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2 Review Course > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

What functional groups are derivatives of ammonia and have the formula NR3?

A

Amines

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2
Q

What functional groups have the formula ROH, ROR’

A

ROH- alcohols and Phenols

ROR’- ethers

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3
Q

What is the maximum about of one substance that is able to dissolve into another?

A

Solubility (affected by intermolecular interactions, temperature and pressure)

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4
Q

what law describes the faster diffusion of smaller molecules compared to larger molecules?

A

Grahams law

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5
Q

Diffusion of a gas across a semipermeable membrane is inversely related to what two factors?

A

membrane thickness and molecular weight

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6
Q

What application of force measurement is used to monitor NMBs?

A

accelerometer

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7
Q

What are examples of scalar values?

A

mass, energy, and work

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8
Q

What are vector values?

A

magnitude and direction. EKG is also an examples

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9
Q

How do you convert Celsius to Kelvin?

A

C + 273

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10
Q

How do you convert Celsius to Fahrenheit?

A

(C x 1.8) + 32

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11
Q

How do you convert Fahrenheit to Celsius?

A

(F-32) / 1.8

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12
Q

At what hour of a procedure do patient lose the most heat?

A

within the first hour

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13
Q

What are the four primary sources of heat loss in decreasing order?

A

1 radiation > convection > conduction > #4 evaporation

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14
Q

What is heat loss through radiation?

A

The patients warm body losing heat to the cold operating room air and equipment.

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15
Q

What is heat loss through conduction?

A

heat loss by touching a less warm environment. Warm body transferring warmth to the cold operating room table.

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16
Q

what is heat loss through convection?

A

heat loss through air currents.

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17
Q

What is heat loss through evaporation?

A

moisture evaporating from the patients skin. Prevented with a HME.

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18
Q

What the process called when a reaction does not increase or decrease a systems energy?

A

adiabatic

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19
Q

The rapid expansion of a gas causing cooling of the gas cylinder is know as what?

A

Joule-thompson effect

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20
Q

What type of flow occurs in the terminal bronchioles?

A

laminar flow

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21
Q

When is the Venturi effect applicable in the OR?

A

jet ventilation

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22
Q

According to LaPlace how do you calculate tension in a sphere and cylinder?

A

cylinder: T = P x R
Sphere: (P x R) / 2

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23
Q

What type of movement describes transverse waves?

A

up and down movement.

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24
Q

What type of movement describes longitudinal waves?

A

back and forth

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25
Q

What MRI zone poses the greatest risk of injury?

A

zone 4

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26
Q

What is the resistance to electrical flow?

A

impedance

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27
Q

Pulse oximetry readings are based off what Law?

A

Beer-Lambert

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28
Q

What wavelengths of light do oxygenated and deoxygenated hemoglobin absorb?

A

oxygenated: 940, Deoxygenated: 660

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29
Q

Which two positions increase the risk of compartment syndrome?

A

Lithotomy and trendelenberg

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30
Q

What are the three most common modalities responsible for nerve injuries?

A

Transaction, compression, and stretch

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31
Q

Which lower extremity nerve is susceptible to injury for tight table straps?

A

Lateral femoral cutaneous

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32
Q

Highlights of ulnar nerve injury.

A

Most common injury, inability to oppose the 4 and 5th fingers, CLAWHAND

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33
Q

Which cord of the brachial plexus does the ulnar nerve derive from?

A

Medial

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34
Q

What are the preferred arm position to avoid ulnar nerve injuries?

A

Supinated or neutral, abducted less than 90 degrees, padding

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35
Q

Which positions are associated with midcervical flexion myelopathy?

A

Sitting and prone

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36
Q

Postoperative visual loss is most likely caused by what two modalities?

A

Ischemic optic neuropathy and central retinal artery occlusion

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37
Q

Which surgical table is most associated with ION?

A

Wilson frame

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38
Q

To avoid compartment syndrome in the lithotomy position the legs should be periodically lowered at what time interval?

A

Every 2-3 hours

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39
Q

What is the gold standard preoperative monitor for detecting the potential for a PAE?

A

TEE with contrast

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40
Q

What two nerves may be damaged in the patient that has their legs crossed for a procedure?

A

Superficial personal nerve of dependent leg. Sural nerve of the superior leg

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41
Q

Location of first degree burns?

A

epidermis

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42
Q

Burn extending to the dermis?

A

second degree. Deep or superficial.

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43
Q

In a second degree burn injury, the skin will regenerate if what tissue is left intact?

A

epithelial basement membrane

44
Q

What is the depth of a third degree burn?

A

extend to the subcutaneous tissue below the dermis

45
Q

What tissues are damaged in a 4th degree burn?

A

muscle, bone, fascia

46
Q

What is considered a major burn?

A

1) a second-degree burn involving more than 10% of the TBSA in adults or 20% at extremes of age, (2) a third-degree burn involving more than 10% of the TBSA in adults, (3) any electrical burn, or (4) a burn complicated by smoke inhalation.

47
Q

Mortality of a burn is 80% likely if what two indices equals 115?

A

TBSA + age of patient

48
Q

What are the four types of burn injuries?

A

chemical, electrical, thermal, and inhalation

49
Q

What type of burn is likely most damaging?

A

electrical

50
Q

What are the three treatment phases of a burn injury?

A

resuscitative, debridement and grafting, and reconstructive

51
Q

Complete the table

A

Here it is!

52
Q

What are the two clinical endpoints of an inhalation injury?

A

pulmonary edema and V/Q mismatch

53
Q

What is the gold standard for diagnosing a inhalation injury?

A

fiberoptic bronch

54
Q

What are the most worrisome signs of inhalation injury during a diagnostic fiberoptic bronch?

A

ulcerations and necrosis

55
Q

The nebulization of which two agents may improve airway injury with inhalation burns?

A

heparin and N-acetylcysteine

56
Q

What are symptoms of various carboxyhemoglobin levels?

A
57
Q

COHgb shifts the curve which direction?

A

Left

58
Q

How does COHgb affect SpO2 readings?

A

falsely elevated

59
Q

A patient with CO poisoning should be treated with 100% FiO2 for how long?

A

until CO levels are less than 5% for 6 hours

60
Q

What are the respiratory effects of cyanide poisoning?

A

hypoxia, lactic acidosis, and elevated MVO2

61
Q

What is the treatment for cyanide poisoning?

A

Hydroxycobalamin (vitamin B12)

62
Q

Fluid losses are the greatest in what time frame following a burn injury?

A

first 12 hours

63
Q

What starling force is most affected by burn injury?

A

decreased capillary oncotic pressure. (pulling back into the capillary)

64
Q

What is the most significant complication of fluid creep (over resuscitation)?

A

abdominal compartment syndrome

65
Q

Intraabdominal hypertension is defined as a bladder pressure greater than ____ or intraabdominal pressure greater than ___.

A

bladder pressure greater than 12mmHg or intraabdominal pressure greater than 20mmHg.

66
Q

What is the triad of symptoms of systemic inflammatory response syndrome?

A

increased CO, tachycardia, decreased SVR

67
Q

how do burns affect pulmonary mechanics (FRC etc.)

A

decreased FRC, decreased chest wall compliance.

68
Q

What are the preferred Vt and plateau pressures for a burn patient?

A

Vt < 7mL/kg of IBW, and plateau pressure < 31

69
Q

What are the causes of early and lake AKI following a burn?

A

early- HoTN and myoglobinuria. late- sepsis

70
Q

What are three indications to stop surgery on a burn patient related to blood loss and temperature?

A

more than 2 blood volumes are lost, temperature < 35 C or a decrease of 1.5 C from baseline.

71
Q

What eye block is performed between the rectus muscles of the globe?

A

sub-tenon

72
Q

What are the three biggest considerations for placement of a retrobulbar block?

A

eye position (neutral), needle depth (25mm/1 in), and needle angle (lateral to parallel).

73
Q

A good indicator of analgesia of the globe is?

A

akinesia of the eye muscles

74
Q

If LA injected for an eye block travels anteriorly underneath the conjunctiva it is called what?

A

chemosis ( subconjunctival edema)

75
Q

What device is used to apply ocular compression after retrobulbar or peribulbar injection?

A

honan balloon

76
Q

What is the proper inflation pressure of a Honan balloon?

A

30mmHg

77
Q

Do anticoagulants need to be discontinued before a regional block for an eye procedure?

A

no

78
Q

Which induction agents decrease intraocular pressure?

A

propofol and etomidate

79
Q

N2O should be discontinued how many minutes before SF6 and perflouropropane injection?

A

15 minutes

80
Q

Prolonged PONV following an eye procedure can be an indication of what complication?

A

increased IOP

81
Q

What pupil changes post ocular block indicate subarachnoid or subdural injection?

A

Constricted before the block and dilates after

82
Q

What is the first sign of BCIS in a patient under general Anesthesia?

A

decreased EtCO2

83
Q

What are the first signs of BCIS with an awake patient?

A

dyspnea and altered LOC

84
Q

What autonomic reflex is responsible for hypotensive bradycardic episodes seen in the sitting position?

A

Bezold-jarisch

85
Q

What are the two main causes of visual loss following non-ocular surgery?

A

ION and retinal vascular occlusion

86
Q

Obesity, male sex, Wilson frame use, longer anesthetic duration, and greater estimated blood loss are risk factors for what complication?

A

ION

87
Q

What is the most common surgical eye injury?

A

corneal abrasion

88
Q

Apart from the spine what organ does ankylosing spondylitis affect?

A

heart - valvular defects, conduction delays, and BBB.

89
Q

Which class of lasers are incapable of producing damaging radiation?

A

class 1

90
Q

What are the most common hazards of medical lasers?

A

thermal trauma, eye injury, perforation of organs or vessels, gas embolization, electrical shock, air contamination, and fire.

91
Q

What are the three substances used to cool the tip of a laser?

A

air, CO2, or liquid

92
Q

What type of laser creates the largest smoke plume?

A

CO2

93
Q

The higher incidence of HTN in obese is due to what three factors?

A

Hyperinsulinemia, elevated mineralocorticoids, and abnormal sodium reabsorption

94
Q

OSA

A

excessive episodes of apnea (10 seconds) and hypopnea during sleep that are caused by complete or partial upper airway obstruction.

95
Q

Hypopnea

A

Hypopnea is defined as a 50% reduction in airflow for 10 seconds that occurs 15 or more times per hour of sleep, and is associated with snoring and a 4% decrease in O2 saturation.

96
Q

What is the usual anatomical location of upper airway obstruction?

A

pharynx

97
Q

Characteristics of obesity hyperventilation syndrome?

A

OSA, hypercapnia, daytime hypersomnolence, arterial hypoxemia, cyanosis- induced polycythemia, respiratory acidosis, pulmonary hypertension, and right-sided heart failure

98
Q

What BMI must be achieved to be considered for bariatric surgery?

A

BMI > 40

99
Q

What EKG finding in the obese is a marker for sudden cardiac arrest?

A

QT prolongation

100
Q

What are the three most positive predictors of difficult intubation in obese patients?

A

Mallampati score (3 or greater) with a large neck circumference and a history of sleep apnea

101
Q

What gastric volume is considered low risk for aspiration during induction?

A

less than 1.5mL/kg

102
Q

What type of bariatric corrective surgery has the highest incidence of PONV?

A

gastric sleeve

103
Q

What is the estimated blood volume of an obese patient?

A

45-55% of actual body weight

104
Q

What nerves are most susceptible to injury in the obese population?

A

ulnar, brachial plexus, radial, peroneal, and sphenoid nerves

105
Q

Following surgery on a bariatric patient, you expect the PaO2 to be the lowest on which post-operative day?

A

2-3 days post-op

106
Q

Pre- and postoperative measurement of which lab value aids in early diagnosis of rhabdomyolysis in the obese patient?

A

creatinine phosphokinase (CPK)

107
Q

What is the most sensitive sign of an anastomotic leak following bariatric corrective surgery?

A

unexplained tachycardia

2 Review Course (9 decks)

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