QBank 3 Flashcards
- Sedated patient unresponsive to stimulation with regular breathing; tears from her eyes:
a. Light plane of general anesthetic
- Ellis classification tooth fractures when enamel, dentin, and pulp involved:
a. Class III
Ellis classification I–fracture within enamel; II–fracture of enamel-dentin; III–fracture involving pulp; IV–fractures involving the roots
- Obstructive vs Restrictive lung disease.
- Obstructive lung disease – a decrease in the exhaled air flow caused by a narrowing or blockage of the airways, which can occur with asthma, emphysema, and chronic bronchitis.
- Restrictive lung disease – a decrease in the total volume of air that the lungs are able to hold. Often, this is due to a decrease in the elasticity of the lungs themselves or caused by a problem related to the expansion of the chest wall during inhalation.
- Effect of Aortic stenosis in MAP?
a. Decrease
At very beginning, aortic stenosis will cause decrease in MAP. this wil lead to compensatory overactivity of heart in short term via sympathetics, while in the long term there will be hypertrophy of left ventricle. these will lead to increase force generation whixch will lead to increased pressure in left ventricle and bringing the MAP towards normal. but as always, compensation is never complete
- Why is Versed the quickest acting benzo?
Most lipid soluble
Because Versed is water soluble it does NOT need Propyl Glycol as carrier (as Diazepam does) and is therefore less irritating to the vein, but its lipid solubility accounts for quick onset)
- Muscle relaxant used in renal pts?
a. Atracurium
Atracurium is a widely-used non-depolarising neuromuscular blocker causing muscular relaxation. It has a short duration of action (20 minutes) because of stability only in cold, acidic environments. It degrades rapidly in the body and so is independent of liver and renal elimination. This is of value in patients with dysfunction of these systems.
- Lethal rhythm most commonly seen in cardiac arrest pts?
a. V-fib
- Drugs that cause Methemoglobinemia?
a. Prilocaine >600mg
• Tx-Methylene Blue 1-2mg/Kg IV
The blood supply to the inferior turbinates:
a. Segment supplied by ethmoidal artery off ophthalmic artery
- What could be damaged during an inferior meatus antrostomy?
a. Nasolacrimal duct
- The most common rhythm seen in cardiac arrest?
a. V fib
- Which form of TMJ noise has the best prognosis?
a. Early opening, late reciprocal click
- What happens to serum Ca, PO4 levels s/p removal of parathyroid glands?
a. Remove glands then calcium (down) and PO4(up)
- Disruption of the BBB?
a. Disrupted by severe HTN, tumors, trauma, strokes, infection, marked hypercapnia, hypoxia, and sustained seizures.
- Cerebral Perfusion Pressure is the difference between?
a. MAP and ICP.
CPP less than 50 mm Hg shows cerebral slowing
CPP between 25-40 mm Hg flat EEG
CPP less than 25 mm Hg will result in irreversible brain function
- Diazepam exerts a synergistic effect when administered concurrently with
a. cimetidin, eerythromycin, diltiazem, verapamil, ketoconazole and itraconazole
Caution is advised when midazolam is administered concomitantly with drugs that are known to inhibit the P450 3A4 enzyme system such as cimetidine (not ranitidine), erythromycin, diltiazem, verapamil, ketoconazole and itraconazole. These drug interactions may result in prolonged sedation due to a decrease in plasma clearance of midazolam.
- Tooth in the infratemporal fossa after cautious attempt at removal what next?
a. close, ABX, Wait 4-6 weeks and attempt again after triangulating with radiographs
- Moebius Syndrome.
a. Moebius Syndrome is a rare disorder characterized by lifetime facial paralysis. People with Moebius Syndrome can’t smile or frown, and they often can’t blink or move their eyes from side to side. In some instances, the syndrome is also associated with physical problems in other parts of the body. Two important nerves - the sixth and seventh cranial nerves - are not fully developed, causing eye muscle and facial paralysis. The movements of the face - blinking, lateral eye movements, and facial expressions are controlled by these nerves. Many of the other 12 cranial nerves may also be affected, including the 3rd, 5th, 8th, 9th, 11th and 12th.
- Fixed unilateral pupil LEAST likely cause:
a. CN II injury
- What joins the maxillary vein to from the retomandibular vein?
a. Sup temp V.
- Between what two fat pads does the inferior oblique muscle run?
a. The IO muscle runs between the nasal and middle fat pad
• There are two upper and three lower fat pads
- Which pharyngeal flap is indicated when there is good lateral wall movement?
a. Superior base pharyngeal flap
- What is the most common postop problem assoc with tracheostomy?
a. Tracheal stensosis
- What is the primary elevator of the palate?
a. levator veli palatini
- Which muscle protrudes the tongue?
a. Genioglossus
- A patient with a bleeding disorder is given desmopressin, what will this cause?
a. Decreased urine volume and increased urine osmolality
- The blood supply for a free ilum is:
- The blood supply for a free ilum is:
a. deep circumflex because of the diameter of the vessel and its predictability
- Radial forearm- radial a and v
- Fibula- peroneal
- Scapular- circumflex scapular a.
- Pec- thoracoacromial a. (primary), lat and sup thoracic (secondary)
- Lat. Dorsi- thoracodorsal a and v
- Trapezius- transverse cervical a
- Deltopectoral skin flap- random pattern cutaneous flap with peforators from internal mammary a
- SCM- occipital a (primary), sup thyroid (secondary)
- Median forehead- supratrochlear (primary), supraorbital and dorsal nasal (secondary)
- Temporalis- deep temporal a
- Temporoparietal fascia- superficial temporal a
- Platysma- subdermal plexus (random pattern flap mainly), also supplied by submental a (some people will claim this to be an axial flap-based on the submental artery, but this is debatable)and superior cervical a (less predictable)
- Which bones comprise the external nasal vault?
frontal process of maxilla
Bones of external nose: paired nasal bones, frontal bone, frontal process the maxilla or nasal process of the maxilla.
The external nasal valve is defined laterally by the nasal ala and medially by the septum, whereas the internal valve is defined by the attachment of the upper lateral cartilage to the septum, which forms an angle of approximately 15°
- Which muscle is not dealt with by a brow lift?
a. orbicularis oculi
- What is the treatment of dry socket/alveolar osteitis?
a. irrigation and placement of topical ointment/eugenol
- What are the most common bacteria involved with human bites?
a. staph and strep
- What is the blood supply of a pedicled buccal fat graft for closing an OA fistula?
a. blood supply from branches of Imax
- A patient has 2 previous attempts to close an OA fistula, what should be done to improve the chances of success?
a. clear any infection
- What is the first line drug of choice for treating PSVT?
a. adenosine
Stable patient treatment:
• Vagal stimulation (carotid message, valsalva)
• Adenosine
• Calcium channel blockers: verapamil, diltiazem
• Beta blockers: metoprolol or esmolol
- A middle aged male pt has diffuse muscle pain and has no jaw dysfunction, what is the diagnosis?
a. fibromyalgia
- Which is the antibiotic treatment for mucormycosis infections?
a. amphotericin B
Treatment includes: radical debridement and high dose amphotericin B.
- The difference between a thermal burn and an electrical burn in a child is which of the following?
a. deep underlying tissue destruction with possibility of late bleeding
Electrical burns have may cause distant organ damage and necrosis due to conduction of current and density; bones>skin>muscle; electrical burns occur more commonly in early childhood due to exploration and adulthood due to work
- What is the best medical treatment for post-herpetic neuralgia?
a. tricyclic antidepressants
- What is the best medical treatment for trigeminal neuralgia?
a. Anticonvulsants- carbamazepine (Tegretol) and muscle relaxants Lioresal (Baclofen)
- What is the most common complication from arthroscopy?
a. scuffing of disk
- Pt with a vitek implant and bony changes on MRI, what is best treatment?
a. remove prosthesis and reconstruct with total joint
- Which patient is best to have hylauronate injected into the TMJ?
a. patients with large MIO, acute closed lock and steep posterior slope of eminence
- What are the indications for arthrocentesis?
a. Persistant closed lock, previous invasive procedure, point tenderness, internal derangement associated with hypomobility due to adhesions, disk immobility and disk displacements, degenerative disease, synovial disease and hypermobility
- 21 y.o. patient with bilateral TMJ pain and a progressive open bite, what is diagnosis?
a. Rheumatoid Arthritis
Chronic inflammatory synovium- B lymphocytes infiltration and expansion, macrophages and T cell invasion release cytokines which lead to synoviocyte proliferation; diagnosis: atleast 1 joint with arthritis > 6 wks, age <16 yrs excluding other causes; labs reveal increased ESR, possible lymphopenia, thrombocytopenia, anemia; articular- girls>boys, systemic- girls=boys, polyarticular- >5 joints, pauciarticular- arthritis affecting 4 or fewer joints
- A kid presents with what sounds like post-septal cellulitis after a tooth extraction involving the maxillary sinsus, he has decreased visual acuity, how do you treat?
a. admit and give IV Abx
- A patient has sympathetically mediated pain what is best treatment?
a. clonidine and phentolamine
- Why are more impacted 3rd molars seen today than previously?
a. change in diet resulting in less attrition of fewer permanent teeth
- What is the test performed before doing a free radial forearm flap?
a. Allen’s Test
- One child is born with a cleft to normal parents, what is the chance of having a second child with a cleft?
a. 4%
- Normal parents with 1 cleft child= 4%
- 1cleft parent with 1 cleft child= 13%
- 1 cleft parent and no children= 2-7%
- Normal parents with 2 cleft children=19%
- 1 cleft parent and 2 normal children=3.5%
- Frey’s syndrome is?
a. para and sympathetic innervation of sweat glands
Cross innervation of auriculotemporal nerve (branch of V3) with otic ganglion and glossopharyngeal nerve (parasympathetic) causing gustatory sweating; aka auriculotemporal syndrome
- What is the most common side effect of romazicon?
a. >10% nausea and vomiting,
• 1-10% palpitations, seizures with long term benzodiazapam use
- Which drug is most likely to cause an arrhythmia?
a. terbutaline
- A patient is s/p ORIF of a mandible fx, which of the following would be a good reason to remove the hardware?
a. infected hardware that is not providing any fixation
- During submental liposuction, which direction should the opening of the cannula face?
a. towards the platysma
- What happens to the level of potassium in a patient in DKA who is given insulin?
a. extracellular level decreases
- A patient with rheumatoid arthritis may have which of the following respiratory problems?
a. restrictive lung disease
- How would you treat a patient that had an alveolar ridge augmentation with HA 3 months ago and now has infraorbital dysesthesia?
a. remove the HA
- OSA can lead to which long term problem?
a. Right sided CHF
- The best treatment for a patient with OSA due to obstruction at the base of the tongue and hypopharynx is?
a. BSSO and advancement genioplasty
- The best reason to place an implant above the osteotomy site of a genioplasty is?
a. decrease the labiomental fold
- Which tumor spreads via perineural invasion?
a. adenoid cystic
- A patient undergoes a VRO and 2 weeks after release of the IMF, she begins to relapase. What is the cause?
a. proximal segment rotation
Proximal fragment rotation is the most likely cause of relapse after a VRO. It has been documented that pogonion will move posteroinferiorly during IMF. Relapse in the vertical dimension may be due to condylar sag or an inadequate period of fixation. During MMF, skeletal forces may cause relapse. Once the MMF is released, then rotation of the proximal segment due to failure of fixation is the likely etiology. Late relapse is usually due to condylar resorption or instability of the joint.
- Which structure lies in the most inferior aspect of the lingual space?
a. hypoglossal nerve
- Mandibular setback of 6mm or less, what makes it unstable?
a. Clockwise rotation of proximal segment
- How can you de-rotate the tip in a rhinoplasty?
a. resect medial crura
Three major nasal tip support mechanisms
• Size, shape and strength of the lower lateral cartilages
• Attachment of medial crura cartilage to caudal cartilage
• Attachment of lower lateral cartilage to the upper lateral cartilage
- What is the advantage of putting a semi-occlusive bandage on a STSG donor site
a. faster healing
A semi-occlusive dressing is placed on the donor site of a STSG to decrease the pain at the donor site by increasing the rate of re-epithelialization.
- What would preserve air flow after a rhinoplasty
a. a spreader graft
- The spreader graft is placed between the septum and the upper lateral cartilages either unilaterally or bilaterally.
- If a lateral osteotomy is performed too low on the piriform aperture, then narrowing of the nasal valve may occur leading to nasal obstruction.
- Which of the following is an advantage of the closed rhino when compared to the open approach:
a. The closed technique is quicker and less invasive.
The surgeon, however, must have a superb understanding of the topographic anatomical details since the nasal skeleton will not be degloved.
- Why are children more likely to get ankylosis after trauma compared to adults?
a. the child’s condyle has a thinner cortex
- Which is characteristic of synovial fluid in a patient with RA?
a. increase proteins
The synovial fluid has reduced viscosity, exhibiting the “mucous-string sign”. WBC (PMNS) ( up to 50,000/mm3 ) are also seen in the synovial fluid. The granulomatous synovial tissue, or pannus, grows over the joint surface into the subchondral bone which then destroys the joint and will result in hypomobility
- What is the vascular supply to the inferior turbinate?
a. Internal max
• Sphenopalatine artery/terminal branches of Imax
- How does a post-septal cellulitis result in decreasing vision?
a. obstruction of venous flow
- How does aortic stenosis affect BP
a. decreased bp, decreased pulse pressure
- Injection into a nerve results in damage/numbness, where is the damage or where was the local placed
a. epineurium
The usual site of injury is epineurial. A hematoma may develop within the epineurium which may then lead to transient or permanent paresthesia. (risk is 1:400-750,000)
- IAN injection leads to trismus what is the cause
a. hematoma in the pterygomandibular space
- Compression of which part of the brain cause anisacoria?
a. upper midbrain
Compression of the upper midbrain in the region of the occulomotor nucleus, will result in anisacoria.
- What type of flap is the temporalis flap?
a. Temporalis muscle flap is an axial flap based on the anterior and posterior deep temporal arteries.
- What is the max number of carpules of 3% mepivicaine a 35kg, 7 y.o. child can receive?
a. 4 carpules
- What is the max dose of 2% lido w/1:100,000 epi?
a. 500 mg
- What muscle relaxant is contraindicated in renal failure patients?
a. Vecuronium
- A 6 y.o.child has a pulse of 60 bpm during a deep sedation, what is the assessment?
a. bradycardic
- You are exposing a palatal cuspid, why use brackets instead of wire
a. Decreased chances of root resorption
Decreases the chance of external root resorption and is easier to place. Want to minimize tissue removal and maintain keratinzed tissue around tooth.
- A 40 y.o patient has a cervicomandibular angle of 100 degrees, what is the cause
a. Submental laxity
As a general rule patients under 40 are better candidates for submental liposuction. Those over age 40 may benefit but may likely need a facelift, submental lipectomy, and/or platysma plication
- Which implant surface forms an ionic bond with bone
a. Hydroxyappatite
- What is the most likely cause of septic shock
a. gram neg endotoxin
Septic shock is usually due to gram negative rods producing endotoxin (70% of cases). Endotoxins are lipopolysaccharides (LPS) and are released when bacterial cell walls are degraded. LPS consists of a toxic fatty acid core and a complex polysaccharide coat. LPS binds to CD14 molecules on leukocytes, endothelial cells, and other cell types.
- What is the most common complication of a radial forearm free flap?
a. exposure of the flexor carpi radialis tendon.
- With a rhinoplasty, what is the minimum width of the lower lateral cartilages that can be left without losing a significant amount of tip support?
a. 5-7mm is the minimum stip of the cephalic portion of the middle and lateral crura of the lower lats.
- IV placed in ACF, which artery are you likely to hit
a. Brachial artery
The contents of the cubital fossa are medially the median nerve, then the brachial artery and it’s two terminal branches, the lateral cephalic vein and the medial basilic vein (usually the largest vein in the ACF) which are connected to one another by the median cubital vein. The median nerve and brachial artery lie deep to the vein.
- What is the benefit of an Estlander flap?
a. abundance of mucosa
- Which graft will integrate or become vascularized the fastest?
a. corticocancellous block
- How should a tooth with an open apex be treated?
a. RCT w/CaOH, stabilize for 7 days
- Where is the brow fat found?
a. Below muscle –
The brow fat lies just deep to the orbicularis oculi muscle and superficial to the periosteum
- A browpexy is indicated for which of the following?
a. Incipient or mild lateral brow ptosis or minor brow asymmetry.
Possible to achieve a 1-3 mm increase in brow height.
- Which lip repair approximates the orbicularis oris by musculocuatneous flap from the lateral lip element ?
a. Millard
The rotation-advancement method of Millard advances a mucocutaneous flap from the lateral lip element into the gap of the upper portion of the lip resulting from the inferior downward rotation of the medial lip element. The repair attempts to place the lip scars along anatomic lines of the philtral column and nasal sill. Other methods include LeMesurier quadrilateral flap repair, Randall-Tennison triangular flap repair, Millard rotation-advancement repair, and Skoog and Kernahan-Bauer upper and lower lip Z-plasty repairs
- The proper tx of a fibrous union is?
a. Debride, graft, and fixation
- What is the nerve that was injured after lipo resulting in paresthesia below the ear, on the neck and preauricular region?
a. Greater auricular
- Which head of the buccal fat pad is most important from a cosmetic standpoint?
a. Buccal
- A STSG takes which layers?
a. Dermis and part of the adnexal structures
- How much of the tongue can you take without negatively affecting speech, swallowing, etc when doing a tongue flap?
a. 50%
Up to one half of the tongue can be rotated for tissue coverage without compromising speech mastication, or deglutition
- When can a tongue flap be divided postop?
a. 10-14 days
- What is the etiology of hand-foot-mouth disease?
a. Enterovirus infection
The most common cause of hand-foot-and-mouth disease is infection due to the coxsackievirus A16. Hand-foot-and-mouth disease is a mild, but highly contagious viral infection common in young children. Hand-foot-and-mouth disease is characterized by sores in the mouth and a rash on the hands and feet. It spreads from person to person, usually through unwashed hands or contaminated surfaces.
- A patient has loss of the upper lid crease several weeks after orbital trauma (swelling has resolved) what is cause?
a. The levator has been disinserted or transected
- What muscles are responsible for supporting the proximal segment of a VRO?
a. masseter and medial pterygoid
The masseter, medial pterygoid m and lateral pterygoid m are responsible for supporting the proximal segment of a VRO. The greater the amount of medial pterygoid that is stripped, the greater the amount of condylar sag that will result
- What is the most likely cause of binocular diplopia following orbital trauma?
a. edema \
The most common cause of binocular diplopia following trauma is orbital edema and hematoma. This is usually found in peripheral fields of gaze, and, if other findings are absent, diplopia in the primary and downward gazes usually resolves along with the edema in 7 to 10 days.
- What muscle is affected if a patient can no longer wrinkle the lateral aspect of the forehead?
a. frontalis
- 30 y.o. presents with cough, skin lesions, mouth ulcers, a perihilar nodes on CXR, what is most likely diagnosis?
a. Sarcoid
- What stage of anesthesia does nitrous ideally promote?
a. stage 2-level 1
- EKG shows NSR:
proceed with sediation
- When to give bicarb?
a. Severe metabolic acidosis with effective ventilator support
- Hyperkalemia
- Hypermagnesemia
- Tricyclic antidepressant poisoning
- Sodium channel blocker poisoning
- Race with highest incidence of Cleft lip/palate:
a. Native American > Asian > Caucasion > African
- Which lamellae includes the obiculari and overlying skin:
a. Anterior lamella
The lower eyelid is composed of 3 lamellae.
• At the level of the tarsus, the posterior lamella consists of the conjunctiva and the tarsus.
• Inferior to the tarsus, the posterior lamella is composed of conjunctiva, the retractor muscle, and the capsulopalpebral fascia.
• The middle lamella fuses with the posterior lamella at the tarsal plate and is composed of the orbital septum.
• The anterior lamella is the orbicularis oculi muscle and overlying skin.
- Factors affecting nerve sensory after BSSO except :
a. gender
- All the following cause of intra operative hemorrhage during IVRO except:
a. Lingual artey
- What part of the mandible is maintained during a mandibular subapical osteotomy?
a. Inferior border of mandible.
- Infectious DNA Virus choices
a. Mono – EBV (DNA)
- Scrofula – TB (Bact)
- AIDs – HIV (RNA)
- Herpangina – Coxsackie (RNA)
- Splenectomy patients susceptible to which infections:
a. Encapsulated bacteria: H. influenza, S. pneumoniae, N. meningitides
- Gram stain from neck wound shows Gram positive in clusters:a.
a. Staph species in clusters, treat with Bactrim because penicillinase
- Ketamine increases:
a. HR, BP, secretions, ICP, analgesia
- Severe cervicofacial infection (necrotizing fascitis) with tea colored urine:
a. rhabdomylosis
- FEV1/FVC ratio is best indicator to assess this disease?
a. irreversible obstructive (COPD)
- CT of large contrasting enhancing fluid collection at the medial posterior angle of the mandible, what is the location:
a. lateral pharyngeal space
- Resting skin tension lines (RSTL) where is incision made to excise?
a. You want to make incisions parallel to the RSTL.
- Mechanism of action of Metformin?
a. Biquanide which reduces hepatic glucose production and enhances glucose utilization by muscle. Sensitizes the target tissue (fat, muscle) to insulin action.
Sulfonylureas increase insulin secretion from the beta cell and potentiate insulin action on several extra hepatic tissues.
- Postop flap monitoring?
a. Observation – visual checks
Common cause of failure is ischemia. Graft can survive on 10% of original blood supply. Monitor for hematoma formation. Drain if present. Congestion is most common problem associated with facial flaps. Pinprick releases dark venous blood. Can manage by releasing some sutures, removal of tight bandages, Medicinal leeches (Hirudo medicinalis) The saliva from the leech contains an anticoag and a vasodilator. HBO is helpful in improving the vascularity of marginal (as in the border) graft tissue.
- What is the most ominous sign of a patient with angina pectoris?
a. Bradycardia and hypotension
- Pulmonary hypertension, right ventricular hypertrophy, left atrial enlargement what is cause?
a. Mitral stenosis
- Pt s/p BSSO with IMF when will relapse occur?
a. adequate fixation and technique, movements of less than 7mm will see a less than 10% relapse at 1 year. Anterior open-bites will be occur most likely at time of removal of MMF, due to not properly seating the condyle in the fossa.
- Lefort I trauma with ORIF open bite when release IMF, why?
a. Posterior interferences causing improper seating of the condyles.
- What inhalational agent do you not use with some one in A-fib?
a. Halothane
- 37 year old with mass on lateral tongue x ten years that has grown over the last two months pictures given included lesion, MRI, and Histo- adipocytes with skeletal muscle:
a. Liposarcoma
- Unilateral pain behind the eye, lacrimation, sharp pains?
a. Cluster headaches
- What inhalational agent is irritating to the airway in pediatrics?
a. Desflurane
- What should not have microneurosurgical repair?
a. Paresthesias have minimal improvement in most patients and a higher incidence of conversion to dysthesias
- Pericardial tamponade resembles?
Hemothorax
- Lower lid bleph needs to be performed at what snap test limit?
a. Normal distraction is less than 6mm
- Most important factors about re-implantation of avulsed tooth?
a. Loss of PDL & dessication
- Most likely reason for thrombus after microvascular anastamosis?
a. Increased collagen
- Laceration repair using multiple Z and W plasties instead of linear repair will allow?
a. Lengthing and less noticeable scarring
- Free- flap post-op swollen and cyanotic, blue?
a. venous congestion
- Canulation of the nasolacrimal duct in a pediatric patient, how long does the tube stay in place
a. 8-12 weeks
- Patient with proptotic globe and periorbital swelling, where is infection?
a. Post-septal
- What disease is associated w/ trigeminal neuralgia?
a. Multiple Sclerosis
- Glucose content of CSF, nasal and bloody secretions.
a. Nasal < CSF < Blood Nasal 30 mg/dl CSF 45 mg/dl Blood 80 mg/dl CSF: glucose is about 2/3 serum, low protein and low K
- Most common early complication after retromandibular approach to condyle?
a. Facial nerve palsy 17.2%, hypertrophic scar 7.5%, salivay fistula 2.3%
- Management of anaphylactic
Uticaria: diphenhydramine 50 mg Q6H (histamine H1 Blocker)
Angioedema: diphenhydramine 50 mg Q6H (histamine H1 Blocker) and IM sub Q epinephrine (0.3- 0.5 mL of 1:1000 soln)
Bronchospasm: inhaled albuterol 2.5mL of 0.5% solution , IV aminophyline 5-6 mg/kg load then 0.2-0.9 mg/kg/hr, and sub Q epinephrine (0.3- 0.5 mL of 1:1000 soln)
Laryngeal stridor: aerosolized epinephrine 0.25 of 1% solution (10mg/ml added to 2 mL isotonic saline and Intubation
Hypotension: volume resuscitation colloids (5% albumin, 6% hetastarch) for initial reuscitation and IV epinephrine 3-5 mL 1:10,000
Persistent hypotension: pressor agents: epinephrine (2 – 8 g/min) or dopamine (5-10 g/min) or norepinephrine (2 – 8 g/min) and IV steroids hydrocortisone 100-200 mg IV q4h
