inhaled 2 part II

Question 1

___ % of patients should not move at 1.2 MAC

Answer 1

95

Question 2

___ % of patients should not move at 1.3 MAC

Answer 2

99

Question 3

MAC-awake

Answer 3

defined as the minimum alveolar concentration at which 50% of subjects will respond to the command “open your eyes”

Question 4

loss of recall is at

Answer 4

1/3 MAC

Question 5

MAC-BAR represents

Answer 5

the MAC necessary to block adrenergic response to skin incision

Question 6

MAC-BAR is usually ___ than MAC

Answer 6

higher.. around 1.5

Question 7

MAC intubation

Answer 7

similar to MAC-BAR in that its values exceed the anesthetic requirements for surgical skin incision

Question 8

Different stimuli are evaluated with different ____

Answer 8

end-tidal concentrations

Question 9

mac of des

Answer 9

6.6

Question 10

mac of iso

Answer 10

1.2

Question 11

mac of sevo

Answer 11

2.2

Question 12

if you have 4L of flow and want 50% nitrous, you would have how much O2 and how much nitrous

Answer 12

2L of each

Question 13

you want 1 MAC using nitrous and sevo. you’re running 4L of flow. and Nitrous Is at 70%. how much sevo?

Answer 13

3L of nitrous, and 1L of O2, and sevo to .66 (2.2 x 30%)

so this gives a total of 1MAC. 70% of it coming from nitrous and 30% coming from sevo.

Question 14

uptake means

Answer 14

absorption from alveoli into the systemic circulation

Question 15

what is used as an index of anesthetic depth, a reflection of the rate of induction and recovery from anesthesia

Answer 15

PA

Question 16

PA is determined by

Answer 16

input minus uptake

Question 17

uptake is determined by

Answer 17

solubility (blood:gas), CO, alveolar to venous partial pressure difference

Question 18

transfer of inhaled anesthetic from arterial blood to brain is dependent on

Answer 18

brain-blood partition coefficient, cerebral blood flow, arterial venous partial pressure difference

Question 19

concentration effect accelerates the rate of

Answer 19

induction

Question 20

second gas effect

Answer 20

the ability of the large-volume uptake of one gas (first gas) to accelerate the rate of increased PA of a concurrently administered companion gas(second gas)

Question 21

increased alveolar ventilation promotes input of inhaled anesthetics to offset ___

Answer 21

uptake by the blood (maintain high alveolar concentration)

Question 22

if blood gas partition is 10 what does that mean?

Answer 22

the concentration of the inhaled anesthetic is 10 in the blood and 1 in the alveolar gas when the partial pressure of the anesthetic in these two phases is identical

Question 23

high blood solubility means

Answer 23

a large amt of agent must be dissolved(undergo uptake) in the blood before equilibrium with the gas phase is reached.

Question 24

high CO results in ___ uptake and ___ induction

Answer 24

fast , slow

Question 25

low CO results in ___ uptake and ___ induction

Answer 25

slow, fast

Question 26

a right to left intracardiac or intrapulmonary shunt ___ the rate of induction

Answer 26

slows (because the shunted blood dilutes the blood coming from ventilated alveoli)

Question 27

complete equilbration of any tissue, including the brain, with the Pa requires at least __ time constraints

Answer 27

3

Question 28

alveolar to venous partial pressure differences (PA-PV) reflects

Answer 28

tissue uptake of inhaled anesthetics

Question 29

highly perfused organs account for less than __ % of body mass but receive __ % of cardiac output

Answer 29

10, 75

Question 30

highly perfused tissues equilibrate __ with the PA

Answer 30

rapidly

Question 31

after 3 time constraints, __% o the returning venous blood flow is at the same partial pressure as the PA

Answer 31

75

Question 32

as alveolar pressure decreases, anesthetic is transferred from the ___ into the ___

Answer 32

tissues to alveoli (emergence)

Question 33

hypoventilation or use of fresh gas flows low enough to permit rebreathing of anesthetic will have what effect on emergence

Answer 33

prolonged

Question 34

which anesthetics have the fastest offset ?

Answer 34

nitrous des. because they are less soluble in the fat/blood

Question 35

diffusion hypoxia

Answer 35

when N20 is abruptly discontinued, the N20 still in the body rapidly diffuses across capillary/alveoli membrane diluting the O2 concentration to a point where it can cause the PAO2 to drop and hypoxia develops

Question 36

how do you offset diffusion hypoxia

Answer 36

100 O2 at the conclusion of nitrous oxide administration

Question 37

other factors that influence emergence

Answer 37

duration, temp (if cold, longer wake up), physical condition, obesity.

Question 38

concentration effect occurs only in ___

Answer 38

induction. not emergence!

Question 39

context sensitive half time depends on what two things

Answer 39

length of administration (context),and solubility (blood& tissues)

Question 40

increased CO –> increased uptake —> ___ FA, ___ induction

Answer 40

decreased, slower

Question 41

Decreased CO —> decreased uptake —> __ FA, ___ induction

Answer 41

increased, faster

Question 42

something that is associated with higher incidence of awareness means ___ MAC

Answer 42

increased. (takes more agent to get them under)