ortho

Question 1

which surgery is most associated with BCIS

Answer 1

hip arthroplasty

Question 2

mma in systemic circulation causes tachycardia or bradycardia

Answer 2

brady & dyrsthymias

Question 3

mma in systemic circulation does what to BP

Answer 3

hypo

Question 4

mma in systemic circulation does what to SVR

Answer 4

dec

Question 5

mma does what to PVR

Answer 5

inc

Question 6

first signs of BCIS in awake person under regional

Answer 6

dyspnea and AMS

Question 7

first sign of BCIS in general

Answer 7

decreased ETCO2

Question 8

tx for BCIS

Answer 8

100% FIO2, IV hydration, neo for hOtn

Question 9

greatest risk for fat embolism is within ___

Answer 9

72h

Question 10

risk factors for fat embolism

Answer 10

pelvic fx, femoral fx, and instrumentation of femoral medullary canal

Question 11

triad of FES

Answer 11

resp insufficiency (hypoxemia, bilateral infiltrates on CXR, ARDS), neurological involvement (confusion to coma), petechial rash (skin of neck and axilla, oral mucose, conjunctiva)

Question 12

cells distal to the tourniquet shift to ____ metabolism

Answer 12

anaerobic

Question 13

max inflation time of tourniquet

Answer 13

2h

Question 14

premature release of bier block results in ___ or ___

Answer 14

sz or cardiac arrest

Question 15

releasing the tourniquet causes ETCO2 to ____

Answer 15

rise

Question 16

releasing the tourniquet causes core body temp to ____

Answer 16

decrease

Question 17

releasing the tourniquet causes BP to ____ and HR to ____

Answer 17

decrease, increase

Question 18

releasing the tourniquet causes SvO2 to ____

Answer 18

decrease

Question 19

releasing the tourniquet causes what acid base imbalance?

Answer 19

metabolic acidosis

Question 20

tourniquet pain is usually transmitted by __ fibers

Answer 20

c (slow pain)

Question 21

under GA, tourniquet pain manifests as ___ and ____

Answer 21

htn, tachycardia. give esmolol

Question 22

bone cement is an ___ reaction

Answer 22

exothermic. releases heat

Question 23

tissue thromboplastin release may cause platelet _____, micro_____, and CV ____

Answer 23

aggregation, microthrombus (lungs) and CV instability

Question 24

BCIS embolization is most frequent during

Answer 24

prosthetic insertion

Question 25

upper extremity should be ___ torr, lower extremity should be ___ torr

Answer 25

250. 350. want 100 over systolic

Question 26

tourniquet pain is less common in ___ anesthesia

Answer 26

regional

Question 27

placement of epidural needle or catheter should not be undertaken within ___ hours of a SQ heparin or within ___h of LMWH

Answer 27

6-8, 12-24

Question 28

stop plavix ___ days

Answer 28

7

Question 29

stop xaralto __ hours

Answer 29

48-72

Question 30

restrictions on aspirin?

Answer 30

none

Question 31

which location of fracture has the most blood loss?

Answer 31

subtrochanteric, intertrochanteric

(followed by base of fem neck, transcervical, sub capital) lower=bleed more

Question 32

embolic event most frequent at ___ of ___ component

Answer 32

insertion of femoral component

Question 33

highest rate of DVT is with what ortho procedure

Answer 33

total knee arthroplasty

Question 34

avoid ___ block in people with resp problems

Answer 34

interscalene