R10 Flashcards
When does a phase 2 block happen with succs?
repeated doses. very unpredictable blockade, can resemble NDNMB.
TOF <30%, post tetanic potentiation
how do we determine the ABO status of a patient?
mix the blood with anti-A, anti-B, and anti-AB antibodies
how do we determine the Rh status of the blood?
mix the patient’s blood with anti-D antibodies
what is a crossmatch?
patient serum is added to donor blood –> looks for incompatibilities
how do we determine antibody screen?
mix patient serum with red cells with known antigens on the surface
why can EMLA cream trigger methemoglobinemia?
contains prilocaine which produces aminophenols that oxidize hgb to methemoglobin
methemoglobinemia: when Fe2+ has been reduced to Fe3+ which makes them unable to carry oxygen
what drugs should methemoglobinemics avoid?
prilocaine, benzocaine, dapsone, metaclopramide, sulfas, quinine,
three main mechanisms of spinal hypotension
venodilation, arterial dilation (both from sympathectomy - 2 to 6 levels above sensory block), bradycardia (from PSNS dominance)
what nerve is blocked at palatoglossal folds?
glossopharyngeal
what is blocked with a transtracheal injection through the cricothyroid membrane?
recurrent laryngeal nerve
where can the Superior laryngeal be blocked
injection at horn of hyoid
rule of 4 in relation of alfentanil to fentanyl
4x faster onset
1/4 potency
1/4 duration
cushing’s triad
bradycardia, hypertension, respiratory changes
who is at most risk for new or worsening neurological injury from a neuraxial?
those with space-occupying extradural lesions
pure shunt
perfusion to alveoli with zero ventilation
hypoxic pulmonary vasoconstriction
local mediators induce in the setting of decreased alveolar oxygen tension - reduce perfusion to alveoli
what is hypercapnia following O2 to COPD patient due to?
v/q mismatch which is driven by inhibition of hypoxic pulmonary vasoconstriction
best way to preoxygenate
100% fio2 with tight fitting mask at 10-12LPM
is ischemic optic neuropathy painful?
no.
sudden onset after surgeries in prone
half life of flumazenil relative to benzos
shorter, might have to re-dose
- 7-2.6 hours for benzos
- 7-1.3 for flumazenil
FRC goes up with what
increased height and age
3-4L in normal adult
FRC in infants equals adults at day4
can you use leukoreduction to prevent graft vs host disease?
no. you need irradiation
what does igA deficiency lead to with transfusions?
risk of anaphylaxis
(previous exposure). ige mediated. bronchospasm and hypotension within 1 hour usually
why is pao2 increased in cyanide toxicity
oxygen is present but cant be used.
cherry red, almond smell, anion gap acidosis
