Pretest notes

Question 1

Pretreatment for pt with vW before surgery?

Answer 1

cryoprecipitate

Question 2

What is the tx if the RQ is >1?

Answer 2

decrease carbs in feeds

Question 3

What is an ideal respiratory quotient (RQ)?

Answer 3

0.75-0.85

Question 4

Fam hx of prolonged paralysis during general anesthesia suggests? Name 2 meds that should be avoided.

Answer 4

pseudocholinesterase deficiency which prolongs the effects of succinylcholine, a depolarizing neuromuscular blocking agent, and mivacurium, a non-depolarizing agent

Question 5

What is Beck’s triad? What does it relate to?

Answer 5

systemic hypotension, jugular venous distention, and distant heart sounds; symptoms of cardiac tamponade

Question 6

What are the signs of cardiac tamponade?

Answer 6

pulsus paradoxus (decrease in systolic blood pressure by more than 10 mmHg at the end of the inspiratory phase of respiration); pericardial fluid; right atrial collapse; equalization of pressures across the four chambers

Question 7

How does PEEP improve oxygenation?

Answer 7

increasing functional residual capacity by keeping the alveoli open at the end of expiration

Question 8

How is acalculous cholycystitis cured?

Answer 8

percutaneous drainage

Question 9

What is the tx of choice in cardiogenic shock?

Answer 9

dobutabmmine

Question 10

TRALI tx?

Answer 10

respiratory support

Question 11

TRALI s/s?

Answer 11

distress, hypoxemia, and bilateral pulmonary infiltrates not due to volume overload

Question 12

What does systemic dopamine do at high doses?

Answer 12

peripheral vasoconstriction, increased blood to organs but decreased kidney function, HTN

Question 13

What does systemic dopamine do at low doses?

Answer 13

increase diastolic BP, redirect blood flow to kidneys and bowel, increased CO and BP

Question 14

Which way does bank blood shift the O2 dssociation curve? Why?

Answer 14

to the L bc it’s low in 2,3-DPG

Question 15

What shifts the O2 dissociation curve to the R (promotes tissue O2 uptake)?

Answer 15

increasing the PaCO2, acidosis, increased T, chronic lung dz

Question 16

To extubate, the spont. resp. rate should be less than ____.

Answer 16

20 breaths/min

Question 17

To extubate, the minute ventilation should be less than ____.

Answer 17

10L/min

Question 18

The patient should be weaned to ___ cm H2O PEEP before attempting extubation.

Answer 18

5

Question 19

To extubate, the negative inspiratory force should be at least greater than ____ cm H2O.

Answer 19

–20 cm

Question 20

What rapid shallow breathing index predicts successful extubation?

Answer 20

60-105

Question 21

What is the rapid shallow breathing index?

Answer 21

ratio of the resp rate to the tidal volume

Question 22

Bleeding from trach: definitive tx?

Answer 22

fibrooptic exploration in the OR

Question 23

Bleeding from trach: tx at the bedside?

Answer 23

inflate balloon, reintubate, use finger to compress artery