Pharmacology II Exams Flashcards
1
Q
Phenobarbital may not protect against ________seizure
A
Nonconvulsive primary generalized seizures
2
Q
cerebellum controlls?
A
balance
3
Q
Drugs that the metabolism of theophylline is inhibited by (choose 2):
A
Erythromycin
Cimetidine
4
Q
Most potent H2 - receptor antagonists:
A
Femotidine
5
Q
Theophylline partially blocks effects of NMBD by?
A
inhibition of phosphodiesterase
6
Q
Gabapentin is eliminated by?
A
renal
7
Q
adding Ketamine and theophylline together does what?
A
decreases seizure threshold
8
Q
strongest predictor of PONV?
A
gender
9
Q
MOA for benzos with PONV?
A
Decreasing synthesis and release of dopamine
10
Q
Metoclopramide blocks _____ on receptor sites at CRTZ
A
dopamine
11
Q
Clobazam is unique due to?
A
No sedation with long term use
12
Q
According to ERAS, which patient would need a decrease in the dose of gabapentin from 600 mg to 300 mg?
A
30 year old female with OSA
13
Q
Which of the following is true?
Levodopa replenishes dopamine stores in
A
the basal ganglia
14
Q
The objective in treating Parkinson’s disease is to? (choose 2)
A
Decrease debilitating symptoms
Palliative Nature
15
Q
80% of the dopamine in the brain is in the? (choose 2)
A
Caudate nucleus
Putamen
16
Q
Gabapentin is given for?
A
partial and generalized seizures
17
Q
All of the following are part of the afferent pathway involved in vomiting stimulation except?
A
Histaminergic pathway
works through
chemoreceptor trigger zone, cerebral cortex labyrinthovestibular center neurovegetative system
18
Q
Which of the following medications is most effective in lowering triglycerides?
A
Fenofibrate (fibrates)
19
Q
Mainstay treatment for hyperlipidemia?
A
Statins (lovastatin)
20
Q
B2 effects with epinephrine? (choose 2)
A
- In presence of betablocker, bronchoconstriction due to alpha bronchial constriction
- Reduces vasoactive mediators for asthma
21
Q
Antidepressant increase suicidal ideation in which two patient populations? (choose 2)
A
Adolescents
Children
22
Q
Beta blocker with vasodilating effect?
A
Nobivolol (bystolic)
23
Q
Levodopa question with newly started levodopa asking about symptoms?
A
Have you had a low blood pressure?
24
Q
A drug that has effect of syncope w/ first dose, anticholinergic effects, and priapism?
A
prazosin (minipress)
25
Which drug is least protein bound?
gabapentin
26
What is seen with malnutrition or renal or hepatic disease, can result in increased plasma concentrations of unbound anti-epileptic drugs, resulting in toxicity?
Hypoalbuminemia
27
In pregnancy, hypoalbuminemia is due to ___ which offsets effect.
Progressive increase in central volume
28
Initial treatments for levodopa hypotension? (choose 2)
Compression stockings
| Fluids
29
Patient with CAD, DM and CVA, getting a surgery done, what would the prudent SRNA assure?
Assure they are on a beta blocker
30
Only agent requiring routine monitoring?
Phenytoin
31
Gabapentin MOA?
enhanced GABA activity
32
Seizure medication for laboring pregnant woman?
Clobazam
33
Which is a pro drug?
Fenofibrate
34
Benzodiazepines increase the frequency of GABA mediated channels.
What does phenobarbital and other barbiturates do?
Increased duration of ion channel opening
35
Most Common adverse effect of statins?
myalgia
36
Phenobarbital principle site of action?
Chloride Ion Channel (Flood p. 347 Table 13.2)
37
Which of the following is naturally occurring?
Lovastatin
38
Which of the following is located outside the blood brain barrier, has contact with CSF, and allows substances in blood and CSF to interact?
CTZ
39
Teratogenesis occurs within
8 weeks
40
In which of the following is myopathy frequent?
Lovastatin
41
The astute SRNA knows that they will have to monitor blood glucose levels with what kind of drip?
epinephrine
42
Most common cholesterol in plasma?
LDL
43
Mrs. Smith was told to stop taking all her medications 4 days before surgery (including levodopa). What signs or symptoms would you expect to see the day of surgery?
Neuroleptic malignant like syndrome
44
New seizure drug's elimination half time is 24hrs. How often do you expect medication given?
Q 12 hrs
45
Niacin most common side effect?
Flushing
46
Intubating someone what do you need to be careful about if they take which med?
Amlodipine
47
All these work on the vomiting center except
Alpha-gaminobutric acid
48
Hydrolysis of triglycerides occurs where?
Pancreas and small intestine
| or intestinal endothelium
Flood p. 542
49
Anatomical sites that activate the vomiting center include all EXCEPT?
Not included: Hypothalamus
Anatomic sites that activate the vomiting center include: -vestibular apparatus,
- thalamus,
- cerebral cortex, and
- neurons within the GI tract (Flood, p. 693)
50
Which is true of niacin?
Hyperglycemia and abnormal glucose tolerance may occur in nondiabetic patients
51
The vomiting efferent signals via cranial nerves? (choose 3)
V, VII, IX, X, and XII
| 5, 7, 9, 10 & 12
52
Histamine receptor antagonist?
Promethazine
53
MOA of macrolides:
Prokinetic properties are attributed to their binding to motilin receptors in the stomach and doudenum
54
Early postop nausea occurs?
within 6 hours
55
The vomiting center is located in the?
medulla
56
Risk for PONV:
35 female lap procedure
| 4 year old Female strabismus surgery
57
What symptoms are associated with scopolamine 24- 48 hours?
visual disturbances
58
Prolong QT? (choose 3)
Metoclopramide
Droperidol
Ondansteron
59
What drug increases Triglycerides?
Cholestyramine
60
Medication for patients actively vomiting pt in PACU?
Dopamine antagonist
61
Controversial but believed to increase PONV?
Neostigmine
62
Medication to avoid with restless leg syndrome?
Reglan (metoclopramide)
63
Which drug has a serotogenic effect?
zofran
64
Reglan works by???? (choose 2)
Dopamine antagonist
| Blocks histamine
65
Reglan works by?? (choose 3) (How does it work/ what does it do to the body/ it's job)
Contract lowers esophageal sphincter
Increases small intestinal mobility
Relaxations of pylorus
66
MOA of Phenytoin?
Sodium channel blockade
67
Which of the following is an early complication with parenteral nutrition
Hypophosphatemia
68
Pyroxidine would be used in caution with what disease
parkinson's disease
69
A deficiency in this vitamin would cause changes in hematopoiesis system and nervous system
Vitamin B12 Deficiency
70
Which of the following is an example of a fat soluble vitamin
Vitamin A
DEAK
71
You would caution the use of what drug with a patient taking St. John’s Wart?
Serotonin Antagonist
72
What medication was taken off the shelf because it causes prolonged QT, MI, stroke death.
Ephedra
73
True or False: Levodopa replenishes dopamine stores in the Medulla?
False, replenishes dopamine stores in the basal ganglia
74
Which of the following medications is most effective in lowering triglycerides?
Fenofibrate (Fibrates)
75
Which is a pro drug?
Fenofibrate
76
In neonates, doses of 1mg or greater may cause hemolytic anemia and increase the plasma concentrations of unbound bilirubin, thus increasing the risk of kernicterus.
Phytonadione
77
Antidepressant increase suicidal ideation in which two patient populations? (choose 2)
Adolescents
| Children
78
Levodopa question with newly started levodopa asking about symptoms?
Have you had a low blood pressure?
79
Which is least protein bound?
Gabapentin
80
The vominting center is located in the?
medulla
81
Deficiency can cause of vitamin A can lead to
Night blindness
82
What factor is not synthesized by vitamin K
XII
83
This deficiency can lead to rickets
Vitamin D
84
Which of the following is not associated with enteral feeding
Decreased absorption in the small intestine
85
All of the following interfere with Warfarin EXCEPT
Golden Seal
86
Which of the following stimulates the release of Growth Hormone
Stress
87
What is the initial building block of corticosteroid synthesis
Cholesterol
88
Corticotropin releasing hormone and ACTH are: (Choose 2) (concentration and time of day)
High in the am
| Low in the pm
89
Which of the following is released from the zona glomerulosa:
aldosterone
90
Which of the following is NOT true regarding absence of ACTH choose 2
Hyperpigmentation is associated with a low ACTH from primary adrenal insuffiency
Pallor is associated with Hyperpituitarism …
from ppt:
Hyperpigmentation in presence of adrenal insufficiency from primary adrenal gland disease reflects high concentrations of ACTH in plasma as the anterior pituitary attempts to stimulate corticosteroid secretion.
Pallor is the hallmark of HYPOpituitarism.
91
Estrogen most common side effect
Nausea
| Yes, FLood p. 773 - “the most frequent unpleasant symptom with the use of estrogen is nausea”
92
Choose three things vasopressin does
Vasoconstriction
Reabsorption of water
Release of corticotropin
93
What is the side effect of iodine?
angioedema
94
When is radioactive iodine contraindicated?
26 year old parturient
95
What is given for DI?
DDAVP
96
What is the Prohormone to T3
T4 is a prohormone to T3
97
AVP and oxytocin are secreted from the ______ and transported via _____ to the ____.
Hypothalamus,
axons,
posterior pituitary
98
PTH has targeted effects on: (Choose 2)
Kidneys
| GI
99
According to the ADA and WHO classification of diabetes which of the following is TRUE (Choose 2)
The underlying disease etiology
| Not classified by age of onset
100
A patient diabetic patient with liver cirrhosis would more than likely be prescribed what sulfonylurea:
Acetohexamide
101
Consequences with diabetes usually resolves with a blood level less than:
200 mg/dL
102
Which of the following describes endocrine glands that secrete hormones adjacent to the site of origin:
Paracrine
103
Which of the following is the longest acting Sulfonylurea:
Chlorpropamide
104
All of the following are side effects of chronic corticosteroid therapy EXCEPT:
Acromegaly
105
What is the level of daily insulin secretion in a normal patient:
40 U/Day
106
True or False: Insulin is metabolized in the portal vein of the liver by second pass?
False
107
Which of the following does NOT cause hypoglycemia:
Metformin
108
What causes lactic acidosis
Metformin
109
he liver is _____ in insulin and uses _____ to produce _______ and be used as an energy source for skeletal and cardiac muscle
Insufficient, free fatty acids, ketones
110
First thing you see with thyroid dysfunction
Cardiac changes
111
Which of the following causes an aberrant production of AVP:
Oat cell carcinoma
112
This has reactions similar to disulfiram
Chlorpropamide
113
What would you expect in a patient with hyper/hypothyroidism: (Not the exact question but something about thyroid disease and anesthesia)
No alterations in MAC because there is no affect on O2
| brain consumption
114
Which of the following is true regarding thyroid disease:
Hyperthyroidism causes 100% increase in O2 consumption
115
pancreatic cells come from
Beta
116
PTH increases
Renal absorption of calcium and inhibits renal reabsorption of phosphate.
117
You would except the O2 consumption in a patient with hyperthyroidism to increase by:
100%
118
Glucocorticoids permissive actions allow individual for response to stress
At low physiologic steroid concentrations
119
What is the cause of DI?
Inadequate secretion of vasopressin by posterior pituitary
120
Permissive action of glucocorticoids:
Occur at low physiological steroid concentrations and prepares the individual for stress
121
The Thyroid receives innervation from the:
Autonomic nervous system (Flood page 738)
122
How many parathyroid glands secrete PTH?
4 (Flood 739)
123
PTH has what kind of relationship with calcium?
Inverse (Flood 739)
124
Early nutritional support is proactive therapy: What 4 things does it help with?
Reduces disease severity
Diminish complications
Decrease Length of Stay
Favorably impacts patient outcome after severe injury
125
Greatest risk of hypoglycemia occurs with drugs with the longest elimination half times (choose 2)
Chlorpropamide and glyburide
126
The most common setting for symptomatic hypocalcemia is
within 12-24 hrs after surgery, particularly after total of or subtotal thyridectomy of 4 gland parathyroid exploration or removal.
127
hypocalcemia can cause:
Neuromuscular irritability
128
What can DDAVP NOT treat?
Nephrogenic diabetes insipidus
129
Pyridoxine b6 can cause what toxic effect?
Neurotoxicity
130
Folic acid deficiency can cause
Megaloblastic anemia
131
Vitamin A is important for:
retina, integrity of mucous and epithelial surfaces, bone development and growth, reproduction, and embryonic development.
132
Hypothalamic and pituitary secretion is ______
Pulsatile
133
The most abundant anterior pituitary hormone is
Growth hormone (Somatotropin)
134
What hormone stimulates linear bone growth?
Growth hormone (Somatotropin)
135
PTH also increases renal tubular absorption of _______; inhibits renal re-absorption of _______.
Calcium, Phosphate
136
Normal Fibrinogen level in parturients?
> 400
137
Antithrombin affects the following factors:
12 (XII),11 (XI),10 (X), 9 (IX)
138
At what Hgb level would you plan to transfuse?
a. There is no single minimum acceptable hemoglobin level for transfusion
139
Half life of Fibrinogen:
~3.7 days
140
Clopidogrel (Choose 2):
a. Most widely used agent
| b. Inability to adequately inhibit P2Y12-dependent platelet function, so resistance occurs in 20% to 30% of patients
141
Prodrugs:
Clopidogrel
| dabigatran etexilate
142
Primary factor of Extrinsic pathway?
7 (VII)
143
What is needed to start the extrinsic pathway? (Choose 2):
a. Tissue Factor (Thromboplastin/Factor III)
| b. Trauma
144
Major factor in the common pathway?
10 (X)
145
Factors can act as: (2)
a. Proteases
| b. Catalysts to convert inactive to active form
146
11. Which of the following is true regarding hemophilia (Choose 2)
a. VIII and Hemophilia A
| b. IX and Hemophilia B
147
What is not true of vWF?
Used prophylactically
148
Cryoprecipitate should not be given for DIC because it lacks factor:
V (5)
149
Which of the following is true (choose 3) (what do you know about protein C, S, and Thrombin?)
a. Protein C and Protein S together break down 5a and 8a
b. Thrombin to activate Protein C
c. Protein C binds to protein S
150
When can HIT occur?
| What do the antibodies to heparin bind to?
a. Can occur 4-5 days after heparin therapy
| b. Antibodies to heparin form and bind factor IV (calcium)
151
Primary Hemostasis is:
platelet activation by injury to where platelets attach to damaged endothelium
152
17. Inflammatory response that includes cytokine release is true of which of the following:
d. Procoagulant response
153
Factor IX is the _____ factor and is stored in the _____
Christmas, liver
154
Inactive enzymatic precursor
Zymogen
155
NOT true regarding coagulation testing (most common lab test, and PT or PTT?)
Most common lab test
| PTT measures extrinsic
156
Which of the following according to ____ would require PRBC transfusion?
9 (all other levels were > 10)
157
What factors are included in Cryo?
Fibrinogen and vWF
| XIII and VIII
158
While there is no literature to prove this, it is possible that storage of PRBCs can cause storage lesions after being stored:
14-21 days
159
Which of the following should be considered in the decision to transfuse? (Choose 3)
a. Target organ ischemia
b. Decreased cardiac reserve and increased myocardial oxygen consumption
c. Ability to transport O2
160
25. A patient that is 50 kg would need how much cryo to increase fibrinogen 50-70 mg/dL
5 units (1 unit Cryo for every 10 kg of body weight)
161
26. Which of the following is true regarding TRALI (Choose 2)
a. Onset within 6 hours of transfusion
| b. Pulmonary artery occlusion less than or equal to 18 mm Hg
162
Which of the following is true regarding TACO?
a. Elevated JVP
b. High BNP
c. Pulmonary Edema
163
28. True regarding FFP (Choose 3):
a. FFP can be frozen after 8 and 24 hours
b. After thawed, FFP can be stored an additional 4 days
c. FFP is what is left after RBCs and Platelets are removed
164
Which drug's elimination half-time is 12-24 hrs?
Abciximab (Reopro)
165
TXA: Choose 3
a. inhibits plasmin at higher doses
b. most of the efficacy data are reported with TXA
c. Synthetic antifibrinolytic
166
31. A patient is scheduled for surgery at 0800, they received their last dose of LMWH at midnight. What time would you reschedule their surgery for?
1200 noon (12hrs)
167
What would you consider lab values to be in DIC (Choose 2):
a. Decreased platelets and fibrinogen
| b. Increased PTT and D-Dimer
168
33. What is a cause of chronic DIC? (I just put the key words in to jog someone’s memory) All I know is that you can have normal labs with chronic
Tumor or large aneurysm with normal clotting labs (PT and PTT)
169
If a patient has an immediate reaction after heparin dosing you would expect?
HIT
170
What drug is an irreversible thrombin inhibitor that can possibly produce antibodies and need to be monitored with aPTT?
Lepirudin
171
What is true about heparin rebound?
a. 2-3 hours after 1st dose of Protamine
| b. Can occur after initial dose of Protamine
172
The influence of renal and hepatic disease with heparin is:
Less than with other anticoagulants
173
In acute anemia, compensatory mechanisms rely on?
Cardiac reserve
174
DDVAP dose?
0.3mg/kg over 15-30mins
175
ASA guidelines for hemoglobin levels that require transfusion (This was two separate questions)
a. 5 (<6 in young healthy patient)
| b. 9 (all other answers were >10, which are outside of guideline range for transfusion)
176
DIC involves (Choose 2):
a. Too much clotting
| b. Too little clotting
177
42. You are performing pre-op for a patient who has been on warfarin for 5 days; what lab would you check (that is only related to warfarin) and what, if anything, would you plan to give?
Check PT and give FFP
178
Patient received 10,000 units of heparin an hour prior; How much protamine do you give?
Patient still has 5,000 units of circulating heparin after one hour (heparin HALF life is one hour), and 1 mg protamine for every 100 units heparin (5,000/100 equals 50) = 50 mg protamine
179
What lab values would you expect to see in a patient with antiphospholipid syndrome: (Choose 2):
a. Prolonged PT, PTT, but patient is actually
* * hypercoagulable**
c. Caused by lupus anticoagulant antibody
180
Factors can be (Pick 2):
a. Proteases
| b. Catalysts for transforming inactive into an active state
181
What is a zygomer:
inactive enzymatic precursor
182
What starts the Intrinsic pathway:
Factor 12
183
Correct sequence of intrinsic pathway: (choose 2)
a. 12 → kallikrein → 12a → ,11 → 11a
| b. Occurs in the blood
184
What is true about heparin (Choose 2):
a. IV onset is immediate
| b. Effects are produced by binding to antithrombin (AT)
185
50. Patient on heparin infusion planning to go to surgery shortly; aPTT level is 157; what should you do?
Omit a dose
186
ACT is good for (Choose 2):
a. Heparin doses of > 1unit/mL
| b. High doses of heparin
187
ACT is affected by:
a. Hypothermia, presence of contact activation inhibitors Aprotinin, may have been one more answer
188
Aprotinin:
use Kaolin ACT
189
Target ACT in CABG:
350-400
190
Which is not true of Arixtra? (fondaparinux)
a. It is a synthetic anticoagulant (true)
b. Half-life of 15 hours (true)
c. Metabolism does not occur and the drug is eliminated by the kidneys (true)
d. It is naturally occurring
d. It is naturally occurring
191
Question about PEs:
a. 3rd MCC of death in traumas who survive first 24 hrs
| b. PE occur 2-22% of pts in major trauma
192
What drug Inhibits vitamin K epoxide reductase that converts the vitamin K-dependent coagulation proteins (Factors II, VII, IX and X) into active forms in Oral or IV
Warfarin
193
What is true about warfarin? (Choose 2):
a. peak effect in 36-72 hours
| b. 97% protein (albumin) bound
194
When to stop anticoagulants:
1-3 days pre-op to give prothrombin time to return to within 20% of normal range
195
What is true about Xarelto: Is this a choose 3?
a. >10,000 fold greater selectivity for factor Xa than for other related serine protease
b. Does not require AT as a cofactor
c. Has non-heparin-like molecule and may be suitable for pts with HIT
196
PCC compared to FFPs
a. quicker INR correction
b. have a lower infusion volume
c. and are more readily available without crossmatching
197
TXA dose:
Loading dose of 1gm over 10 mins then 1 gram over 8 hours
198
Question about aprotinin
a. Polypeptide serine protease inhibitor
Used for low risk CABG in canada-used for compassionate use in US
199
vWB: using DDAVP (Pick 2)
a. Will be ineffective in treatment of types 2 - 3 (the severe forms)
b. Will only be effective in mild form of vWB (type 1)
200
Source of factor III:
Platelets
201
What lab work would you expect to see in vitamin K deficiency?
Prolonged (increased) PT
202
What is true regarding propofol?
a. Baroreceptor reflex control of HR may be depressed by propofol
b. Stimulation produced by by direct laryngoscopy and in intubation of the trachea reverses the blood pressure effects of propofol
203
Propofol half life?
0.5-1.5 hours
204
Succinylcholine half life?
47 sec
205
What is true regarding cisatracurium? Pick 3
a. Hoffman elimination accounts for 77% of metabolism
b. Small amount is eliminated by renal
c. At regular doses it does not release histamine
206
Tylenol hepatic metabolism by?
a. NAPQ1 (N-acetyl-p-benzoquinonneimine)
207
Dosage of etomidate for a patient weighing ____ lbs?
0.2-0.4 mg/kg
208
Dosage of ketamine for a patient weighing __162___ lbs?
1-2 mg/kg
209
Profound block of Rocuronium can be reversed with how much sugammedex?
8 mg/kg
210
Sugammadex work on all of the following drugs except?
Cisatracurium
211
Sugammadex make 1:1 complexes, with greatest to least effects on?
Roc > Vec >> Pan
212
11. Clearance of propofol from the plasma exceeds hepatic blood flow… elimination/metabolism?
a. Oxidative metabolism by cytochrome P450
| b. Lungs by first pass
213
12. Dose of Neostigmine for reversal?
40 mcg- 70 mcg/kg
214
Succ dosing causing bradycardia occurs within ___ min of repeated dose?
5
215
Do not mix meds with propofol, but sometimes _______ is used.
Lidocaine
216
Dose of Glyco when using neostigmine for reversal
7 to 15 mcg/kg
217
Phenylephrine is similar to?
Norepinephrine
218
Who is at greatest risk for postop hyperglycemia after 1 dose of dexamethasone?
Obesity
219
4 year old with Propofol bradycardia?
epinephrine (p 165)
220
Propofol
a. decreased cerebral metabolic rate for oxygen
| b. Large doses of propofol to decrease cpp
221
Relatively selective modulator of GABAA has activity at glycine receptors.
Propofol
222
Paradoxical vocal cord motion?
midazolam 0.5-1mg
223
What is given orally 30 mins before induction to children?
Midazolam 0.5mg/kg
224
Esmolol initial dose?
0.5 mg/kg
225
Select 3 about Fentanyl?
a. prolonged elimination half time by cardiopulmonary bypass
b. 75% of initial Fentanyl first pass pulmonary uptake
c. Rapid onset and shorter duration of action than morphine
226
Fentanyl when given in a single dose, compared to morphine?
a. Has a shorter duration
| b. Has a rapid onset
227
question about which drug has larger Vd?
Fentanyl greater lipid solubility
228
29. Max dose of propofol in patient weighing 218 lbs (99 kg)?
1.5-2.5 mg/kg
229
Elimination of vecuronium (Choose 2):
a. Has parent compound present in bile
| b. Primarily eliminated by the liver/elimination half time is dependent on hepatic blood flow
230
Anaphylaxis from propofol most likely from patients who also have an allergy to which type of med?
NMBDs
231
Responsible for hydrolysis of esmolol?
Plasma esterase
232
When giving etomidate, need to be cautious with patients who have which condition?
Seizures
233
Elimination of succinylcholine follows?
First order kinetics
234
In what patients is there a risk of hyperglycemia from administration of dexamethasone?
Obesity
235
Succinylcholine increases intragastric pressure by:
Increased vagal tone
236
Ketamine
Cerebral vasodilator
| Increases SBP
237
Vecuronium metabolism/elimination:
More liver metabolism (70%) than renal
238
What 2 conditions can increase chances of hyperkalemia when using Succinylcholine:
a. G.B. syndrome
| b. Severe Metabolic acidosis
239
Ephedrine has a duration of action ___times than epinephrine
10 times
240
Vecuronium eliminantion.
The liver is the principal organ of elimination
241
Which is true of precursors?
Dopamine is the precursor to epinephrine and epinephrine is precursor to norepinephrine
242
Esmolol as treatment for cocaine toxicity can lead to: (flood 483)
CV Collapse
243
Etomidate is known… or you would use it cautiously because it can result in: (flood-171)
Adrenocortical suppression
244
The SRNA would make a DART how? (hammon)
3ml total = 2 ml Succ (40mg), 1ml Atropine (0.4mg) in an IM injection
245
Succs is metabolized by (flood-325)
- butyrylcholinesterase
| - plasma cholinesterase
246
Sufentanil has an 84-100% of chest wall rigidity making ventilation difficult. Give? (flood-223)
Neuromuscular blocking drug
| Opioid antagonism-naloxone
247
Pick two for propofol (flood-163)
1. Compared with thiopental, propofol decreases the prevalence of wheezing after induction of anesthesia
2. Metabisulfite may cause bronchoconstriction in asthmatic patients
248
Something about cisatracurium differences from atracurium (flood-330)
cisatracurium is about four to five times as potent as atracurium
249
Which is true regarding Ephedrine? (flood-459)
Synthetic indirect acting sympathomimetic
250
Rapid administration of Phenylephrine, 1 mcg/kg IV (flood-460)
to GA pts with CAD can cause transient impairment of Left ventricular globe function
251
Usual dose of Succ:
1mg/kg
252
Rocuronium is primarily eliminated by
liver
| and excreted in bile
253
Propofol does all of the following EXCEPT:
Relief of acute nociceptive pain
| (It IS an Antiemetic, antipruritic, and an anticonvulsant)
254
Levodopa is converted to Dopamine by:
L-amino-acid decarboxylase (dopa decarboxylase enzyme)
255
identify the hypophyseal fossa in sella turcia of:
sphenoid bone
256
A total thyroidectomy and subsequent absence of calcitonin does what (p. 739)
Does not measurable influence the plasma concentrations of calcium because of the predominance of parathyroid hormone
257
What patient type would you use Pyridoxine with caution in: (p. 724)
Parkinson Disease
258
elimination half time of glucagon
3-6mins
259
Sulfonylureas cross the placenta and can produce (p. 754)
Fetal hypoglycemia
260
question about platelets Storage
There remains a permissive bacterial growth as platelets:
Reducing donor exposures by
- are stored at 22C
| - apheresis platelets. (It used to come from multiple sources increasing the risk of exposure
261
normal platelet
150,000-400,000
262
Thawed Plasma maintains normal levels of all factors except
VIII which falls to 60%
| Factor V falls to 80% of normal
263
10-15ml/kg of FFP will result in a rise of most coagulation proteins by
25-30%
264
DIC treatment (flood 624)
Remove underlying cause-institute anticoagulation in efforts to reduce further consumption of coag factors.
265
platelets
| Lab test determine platelet
count NOT function
266
protamine found
found from Salmon sperm
- strong positive alkaline
267
Act values can be misleading during CABG due to
Hypothermia and hemodilution during CABG
268
What has a greater risk DVT
Hip surgery is greater than general surgery
269
First isolated from leeches
Lepirudin and Desirudin
270
aPTT =
activated partial thromboplastin time
normal = 30-35sec
271
PT =
prothrombin time
