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Anesthesia > OpenAnesthesia > Flashcards

OpenAnesthesia Flashcards

1
Q

pump flow range

A

1.6-3 L/min/m2

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2
Q

CPB mixed venous goals

A

SvO2 >65%

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3
Q

CPB glucose

A

aggressive (80-110 mg/dL) management ass with worse outcomes

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4
Q

meds to avoid with reproductive assistance, why?

A

droperidol and metoclopramide; both can increase prolactin levels, which can follicle maturation and corpus function

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5
Q

LMWH clearance

A

renally - prolonged in renal insufficiency, directly proportional to creatinine clearance

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6
Q

how to monitor enoxaparin

A

PTT is not usually monitored, can test anti-Xa activity (peak at 4 hours), therapeutic for tx 0.6-1.0 U/ml and ppx 0.1-0.3 U/ml

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7
Q

uterine atony risk factors

A

oxytocin, multiples, polyhydramnios, chorioamnionitis (NSAIDs irreversibly inhibit platelet function but little affect on uterine tone)

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8
Q

TRALI mechanism

A

GVHD - leukocytes/neutrophils causing flood of neutrophils and inflammatory mediators to lungs causing increased microvasc permeability

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9
Q

Haldane effect

A

Deoxygenated blood can carry increasing amounts of carbon dioxide

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10
Q

Bohr effect

A

an increase of carbon dioxide in the blood and a decrease in pH results in a reduction of the affinity of hemoglobin for oxygen

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11
Q

IgA deficiency considerations

A

blood products need to be washed before administration

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12
Q

cryo contains

A

VIII (100 IU), vWF, XIII, and fibrinogen (250 mg)

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13
Q

type

A

patient’s RBCs mixed with serum with known antigens (ABOD)

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14
Q

screen

A

(indirect) put patients serum with RBCs with known antigens

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15
Q

crossmatch

A

patient’s serum with donor cells

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16
Q

therapeutic hypothermia

A

32-34 for 24 hours

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17
Q

emergent therapy for stroke 2/2 air embolism

A

hyperbaric O2

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18
Q

HBO uses

A

arterial air embolism, CO poisoning, decompression sickness, severe anemia, hypoperfusion, gas gangrene

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19
Q

HBO MAC effects

A

decrease in MAC because HBO increases partial pressure of volatiles at higher barometric pressure and gas density increases so rotameter flowmeters will read falsely high (2% sevo at 1 atm produces same as 0.66% sevo at 3 atm)

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20
Q

1 mm Hg CO2 decrease - CBF?

A

decreases 3-4%, goal 30-35

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21
Q

goal CPP with increased ICP

A

60-70 mm Hg

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22
Q

prevention of contrast nephropathy

A

periprocedural continuous hemofiltration, oral N-acetylcysteine, bicarbonate infusion

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23
Q

predisposition to renal damage with contrast

A

Cr >1.5, GFR < 60, DM nephropathy, hypovolemia, high dose contrast media, multiple myeloma

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24
Q

pierre robin ass syndromes

A

stickler syndrome, velocardiofacial syndrome, treacher-collins

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25
Q

pierre robin characteristics

A

micrognathia, glossoptosis (prone position may help), airway obstruction –> can cause cor pulmonale, can also see cleft palate, high incidence of central/obstructive apnea

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26
Q

congenital lobar emphysema management

A

inhalational induction, spontaneous ventilation preferred, single lung ventilation, nitrous contraindicated

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27
Q

congenital lobar emphysema characteristics

A

causes hyperinflation of lungs, resp distress in newborn-6 mos, left lung more common, left upper lobe most common,

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28
Q

congenital lobar emphysema physical exam

A

decreased breath sounds, hyper-resonant, hyperinflation on CXR

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29
Q

CPB roller pump

A

roller pump flow is predictable and depends on revolutions per minute of the pump, retrograde flow is not possible, but if there is outflow occlusion, pressure can build and cause tubing rupture or separation

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30
Q

CPB centrifugal pump

A

retrograde flow is possible, flow depends on pressure differential created by the spinning cones –> cause negative pressure that propels fluid forward, flow varies with afterload an preload

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31
Q

roller pump vs centrifugal

A

roller has predictable speed and cost less

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32
Q

best echo view for ischemia

A

transgastric mid-papillary short axis

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33
Q

fluconazole active against

A

candida, Cryptococcus, coccoidioides immitis

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34
Q

needed for nitrogen balance calculations

A

nitrogen intake, 24 hour urine nitrogen, 24 hour change in BUN (very sick usually have negative nitrogen balance)

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35
Q

PNA diagnosis from BAL

A

10,000 colonies, 1,000,000 for endotracheal aspirates, 1,000 for protected brush specimen

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36
Q

hyperkalemia treatment

A

hyperventilation, gluscose/insulin, beta agonist, lasix, dialysis, aldosterone agonist

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37
Q

nitroglycerin

A

much more potent venodilator than arterial dilator

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38
Q

hydralazine metabolism

A

metabolized by acetylation in the liver

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39
Q

synchronized cardioversion

A

shock synchronized with QRS to avoid shock during refractory period (R on T)

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40
Q

smoking cessation 48-72 hours

A

increased secretion, more reactive airway activity, decreased carboxyhgb, improved oxygentation

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41
Q

smoking cessation 2-4 weeks? 8 weeks?

A

decreased secretions, decreased airway reactivity; decreased overall post-op morbidity and mortality

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42
Q

MS management

A

sensitive/insensitive to NMBD, suc may cause hyperkalemia, hyperthermia may cause exacerbations, neuraxial not recommended?, MAC may be reduced

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43
Q

MS

A

autoimmune disease of inflammation, demyelination, and axonal damage to CNS, tx with corticosteroids, methotrexate, azathioprine, glatiramer acetate, interferon-beta

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44
Q

autonomic hyperreflexia

A

HTN followed by profound vagal response (brady), may see vasodilation and flushing above injury (2/2 high afterload)

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45
Q

layers for paramedian neuraxial

A

skin, sub Q fat, paraspinal muscles, ligamentum flavum, dura mater, subdural space, arachnoid mater, subarachnoid space

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46
Q

DMD heart changes

A

dilated CM from fatty infiltration, prominent Q waves, inverted T waves, cardiac involvement seen in 90% patients, can lead to LV failure and sudden death (ACE-I and bb)

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47
Q

DMD presentation

A

most severe MD, 3-5 years start, waddling gait, progressive falls, difficulty with stairs, gower (both hands to get up from seated position)

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48
Q

becker’s dystrophy

A

problem with dystrophin results in leaking muscle membranes and elevation of CPK, pseudohypertrophy of muscles from fibrofatty infiltrates

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49
Q

LA absorption

A

ICE-BS intercostal, caudal, epidural, brachial, sciatic/femoral

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50
Q

gasserian ganglion

A

formed from 3 divisions of trigeminal nerve, trigeminal nerve root emerges from here and travels to its nucleus in the pons

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51
Q

trigeminal neuralgia cause

A

irritation of nerve root by blood vessel (superior cerebellar artery), MS, tumor, trauma

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52
Q

trigeminal neuralgia treatment

A

carbamezapine (tegretol), oxycarbemezapine (trileptal), phenytoin, baclofen, gabapentin, microvascular decompress, nerve lesions, motor cortex stim

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53
Q

carbamezapine and phenytoin side effects

A

hyponatremia, agranulocytosis, hepatic toxicity; gingival hyperplasia

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54
Q

WHO analgesic ladder

A
  1. non-opioid w/wo adjuvants 2. weak opioids w/wo adj 3. strong opioids w/wo adj
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55
Q

acute hemolytic reaction

A

can occur 3-21 days after transfusion, elevated unconjugated bili, back pain, fever, SOB, chest pain, pain at sight of infusion, HA, change in vitals, pulm edema, bleeding, renal failure

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56
Q

febrile transfusion reaction

A

0.5% RBC transfusions, 30% platelet transfusions, see increase > 1 degree C, HA, chills, back pain, may take 2 hours to develop

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57
Q

febrile transfusion reaction treatment

A

stop transfusion (may be hemolytic), acetaminophen, diphenhydramine, leukoreduced transfusions in the future and premed with acetaminophen

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58
Q

LVAD contraindications

A

PFO/ASD, AI, MS (tends to improve MR)

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59
Q

acute hemorrhage and resus, which factor is first to reach critical low

A

fibrinogen

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60
Q

can fibrillating atrium be paced

A

no

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61
Q

Pacemaker

A

Paced, Sensed, Response to sensed event, Rate modulation, Multisite pacing

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62
Q

highest risk for abnormal placentation

A

placenta previa (increased maternal age, C-sections)

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63
Q

bronchial blocker disadvantage

A

higher cost, not able to add CPAP or suction operative lung

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64
Q

missed musculocutaneous on ax block

A

maintain biceps motor, elbow flexion and supination, sensation to lateral forearm

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65
Q

tibial nerve stim

A

innervates gastroc and soleus muscles of calf - controls plantar flexion of toes and ankle

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66
Q

2-chloroprocaine epidural use

A

associated with decreased efficacy of subsequent epidural opioids because it antagonizes mu and kappa opioid receptors (onset 6-12 min, peak 10-20, duration 30-60 min)

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67
Q

2-chloroprocaine epidural use

A

associated with decreased efficacy of subsequent epidural opioids

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68
Q

SC stimulator procedure management

A

can be extensive dissection and awake has lower fail rate; can use spinal, LA with conscious sedation, thoracic epidural (single shot)

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69
Q

spinal cord stim

A

send pulsed electrical signals to spinal cord to control chronic pain, stim electrodes are placed in epidural space, generator in lower abd or gluteal region, and generator remote

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70
Q

spinal cord stim indications

A

failed back surgery syndrome, refractory angina pectoris, PVD, CRPS I

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71
Q

failed back surgery syndrome

A

40% of patients s/p spinal surgery

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72
Q

refractory angina pectoris

A

angina caused by CAD not controlled with meds, surgery, etc –> treat with SCS decrease chest pain, hospital admission, increase exercise duration, less morbidity than other open procedures for pain

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73
Q

SCS for PVD

A

when PVD is inoperable –> improves quality of life, limb mobility, pain relief

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74
Q

AMS differential diagnosis post craniotomy

A

hemorrhage, tension pneumocephalus, venous/arterial stroke, hydrocephalus, infection, seizures, metabolic, retraction/surgical injury

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75
Q

CBF, slowing, flat EEG

A

50ml/100g/min (15% CO), 20, 12

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76
Q

CMRO2

A

3ml/100g/min

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77
Q

PaCO2 and CBF/CBV

A

decrease CBF 1-1.5 and CBV 0.05

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78
Q

cerebral vasospasm treatment

A

hypertensive euvolemia (HTN, hypervolemia, hemodilution), nimodipine, balloon angioplasty, papaverine/verapamil intraterial injection (vasodilators)

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79
Q

cerebral vasospasm presentation and detection

A

3-10 s/p SAH (think hydrocephalus, seizure, hyponatremia, rebleed), use cerebral angiography, transcranial Doppler (increased arterial velocity

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80
Q

vasospasm prevention

A

nimodipine, remove subarachnoid blood ASAP, instill thrombolytics (urokinase), antinflam (NSAIDs/steroids)

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81
Q

AAA repair renal problems

A

see ATN, decrease chance with good intravascular volume and heart function

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82
Q

AAA crossclamp complications (increase)

A

increased wall motion abn, increased wedge and CVP, increased coronary blood flow, increased mixed venous, increased epi/norepi, renal vasc resistance

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83
Q

AAA crossclamp complications (decrease)

A

decreased CO, EF, RBF, CO2 production, renal cortical blood flow, GFR

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84
Q

intralipid dose

A

1.5ml/kg bolus and 0.25 ml/kg/min infusion

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85
Q

bupi cardiac toxicity

A

binds more strongly to resting/inactive Na channels and dissociates from channels during diastole more slowly

86
Q

methgb with LA

A

prilocaine (o-toluidine), benzocaine

87
Q

most common arrhythmia with bupi

A

wide complex ventricular rhythm (vtach)

88
Q

MS and pregnancy

A

20-30% experience exacerbation post partum 2/2 loss of immune-tolerant pregnancy state

89
Q

most important crossclamp factor

A

level of clamp - infrarenal least hemodynamic changes

90
Q

CEA neuromonitoring

A

awake, EEG, SSEP, transcranial Doppler, cerebral oximetry stump pressure

91
Q

hypernatremia and MAC

A

increases MAC

92
Q

ADH site of action

A

distal and collecting tubules

93
Q

avoid with HOCM

A

increasing velocity of blood across LVOT - decreasing SVR, decreasing preload, increasing contractility, increasing HR

94
Q

HOCM treatment

A

beta blockers, CCB, amiodarone (for afib), diuretics (with caution for diastolic dysfunction)

95
Q

pHTN diagnosis

A

resting PAP >25, PCWP/LAP 15, PVR >3 (RVH is not required)

96
Q

morphine neonate vs adult differences

A

increased half life (6-9 hr) until 2-3 months (2-4 hr), more protein bound in adults

97
Q

methadone CV

A

prolongs QT

98
Q

prostaglandin E1

A

used for interrupted aortic arch and hypoplastic left heart syndrome (0.1 mcg/kg/min) - maintains ductal patency

99
Q

prostaglandin E2

A

ductus arteriosus patent in utero

100
Q

prostaglandin E1 se

A

hypotension, fever, apnea, myoclonus, irritability

101
Q

beta thal minor

A

microcytic red cells

102
Q

beta thal major (cooleys)

A

fine at birth because of hgbF, then hemolysis causes severe anemia - pale, jaundice, hepatosplenomegaly, growth retard, skeletal abn

103
Q

beta thal major treatment

A

regular transfusions of bone marrow transplant

104
Q

CV changes pregnancy

A

may see cardiomegaly, S3, regurg murmurs (TR-systolic), dilation can cause RAD and RBBB - S4 is pathologic so get it checked

105
Q

coagulation changes pregnancy

A

hypercoagulable state with increase in factors, decrease in protein S (anticoagulant) and resistance to protein C (anticoagulant), platelet turnover increases

106
Q

pregnancy EKG

A

heart moved cephalad and laterally - sinus tach, other dysrhythmias, ST depression, T wave flattening, LVH, LAD

107
Q

HAART drug interactions

A

protease inhibitors inhibit cytochrome p450 metabolism - CCB, macrolide antibiotics, barbs, alprazolam, midazolam, carbamazepine, azole antifungals, phenytoin, rifampin

108
Q

large v waves

A

MR

109
Q

mitral stenosis

A

increase preload, decrease HR, maintain SVR, giant a waves, pressure gradient >10 across valve, PCWP reflects LA not LV

110
Q

CMRO2 reduction with anesthetics

A

barbs and others decrease by 50% (amount responsible for electrical activity)

111
Q

central retinal artery occlusion

A

associated with external pressure on globe, unilateral most of the time, no improvement in visual acuity over time, see pale retina and cherry red spot on macula

112
Q

morphine peak

A

1 hour 2/2 very hydrophobic

113
Q

student’s t test

A

compare means of 2 normally distributed populations

114
Q

mann-whitney

A

compare two populations that are not normally distributed

115
Q

coronary perfusion pressure

A

aortic diastolic pressure minus LVEDP

116
Q

coronary blood flow

A

(aortic diastolic pressure - LVEDP)/coronary vascular resistance

117
Q

chattering/fluttering and treatment

A

of venous cannula when compliant arterial/venous walls collapse against intake cannula opening; treat by increasing blood volume or decreasing siphon pressure

118
Q

mild preeclampsia

A

BP 140/90, 24 hour urine >300mg (+1 dipstick x 2), after 20 weeks

119
Q

severe preeclampsia

A

SBP>160 or DBP>110 x 2 (6 hr), 24 hr urine >5g (+3 dipstick x 2), pulm edema/cyanosis, oliguria <400 ml in 24 hr, HA, epigastric pain and/or impaired liver function, thrombocytopenia, oligohydramnios/decreased fetal growth/placental abruption

120
Q

poiseuille’s law

A

Q=(pixPxr^4)/(8xviscosityxlength)

121
Q

preeclampsia increases risk of

A

postpartum venous thromboembolism, chronic HTN, CV disease; risk of adverse outcomes worse if onset <34 weeks

122
Q

sodium citrate

A

non-particulate antacid rapidly decreases acidity of gastric contents, duration 1 hour

123
Q

alpha-stat

A

d/n add bicarb, associated with less post op cognitive dysfunction

124
Q

pH-stat

A

temperature corrects for pH and pCO2

125
Q

etomidate and ECT

A

increases seizure duration

126
Q

bicuspid aortic valve significance

A

increased risk for aortic aneurysm and dissection

127
Q

normal pulm vascular resistance

A

0.25-1.6 wood units or 20-130 dyne-sec-cm-5 (when equation multiplied by 80)

128
Q

normal SVR

A

9-20 wood units or 700-1600 dyne-sec-cm-5

129
Q

normal PA SBP

A

1/8-1/10 systemic SBP

130
Q

transpulmonary gradient

A

mPAP - PCWP, >14 increased pressure and >16 with elevated right atrial pressure (>20) predictive value for RV failure

131
Q

pulmonary HTN

A

> 1/4 systemic SBP

132
Q

PABA allergy

A

ester LA

133
Q

AR management goals

A

“fast and loose” relative tachy (reduces time in diastole for regurg), maintain preload, reduce afterload, maintain contractility

134
Q

decreased lvad effectiveness

A

Ai will decrease output the most, TR and MS also decrease; PFO increases chance of hypoxemia and paradoxical embolus

135
Q

pyloric stenosis lab abnormality

A

hypochloremic, hypokalemic metabolic alkalosis with possible aciduria (normalization of chloride signifies resolution of alkalosis)

136
Q

true ventricular aneurysm

A

at apex, dilated and dyskinetic area with all layers, 90 days after MI (abn remodeling), smooth transition with orifice 0.9-1.0

137
Q

pseudo ventricular aneurysm

A

saccular/globular at site of chronic ventricular rupture lined with only pericardium after MI, trauma, surgery, infection, abrupt transition with small orifice <0.5, bi-directional flow on doppler

138
Q

affect oxygenation during one lung

A

degree of HPV (volatiles, hypocapnea, vasodilators), high airway pressures (PEEP, hypervent, high PIP)

139
Q

abd compartment syndrome bladder pressure

A

> 20-25; 25-35 need eventual decompression, >35 immediate decompression

140
Q

abd compartment syndrome bladder pressure

A

> 20-25

141
Q

abd compartment syndrome presentation

A

sudden intra-ab pressure increase, increased PIP, decreased UOP, hypoxia, hypercarbia, hypotension

142
Q

afib treatment

A

rate control w/ beta blocker, CCB; cardioversion w/ amiodarone, sotalol, procainamide, synchronized DC (stable/unstable)

143
Q

underestimate LV preload

A

MS, noncompliant LV, AI, AS

144
Q

nitrous cylinder pressure drops

A

about 400 L remain

145
Q

temp and CO2 and pH

A

low temp - low arterial CO2 - high pH

146
Q

pH stat

A

cooled blood will have high pH, to correct will add CO2, which will cause acidosis which will increase CBF

147
Q

idiopathic Thrombotic Thrombocytopenic Purpura treatment

A

medical emergency treated urgently with plasma exchange - FFP

148
Q

TRALI diagnosis

A

new onset acute lung injury symptoms (PaO2/FiO2 300, pulm artery pressure < 19 mm Hg, Edema Fluid/Plasma Protein Ratio >0.75), <0.65 differentiates between a transudate (pulmonary edema) and an exudate (TRALI), greater amount of protein in the edema fluid (larger ratio), more likely exudate

149
Q

stewart approach to acid base

A

bicarb is not a mathematically independent determinant of pH - pH independent variables are total weak acid concentration, strong ion difference, and pCO2

150
Q

DI lab values

A

sodium >145, urine osm 310, urine spec gravity <1.005(polyuria, polydipsia)

151
Q

fire triad

A

oxidizer (O2, nitrous), ignition source (lasers, burrs, drills, fiberoptic scopes, electrosurgical devices), fuel (ETT, sponges/gauzes, drapes, masks) *metal ETT are combustion resistant

152
Q

vit K

A

IM/oral take 6-8 hours to decrease INR, IV vit k associated with anaphalactoid reaction - hypotension, seizures, death

153
Q

argatroban

A

reversible direct thrombin inhibitor - does not directly affect platelet function

154
Q

airway fire management

A

stop the procedure, remove ETT, stop gases, remove flammable material, pour saline into airway, reestablish ventilation, examine ETT, consider bronchoscopy, assess patient status and decide what’s next step in patient care

155
Q

finding with epidural >6 hrs

A

fever

156
Q

disadvantages of stress ulcer prophylaxis

A

increased incidence of PNA, C. dif, and thrombocytopenia

157
Q

positive intravascular test dose under anesthesia peds

A

T wave amplitude increase >25%, >10 bpm elevation, increase in SBP >15

158
Q

pHTN definition

A

resting PAP >25

159
Q

WHO pHTN classifications

A

class 1 - arterial HTN (includes idiopathic aka primary), class 2 - venous HTN, class 3 - pHTN ass with hypoxemia, class 4 - chronic thromboembolic pHTN, class 5 - miscellaneous

160
Q

severe HF managment

A

difficulty with increased/reduced preload, d/n tolerate pHTN, increased SVR will decrease SV, brady/tachy poorly tolerated, keep 80-90 bpm

161
Q

prolongs QT

A

sevo, iso, thiopental

162
Q

PONV children

A

rare, 3 yo risk is 40% and increases until puberty, increased with T&A, strabismus, hernia, orchipexy, penile surgery

163
Q

Eberhart’s PONV classification in children

A

personal/family history of PONV, duration of anesthesia >30 min, age >3 yo, strabismus surgery (10, 30, 55, 70% risk)

164
Q

ASDs

A

40% of all CHD, 2-3 x more common in women, ostium secundum 70%, ostium primum 20%, sinous VSD 10%

165
Q

Ostium secundum

A

70%, ass with mitral valve prolapse

166
Q

ostium primum (endocardial cushion defect/AV septal defect)

A

20%, ass with cleft of anterior leaflet of mitral valve that causes MR (downs)

167
Q

sinous vsd

A

10%, ass with anomalous venous return

168
Q

lmwh 2x daily dose

A

not recommended with epidural no matter the dose

169
Q

lmwh and epidural

A

placement 12 hours after prophylaxis, placement 24 hours after treatment, removal 10-12 hours after last dose, after removal next dose should be delayed at least 2 hours

170
Q

ECG and mechanics of heart

A

end of PR mitral closes, R wave starts isovolumic contraction, S wave aortic valve opens, near end of ST aortic valve closes - isovolumic relaxation, end of T wave mitral opens and diastole starts

171
Q

liver blood supply

A

1/3 hepatic artery - 50% O2, 2/3 portal vein - 50% O2

172
Q

bicuspid AV

A

most common congen CV anom, more men, ass with coarctation of aorta, often leads to AS, also at risk for AI and endocarditis

173
Q

independent stress ulcer risks

A

coagulopathy and mechanical ventilation for 48 hrs

174
Q

TEF cause and ass

A

failure of foregut to separate from larynx, ass with VACTERL (veterbral anom, anal atresia, CV anom, TEF, esophageal atresia, renal/radial anom, limb defects)

175
Q

TEF cardiac anom

A

35% ASD, VSD, AV canal, TOF, coarctation of aorta

176
Q

altitude effects

A

higher sea level/higher altitude - decreased partial pressure of gas = lighter anesthetic depth

177
Q

Desflurane vaporizer

A

heated vaporizer (not variable bypass) so at different altitudes % set is % produced

178
Q

first line for delirium

A

haloperidol D2 agonist with warning for fatal ventricular arrhythmias

179
Q

TEF renal anom

A

renal agenesis, reflux, renal failure

180
Q

diffusion constant of gas

A

directly proportional to solubility and inversely proportional to square root of molecular weight

181
Q

classic vs modified classic sciatic nerve block

A

PSIS and greater trochanter vs PSIS, greater trochanter, and line from sacral hiatus to greater trochanter (Labat vs Winnie)

182
Q

pKa lido, bupi, ropi, tetra, chorpro

A

7.8, 8.1, 8.2, 8.5, 9

183
Q

IABP inflation and deflation

A

inflate after AV closes (dicrotic notch), deflate fully before AV opens

184
Q

bactericidal

A

cephalosporins, vancomycin, aminoglycosides, FQs, daptomycin, metronidazole

185
Q

bacteriostatic

A

macrolides, tetracycline, trimethoprim, sulfonamides

186
Q

neuraxial block drugs to avoid

A

avoid with thrombolytics - even though half-life is a few hours, fibrinogen and plasminogen are decreased for 27 hours

187
Q

ascending aortic aneurysm ass

A

hoarseness from compression of L RLN, dyspnea from compression of trachea, left mainstem bronchus or pulmonary artery, SVC syndrome, venous HTN

188
Q

increased AFE risk

A

multiparity, placenta previa, placental abruption, cervical lacerations, uterine rupture, operative vaginal delivery

189
Q

SIRS criteria

A

T >38/90, RR >22 or pCO2 12,000 or >10% bands

190
Q

renal failure with immunosuppression

A

calcineurin inhibitors, tacrolimus, and cyclosporine

191
Q

immune suppression stages

A

induction, maintenance, and anti-rejection if needed

192
Q

chemo stages

A

induction, consolidation, maintenance (then CNS prophylaxis for ALL)

193
Q

types of shock

A

distributive (neurogenic, sepsis), hypovolemic, cardiogenic, obstructive (tamponade, PE, pneumo)

194
Q

papillary muscle blood supply

A

posterior pap - post descending artery (most vulnerable to ischemia), anterior pap - LAD and circumflex coronary artery

195
Q

ECT contraindications

A

pheo (absolute); Relative = increased ICP/brain tumor with no mass effect, recent stoke CV conduction defects, high risk pregnancy, aortic/cerebral aneurysms, asthma/COPD (theophylline can cause status epilepticus)

196
Q

dural sac termination

A

birth to 1 year S3, by 1 yo S2

197
Q

ANOVA

A

simultaneously compares the differences among population means of more than two independent groups for a one-factor experiment

198
Q

chi-square

A

test for categorical variables determines whether there is a difference in the population proportions between two or more groups.

199
Q

unpaired t-test

A

compares the population means between two independent (and normally distributed) groups

200
Q

paired t-test

A

examines repeated measurements obtained from the same set of individuals

201
Q

PABA

A

metabolite of esters

202
Q

Dipyridamole

A

phosphodiesterase inhibitor, increases cyclic AMP which blocks the uptake of adenosine, reducing adenosine at the platelet vascular interface or via direct stimulation of prostacyclin release from the endothelium

203
Q

HCTZ electrolytes

A

Low Na, low K, low Mag, increase Ca and cholesterol labs

204
Q

Only abductor of vocal cords? Innervated by?

A

posterior cricoarytenoid muscle innervated by RLN

205
Q

Risk factors for post herpetic neuralgia

A

Age >60, female, severe acute pain

206
Q

Neurotransmitter preganglionic

A

sympathetic and parasympathetic PREganglionic neurons are cholinergic (release acetylcholine)

207
Q

Neurotransmitter postganglionic sympathetic

A

POSTganglionic sympathetic neurons are adrenergic and release norepinephrine

208
Q

Neurotransmitter postganglionic parasympathetic

A

POSTganglionic parasympathetic neurons are and thus release acetylcholine

209
Q

Anterolateral pap muscle

A

LAD and left circumflex

210
Q

Posteromedial pap muscle

A

Right coronary - at risk with inferior MI (see MR)

Anesthesia (16 decks)

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