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Prodigy > Prodigy Films F to O > Flashcards

Prodigy Films F to O Flashcards

1
Q

What are FA & FI?

A

FA - fractional concentration of anesthetic in the ALVEOLI

FI - - - - - - INSPIRED GAS

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2
Q

explain FA FI importance

A

faster FA/FI = 1 faster induction will occur

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3
Q

how to increase FA/FI

A 
increase minute ventilation
Decrease FRC & CO
Increase FGF > 4 L/min
Decrease circuit volume,
Decrease agent solubility (helps circuit absorbs less too)
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4
Q

what is most important factor in the rate of rise in the FA/FI

A

uptake

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5
Q

how does uptake affect FA/FI? how about CO?

A

decreases FA, so it slows the rate of rise of FA/FI

increased CO increases uptake and decreases FA even more

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6
Q

What factors increase MAC? (need more Gas)

A 
Young age
Chronic alcohol abuse
CNS stimulants
Hyperthermia
Hyperthyroidism
Hypernatremia
Red hair female
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7
Q

What factors decrease MAC?

A 
increased age (6% per decade)
Pregnancy
Metabolic acidosis
lithium
acute alcohol ingestion
anemia
Lidocaine, Opioids, Ketamine, Benzo, Alpha 2 agonists, 
hypothermia, Hypoxia, Hyponatremia, Hypoosmolarity
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8
Q

What is MAC?

A

necessary to prevent skeletal muscle movement 50% pt’s to noxious stimuli

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9
Q

Name factors that don’t affect MAC

A 
Duration of anesthetic
Gender
Hypo/Hypercapnia
K imbalances
Metabolic alkalosis
HTN
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10
Q

what factors affect fetal transfer of drugs

A

Molecular weight < 500 Daltons (BB, NTG, Nitro)
lipid solubility (fent/ Ketamine)
ionization
concentration gradient

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11
Q

what drugs do not cross placenta

A

Heparin ,Insulin, Protamine (all large Daltons > 1000)

Glyco / SUX ( water soluble drugs do not)

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12
Q

What drugs do cross placenta

A

beta blockers
NTG
Nitroprusside
Fentanyl / Ketamine (lipid soluble)

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13
Q

what is Fick’s Law of DIssusion?

What factors affect it (4)?

A
  • rate of diffusion across membrane,
  • takes into account
    1 molecular weight (inversely proportional),
    2 solubility
    3 concentration gradient (directly proportional),
    4 membrane thickness
    (helps explain diffusion hypoxia)
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14
Q

what is first pass metabolism

A

orally administered drugs are metabolized by the liver prior to entering circulation

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15
Q

flow volume loops
what does point in top left corner represent?
middle right ?
lower left corner?

A

top left = peak expiraotry flow rate
right most point = residual volume
lower left corner = TLC

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16
Q

flow volume loop X & Y axis?

A 
X = volume 8 to 1 L 
Y = flow 0 to 7.5 up and 0 to 7.5 down
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17
Q

what is a dyne?

A

1/100,000 of a newton which is equal to 102 grams. its just a very small unit of measurement for body since a newton is too big.

18
Q

what is Frank starling mechanism?

A

more blood that returns to heart allows more blood to be ejected since actin and myosin align

19
Q

what is the sphincter of Oddi?

A

where common bile duct & pancreatic duct meet to empty into the duodenum.

20
Q

what is Gay Lussacs Law?

A

p1T2 = p2T1, direct relationship, think heating a cylinder

21
Q

GFR normal level?

what increases GFR & what decreases it?

A

normal 125 mL / min
increased = by Dilation afferent arteriole, increased renal blood flow and increased efferent arteriole resistance
decreased = by increased afferent arteriole tone

22
Q

what does glossopharyngeal nerve innervate?

A

posterior 1/3 of tongue, tonsils, pharyngeal wall

23
Q

what is brain glucose consumption #?

A

5 mg /100g / min
closely parallels CMRO2
hyperglycemia above 180 can be detrimental as produces lactic acid but hypoglycemia can be bad as well.

24
Q

What is grahams law of Diffusion ( Effusion) ?

A

the rate of diffusion of a gas is inversely proportional to its molecular weight. ( smaller particles spread out faster than bigger particles!!!!!!!!!)
effusion = rate that gas particles escape thru tiny hole

25
Q

what is conductive heat loss?

A

transfer of heat by direct contact between a warmer object and cooler object.

26
Q

what is convection heat loss?

A

heat from our skin cools the air around onur skin .

second greatest source of heat loss. (radiation is #1)

27
Q

what is evaporation heat loss? what causes it and what can we do about it?

A

liquid to gas,

use lower gas flows and in line humidifiers , caused by alcohol and sterile preps

28
Q

what is radiation heat loss?

A
  • transfer of infrared energy from body to cooler operating room environment, - ———- greatest amount of heat loss,
  • occurs in areas of greatest blood flow and the head is number 1, why wrap head in warm blankets
29
Q

hematologic effects of renal disease? what is treatment and how to best check it?

A

even pt’s with normal PT/PTT and PLTS can bleed from epistaxis, GIB & subdural bleed, from uremic bleeding
best to check bleeding time
treat with desmopressin 0.3 mcg/kg IV preoperatively peaks in 2-4 hrs and lasts 6-8 hrs

30
Q

what is hemodiaysis

A

removing waste by diffusion thru semipermeable membrane, reduces BUN by 70%
SE = hypotension and hypoexmia, muscle cramping, dysrhythmias & reaction to tubing

31
Q

what is Henry’s Law?

A

amount of gas dissolved in liquid is directly proportional to partial pressure of gas above it,
why you can turn sevo to 6% and get more gas in blood than 2%

32
Q

explain henry law and Sevo gas?

A

the delivery of a higher concentration of anesthetic than the desired end point can speed the uptake of the anesthetic.

33
Q

what is hepatic clearance

A

rate of drug metabolism = hepatic blood flow x (drug conc going in - out)

34
Q

what is hepatic extraction ratio

A

% of drug the liver can clear as it passes through

35
Q

liver receives how much of CO

A

25%

36
Q

how much blood can liver hold and whats its spinal innervation?

A

1L

T3-T11

37
Q

what is Hering Breur Reflex?

A

stretch receptors send signals to dorsal respiratory group

triggered by 1.5L overinflation of lungs, feedback loop that can increase RR

38
Q

what is hyperparathyroidism

A

90% from benign adenoma or from

parathyroid carcinoma or multple endocrine neoplasia

39
Q

what are s/s of hyperparathyroidism

A

same as elevated Ca
kidney stones, GI ulcers/ cramping, muscle weakness, polyuria/polydipsia/confusion
HTN, short QT, prolong PR & QRS, bradycardia

40
Q

treatment of hyperparathyroidism

A

tumor removal, NSS infusion, LOOP diuretics, biphosphonates & calcitonin

Prodigy (12 decks)

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