve

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28
Q

Which nerve is responsible for the motor function of the cricothyroid muscle?

A

external branch of the superior laryngeal nerve

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29
Q

Which nerve is responsible for sensation below the vocal cords and motor function of everything but the cricothyroid muscle?

A

recurrent laryngeal nerve

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30
Q

When replacing an NPO deficit, how much fluid is given during each of the first three hours?

A

1/2 of the total deficit during the 1st hour,
1/4 of the total deficit during the 2nd hour,
1/4 of the total deficit during the 3rd hour.

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31
Q

How many mL/kg of fluid is required to replace insensible losses for minimal trauma?

A

4 mL/kg

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32
Q

How many mL/kg of fluid is required to replace insensible losses for moderate trauma?

A

6 mL/kg

33
Q

How many mL/kg of fluid is required to replace insensible losses for extensive trauma?

A

8 mL/kg

34
Q

What is the ratio of how much crystalloid fluid you would give for each mL of blood lost?

A

3:1 (3mL crystalloid for each mL of blood lost)

35
Q

What is the ratio of how much colloid fluid you would give for each mL of blood lost?

A

1:1 (1mL colloid for each mL of blood lost)

36
Q

What is the calculation for allowable blood loss (ABL)?

A

EBV x (starting Hct - target Hct)
ABL = ————————————
starting Hct

(ABL = (70mL/kg x 70kg) x (45% - 30%) / 45%

= (4900 x 15) / 45 = 1633mL

37
Q

A 10mL/kg transfusion of PRBCs will increase Hgb by ____ and the Hct by ____.

A

Hgb by 3g/dL

Hct by 10%

38
Q

Which nerve is most commonly injured due to positioning errors?

A

ulnar nerve

39
Q

Which nerve is most commonly injured while patients are in the supine position?

A

ulnar nerve

40
Q

Which two nerves are most commonly injured while patients are in the lithotomy position?

A

sciatic nerve and common peroneal nerve

41
Q

What causes the majority of postop vision loss following prone spinal procedures?

A

ischemic optic neuropathy

42
Q

At what platelet count would you usually consider giving a platelet transfusion?

A

< 50,000

43
Q

One unit of platelets will increase the platelet count by how much?

A

5,000 - 10,000

44
Q

At what platelet count does spontaneous bleeding usually occur?

A

~20,000

45
Q

Platelets can be given specifically to treat what?

A

thrombocytopenia

46
Q

Fresh frozen plasma contains all coagulation factors, except what?

A

platelets

47
Q

How high would the PT/PTT need to be in order to require fresh frozen plasma?

A

> 1.5 times normal

48
Q

Fresh frozen plasma can be used as the urgent reversal of what medication?

A

coumadin

49
Q

Cryoprecipitate is used to treat what disease?

A

hemophilia A

50
Q

Cryoprecipitate contains more _______ than fresh frozen plasma.

A

fibrinogen

51
Q

One unit of whole blood will increase your hematocrit by how much?

A

3-4%

52
Q

One unit of PRBC will increase your hematocrit by how much?

A

2-3%

53
Q

What is the shortcut ratio for normal hemoglobin and hematocrit?

A

1:3 (Hgb:Hct)

or Hgb x 3 = Hct (+/-3)

54
Q

What is the hematocrit of one unit of PRBC?

A

~70%

55
Q

What are the 3 ways to lose red blood cells?

A

decreased production

increased destruction

bleeding

56
Q

What is the normal range for white blood cells?

A

4,000 - 7,000

57
Q

Most common type of anemia found in the hospital?

A

iatrogenic anemia

58
Q

Delayed hemolytic transfusion reactions can occur up to ____ days after a transfusion.

A

14

59
Q

Based on what we were told in class, what is probably the first sign/symptom of a hemolytic reaction?

A

free hemoglobin in blood and urine

60
Q

Transfusion related acute lung injury (TRALI) mimics what respiratory condition?

A

ARDS

61
Q

Bilateral pulmonary edema seen with transfusion related acute lung injury (TRALI) can occur within how many hours of transfusion?

A

4 hours

62
Q

If the PTT is elevated and the PT is normal, would this be an intrinsic, extrinsic, or overall clotting problem?

A

intrinsic clotting problem

63
Q

If the PTT is normal and the PT is elevated, would this be an intrinsic, extrinsic, or overall clotting problem?

A

extrinsic clotting problem

64
Q

If the PTT is elevated and the PT is elevated, would this be an intrinsic, extrinsic, or overall clotting problem?

A

overall clotting problem

65
Q

Where is Factor VIII produced?

A

in the endothelium

66
Q

Venous air embolisms are a concern when the patient is in what position for surgery?

A

sitting position

per Dr. Hogan, you can hear venous air emboli with the precordial stethoscope

67
Q

Name the 3 single and 3 paired cartilages that make up the larynx.

A

Singles: Paired:
cricoid arytenoids
thyroid corniculates
epiglottis cuneiforms

68
Q

What Cormack and Lehane grade would be given if most of the glottis is visible?

A

Grade 1

69
Q

What Cormack and Lehane grade would be given if only the posterior portion of the glottis is visible?

A

Grade 2

70
Q

What Cormack and Lehane grade would be given if the epiglottis, but no part of the glottis, can be seen?

A

Grade 3

71
Q

What Cormack and Lehane grade would be given if no airway structures can be visualized?

A

Grade 4

72
Q

Bilateral injury of the superior laryngeal nerve causes what?

A

hoarseness, tiring of voice

73
Q

Unilateral injury to the recurrent laryngeal nerve causes what?

A

hoarseness

74
Q

Acute, bilateral injury to the recurrent laryngeal nerve causes what?

A

stridor, respiratory distress

75
Q

Chronic, bilateral injury to the recurrent laryngeal nerve causes what?

A

aphonia

76
Q

ASA classification of a healthy person that is a smoker? (per Ms. Harmon)

A

ASA II

77
Q

ASA classification of someone with OSA? (per Ms. Harmon)

A

ASA III

78
Q

ASA classification of someone who had an MI in the past? (per Ms. Harmon)

A

ASA III

Principles I (7 decks)

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