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ABA Oral Boards > Oral Board Flash Cards > Flashcards

Oral Board Flash Cards

1
Q

Oliguria

A

“PreRenal:
Hypovolemia, Hypotension, Hypoperfusion, Renal Artery/Vein stenosis/thrombosis, CHF, tamponade, ischemia
Renal
ATN, Intrinsic Disease, CRF
PostRenal:
Obstructed Foley, Ureteral/Urethral obstruction”

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2
Q

Tachycardia

A 
"Hypoxia
Hypercapnia
Dysrhythmia - SVT
Ischemia
Tamponade
PTX
Hypopvolemia
Anemia
Fever
Light Anesthesia
Pain
Medications - Pancuronium, Desflurane
MH
Pheo
Thryroid storm"
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3
Q

Hypotension

A 
"Preload:
Hypovolemia
Anemia
Medications
No venous return - PEEP, tamponade. PTX
Afterload:
Sepsis
Anaphylactoid/tic
Addisonian Crisis
Contractility:
Ischemia
Dysrhythmia
PTX
Tamponade
Valvular Disease
CHF"
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4
Q

Hypoxia

A 
"Wall to patient!
Wall disconnects
Circuit disconnects
Stuck valves
Inappropriate vent settings
Inappropriate FiO2
Kinked ETT
Malpositioned ETT
Obstructed ETT

Anemia

Dysrhythmia
Ischemia
CHF

PTX
Bronchospasm
Aspiration
Consolidation/PNA
VQ mismatch
PE
Effusion
COPD
Atelectasis

Brainstem injury
High spinal”

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5
Q

Nausa/Vomitting

A 
"Pain
Hypotension
Increased ICP
Medications
Vagal
Obstruction"
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6
Q

Wheezing

A 
"Upper Airway
Laryngeal edema
Laryngospasm
Laryngomalacia
Tumor/Polyp
Vocal cord paralysis
Infection
Lower Airway
Bronchospasm
Kinkend/plugged ETT
PTX
Cardiogenic
Anaphylaxis
Asporation
Carcinoid
PE"
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7
Q

HTN

A 
"Medications
Chronic HTN
Renal failure
Hypoxemia
Hypercarbia
Pain
Light anesthesia
Pheo
MH
Thyroid storm
Increased ICP"
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8
Q

Agitation

A 
"ABC's!!!
Med effect
Pain/Anxiety
Disorientation
Distended Bladder
Hypoxia
Hypercapnia"
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9
Q

Bradycardia

A 
"Primary Heart:
Sick sinus
Heart Block
MI
Reaction:
Hypoxia
Hypercarbia
Distended Atrium/Ventricle
Spinal cord injury
Brain stem injury
Vagal from surgeon retraction
Bladder distension
Medication"
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10
Q

Hypercarbia

A 
"Increased Production
Sepsis
MH
Thyroid storm
Decreased Elimination
Exhausted soda lyme
Stuck valvles
Low flows
Increased dead space or V/q mismatch
PE
Hypoventilation - SV underbreathing or inappropriate vent settings
"
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11
Q

Indications for TEE

A 
"Assessment of myocardial Fxn
Diastolic dysfxn
Accuracy of cardiac procedures
Air detection
Unexplained hemodynamic disturbance"
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12
Q

Epidural Risks/Benefits

A 
"Risks
Hypotension/Sympathectomy
High Spinal
LA toxicity
Arachnoiditis
HA
Back Pain
Benefits
Better pain relief
Improved respiratory fxn
Bowel motility
Decreased risk of DVT/PE"
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13
Q

Risk factors for placenta previa

A

“Multiparity
Advanced age
Prior uterine surgery”

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14
Q

Hypoxia on OLV

A

“1)Declare emergency, get help

2) Machine to pt, hypoxia difffernetial, especially cuff herniation
3) Hand ventilate, check for compliance
4) 100% FiO2, recruitment breaths
5) Check other monitors - ischemia
6) Auscultate
7) Suction
8) CPAP to operative lung
9) PEEP to non-operative lung
10) 2 lung vent
11) Clamp PA”

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15
Q

ARDS Definition

A

“1)Acute onset

2) PaO2/FiO2 <200 - significant gradient
3) B/L infiltrates
4) PCWP <18, absence of signs of volume overload”

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16
Q

Abnormal SSEP’s during case, causes

A 
"Oxygenation
Ventilation
Temp
Anesthesic dose
Surgical instruments, retractors"
17
Q

Autonomic neuropathy Signs/Sx

A 
"Early satiety
Neurogenic bladder
No Sweating
Resting tachycardia
Silent MI
No HR variability w respiration
Orthostasis
Insensitivity to propranolol or atropine
No HR response to hypovolemia
Sudden death"
18
Q

Causes of Decreased SVO2

A

“Decreased supply vs increased extraction
Decreased supply
Hgb - bleeding
Hypovolemia
Increased extraction
Hypermetabolic states - MH, Sepsis, Thyrotoxicosis”

19
Q

Pacemakers - Drugs to avoid

A

“Etomidate - myoclonus
Sux - fasiculations
Halothane - AV conduction defects
Lidocaine - decreased AV conduction”

20
Q

CEA post-op complications

A

“MI - #1 cause of morbidity after CEA
Neuro/stroke -
Cranial nerve injury
Respiratory - B/L CEA abolishes respiratory drive, predisposes to apnea”

21
Q

Indications for intubation

A 
"Apnea
Inability to protect airway
Protection from aspiration
Potential airway compromise
GCS<9
Inability to maintain oxygenation"
22
Q

Severe Pre-eclampsia Criteria

A 
"SBP>160
DBP>110
Signs of end organ damage
Proteinuria >5gm in 24 hours
Oliguria 
Pulmonary edema
Visual changes, HA's, MS change
RUQ pain/Impaired liver fxn
HELLP
TCP???
IUGR or oligohydramnios"
23
Q

Transfusion risks

A 
"Infection - Hep B, Hep C, HIV
Volume overload
TACO
TRALI (1/5000)
Immune compromise
Febrile reaction (1/1000)
Hemolytic reaction (1/100,000)
GVHD"
24
Q

CBF

A

“Increases with PAO2 < 60
Coupled to CMRO2
Affected by temp, viscosity, vascular tone
Autoregulated when PaCo2 between 20-80”

25
Q

Rheumatic arthritis

A

“Atlanto-occipital instability, Decreased neck ROM
TMJ stiffness, poor mouth opening
Pulmonary - restrictive disease
Pericardial thickening or effusion, myocarditis, CAD
Pleural effusion, fibrotic lungs
Anemia, Eosinophilia
Adrenal insufficiency due to chronic steroid use
Immunosuppression
Liver dysfunction 2/2 methotrexate use”

26
Q

Discuss lung V/Q in OLV

A

“Obligatory R to L shunt through non-ventilated lung
Shunt reduced by gravity as 60% of BF goes to non-op lung
HPV - shunts 80% of BF to non-op lung
Surgical compression - further shunts blood away from operative lung”

27
Q

Post-op pulmonary dysfunction

A

“Residual anesthetic
Surgical trauma
Post-op pain”

28
Q

5 T’s

A 
"Toxin - including anesthetic agents
PTX
Cardiac Thrombus
PE
Tamponade"
29
Q

Post-op Pneumonectomy complications

A 
"Bleeding, HTX
PTX
RV failure, pulmonary edema
Atelectasis
PNA
Bronchospasm
Nerve injury - Phrenic, vagus, recurrent laryngeal
Subclavian injury"
30
Q

Myasthenia: Non-depol vs Sux

A

Resistant to sux, sensitive to non-depols

31
Q

Problems w jet ventilation

A

“Barotrauma
Unreliable delivery of anesthetic agent
Secretions/blood pushed into trachea
Inadequate CO2 elimination”

32
Q

Magnesium levels

A 
"Normal = 1-2
Therapeutic = 4-8
6-10 = QRS widening
>10 = loss of DTR's
>15 AV block and respiratory arrest
25 = cardiac arrest"
33
Q

Newborn and anesthetics/Neuro-anesthesia

A 
"Decreased protein binding
Immature BBB
Decreased drug clearance
Decreased cerebral autoregulation - predisposes to edema
Immature NMJ - sensitive to NMB
More caudal extension of cord - L3"
34
Q

Cirrhosis manifestations

A

“MS changes, cerebral edema, encephalopathy, asterixis
Increased blood volume, vascular permeability, low SVR, anemic, decreased albumin, bleeding 2/2 coags
Increased abd pressure, aspiration risk, esophageal varices, GI bleed
High CO, pericardial effusion, dilated cardiomyopathy
Renal failure
Pulmonary HTN, Pleural effusions, airway edema, decreased FRC”

35
Q

Risk factors for PPH

A 
"HTN
PEC
Coagulopathy
Abnormal Placentation
Previous c/s, VBAC
Cocaine/methamphetamine use
Prolonged induction with pitocin
Multiparity
Polyhydramnios
Chorioamnionitis
Age <20 or >40"
36
Q

Anesthesia for COPD

A

“Consider regional
Limit surgical duration, lap if possible
Preop: smoking cessation, ABX, bronchodilators
Multimodal pain management post op”

37
Q

Effects and risks associated with Intraop HTN

A 
"Increased myocardial O2 consumption
Increased LVEDP
Leads to ischemia, subendocardium hypoperfused
Stroke risk increased
Renal dysfunction
Bleeding risk"
38
Q

Factors that increase Pulmonary vascular resistance

A 
"Hypoxia
Hypercarbia
Pain
Acidosis
Light anesthesia
Nitrous
Sympathetic discharge
Hypothermia
Alpha agonists - B2 agonists decrease PVR"
39
Q

Increased SVO2

A

Think cyanide toxicity or inadvertent wedge of PAC sampling pulmonary capillary blood, hypothermia

ABA Oral Boards (1 decks)

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