Brainscape's Knowledge GenomeTM

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


See full index

TrueLearn > New TrueLearn Questions > Flashcards

New TrueLearn Questions Flashcards

1
Q

pt on naltrexone, what to do for pre-medication?

A

ok to give versed and fentanyl

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

which condition is caused by autoimmune destruction of postsynaptic ACh receptors at the NMJ?

A

myasthenia gravis

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

pt on naltrexone, what to do when opioid is required?

A

opioids still work, but higher dose needed to overcome antagonistic effect of naltrexone

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

how does the solubility of a gas affect its diffusion?

A

the more soluble a gas, the more readily it will diffuse. e.g. CO2 much more soluble in water than O2, so CO2 diffuses much faster across the alveolar-capillary membrane

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

what vent settings to change when there is auto-PEEP?

A

decrease RR (to slow down breathing) and increase time for expiration compared to inspiration (with I:E ratio)

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

where is norepinephrine metabolized?

A

lungs

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

what changes in potassium and pH would you expect after massive transfusion?

A

increased potassium (RBC cell membrane degrades, K leaks out)

decreased pH (anaerobic metabolism during storage b/c no oxygen, lactic acidosis)

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

what percentage of anesthesiologists who had substance abuse eventually relapse and fail long-term abstinence?

A

40%

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

which coagulation factors are synthesized in the liver and require vitamin K-dependent gamma carboxylation?

A

Factors 2, 7, 9, 10, proteins C and S

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

which coagulation factor is decreased during pregnancy?

A

anticoagulant factor protein S

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

how long does emergence delirium last for in pediatric patients?

A

10-30 minutes, and usually resolves without any treatment

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

which procedure increases the risk of intraoperative awareness?

A

C-section

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

mechanism by which thiazide diuretics increase Ca2+?

A

enhancing Na+/Ca2+ antiporter exchange

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

which local anesthetic has the fastest onset of action when used for spinal anesthesia?

A

lidocaine

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

what is the most anterior structure on ultrasound in the popliteal fossa?

A

popliteal artery

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

which artery is the popliteal artery a continuation of?

A

superficial femoral artery

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

where are nicotinic acetylcholine receptors found?

A

in the ganglia of both the sympathetic and parasympathetic systems

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

what gastric fluid volume and pH are considered high risk for aspiration lung injury?

A

volume >25 mL and pH <2.5

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

MH occurs following exposure to what agents?

A

volatile anesthetics and succinylcholine

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

which anti-platelet drugs are prodrugs that require activation by hepatic cytochromes in order to exert their clinical effects?

A

clopidogrel, prasugrel, and ticlopidine

“Grel needs ‘help’—these drugs need activation to help them work.”

Ticlopidine – P, D – pro drug

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

which anti-platelet drugs are direct ADP receptor inhibitors that do not require enzymatic activation?

A

cangrelor and ticagrelor

“Grelor sounds like ‘go’—these drugs are ready to go without activation.”

Vs.

Mnemonic: “Grel needs ‘help’—these drugs need activation to help them work.”

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

what type of drugs are used in pts with occlusive arterial disease?

A

antiplatelet drugs that prevent platelet aggregation

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

how does upregulation of immature (fetal) nicotinic acetylcholine receptors affect its sensitivity to neuromuscular blocking agents?

A

increased sensitivity to acetylcholine and succinylcholine but decreased sensitivity to nondepolarizing neuromuscular blocking agents

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

when is there upregulation of immature (fetal) nicotinic acetylcholine receptors?

A

during times of decreased stimulation at the neuromuscular junction such as in severe burns, infection, sepsis, immobilization, CVAs, and extended use of neuromuscular blocking agents

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

when is there downregulation of mature nicotinic acetylcholine receptors?

A

chronic pyridostigmine use in myasthenia gravis, organophosphate poisoning, or exercise conditioning

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

ASA 2 definition and examples?

A

mild systemic disease

-obesity (but not morbidly obese)
-well controlled DM or HTN
-mild lung disease

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

ASA 3 definition and examples?

A

severe systemic disease

-morbid obesity
-poorly controlled DM, HTN, COPD
-hepatitis
-ESRD on dialysis
-MI, CVA, TIA, or CAD/stents >3 months ago

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

ASA 4 definition and examples?

A

severe systemic disease that is a constant threat to life

-MI, CVA, TIA, or CAD/stents <3 months ago
-current cardiac ischemia
-severe valvular dysfunction or reduced EF
-ARDS
-sepsis, shock, DIC
-ESRD NOT on dialysis

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

ASA 5 definition and examples?

A

moribund pt not expected to survive without surgery

-ruptured abdominal or thoracic aneurysm
-massive trauma
-intracranial bleed with mass effect
-ischemic bowel with significant cardiac pathology or multiple organ dysfunction

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

ASA 6 definition and examples?

A

brain-dead pt whose organs will be removed for donation

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

how does the lipid solubility of opioids affect the onset, spread, and duration in the CSF?

A

highly lipid soluble drugs have rapid onset, less extensive spread, and short duration

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

order of opioids from least lipophilic to most lipophilic?

A

hydromorphone
morphine
alfentanil
fentanyl
sufentanil

“Hardly Moving After Fentanyl Shot”

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

mechanism of action of volatile anesthetics?

A

potentiates pre-synaptic and post-synaptic GABA release, and glycine

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

how does immobility from volatile anesthetics occur?

A

due to inhibitory effects on the spinal cord rather than in the brain

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

how is the sensory afferent limb of the corneal reflex mediated?

A

trigeminal nerve (CN 5) ophthalmic branch

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

how is the motor efferent limb of the corneal reflex mediated?

A

facial nerve (CN 7)

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

what happens to the serum concentration of albumin during pregnancy and why?

A

decreases, not due to a decrease in total albumin but rather an increase in plasma volume

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

what happens to the serum concentration of fibrinogen during pregnancy and why?

A

increases
both fibrinogen and factor 7 increase, which create a hypercoagulable state during pregnancy

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

what happens to the serum concentration of transferrin during pregnancy?

A

increases

serum iron falls because of hemodilution but transferrin and TIBC increase during pregnancy because of increased iron demand

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

what is a nonparticulate acid that is used to decrease the risk of pulmonary aspiration?

A

sodium citrate

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

which medication prolongs the QT interval?

A

methadone

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

what is the name of the law that describes the relationship between resistance of flow through a tube and the radius of that tube?

A

Poiseuille’s Law

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

in myotonic dystrophy, what is the risk of malignant hyperthermia and the use of succinylcholine?

A

no increased risk of MH but succinylcholine should be avoided due the risk of hyperkalemia and diffuse sustained muscle contractions

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

how is succinylcholine’s action terminated?

A

by diffusion away from the NMJ

it’s then hydrolyzed in the plasma by pseudocholinesterase

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

what happens to the heart rate after administration of succinylcholine?

A

bradycardia, especially in children

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

how does hyperglycemia occur in times of surgical stress?

A

reduction in insulin release and increased resistance to insulin

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

how should a needlestick injury be treated?

A

wash with soap and water
expressing fluid should NOT occur

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

pt has laryngospasm after IM ketamine, has no IV access, next step?

A

administer IM succinylcholine

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

first steps in management of laryngospasm?

A

remove offending stimulus, apply 100% oxygen with CPAP, jaw thrust at Larson’s point (pain stimulates the autonomic nervous system and relaxes the vocal cords)

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

how does MAC change with age?

A

MAC increases from birth until 1 year, then decreases after

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

Electrolyte findings in pyloric stenosis?

A

hyponatremia, hypokalemia, hypochloremia, metabolic alkalosis with compensatory respiratory acidosis

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

normal serum bicarb level?

A

22-28 mEq/L

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

what is an important clinical manifestation of hypophosphatemia from refeeding syndrome?

A

respiratory failure from diaphragmatic weakness due to ATP depletion

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

at which postconceptual age do preterm infants have an increased risk of perioperative apnea?

A

less than 60 wks postconceptual age

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

what to administer with neostigmine for reversal in order to avoid fetal bradycardia?

A

atropine, which crosses the placenta more easily than does glycopyrrolate

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

what is the least stable coagulation factor in FFP?

A

Factor 8

“Factor 8 can’t wait”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

how does terbutaline work?

A

can cause tocolysis as a b2 agonist, smooth muscle relaxation causes uterine relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

metabolic side effects of b-adrenergic receptor agonists?

A

hypokalemia and hyperglycemia
e.g. terbutaline and ritodrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

zero-order vs. first-order kinetics

A

zero-order: a constant amount of the drug is eliminated over time. graph shows linear decline in concentration over time

first-order: a constant fraction of the drug is eliminated over time. graph shows exponential decline in concentration over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

normal PaCO2 range?

A

35-45 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

normal PaO2 range?

A

75-100 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

nitrous oxide mechanism of action?

A

NMDA antagonist

Nitrous Oxide → NMDA Off
“Nitrous (N2O) turns NMDA Off” can help cement the idea that it blocks NMDA-mediated excitation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

next step when pt has refractory ventricular fibrillation despite rounds of shocks and epinephrine?

A

amiodarone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

proper placement and orientation of axillary roll?

A

oriented A-P and placed caudal to the axilla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

excessive fasciculations from succinylcholine would be most expected in which disorder and why?

A

myotonic dystrophy because it’s a disease of impaired muscle relaxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

which additive increases duration of action for local anesthetics?

A

alpha-2 adrenergic agonists like clonidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

dexamethasone addition effect on local anesthetic?

A

increases duration of analgesia for both ropivacaine and bupivacaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

epinephrine increases the duration of local anesthetics except for which ones?

A

ropivacaine and bupivacaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

effect of adding bicarbonate to local anesthetics, especially bupivacaine?

A

alkalization will cause precipitation and will not increase the speed of onset or duration of action

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what is the primary efferent pathway for the hippocampus?

A

fornix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

which structure in the brain is involved in memory formation?

A

hippocampus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

what is associated with a higher risk of AKI during surgery?

A

overly restrictive IV fluid management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

which medication is contraindicated for treatment of uterine atony in pts with HTN and preeclampsia?

A

methergine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

which medication is contraindicated for treatment of uterine atony in pts with asthma?

A

prostaglandin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what is magnesium sulfate used for in pregnancy and what is a side effect?

A

seizure prophylaxis in preeclampsia
causes uterine relaxation which can contribute to uterine atony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

on a radiograph, how to identify T1?

A

the first rib arises from T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what level is vertebra prominens?

A

C7

C se-VEN = promi-NENs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

which nerve is largely unaffected by the lithotomy position?

A

posterior femoral cutaneous nerve, which is not a branch of the sciatic nerve but rather originates directly from the sacral plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

which nerves are affected by the lithotomy position?

A

obturator nerve and lateral femoral cutaneous nerve (both pass beneath the inguinal ligament and is compressed with hip flexion)

sciatic nerve and its branches (stretched with hip flexion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

carotid sinus vs. carotid body?

A

sinus monitors blood pressure, regulates HR and BP. think “sinus pressure”

body is a chemoreceptor, monitors blood gas levels, regulates respiratory activity.
think “body” for “blood gas”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

how does increased afterload affect the velocity of fiber shortening during contraction in a normal functioning heart?

A

when afterload increases, the fibers must generate more force to overcome the resistance. this increased demand for force slows down the speed at which the fibers can shorten

Imagine pushing a door open. If the door is light, you can push it quickly (low “afterload”). If the door is very heavy (high “afterload”), it will open much more slowly even though you are using more force.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

what effect can ketamine have on a patient who has been critically ill?

A

ketamine normally causes a sympathetic stimulation by inhibiting reuptake of catecholamines. When a pt is depleted of catecholamines, ketamine is unable to cause this and blood pressure may fall.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

which artery supplies the AV node?

A

right coronary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

how does ingestion of a carbohydrate beverage two hours before surgery decrease insulin resistance?

A

surgery and fasting before surgery increases the stress response, which leads to the release of hormones like catecholamines and cortisol, which promote insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

in order to obtain additional anesthetic coverage of the medial upper arm from torniquet pain, which nerve is blocked?

A

intercostobrachial nerve

85
Q

what does the axillary block have a lower risk of compared to other upper extremity blocks?

A

pneumothorax

86
Q

in order to obtain additional anesthetic coverage of the lateral surface of the forearm, which nerve is blocked?

A

musculocutaneous nerve

87
Q

which nerves does the axillary block target?

A

M, U, R
Does NOT include the axillary nerve despite its name

88
Q

which supplemental nerve is included in an axillary nerve block and which area does it cover?

A

musculocutaneous nerve
Lateral aspect of forearm

89
Q

what is the most common complication of an autologous blood transfusion?

A

infection

90
Q

how does the celiac plexus block affect the autonomic nervous system?

A

the celiac plexus provides sympathetic outflow to the internal organs in the abdomen. blockade of the celiac plexus results in a loss of sympathetic innervation.

91
Q

US cylinder color code for oxygen

A

green
“plants are green and produce oxygen”

92
Q

US cylinder color code for carbon dioxide

A

gray
“gray clouds and gray smoke carry carbon dioxide”

93
Q

US cylinder color code for nitrous oxide

A

blue
“feeling blue? nitrous oxide brings the giggles”

nitrous oxide is known as laughing gas

94
Q

US cylinder color code for nitrogen

A

black
“nitrogen gives black stout beers their smooth finish”

nitrogen is used to pressurize stout beers like Guinness, which are dark or black in color

95
Q

US cylinder color code for helium

A

brown
“helium makes you sound like a brown chipmunk”

Inhaling helium changes your voice to a high-pitched squeak, much like a chipmunk’s voice. Since chipmunks are brown, this connection can help you link helium with the color brown.

Think of H for helium and H for “hazel,” a shade of brown.

96
Q

US cylinder color code for air

A

yellow
“yellow sun warms the air”

Connect the color yellow with the sun, which heats the air. This imagery can help you remember that air cylinders are color-coded yellow.

97
Q

EKG findings of a pt taking digoxin?

A

downsloping (scooping) ST segment depression

98
Q

which conditions promote digoxin toxicity?

A

electrolyte disturbances and renal insufficiency (most of digoxin is excreted unchanged via the kidneys)

99
Q

how should IV crystalloid be administered after a burn injury?

A

first half in the first 8 hours
second half in the next 16 hours

100
Q

how to calculate how much fluids should be given after a burn injury?

A

4 mL x total body weight (kg) x percentage of burned total body surface area

101
Q

what is the first line treatment for trigeminal neuralgia?

A

carbamazepine

102
Q

IV extravasation of a vasoconstrictor, how to manage?

A

inject phentolamine into the affected area

103
Q

succinylcholine side effects are seen in which conditions?

A

pt with MS and hyperreflexia
MS is autoimmune destruction of axons and myelin
this denervation and misuse myopathy leads to a higher risk for hyperkalemia

104
Q

where are the scalene muscles located in relation to the brachial plexus roots in an interscalene block?

A

anterior scalene muscle located immediately medial to the brachial plexus roots

middle scalene muscle located immediately lateral to the brachial plexus roots

105
Q

what is the onset of action time after a standard intubation dose of rocuronium?

A

1-2 minutes

106
Q

what is the standard intubation dose of rocuronium?

A

0.6 mg/kg

107
Q

which structure in the brain is responsible for voluntary motor control?

A

basal ganglia

108
Q

how does morphine improve coronary perfusion?

A

morphine reduces preload and afterload. this reduces myocardial oxygen demand and improves coronary perfusion pressures by reducing ventricular end-diastolic pressures

109
Q

which hormones increase hepatic blood flow?

A

glucagon receptors
dopaminergic D1 receptors
adrenergic beta-2 receptors

110
Q

what is the equation for left ventricle coronary perfusion pressure?

A

aortic diastolic pressure - left ventricle end-diastolic pressure

111
Q

what causes post-operative hoarseness after endotracheal intubation?

A

arytenoid subluxation

112
Q

acetazolamide mechanism of action?

A

inhibits carbonic anyhdrase. normally, carbonic anhydrase results in the reabsorption of bicarb, but blocking carbonic anhydrase prevents reabsoprtion of bicarb along with water

113
Q

what blood gas changes will be seen with acetazolamide?

A

azetazolamide inhibits carbonic anhydrase, preventing the reabsorption of bicarb, which results in metabolic acidosis with a decrease in partial pressure of CO2 as respiratory compensation

pH decreases
bicarb decreases
PaCO2 decreases

114
Q

what cardiovascular effects are seen with methohexital?

A

methohexital is a barbiturate that decreases cardiac output, decreases systemic vascular resistance, and causes reflex tachycardia, which are harmful to patients with CAD

115
Q

which nerve innervates the medial arm and is NOT anesthetized during a brachial plexus block?

A

intercostobrachial nerve

116
Q

which nerve does transtracheal injection through the cricothyroid membrane block?

A

recurrent laryngeal nerve

used to anesthetize the vocal cord and trachea during awake intubation

117
Q

which branch of which nerve provides sensory innervation to the glottis ABOVE the vocal cords?

A

internal branch of the superior laryngeal nerve

118
Q

what are the absolute contraindications to MAC?

A

there are no absolute contraindications to MAC

119
Q

what are the relative contraindications to MAC?

A

inability to cooperate, communicate, or lie still

120
Q

what does the modified Aldrete scoring system look at?

A

activity
respiration
consciousness
circulation (bp)
o2 sat

“A Really Cool Cat Observes”

121
Q

do loop and thiazide diuretics cause metabolic acidosis or alkalosis and why?

A

alkalosis, caused by increased excretion of hydrogen ions

122
Q

pt in the OR begins to vomit and there is concern for possible aspiration. next step?

A

place in T-berg

123
Q

how is static compliance of the respiratory system calculated?

A

compliance = dV / dP
= tidal volume / (plateau pressure - PEEP)

124
Q

how is dynamic compliance of the respiratory system calculated?

A

compliance = dV / dP
= tidal volume / (peak pressure - PEEP)

125
Q

what is the equation for standard error?

A

standard deviation / square root N

126
Q

which diuretics cause hyperkalemia?

A

ACE inhibitors, ARBs, aldosterone antagonists

127
Q

how does precedex affect ventilation?

A

preserves ventilation and the ventilatory response to hypercarbia

128
Q

what muscles are the last to be recruited at maximal work of breathing and impending respiratory failure

A

back and paravertebral muscles

129
Q

which agents can cause rhabdomyolysis?

A

succinylcholine and HALOGENATED volatile anesthetics

130
Q

what is the half-life of IV labetalol?

A

6 hours

131
Q

what is the duration of IV labetalol?

A

16-18 hours

132
Q

what is cromolyn not used for?

A

it has no bronchodilatory effects and should not be used for bronchospasm or acute asthma attacks

133
Q

how does chronic carbamazepine affect neuromuscular blocking effects?

A

carbamazepine induces CP450, which is responsible for metabolizing vecuronium, leading to a reduced neuromuscular blocking effect

134
Q

blood-gas partition coefficients from smallest to largest?

A

“Do Not Stop Inhaling”

D - Desflurane (Smallest coefficient)
N - Nitrous Oxide
S - Sevoflurane
I - Isoflurane (Largest coefficient)

135
Q

context-sensitive half-time from highest to lowest?

A

“Fat Anaesthetists Prefer Recess”

Fat → Fentanyl (Longest half-time)
Anaesthetists → Alfentanil
Prefer → Propofol
Recess → Remifentanil (Shortest half-time)

136
Q

effect of propofol on cerebral blood flow and cerebral metabolic consumption of oxygen?

A

decreases both

137
Q

halogenated volatile anesthetics effect on cerebral blood flow and cerebral metabolic consumption of oxygen?

A

reduce cerebral metabolic consumption of oxygen but increase cerebral blood flow

138
Q

during pregnancy, what happens to GFR and renal plasma flow and why?

A

both are increased due to a larger cardiac output

139
Q

how does septic shock affect cardiac output?

A

Vasodilation reduces systemic vascular resistance (SVR), which triggers a compensatory increase in heart rate (HR) and stroke volume (SV) to maintain blood pressure.

140
Q

how does septic shock affect pulmonary capillary wedge pressure?

A

decreases, due to peripheral vasodilation

141
Q

how does septic shock affect mixed venous oxygen saturation?

A

increases, due to increased cardiac output and decreased oxygen use
Cardiac output increases bc heart rate increases and contractility increases

142
Q

what vertebral level is associated with the line drawn in the horizontal plane at the upper margin of the iliac crests?

A

L4-L5

143
Q

what are the physiological effects of stellate ganglion block on skin temp and skin resistance?

A

stellate ganglion is part of the sympathetic trunk, so this sympathetic blockade leads to vasodilation of blood vessels in the skin (which leads to increased skin temperature) and reduced sweating (which leads to high skin resistance because sweat contains electrolytes that conduct electricity)

144
Q

cortisol effects on immune system?

A

Leukocytosis in Cushing syndrome does not reflect improved immune function. It’s a redistribution effect of neutrophils into the bloodstream, while the overall immune response is weakened.

145
Q

cushing syndrome effects on electrolytes?

A

hypokalemia and metabolic alkalosis

cortisol mimics aldosterone, leading to increased absorption of sodium and excretion of potassium and hydrogen ions

146
Q

amount of rebreathing in Mapleson circuits from greatest to least during spontaneous ventilation?

A

A > D > C > B

“All Dogs Can Breathe”

147
Q

amount of rebreathing in Mapleson circuits from greatest to least during controlled ventilation?

A

D > B > C > A

“Dead Bodies Can’t Assist”

148
Q

which coagulation factor is increased in liver disease?

A

factor 8

149
Q

in order for pulse pressure variation (PPV) to most accurately predict volume response, should PEEP be used or not?

A

PEEP should not be used

150
Q

in order for pulse pressure variation (PPV) to most accurately predict volume response, what ventilation mode should be used?

A

controlled, positive pressure ventilation like volume control

151
Q

in order for pulse pressure variation (PPV) to most accurately predict volume response, what tidal volume should be used?

A

high tidal volume
>7-8 mL/kg

152
Q

when can you restart LMWH after removal of an epidural?

A

can restart 4 hours after catheter removal

153
Q

what can you restart 4 hours after removal of epidural catheter?

A

LMWH, both prophylactic and therapeutic, all dosages

154
Q

total body surface area (TBSA) % of head and neck?

A

9% total
(4.5% front, 4.5% back)

155
Q

total body surface area (TBSA) % of each arm?

A

9% total
(4.5% front, 4.5% back)

156
Q

total body surface area (TBSA) % of each leg?

A

18% total
(9% front, 9% back)

157
Q

total body surface area (TBSA) % of anterior trunk (front of the chest and abdomen)?

A

18%

158
Q

total body surface area (TBSA) % of posterior trunk?

A

18%

159
Q

total body surface area (TBSA) % of perineum?

A

1%

160
Q

maintenance fluid regimen for 1-week-old full term infant?

A

120 mL/kg/day

161
Q

intravascular injection of epidural test dose of lidocaine + epi, what would happen?

A

tachycardia

162
Q

intravascular injection of epidural test dose of lidocaine + epi, in a pt taking beta blocker, what would happen?

A

HTN

163
Q

what kind of cells does the trachea contain and why?

A

ciliated pseudostratified columnar cells
to aid in the clearance of respiratory debris

164
Q

what kind of cells do bronchioles contain?

A

simple ciliated columnar cells

165
Q

the trachea contains how many hyaline cartilages and what shape are they?

A

15-20 U-shaped hyaline cartilages

166
Q

the larynx contains how many cartilages?

A

nine
three unpaired and three paired

167
Q

stimulation of what causes reflex bronchoconstriction?

A

parasympathetic stimulation through the vagus nerve

168
Q

how does an epidural infusion of local anesthetic affect GI function return?

A

the sympathectomy decreases the time to return of GI function

169
Q

how do single dose neuraxial opioids affect GI function?

A

no effect because it does not affect the sympathetic component that causes decreased bowel motility

170
Q

what is the formula for pH?

A

pH = -log[H+]

171
Q

what concentration of [H+] does a pH of -1 correspond to?

A

10 M

172
Q

what concentration of [H+] does a pH of 0 correspond to?

A

1 M

173
Q

what concentration of [H+] does a pH of 1 correspond to?

A

10^-1 M = 0.1 M

174
Q

what concentration of [H+] does a pH of 10 correspond to?

A

10^-10 M = 0.0000000001 M

175
Q

when do most medication errors occur?

A

within 20 minutes of induction of anesthesia

176
Q

vapor pressures from lowest to highest for gases?

A

sevoflurane < isoflurane < desflurane < nitrous oxide

“Sevo Is Dainty, Nitrous is Nuclear”

177
Q

carotid sinus vs. carotid body?

A

sinus detects stretch (baroreceptor for blood pressure)

body detects breathing (chemoreceptor for oxygen and CO2)

178
Q

monomorphic ventricular tachycardia, pt is hemodynamically unstable, next step?

A

cardioversion

179
Q

monomorphic ventricular tachycardia, pt is hemodynamically stable, next step?

A

Antiarrhythmic drugs (amiodarone, lidocaine, procainamide)

180
Q

what medications are contraindicated in Wolff-Parkinson-White syndrome and why?

A

AV nodal blockers like adenosine, CCBs, beta-blockers because they prevent normal physiologic conduction through the AV node, leading to preferential conduction down the accessory or preexcitation pathway that can lead to a fatal arrhythmia

181
Q

which nerves does the celiac plexus block?

A

T5 to L2

“T5 to L2: Take 5 for Less Pain Too.”

182
Q

which region does the celiac plexus block?

A

from distal esophagus to transverse colon
includes kidneys and adrenal glands

183
Q

what hemodynamic effect does a celiac plexus block have?

A

orthostatic hypotension, due to decreased postural hemodynamic reflexes

184
Q

what GI effects does a celiac plexus have?

A

sympathectomy causes increased GI motility and diarrhea
beneficial in counteracting constipation caused by opioids

185
Q

normal PaCO2?

A

40 mmHg

186
Q

what to give to prevent delayed cerebral ischemia caused by cerebral vasospasm after SAH?

A

oral nimodipine

187
Q

which pathway is thiamine needed for?

A

citric acid cycle

188
Q

goal for heart rate in aortic insufficiency?

A

avoid bradycardia because lower HR means more time spent in diastole, which is when aortic regurgitation occurs

189
Q

goal for afterload in aortic insufficiency?

A

avoid increased afterload (and reflex bradycardia) which can worsen regurgitation

190
Q

what to use for induction in aortic insufficiency?

A

opioids and benzodiazepines to reduce sympathetic stimulation during DL. sympathetic stimulation increases afterload which leads to increased regurgitation

191
Q

what should not be given during neonatal resuscitation?

A

naloxone and sodium bicarbonate

192
Q

which metabolic imbalance does NS lead to?

A

hyperchloremic metabolic acidosis due to its high chloride concentration

193
Q

when is it safe to use LR?

A

it’s safe to use in CKD. the rise in potassium levels is negligible

194
Q

what electrolyte imbalances does diarrhea cause?

A

metabolic acidosis

195
Q

how to decrease incidence of postoperative sore throat with LMAs?

A

maintain cuff pressure at <40 mmHg

196
Q

what ekg findings does hypercalcemia cause?

A

Shortened QT interval (due to faster ventricular repolarization, shortened ST segment).

Elevated calcium enhances L-type calcium channel activity, speeding up repolarization.

197
Q

what ekg findings does hypocalcemia cause?

A

prolonged QT interval due to prolonged ST segment

198
Q

what ekg findings does hypokalemia cause?

A

flattened/inverted T waves

199
Q

dorsal column spinal tract carries signals for which senses?

A

fine touch/pressure
vibration
propioception

200
Q

spinothalamic tract carries signals for which senses?

A

crude touch/pressure
pain & temperature

201
Q

when is “E” emergency surgery added to ASA?

A

when there could be loss of limb or life

202
Q

after how long can you give repeat dose of ondansetron?

A

six hours

203
Q

at term, the uterus receives what percentage of maternal cardiac output?

A

20%

204
Q

uterine arteries supply which percentage of uterine blood flow?

A

85%

205
Q

ovarian arteries supply which percentage of uterine blood flow?

A

15%

206
Q

cushing syndrome effects on immune system?

A

increased leukocyte count but causes immunosuppression

207
Q

cushing syndrome electrolyte findings?

A

hypokalemic metabolic alkalosis
cortisol mimics aldosterone

208
Q

what is the main source of occupational exposure to radiation?

A

radiation scattered from the patient’s body

209
Q

what is the annual limit for occupational exposure to radiation?

A

5 rem

210
Q

which factors are increased in liver disease?

A

factor 8 and vWF

211
Q
A

TrueLearn (4 decks)

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