Mixed questions Flashcards
Treatment for cerebral spam
Nimodipine
Atracurium metabolite and effect
Laudanosine
Epileptogenic effect
Ketamine entiomers
S, increase CMR
R, decrease CMR
Both of them present
Clinical assessment of preload
PAWP
Death in patients with sepsis
10%
SOFA score
Cr, MAP, GCS, Ptl, Br, PaFi
Pneumothorax in US
Lost of b lines
predominance of a lines
loss of sandy beach
Barcode sign
Most important predictor of transformation from acute to chronic pain
Intensity of pain
In response to Pain, what hypothalamus does
Release of catecholamines and increase sympathetic tone
Respiratory ventilation for pulmonary edema
NIV
Phases of Major Traumatic Resuscitation
- Active bleeding
- Partially controlled
- Restored physiology
General parameters for ALL patients after TBI
- Maintain systolic BP ≥ 100 mm Hg for patients 50-69 years-old or ≥ 110 mm Hg for patients 15-49 or ≥ 70 years-old
- Keep Hct 30%-33%
- Maintain serum sodium at 140-145 mEq/L unless patient has ICP elevations
- Encourage use of PETCO2 monitoring
- Initiate DVT prophylaxis
- Initiate nutrition as soon as medically appropriate with full caloric replacement by 7 days after injury
- Initiate anticonvulsants for the first 7 days after injury; phenytoin is the agent of choice
Initial interventions after TBI
- Establish airway, breathing, and circulaton
- Ventilate to maintain PaCO2 to 35 mm Hg and avoid hyperventilation
- Provide supplemental O2 to keep PaO2 > 70 mm Hg or SpO2 > 94%
- Maintain normothermia
- Maintain head of bed to optimize CPP and minimize ICP
- Ensure good head and neck alignment
- Reduce unnecessary noxious stimuli
- See sedation algorithm
Drugs involved in perioperative anaphylaxis
Muscle relaxants 69.2%
Latex 12.1
Antibiotics 8
In a three-compartment model, whats do V1 V2 V3 represents
V1 central compartment. Blood
V2. Rapidly equilibrating compartment. Muscle
V3. Slow equilibrating. Fat
Extra compartment, effect site
Time to peak effect and t1/2 after bolus
Carotid stent vs endarterectomy
CS. Lower risk of cranial nerve palsy, site hematoma, MI
More risk of stroke and death
Carotid endarterectomy charac
Most of the patients return to baseline (BP) after 12/24h
Aspirin as usual
Goal BP 20% above baseline
Reperfusion after cause disturbances in autoregulation of BP
Where in the heart, is located the sensor electrode of a CRTD
Left ventricle
What transesophageal pacing activates
The left atrium due to its proximity to the esophagus
What is oversensing in a pacemaker
The pacemaker understands the EMI (electro magnetic interference) as intrinsic activity and does not initiate the rhythm
Minimal radiation of a pacemaker
5 Gy
When after surgery can we see nerve injury?
Some days after the surgery
Minimal distance of a pacemaker from defibrilation
8 cm
Most common nerve injury after robotic prostatectomy
Brachial due to the extreme Trendelenburg
What nerves lithotomy position can damage
common peroneal nerve and sciatic nerve
Cardiotoxicity of local anesthetics
Decrease the rate of depolarization of Purkinje fibers
Minimum time for surgery after PCI
With or w/o stent, minimum 4-6 weeks
Test for malignant hyperthermia and where
For IVCT (caffeine muscle contracture test), the muscle biopsy will be performed on the quadriceps
Where can we see cannon a wave
A-V dissociation
Charac of cholestasis
GT increase
Alkaline phosphatase increase
Bil conjugated increase
Aminotransferase increase
Transcranial doppler
normal flow: mean = 55cm/sec.
mild: > 120cm/sec.
moderate: > 160cm/sec.
severe: > 200cm/sec.
Diagnosis of hemolytic transfusion reaction
Direct antiglobulin test
St Johns Wort
Reuptake inhibitor of Nor, serotonin, dopamine
