Quick Hits Flashcards

1
Q

Protons, neutrons, and electrons; which are positive, negative, and neutral?

A

Protons - Positive charge

Neutrons - No charge

Electrons - Negative charge

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2
Q

An ion with a positive charge is called? What about a negative?

A

Cation - positive (lost electrons)

Anion - negative (gained electrons)

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3
Q

Order bonds from strongest to weakest.

Ionic
Polar covalent
Van der Waals
Covalent

A

Strongest
1. Covalent
2. Ionic
3. Polar covalent
4. Van der Waals

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4
Q

What type of bond is water?

A

Polar covalent (hydrogen bonds)

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5
Q

Which law describes the total pressure is equal to the sum of all partial pressures exerted by each gas mixture?

A

Daltons

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6
Q

Which law describes gas solubility?

A

Henrys

At a constant temperature, the amount of gas that dissolves in a solution is directly proportional to the partial pressure of that gas over the solution

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7
Q

Anesthetic emergence being prolonged is an example of which law?

A

Henrys

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8
Q

An over pressurized vaporizer is an example of which law?

A

Henrys

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9
Q

Increasing FiO2 increases PaO2 is an example of which law?

A

Henrys

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10
Q

Which law describes the transfer of a gas through a tissue medium?

A

Ficks

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11
Q

Cardiac output calculation and placental drug transfer is an example of which law?

A

Ficks

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12
Q

Which law describes why smaller molecules diffuse faster than larger?

A

Grahams

The lower the molecular weight, the faster it can diffuse

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13
Q

Does a decreased pressure increase or decrease solubility?

A

Decreases

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14
Q

Does an increased pressure increase or decrease solubility?

A

Increases

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15
Q

Does a decreased temperature increase or decrease solubility?

A

Increases

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16
Q

Does a increased temperature increase or decrease solubility?

A

Decreases

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17
Q

What is the universal gas law?

A

Pv = nrT

P=pressure
V=volume
n=number of moles
r=constant 0.0821
T=Temperature

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18
Q

An O2 tank exploding is an example of which law?

A

Gay-Lussacs - at a constant volume the pressure and temperature of a gas are directly proportional

**Heated gas increases the pressure in a container

P/T

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19
Q

LMA cuff rupture in the autoclave is an example of?

A

Charles - at a constant pressure, the volume and temperature are directly proportional

***Heated gas expands

V/T

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20
Q

Squeezing a bag valve mask
Pneumatic
Bellows
Diaphragm contraction

are examples of?

A

Boyles - When temperature is held constant, the volume and pressure are inversely proportional

***** As volume decreases, the pressure increases

P*V

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21
Q

Which law descries that the current passing through a conductor is directly proportional to the voltage and inversely proportional to the resistance?

A

Ohms

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22
Q

Which law takes Ohms law and factors in diameter, viscosity, and tube length?

A

Poiseuille’s

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23
Q

Doubling the radius of an IV increases flow by how much?

A

16 times

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24
Q

How does fever effect blood flow?

A

It decreases viscosity which increases blood flow

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25
Q

Tripling the radius of an IV increases flow by how much?

A

81 times

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26
Q

Quadrupling the radius of an IV increases flow by how much?

A

256 times

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27
Q

What s laminar, transitional, and turbulent flow?

A

Reynolds number

Laminar flow < 2000
Transitional 2000-4000
Turbulent > 4000

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28
Q

If fluid velocity is high, what is the pressure exerted on the walls of the tube? What principle is this?

A

Bernoulli’s

Pressure is low on the walls of the tube

If flow is low, then the pressure is high on the walls

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29
Q

What is the venturi effect? Ex?

A

If the pressure inside the tube falls below atmospheric pressure, then the air is entrained in the tube

Jet ventilator, venturi mask, nebulizer

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30
Q

What is the Coanda effect?

A

The jet flow attaches itself to a nearby surface and follows it

Like a snake

Ex: mitral regurgitation

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31
Q

Which law describes the relationship between wall tension, internal pressure, and radius?

A

Law of LaPlace

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32
Q

What is the minimum safe distance from radiation source?

A

6 feet

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33
Q

What is the yearly maximum safe exposure for an adult? Pregnant?

A

5 rem

.5 rem

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34
Q

What is the most susceptible tissue for radiation? What about pregnancy ?

A

Eye and thyroid

Baby for pregnancy

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35
Q

What are three ways to limit radiation exposure?

A
  1. Increase distance
  2. Decrease duration
  3. Wear shielding
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36
Q

Which gases are liquid at room temp?

A

Nitrous and CO2

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37
Q

What is specific heat?

A

Amount of heat required to increase temperature of 1gram by 1 degree C

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38
Q

What describes why an O2 tank feels cold when opened?

A

A gas stored at a high temperature when released fast

Joule-Thompson effect (adiabatic process)

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39
Q

How to convert C to K? K to C?

A

C = K - 273

K = C + 273

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40
Q

How to convert C to F? F to C

A

C = (f-32) x 5/9

F = (C X 1.8) + 32

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41
Q

What is Avogadro’s number?

A

1 mole of any gas is made of 6.023x10 to the 23rd atoms

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42
Q

Boiling of water?

A

212 F

100 C

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43
Q

1 cm H2O is equal to what in mmHg?

A

1cm H2O = 0.74mmHg

1mmHg = 1.36cm H2O

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44
Q

What type of bond are metals and acids+bases?

A

Ionic

Complete transfer of valence electrons

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45
Q

What is the number one source of heat loss?

A

Radiation 60% - Through the skin

Top of head

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46
Q

What is the number two source of heat loss?

A

Convection 30% - Cold air

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47
Q

What are the 4 ways to lose heat?

A

Radiation - 60%
Convection - 30%
Water loss - 20%
Conduction - 5%

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48
Q

What is the number one way to minimize heat loss in the OR?

A

Forced air warmer

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49
Q

Hypothermia is a body temperature less than?

A

36 C

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50
Q

What is the most accurate site for temperature?

A

Pulmonary artery

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51
Q

What is the best temperature monitoring site for accuracy and extended timeframe?

A

Esophageal

(PA is an invasive site)

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52
Q

How much does shivering increase O2 consumption?

53
Q

Best treatment options for post operative shivering?

A

Demerol (meperidine)
Clonidine
Precedex

54
Q

Does a skin measurement monitor the core or peripheral temperature?

A

Peripheral

*All others monitor core

55
Q

What three things are needed for an airway fire?

A

Ignition Source

Fuel

Oxidizer

56
Q

Examples of fuel for airway fire?

A

ETT
Surgical supplies
Drapes

57
Q

Examples of ignition source for airway fire?

A

Cautery
Laser

58
Q

Examples of oxidizer for airway fire?

59
Q

What is the first step with an airway fire? What is a key step when doing this?

A

REMOVE ETT

DO NOT squeeze the bag while doing so or else it’ll create a blow torch

60
Q

What does laser stand for?

A

Light
Amplification
Stimulated
Emission
Radiation

61
Q

Three types of lasers?

A

Monochromatic - single wavelength

Coherent - oscillates in same phase

Collimated - narrow beam

62
Q

Laser Goggles - which structures do they effect

A

CO2 = Clear lenses (cornea)

Nd:YAG = green goggles (retina)

Ruby = red goggles (retina)

Argon = amber goggles (retina)

63
Q

Which wavelength penetrates deep and which does not?

A

Long - absorb more water and do not go deep

Short - absorb less water and do go deep

64
Q

FiO2 during laser use?

A

30% or less FiO2

64
Q

Should nitrous be used around lasers?

65
Q

5 steps with an airway fire?

A
  1. Remove ETT
  2. Stop all gas flow
  3. Remove flammable material
  4. Pour water or saline
  5. Use extinguisher
66
Q

Burn image

67
Q

Which burn will have loss of all sensation?

A

3rd and 4th degree?

68
Q

Which burns require grafting?

A

2nd degree deep
3rd
4th

69
Q

Which burn involves muscle? What about subq tissue?

A

Subq tissue - 3rd degree

Muscle - 4th degree

70
Q

Best type of fluid to give in the first 24 hours of a burn?

71
Q

Best type of fluid to give in the second 24 hours of a burn?

72
Q

Which type of fluid is avoided in the first 24 hours of a burn?

73
Q

Fluid status of a burn patient in the first 24 hours?

A

Hypovolemic
Hemoconcentrated
Edema from loss of albumin

74
Q

A rising Hgb in the first few days following a burn indicates what?

A

Inadequate fluid resuscitation

75
Q

Parkland formula for burns?

A

1st 24 hours -
4ml LR + % TBSA * kg

2nd 24 hours
D5W

76
Q

How should fluid be replaced in the first 24 after a burn?

A

1/2 in the first 8 hours

1/2 in the next 16 hours

77
Q

Urine output goals for burns

Adult
Children
High voltage burns

A

Adult - .5mL/kg/hr

Child - 1mL/kg/hr

Electrical- 1.5mL/kg/hr

78
Q

What is a big nephrotoxin released during electrical burns?

A

Myoglobinemia - needs to be flushed out

79
Q

How is abdominal compartment syndrome defined as?

A

> 20mmHg AND evidence or organ dysfunction

80
Q

CO binds to Hgb at what rate? How does it effect the OxyHgb curve?

A

200x more than O2

OxyHgb curve - to the left

81
Q

Treatment for carbon monoxide poisoning?

A

100% FiO2

Hyperbaric

82
Q

Blood gas of a carbon monoxide poisoning?

A

Metabolic acidosis - blood is cheery red

83
Q

What is the gold standard of assessing the airway of a burn patient?

A

Fiberoptic bronch

84
Q

Should a surgical airway be utilized in a burn patient?

A

Just as a last resort - increases infection rates

85
Q

When do up-regulation of extra junctional receptors start in burn patients?

A

After the first 24 hours

86
Q

Dosing of nondepolarizing NMBs in burn patients?

A

Increased dose due to more receptors

87
Q

Hypermetabolic

A

Burn patients become hypermetabolic

Increased
HR
RR
O2 consumption
Catabolism

88
Q

PNS VS SNS in ECT treatment - 1st and 2nd phase

A

1st Phase - increased PNS tone (tonic)

2nd Phase - increased SNS tone (clonic)

89
Q

What is the minimum seizure recommendation for ECT?

A

25 seconds

90
Q

How does hypocapnia and hyperventilation effect seizure duration?

A

Increases it

91
Q

Which opioid increases seizure duration?

A

Alfentanil with propofol

92
Q

Which drugs increase seizure duration?

A

Etomidate
Ketamine
Alfentanil with propofol
Aminophylline
Caffeine

93
Q

Which drugs have no effect on seizures?

A

Methohexital
Precedex
Clonidine

94
Q

What is the gold standard of ECT?

A

Methohexital but does not have an effect on seizure duration

95
Q

How does lithium effect NMB?

A

Prolongs both succ and Non depolarizers

96
Q

What can MAOI’s do during ECT?

A

Can experience a hypertensive crisis with those who receive indirect acting sympathomimetics

97
Q

FACT

Not all drug induced hyperthermia is MH - there are other causes

98
Q

Neuroleptic malignant syndrome causes hyperthermia -why?

A

Caused by dopamine depletion

99
Q

Serotonin syndrome causes hyperthermia -why?

A

Excess 5HT activity

100
Q

Anticholinergic poisoning causes hyperthermia -why?

A

Excessive blockage of AcH

101
Q

How is Anticholinergic poisoning treated?

A

Physostigmine

102
Q

How is Serotonin syndrome treated?

A

Cyproheptadine

103
Q

How is Neuroleptic malignant syndrome treated?

A

Dantrolene or bromocriptine

104
Q

Which diseases have muscle rigidity?

A

MH
Serotonin syndrome
Neuroleptic malignant syndrome

105
Q

Neuroleptic malignant syndrome or MH; which has a genetic link?

106
Q

Neuroleptic malignant syndrome or MH; which develops acutely?

107
Q

Neuroleptic malignant syndrome or MH; which is associated with psych meds?

A

Neuroleptic

108
Q

Neuroleptic malignant syndrome or MH; which has muscle rigidity, hyperthermia, tachycardia, and acidosis?

109
Q

Neuroleptic malignant syndrome or MH; which is treated with dantrolene?

110
Q

Neuroleptic malignant syndrome or MH; which can receive NMB?

A

Neuroleptic

111
Q

Which two perioperative drugs can lead to anticholinergic poisoning?

A

Atropine
Scopolamine

112
Q

S&S of anticholinergic poisoning?

A

Red, dry, hot skin
Delirium
Mydriasis

113
Q

Normal intraocular perfusion pressure and how is it measured?

A

10-20mmHg

MAP-IOP

114
Q

What positions increase intraocular pressure?

A

Prone
Trendelenburg

115
Q

How does O2 effect IOP?

A

Hypoxemia - increases IOP

116
Q

How does hypercarbia effect IOP?

A

Hypercarbia - Increases IOP

117
Q

How does MAP and CVP effect IOP?

A

Increased MAP/CVP - Increases IOP

118
Q

How does succ and Nondepolarizers effect IOP?

A

Succ - increases

Nondepolarizers - decreases

119
Q

How does anticholinergics effect IOP?

120
Q

How does ketamine effect IOP and the eye?

A

Does not increase IOP

BUT

causes nystagmus and blepharospasm

121
Q

How does an LMA/ETT effect IOP?

A

LMA - no effect

ETT - increases from intubation

122
Q

Which NMB should be used in an open globe injury?

A

Roc 1.2mg/kg

Avoid succ because it can raise by 10mmHg for 10 minutes

123
Q

Concerns for strabismus surgery?

A

Increased risk of PONV

Increased risk of oculocardiac reflex

124
Q

Which two drugs decrease aqueous humor production?

A

Timolol

Acetazolamide

125
Q

When should nitrous be avoided with a SF6 bubble?

A

Stop 15 minutes before placement of bubble

Avoid for 7 days

126
Q

When should nitrous be avoided with a silicone oil bubble?

127
Q

When should nitrous be avoided with a air bubble?

128
Q

When should nitrous be avoided with a perfluoropropane bubble?