Jennifer's Notes

Question 1

How does hypocalcemia affect the EKG?

Answer 1

prolonged QT interval

Question 2

How do you calculate normal vital capacity?

Answer 2

60-70 cc/kg

Question 3

What is normal FEV/FVC?

Answer 3

> 80%

Question 4

How do you calculate FEV for a healthy 75 kg man?

Answer 4

75 * 65 = 4875 Vc 4875 * 0.8 = 3900 cc FEV

Question 5

What is a normal value for Vc for an average 70 kg man?

Answer 5

about 4 L

Question 6

What is a normal value for TLC for an average 70 kg man?

Answer 6

5.5 L

Question 7

What is the normal value for FRC for an average 70 kg man? How do you calculate FRC?

Answer 7

2.5 L 28 - 30 cc/kg

Question 8

What is a normal value for RV in an average 70 kg man?

Answer 8

1.5 L

Question 9

What is a normal value for ERV in an average 70 kg man?

Answer 9

1 L

Question 10

What is a normal value for IC in an average 70 kg man?

Answer 10

3.5 L

Question 11

How do you calculate dead space in adults?

Answer 11

2.5 ml/kg

Question 12

How do you calculate dead space in peds?

Answer 12

2 ml/kg

Question 13

Where is the hyoid bone in adults?

Answer 13

C3

Question 14

How many alveoli does each lung have in an adult?

Answer 14

300 million

Question 15

How many alvioli does each lung have in a newborn?

Answer 15

20 -50 million

Question 16

What is the H&H for a newborn?

Answer 16

15- 20

44-64

Question 17

What is the H&H for an child?

Answer 17

10 - 15

32 - 44

Question 18

At what generation does gas exchange occur?

Answer 18

17 just past the terminal bronchioles

Question 19

At what generation does alveolar ventilation occur?

Answer 19

23

Question 20

What are causes of restrictive lung disease? (5)

Answer 20

PAINT

pleural

alveolar

interstitial

neuromuscular

thoracic

Question 21

What are the causes of obstructive lung disease? (6)

Answer 21

emphysema

chronic bronchitis

cystic fibrosis

asthma

bronchioectasis

obliterans

Question 22

What are factors that increase pulmonary resistance? (6)

Answer 22

hypoxemia

hypercarbia

pulmonary embolus

increased PEEP

acidosis

sympathetic stimulation

Question 23

What doe the T1-T4 cardioaccelerator fibers do with respect to the lungs?

Answer 23

bronchodilation due to B2 activation

Question 24

What is the order of least to most metabolized gases?

Answer 24

N2O Des Iso Sevo Halo

Question 25

What is the treatment for a tet spell for a tetralogy of fallot patient?

Answer 25

increase preload (IV bolus of fluids) minimize PVR (increase FiO2 and decrease paCO2) increase SVR (knee-chess position and give phenylephrine) consider negative inotropes (beta-blockade)

Question 26

What type of shunt is tetralogy of fallot characterized by?

Answer 26

right-to-left shunting (think of the hypoxia it causes)

Question 27

How do you treat pre-eclampsia?

Answer 27

labetalol or hydralazine

Question 28

What are drugs that effect SSEPs? (3)

Answer 28

ketamine etomidate volatile agents (use 1/2 mac)

Question 29

What is the equation for determining CO given MAP, SVR, and CVP?

Answer 29

MAP = (CO \* SVR) + CVP Make sure SVR is in woods units. If dyn·s/cm5, divide by 80. Normal SVR about 12.

Question 30

What is the major complication of a Bier block?

Answer 30

local anesthetic toxicity

Question 31

What are the first signs of lidocaine toxicity?

Answer 31

CNS symptoms include lightheadedness and dizziness

Question 32

What level is the cricoid in peds?

Answer 32

C4

Question 33

What is the O2 consumption in peds?

Answer 33

7 ml/kg compared to 3.5 ml/kg in adult

Question 34

What is ACLS protocol for treating SVT? (2)

Answer 34

Adenosine 6 mg Verapamil 2.5 - 5 mg

Question 35

What is the treatment for a-fib, a-flutter? (5)

Answer 35

ablation synchronized cardioversion verapamil or diltiazem (slow the heart rate with Ca channel blocker) beta blockers may be used as well amiodarone, sotalol, flecainide (antiarrhythmic drugs)

Question 36

What is the PALs protocol for v-fib?

Answer 36

epi 0.01 mg/kg IV/IO

Question 37

What is ACLS protocol for v-fib?

Answer 37

1 mg

Question 38

What commonly used anesthesia drug does not cross placenta?

Answer 38

gyclopyrrolate

Question 39

What receptors are found on the vessels?

Answer 39

alpha 1 alpha 2 beta 2

Question 40

What position causes peroneal nerve damage?

Answer 40

lithotomy

Question 41

COPD causes what changes to PFTs? (4)

Answer 41

decreased FEV1/FVC ratio decreased FEF25-75 increased RV normal to increased FRC, TLC

Question 42

What is desmopressin?

Answer 42

synthetic replacement for vasopressin that reduces urine production used to treat diabetes insipidus

Question 43

What are the names of the vitamin K dependent factors?

Answer 43

II prothrombin VII stable factor, or, proconvertin IX plasma thromboplastin component (Christmas factor) X Stuart-Prower factor

Question 44

If you have the following lab values: pH = 7.60; CO2 = 30; HCO3- =22 What is the condition?

Answer 44

uncompensated respiratory alkalosis A good resource to learn this quickly: http://www.teachingmedicine.com/pdf\_files/ABG.pdf

Question 45

What nerve does the RLN originate from?

Answer 45

vagus

Question 46

What is associated with Ludwig's angina?

Answer 46

dyspnea

Question 47

In a pt with muscular dystrophy, what should you consider regarding anesthetic technique?

Answer 47

NO SUX because it causes rhabo and death

Question 48

What are the mEq of 0.9 NS?

Answer 48

154 meq Na 154 meq Cl

Question 49

What would you expect regarding erythropoiten and ESRD?

Answer 49

anemia

Question 50

What 2 arteries form the basilar artery?

Answer 50

verebral

Question 51

What do inhaled agents cause to increase regarding the kidney? Na absorption GFR RBF Urine output Creatinine

Answer 51

creatinine

Question 52

What is a physical sign of fat embolism?

Answer 52

petechiae

Question 53

What is the best abx to give pt with valve replacement?

Answer 53

ampicillin 2 g + gentamyacin 1.5 mg/kg

Question 54

What is the treatment for a-flutter?

Answer 54

cardioversin

Question 55

What is the mechanism of action of dantroline?

Answer 55

depresses excitation-contraction coupling in skeletal muscle by binding to the ryanodine receptor, and decreasing free intracellular calcium concentration

Question 56

What is ranitidine mechanism of action?

Answer 56

competitive, reversible inhibitor of the action of histamine at the histamine H2-receptors found in gastric cells

Question 57

A 3 y/o African american girl has Hb 18, family hx of polycystic renal dz. Preop Hg is 10. What caused it?

Answer 57

nothing his is normal

Question 58

Blockade of what nerve that affects abduction of thumb?

Answer 58

median

Question 59

How many mA is needed to ellicit TOF?

Answer 59

20 mA?

Question 60

What are examples of R--\>L shunts? (5)

Answer 60

Pulmonary atresia wih VSD, tricuspid atresia Tetralogy of Fallot Eisenmenger's syndrome (severe) starts as L--\>R but increased PHTN leads to reversal of shunt Ebstein's malformation of tricuspid Patent foramen ovale

Question 61

What must you be careful of in pts with R--L shunts?

Answer 61

air embolism L--R shunts are not of great concern because blood flows from systemic to pulmonary system