Monitors

Question 1

Overdamping of A-line caused by….

Answer 1

When natural frequency decreases.

Length of tube, viscosity of fluid and density directly related

Inversely related to radius and tube stiffness.

(increasing length of tube, having multiple connections, loose connections, clots, kinks, air bubbles)

Question 2

The most factor prevent arterial artery thrombosis from A-line is …

Answer 2

Using a large gauged catheter and longer catheter

Question 3

With oversized BP cuff

Less/more pressure is required to occlude the brachial artery?

Answer 3

Less pressure needed to occlude systolic pulse and therefore BP will be underestimated

Question 4

Prolongation of QT is a ddx for 2 electrolytes abnormalities?

Answer 4

HYPO k or Ca

With HypoK (tall peaked T waves) seen when K >9

HypoCa -> the muscle cramps, hyperreflexia, spasm and seizures as wells as decreased cardiac contractility

Question 5

Indication for urgent dialysis

Answer 5

A: acidosis
E: electrolytes (hyperK or Ca)
I: intoxication (AG, OG)
I: overload of volume (plum edema)
U: uremia

Question 6

Hypokalemia on ECG?

Answer 6

No pot[assium], no t[ea], but ‘U’

ST depression or negative T
U wave
Extrasystole
Prolongation of QT

Question 7

According to ACLS protocols, the primary survey for asystole is “ABCCD”

Answer 7

airway, breathing, circulation, confirmation of true asystole, and defibrillation (or recognition that asystole is not a shockable rhythm).

In a patient monitored in an emergency or teleme- try setting, confirmation of true asystole would include checking a second lead, con- firming that the leads are attached to the patient, and that cables are correctly attached. The use of epinephrine and atropine, or the consideration of discontinuation of resuscita- tion, would be appropriate after the confir- mation of true asystole.

Question 8

Stage 1 HTN

Stage 2 HTN

Answer 8

140-159 or DBP 90-99

160 and above or DBP > 100

Prehypertension is between normal and 1st stage

Question 9

Mgmt of carcinoid tumor resection involves limiting the release of vasoactive substance (serotonin, kallikerin, histamine) which can lead to profound hypotension and bronchospasm

Answer 9

Regional instead of GA (Avoiding increase catacholamine surge which leads to carcinoid flares)

Hypotension can + SNS discharge therefore aggressive fluids to avoid hypovolemia.

Avoid Histamine releasing drugs

Perioperative octreotide

Question 10

SBP and MAPs changes as goes beyond the aorta? To radial?

Answer 10

SBP increases as pressure wave travels distally (radial artery has higher SBP then aorta)

MAPs decreases. (Aorta > radial).

Question 11

For every 1 cm the BP cuff above the heart, a … mmHg added.

Answer 11

0.7 mmHG added to BP for every 1 cm of cuff above heart

Question 12

Most sensitive lead to detect LV MI and examines left Coronary Artery?

Answer 12

V5 and V4

Question 13

ECG lead has the highest to detect p wave rhythm and -/+ right coronary artery?

Answer 13

Lead 2

Question 14

Which common arrhythmia that if patient has it, makes difficult to detect MI on 2 lead ECG (V5 and ll)?

Answer 14

LBBB