Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Advanced Principles I > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

What drug may cause a modest transient increase in ICP?

A

succs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do you want to ensure before laryngoscopy for a crani and why?

A

adequate depth of anesthesia and profound skeletal muscle paralysis to prevent noxious stimulation or movement that can increase BF, CBV, ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why might you use propofol or barbiturates to induce a crani patient?

A

decreases CMR, CBF, CBV and ICP; can be used to induce isoelectric EEG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What may be a downside to using propofol or barbiturates for induction of a crani patient?

A

can cause hypotension (decreased perfusion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When would you avoid using etomidate in a crani patient?

A

if you suspect cerebral vasospasm or other conditions associated with cerebral ischemia- also higher rate of PONV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does etomidate do to CMR and ICP?

A

dose dependent decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does ketamine do to CBF, CMR, and ICP?

A

increases all

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Do opioids have a significant effect on cerebral physiologic parameters?

A

no, as long as MAP is maintained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If you use remi for induction for a crani, what should you also use?

A

infusion of remi to avoid abrupt offset and resultant HTN and tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why might you use lidocaine for a crani patient?

A

suppress cough reflex during laryngoscopy and blunt hemodynamic response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why might you avoid atracurium and mivacurium as your NDMRs for induction during a crani?

A

cause histamine release and may cause reduction in CPP from decreased MAP and increased ICP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can you offset the transient rise in ICP while using succs?

A

give defasciculating dose of NDMR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In an adult, describe the distribution of the “rule of 9s”

A

anterior+posterior head: 9% anterior torso: 18% posterior torso: 18% each anterior leg: 9% each posterior leg: 9% anterior+posterior arm: 9% genitalia/perineum: 1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In a child, describe the distribution of the “rule of 9s”

A

anterior head: 9% posterior head: 9% anterior torso: 18% posterior torso: 18% each anterior leg: 6.75% each posterior leg: 6.75% anterior+posterior arm: 9% genitalia/perineum: 1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Identify the subdural vs epidural bleed

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How much cardiac output does the brain receive?

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is normal total CBF?

A

50 ml/100 g/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CBF parallels ?

A

metabolic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the 5 determinants of CBF?

A

CMR, CPP, venous pressure, PaCO2, PaO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the order of CSF flow?

A

choroid plexus -> lateral ventricles -> foramina of monroe -> 3rd ventricle -> aqueduct of sylvius -> fourth ventricle -> foramina of luschka and magendie -> subarachnoid space -> brain -> arachnoid villi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the Parkland formula?

A

fluid resuscitation for burns: 4 ml x weight in kg x % of burn give half over 8 hours and the second half over 16 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What kind of fluids should you avoid in the 1st 24 hours of thermal injury?

A

colloids

23
Q

What is the detection window for alcohol?

A

2-12 hours

24
Q

What is the detection window for benzos?

A

72 h

25
Q

What is the detection window for cocaine?

A

48-72 hours

26
Q

What is the detection window for meth?

A

48 hours

27
Q

What is the detection window for heroin?

A

48 hours

28
Q

What is the detection window for methadone?

A

72 hours

29
Q

What is the detection window for prescription opioids?

A

6-96 hours

30
Q

What is the detection window for marijuana?

A

7 days to 2 months with chronic use

31
Q

What is the detection window for ecstasy?

A

48 hours

32
Q

What is the detection window for LSD?

A

36-96 hours

33
Q

What is the detection window for PCP?

A

8-14 days

34
Q

What is the detection window for ketamine?

A

7-14 days

35
Q

What is the detection window for y-hydroxybutyric acid (date rape drug)?

A

12 hours

36
Q

What are your anesthetic considerations for myasthenia gravis?

A

reduce dose of succs (may be on AChE drugs), reduce dose of NDMRs, caution with respiratory depressants

37
Q

What is myasthenia gravis?

A

autoimmune destruction of postsynpatic ACh receptors- generalized muscle weakness and myocarditis

38
Q

What is muscular dystrophy?

A

X linked recessive disorder- absent dystrophin- disruption of outer muscle membrane that leads to weakening and muscle wasting

39
Q

What are some anesthetic considerations for muscular dystrophy?

A

avoid succs (can cause exaggerated K release), increased sensitivity to NDMRs, increased incidence of MH, delayed gastric emptying, exaggerated response to inhaled agents, check cardiac function

40
Q

What is Parkinson’s disease?

A

degenerative disorder of CNS that affects motor function and speech- decreased dopamine in substantia nigra in basal ganglia (imbalance between inhibitory dopamine and excitatory ACh)

41
Q

What are some anesthetic considerations for Parkinson’s?

A

continue pharm therapy throughout periop period, avoid drugs that reduce dopamine (phenergan, metaclopramine, droperidol), may use anticholinergics for tremor, may have severe hypo/hypertension on induction, use direct acting pressors as opposed to indirect; NMBs usually unaffected

42
Q

What is Alzheimers?

A

neurodegenerative disease- fewer nicotinic cholinergic receptors and reduced ACh

43
Q

What are some anesthesia considerations for Alzheimers?

A

anesthesia may worsen preexisting dementia, avoid sedative drugs, avoid centrally acting anticholinergic drugs (glyco is safe to use because ionized), may be taking AChE that influence NDMRs

44
Q

What is Huntington’s?

A

mutant Huntington results in neuronal cell death- uncoordinated jerky movements and decline in mental abilities

45
Q

What are anesthetic considerations for Huntington’s?

A

can use droperidol or haldol for preop sedation, may have increased sensitivity to succs and NDMRs, prevent shivering

46
Q

What is cerebral palsy?

A

upper motor neuron dysfunction related to anoxic cerebral damage

47
Q

What are anesthetic considerations for cerebral palsy?

A

intubation is required (decreased laryngeal reflexes and GERD), succs is okay, avoid hypothermia

48
Q

What are some anesthetic considerations for denervation injury?

A

use direct arterial dilators and alpha blockers (have nipride and nitro readily available), use nondepolarizers over succs (which can cause K release)

49
Q

What is multiple sclerosis?

A

autoimmune disease characterized demyelination and axonal damage

50
Q

What are some anesthetic considerations for MS?

A

may have exaggerated response and K release to succs, may have prolonged response to NDMRs, spinal anesthesia may cause exacerbation, avoid increases in body temperature

51
Q

What is GBS?

A

autoimmune disease where the body’s immune system attacks the peripheral nervous system, often after virus

52
Q

What are anesthetic considerations for GBS?

A

avoid succs (hyperkalemia), sensitive to NDMRs, may need stress dose steroids, expect labile autonomic nervous system function (A-line)

53
Q

What are some concerns for all neuromuscular diseases?

A

respiratory dysfunction, risk of aspiration, delayed gastric emptying

Advanced Principles I (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions