Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ITE > ITE > Flashcards

ITE Flashcards

1
Q

What is the mechanism of action of midazolam?

A

positive allosteric modulator of GABAa receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

increased 2,3 diphosphoglyceric acid (DPG)

A

stabilizes deoxy Hg therefore shift curve to the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ultrasound is sound above what range?

A

20,000 cycles per second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

two most frequent CV side effects of amiodarone?

A

bradycardia and hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

when do you use a t test?

A

to compare the mean outcome between two independent populations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

where are catecholamines made and name examples of catecholamines?

A

adrenal medulla. Epinephrine, norepinephrine, and dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what physiologic lung volumes increase during pregnancy?

A

inspiratory capacity, tidal volume, inspiratory reserve volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

why should corticosteroids be used cautiously in glaucoma?

A

corticosteroids increase IOP and can cause steroid induced glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the best image modality to diagnose cerebral vasospasm?

A

cerebral angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the best treatment of vasospasm?

A

“Triple H” therapy - hypervolemia, hypertension, and hemodilution

nimodipine also reduces intracelluluar Ca availability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the safest opioids in end stage renal dx patients?

A

fentanyl and methadone which are both metabolized in the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

normal cvp

A

2-6 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

normal PCWP

A

6-12 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

normal CI

A

2.5 - 4 L/min/m2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

normal SVR

A

800-1200 dynes x sec /cm5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the mechanism of paresthesia during hyperventilation?

A

creates a respiratory alkalosis so hydrogen ions get released from negatively charged proteins like albumin. Calcium then binds to albumin decreasing its availabiliyt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

definition of oliguria

A

<0.5cc/kg/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

common symptoms of carcinoid syndrome

A

flushing, diarrhea, right sided heart dx, bronchoconstriction (wheezing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Draw and describe meaning of early decerlation

A

usually an indication of head compression. nothing to do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Draw and describe late deccereration

A

uteroplacental insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

draw and describe variable deccelerations

A

umbilical cord compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what type of local anesthetic is most likely to cause allergic reaction?

A

Esthers because they get degraded into an allergen called PABA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

which enzyme does etomidate inhibit leading to adrenal insufficiency?

A

11 beta hydroxylase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

conn sydrome (primary hyperaldosteronism) causes

A

hypokalemic metabolic acidosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the side effects of etomidate?

A

adrenal insufficiency, thrombophlebitis, myoclonus, hiccoughs, burning on injection due to propylene glycol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are alternatives to heparin for AC during cardiopulmonary bypass surgery?

A

direct thrombin inhibitors such as bivalirubin, argatropan, hirudin, dabigatran

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

why do you need a larger dose of spinal local anesthetic in infants and children?

A

CSF volume is higher on a ml/kg basis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what drug is contraindicated in MH pt being treated with dantrolene?

A

Any Ca channel blocker such as diltiazem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what benzo is the best to give to end stage renal dx patient?

A

lorazepam (Ativan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how does hypercalcemia effect your dosing of nondepolarizing paralytics?

A

need to use an increased dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what factors increase hoffman elimination of cisatricurium?

A

increased pH and temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

when using epidural opioids, what factor contributes the most to spread?

A

lipophillicity. Highly lipophilic drugs will stay at level of injection. Whereas less lipophilic drugs like morphine will have more systemic spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

name your anticholinergics and their effects

A

glycopyrrolate and atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

explain citrate toxicity

A

occurs due to citrate binding to calcium –> hypocalcemia. Worsened by hyperventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is normal ICP?

A

5-20 cm H20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is a normal urine ion gap?

A

0 - 5 (anything above this suggest a renal tubular acidosis because kidneys are unable to excrete enough Cl ions and therefore decreased amounts of NH4+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

medications that induce CYP-3A4

A

carbamazepine, phenytoin, phenobarbital, St. John’s wort, dexamethasone, topiramate, and oxcarbazepine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

cerebral metabolic rate is decreased by what % per each degree celsius?

A

cerebral metabolic rate of oxygen consumption is decreased by about 7.5% for each degree Celsius decrease.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

complete burst suppression occurs at what degree of celsius?

A

18 degreess celsius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what remains constant during volume control ventilation

A

inspiratory flow is constant with varying pressures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what remains constant during pressure control ventilation

A

constant inspiratory pressure w/ deccelerating inspiratory flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is the difference between CAM-ICU and RASS score?

A

CAM-ICU is the initial screening tool for delirium and first two questions need to be positive:

  1. Is there an acute change in mental status or fluctuating course – yes/no
  2. Is the patient inattentive or easily distracted – yes/no

Next set of questions:

  1. Is there an altered level of consciousness or RASS other than 0 – yes/no
  2. Does the patient experience disorganized thinking – yes /no

An altered RASS score or an altered level of consciousness is one of the element of the second part of the CAM-ICU screen. The RASS is an agitation sedation score.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

autonomic hyperreflexia is most likely to occur above what levels?

A

T5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the oxygen content of arterial blood?

A

CaO2 = SaO2 x (Hb x 1.34) + .0031 x PaO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what is the mechanism of action of adenosine?

A

It acts on receptors in the cardiac AV node, significantly reducing conduction time. [This effect occurs by activation of specific potassium channels, driving potassium outside of cells, and inhibition of calcium influx, disrupting the resting potential of the slow nodal cardiac myocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

myasthenia gravis patients are sensitive to what type of NMB?

A

non depolarizing NMB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

lambert eaton patients are sensitive to what type of NMB?

A

succinylcholine and non depolarizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what are the side effects of hypermagnesemia?

A

skeletal weakness, loss or deep tendon reflexes, depression of cardiac conduction and contractility -> bradycardia, widened qrs, hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

when is the max spinal cord edema occur after spinal cord injury?

A

3-6 days after injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what surgeries have highest risk of delirium?

A

cardiac, thoracic and orthopedic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what anesthetic agents induce seizures?

A

ketamine, etomidate, lidocaine, methohexital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

best treatment for type II second degree AV block or third degree AV block?

A

transcutaneous pacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

non depolarizing NMB dosing should be reduced for what types of patients?

A

myopathy disorders, MG, and Lambert Eaton

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what preoperative risk factors MOST predicts the need for extended postoperative ventilation?

A

Hx of MG for > 6 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what scale do you use to predict morality for a SAH?

A

Hunt and Hess scale
Grade 0: Unruptured aneurysm
Grade 1: Asymptomatic or mild headache
Grade 2: Moderate-to-severe headache and/or cranial nerve palsy only
Grade 3: Mild focal deficit and/or confusion/lethargy
Grade 4: Hemiparesis and/or stupor
Grade 5: Coma or decerebrate posture

56
Q

What’s another name for lambert eaton syndrome?

A

myasthenia syndrome

57
Q

what are disease states that lead to upregulation of nicotinic ACH receptors?

A

prolonged immobilization >24hrs, certain neuromuscular disorders, including Guillain-Barré syndrome (GBS), multiple sclerosis (MS) (D), and motor neuron diseases like amyotrophic lateral sclerosis (ALS), stroke, intracranial lesion.

58
Q

How long is succinylcholine’s effect last?

A

9 - 13 minutes

59
Q

what the harm of upregulation in nicotinic ACH receptors?

A

Prone to hyperkalemia and resistance to non depolarizing neuromuscular agents

60
Q

how to calculate intraoperative low tidal volumes

A

6 ccs x kg ( predicted body weight which factors in height)

61
Q

differentiate the drugs used for organophosphate poisoning prophylaxis vs treatment

A

organophosphates are anticholinesterase inhibitors causing a surge in ACH –> DUMBBELS. Prophylactically you can use pryridostigmine

Treatment you use atropine which crosses the BBB and pralidoxime which binds to the poison bound cholinesterases and uncouples them

62
Q

describe the inverse steal phenomenon

A

If hypocapnia is induced, the normal cerebral vasculature will constrict, resulting in increased resistance through the remainder of the cerebral vasculature. Local vascular mediators will cause areas of impaired flow to maximally dilate even in the setting of hypocapnia. The net effect of this is to increase blood flow and oxygen delivery to otherwise ischemic portions of the brain.

63
Q

how does altitude affect desflurane?

A

Desflurane vaporizers need to be adjusted for varying barometric pressures, increasing the percent volume for increasing altitude to maintain a constant partial pressure of anesthetic. Variable bypass vaporizers need no adjusting for changing barometric pressures.

64
Q

what is the criteria for hypertensive urgency?

A

BP >180 / 110 . Check for end organ damage before proceeding for surgery. Dont decrease BP by more than 25%

65
Q

which blood products are more associated with transfusion related lung injury?

A

plasma and platelets which have more plasma/ leukogenic factors

66
Q

whats the analgesic onset for a fentanyl patch?

A

12-24 hrs

67
Q

what’s the onset and duration of IV fentanyl

A

onset 1 -3 minutes and duration 30-60 minutes

68
Q

How is succinylcholine and ester local anesthetics broken down?

A

By pseudocholinesterases

69
Q

what are signs of propofol toxicity?

A

bradycardia, metabolic acidosis, rhabdo, enlarged liver

**check triglycerides as a precursor

70
Q

name your cardioselective beta 1 blocker

A

metoprolol, atenolol, esmolol

71
Q

name your nonselective beta blockers

A

labetolol and carvdilol (have alpha 1 and beta 2 blocking)

72
Q

ways to assess gas exchange via an ABG?

A

An arterial blood gas showing PaO2 greater than 60 mm Hg and a PaCO2 of less than 45 mm Hg.

73
Q

which gas is more associated with emergence delirium?

A

sevoflurane

74
Q

how does chronic emphysema affect your V/Q ratio?

A

increases ratio because the damage alveoli don’t get well perfused but are still getting ventilated

75
Q

what is the hematocrit criteria for polycythemia?

A

> 54%

76
Q

what gas has the lowest fat:blood solubility?

A

nitrous oxide which is why it does not stay in tissues and comes off so fast

77
Q

how long does propofol take to wear off?

A

6-9 minutes

78
Q

what weight should you use for rocuronium dosing?

A

ideal body weight

79
Q

what weight should you use for succinylcoline dosing?

A

total body weight

80
Q

brain death occurs how many minutes after cardiac arrest ?

A

3-8 minutes

81
Q

early signs of digoxin toxicity?

A

heart block or ventricular ectopy

82
Q

why is hyperglycemia associated with worse neurologic outcomes in acute cerebral ischemia?

A

The combination of hyperglycemia + lack of adequate O2 increases anaerobic metabolism which increases your levels of lactic acid

83
Q

what is the saturated vapor pressure?

A

the amount of pressure vapor in equilibrium with liquid phase. Therefore the higher the SVP, the more agent that is in vapor form

84
Q

what is the equation for vapor output volume?

A

outflow = input x (saturated vapor pressure SVP / (atm P -SVP))

85
Q

MAC decreases by what percentage for every decade of life after 40?

A

6%

86
Q

what is the conversion of cmH20 to mmHg?

A

10 cm H20 = 7.4 mmHg
or
15 cm H20 = 10 mmHg

87
Q

where should the ETT placed on xray?

A

5 - 7 cm above the carina

88
Q

lab values for primary hypothyroidism

A

high TSH and low T4

89
Q

lab values for secondary hypothyroidism

A

low TSH and low T4

90
Q

recall the rule of 6’s for TEG

A
  • R time around 6 minutes
  • Alpha angle around 60 degrees
  • Maximal amplitude around 60 mm
  • LY30 of around 6%
91
Q

mnemonic for Aortic insufficiency

A

A mnemonic for both aortic insufficiency and mitral insufficiency is: fast, full, forward which means fast heart rate (or avoiding bradycardia), full preload, and forward flow (avoiding afterload).

92
Q

what is the most potent stimulator for AVP release ?

A

systemic arterial hypotension mediated by aortic and carotid baroreceptors

93
Q

what are the draw backs of PCA vs nurse given IV opioiods?

A

higher incidence of pruritis and higher total opioid consumption

94
Q

What is the mechanism of a bier block?

A

it gets absorbed into the venous system to provide anesthesia to distal nerves

95
Q

what organs are innervated by a celiac plexus?

A

stomach, pancreas, diaphragm, liver, spleen, small colon, large colon up to transverse colon, adrenal glands, and kidney.

96
Q

what herbal supplement causes hypoglycemia

A

ginseng

97
Q

what complication is seen in left central line placement vs right ?

A

left side is where the thoracic duct empties into the left IJ/ subclavian therefore chylothorax

98
Q

the lateral femoral cutaneous nerve is made up of what fibers?

A

L2-L3

99
Q

what layer surrounds the femoral nerve?

A

fascia iliaca

100
Q

definition of abdominal compartment syndrome

A

> 20 mmHg

101
Q

supportive treatment measures for abdominal compartment syndrome

A

keep patient flat

colonic enemas to empty the bowels and decrease the pressure

102
Q

Abx for spontaneous bacteria peritonitis ?

A

ceftriaxone or piperacillin/tazobactam (zosyn)

103
Q

what is the time onset for transfusion related lung injury ?

A

6 hours from transfusion

104
Q

what is the expected blood volume for a child 1 - 12 yo?

A

70 - 75 mL /kg

105
Q

appropriate perineural stimulation occurs at what mA?

A

.2-.5 mA

106
Q

what is the maximum dose of acetaminophen in adults / day?

A

3 grams

107
Q

what is the maximum dose of acetaminophen in children?

A

50 -75 mg/kg/day

108
Q

when is the peak onset of acetaminophen?

A

90 mins after gut absorption

109
Q

what is the half life of acetaminophen?

A

2-3 hrs

110
Q

what does hydromorphone / morphine have more dermatomal spread than fentanyl?

A

because not as lipophilic and therefore more of it remains in the epidural space w/ increase cephalad spread

111
Q

how does decreased fio2 decrease risk of atelectasis?

A

because you have more air (which is largely made up of nitrogen) which keeps the alveoli open

112
Q

what are independent pre op risk factors for post op AKI w/ normal renal function?

A

age > 59, chronic liver disease, emergency sugery, peripheral vascular occlusive disease, BMI >32, COPD requiring bronchodilator, high risk surgery - intrathoracic, intraperitoneal, supringuinal surgery, those involving large blood loss or fluid shifts

113
Q

what is the relationship between radiation exposure and distance?

A

radiation exposure = 1 / r ^ 2

114
Q

what should be your initial bolus for pediatric resuscitation?

A

20 - 30 cc/kg

115
Q

what are the four cardiac lesions that define tetralogy of fallot?

A

overiding aorta
pulmoninc stenosis
VSD
right ventricular hypertrophy

116
Q

what lab value is the best determinant of synthetic liver function?

A

PT / INR

117
Q

when to consider peritoneal dialysis?

A

for patients who cannot tolerate the hemodynamic changes induced during traditional hemodialysis

118
Q

what nerves do you need to block for an awake fiberoptic intubation?

A

glossophargyngeal nerve, internal brach of the superior laryngeal nerve, and recurrent laryngeal nerve

119
Q

what is lithiums affect on non depolarizing NMB?

A

it potentiates effect by activating K channels

120
Q

what is phentolamine mechanism of action?

A

alpha 1 and 2 antagonist

121
Q

what is the name and effect on HR w/ decrease cardiac preload?

A

Bezold - Jarisch reflex which causes increased paryasympathetic response causing bradycardia

122
Q

when does separation anxiety begin for infants?

A

at 6-8 months

123
Q

what is lusitropy

A

myocardial relaxation

124
Q

what is the most sensitive test for MH?

A

halothane caffeine contracture test

125
Q

what are complications with brachial artery catheterization?

A

thrombosis and nerve injury to median nerve because it is wrapped in sheath that covers the median, ulnar, and radial nerves. If you cause a hematoma you can cause nerve injury due to compression

126
Q

describe the bohr effect

A

in alkalotic conditions like in the lungs, Hg has a higher affinity for oxygen. In acidotic conditions, like near tissues, Hg has less affinity for O2

127
Q

what lung parameter is unchanged in obese patients?

A

closing capacity

128
Q

spinal cord stimulator activates what part of the spinal cord?

A

dorsal column

129
Q

what ECG findings are associated with hypocalcemia?

A

prolonged QT waves

130
Q

how do acetylcholinesterase inhibitors affect a phase I block?

A

augments the block because they also inhibit butylrylcholinesterase which is degrades succinylcholine. Therefore, more succinylcholine around

131
Q

what drug should be based on total body weight?

A

succinylcholine. Obese patients have more pseudocholinesterase

132
Q

what compartments increase for elderly regarding drugs?

A

volume of distribution increases (more fat than muscle)

133
Q

what compartment decreases for elderly regarding drugs?

A

central compartment volume because total body water decreases

134
Q

what is the intrinsic INR of FFP?

A

1.6-1.8

135
Q

Specific medications in anesthesia and how dosage should be calculated:
Total body weight: maintenance infusion dose of propofol, succinylcholine
Lean body weight: thiopental, induction dose of propofol, fentanyl
Ideal body weight: rocuronium, vecuronium

A

Specific medications in anesthesia and how dosage should be calculated:
Total body weight: maintenance infusion dose of propofol, succinylcholine
Lean body weight: thiopental, induction dose of propofol, fentanyl
Ideal body weight: rocuronium, vecuronium

136
Q

hydralazine main mechanism of action

A

arterial vasodilator

137
Q

standard error equation

A

standard deviation / square root of sample size

ITE (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions