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1
Q

With what protein does calcium combine to initiate contraction in skeletal or cardiac muscle?

A

Troponin

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2
Q

What is one of the earliest and most sensitive signs of MH?

A

Sudden severe increase in eTCO2 capnography

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3
Q

Which drugs should be avoided with Parkinson’s Disease?

A

Any drugs that inhibit dopamine (Droperidol, Reglan, possibly Opioids)

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4
Q

C1 is also known as the ______.

A

Atlas

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5
Q

C2 is also known as the ______.

A

Axis

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6
Q

What does the legal term “Libel” mean?

A

Defamation of another person by written means

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7
Q

What is stated in the American Disabilities Act of 1990?

A

Requires reasonable accommodation for removing chemically dependent employees

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8
Q

What is the most common cause for lawsuit related to OB?

A

Maternal death

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9
Q

Who is responsible for quality assurance?

A

Each hospital department or service is responsible for monitoring quality assurance in their area which is required by JCAHO

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10
Q

List 3 congenital defects in which there is a RIGHT to LEFT shunt?

A
  1. Tetrology of Fallot
  2. Pulmonary Atresia (w/ ventricle/septal defect)
  3. PFO (Patent Foramen Ovale)
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11
Q

What is the EBV (estimated blood volume) for an infant less than 3 months in age?

A

90 mL/kg (Valley p. 416)

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12
Q

What is the EBV (estimated blood volume) for a premature newborn?

A

100-120 mL/kg (Valley p. 416)

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13
Q

What is the EBV (estimated blood volume) for an infant 3 to 12 months in age?

A

80 mL/kg (Valley p. 416)

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14
Q

What is the EBV (estimated blood volume) for an infant greater than 12 months in age?

A

70 mL/kg (Valley p. 416)

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15
Q

What is the dose of Atropine for reflex bradycardia?

A

0.03 mg/kg

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16
Q

What type of valve is an O2 Flush Valve?

A

Ball & Spring Valve

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17
Q

Which nerve is located in the coracobrachialis muscle?

A

Musculocutaneous

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18
Q

Where are the high points located in the spinal cord?

A

High points are located at C3 & L3

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19
Q

Where are the low points located in the spinal cord?

A

Low points are located at T6 & S2

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20
Q

In which Lung Zone has a lower V/Q ratio than Zone 1, is better perfused and better ventilated?

A

Zone 3

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21
Q

In which Lung Zone should the tip of a Pulmonary Artery Catheter (PAC) ideally be placed?

A

Zone 3

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22
Q

What type of murmur will you most likely hear with Idiopathic Hypertrophic Subaortic Stenosis or IHSS? Why?

A

Mitral Regurgitation

Because of the dysfunction of the anterior leaflet of the mitral valve

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23
Q

What changes would you see in a Pressure Volume Loop after giving Phenylephrine? Why?

A

The Pressure Volume Loop shift UP (greater pressures) and RIGHT (greater volumes)

  • Increase SVR (primarily)
  • Increase in arterial blood pressure
  • Increase in afterload
  • Decrease in stroke volume (SV)
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24
Q

What is the most important spinal nerve tract for relaying pain and temperature sensation to the brain?

A

Lateral Spinothalamic Tract

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25
Q

Neuromuscular Blockers are ____% ionized at normal pH, they are also highly bound to ______. They (do/ do not) cross the placenta. They (do/ do not) cross the BBB.

A
  • 100%
  • Protein
  • Do not
  • Do not
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26
Q

Abnormally low circulating levels of maternal thyroxine result in what condition in infants & children?

A

Cretinism (severe stunted physical and mental growth)

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27
Q

What are signs and symptoms of Hypothyroidism in an adult?

A
  • Myxedema (usually Exophthalmos)
  • Slow mental function and movements
  • Weight gain
  • Dry skin
  • Intolerant to COLD
  • Depressed ventilatory responses
  • Renal disease
  • Abnormal cardiac conductivity (decrease cardiac function)
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28
Q

What is Chvostek’s sign?

A

Hyperirritable contracture of the facial muscle produced by tapping the facial nerve (CN7) as it passes through the parotid gland. Indicator of HYPOCALCEMIA

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29
Q

How does maternal blood circulate through the placenta?

A

Blood is initially carried in the UTERINE ARTERIES, then dispersed into the INTERVILLOUS SPACE then passes the FETAL VILLI before draining back to the VEINS of the UTERINE WALL

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30
Q

How many artery/veins are their in the umbilical cord?

A

2 ARTERIES

1 VEIN

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31
Q

A transtracheal block requires ___ mL of ___% Lidocaine

A
  • 4 mL

- 4 %

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32
Q

How many liters are their in full e-cylinder tank of N2O? What is the PSI?

A
  • 1590 L

- 750 psi

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33
Q

How many liters are their in a full e-cylinder tank of O2? What is the PSI?

A
  • 660 L

- 2200 psi

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34
Q

How many liters are their in a full e-cylinder tank of Air? What is the PSI?

A
  • 625 L

- 1800 psi

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35
Q

What is the cause of Central Diabetes Insipidus?

A

The posterior pituitary failing to release ADH

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36
Q

What is the cause of Nephrogenic Diabetes Insipidus?

A

When renal tubules fail to respond to ADH

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37
Q

What is normal serum osmolality?

A

300 mOsm/kg

270-310 mOsm/kg

38
Q

Which electrolyte controls RESTING MEMBRANE POTENTIAL?

A

Potassium

39
Q

Which electrolyte controls THRESHOLD?

A

Calcium

40
Q

In the Adrenal Cortex are what 3 zones? These zones excrete?

A

Zone of Glomerulosa - Aldosterone (mineralcorticoid)
Zone of Fascsiculata- Cortisol (glucocorticoid)
Zone of Reticularis- Androgens (sex hormones)

41
Q

The Adrenal Medulla secrete __________. These are ______, _______, and ______.

A
  • Catacholamines
  • Epinephrine
  • Norepinephrine
  • Dopamine
42
Q

The Adrenal Medulla secrete __________. These are ______, _______, and ______.

A
  • Catacholamines
  • Epinephrine (80%)
  • Norepinephrine (20%)
  • Dopamine
43
Q

Ion trapping occurs with maternal _______ and fetal ______.

A
  • Maternal ALKALOSIS

- Fetal ACIDOSIS

44
Q

Name a potassium sparing diuretic? Where do potassium sparing diuretics act on in tubules?

A
  • Spironolactone (Aldactone)

- LATE DISTAL TUBULES and COLLECTING DUCTS

45
Q

Name a loop diuretic? Where do loop diuretics act on in tubules?

A
  • Furosemide (Lasix)

- Loop of Henle

46
Q

Name a diuretic that works on the proximal tubules?

A

Diamox

47
Q

Name a diuretic that works on the proximal tubules?

A

Mannitol and Diamox

48
Q

Papilledema involves which cranial nerve? Why?

A

Optic Nerve (CN2)

The dura of the brain extends as a sheath around the optic nerve. When pressure increases in the CSF, it increases in the optic nerve sheath

Papilledema = Edema and Hyperemia of the OPTIC DISK when ICP increases

49
Q

Capillary integrity, allowing colloids to remain in the intravascular compartment, return in the burn patient after how long?

A

24 to 48 hours

50
Q

What is Ptosis? What is Diplopia? These are the most common initial symptoms of what disease process?

A
  • Drooping eyelid
  • Double vision
  • Myasthenia Gravis
51
Q

Which drugs do not cross the placenta?

A
  • Heparin
  • Insulin
  • Glycopyrrolate (Robinul)
  • Succinylcholine
  • NDMB’s
52
Q

Administration of which local anesthetic can lead to the development of methemoglobinemia? What is its metabolite?

A
  • Prilocaine

- O-toluidine

53
Q

What are the wavelengths of light for pulse oximetry (SpO2)?

A

RED/ DeOXygenated hemoglobin/ 660 nm

INFRARED/ oxygenated hemoglobin/ 940 nm

54
Q

What are the wavelengths and absorption of light for pulse oximetry (SpO2)?

A

RED/ DeOXygenated hemoglobin/ 660 nm

INFRARED/ oxygenated hemoglobin/ 940 nm

55
Q

Which regional block is a high risk for pneumothorax?

A

Supraclavicular block

56
Q

What nerve is NOT INCLUDED in an axillary block and requires a separate block?

A

Musculocutaneous

57
Q

Negative pressure during caudal anesthetic is detectable after going through what structure?

A

Sacrococcygeal ligament

58
Q

What drugs should you avoid in a patient with a carcinoid tumor because of histamine release?

A
  • Morphine
  • Atracurium
  • Curare
  • Mivacurium
  • Trimethaphan
59
Q

What electrolytes are in Lactated Ringer’s?

A
  • Sodium
  • Potassium
  • Chloride
  • Calcium
  • Lactate
60
Q

Which part of the spinal cord is the blunt, tapering tip?

A

The Conus Medularis

61
Q

What are the Stages of Labor and Pain Pathways?

A

1st Stage- T10-L1
2nd Stage- T10-S4
3rd Stage- Deliver of baby & Placenta

62
Q

What is the Haldane Effect? How does it relate to Oxygen on the Carbon Dioxide (CO2) Disassociation Curve?

A
  • The Haldane Effect describes how a change in partial pressure of oxygen (PO2) in the blood influences the blood on the CO2 Disassociation Curve
  • As PO2 INCREASES, the CO2 curve shifts DOWN/RIGHT
  • As PO2 DECREASES, the CO2 curve shift UP/LEFT
63
Q

Who’s law permits the amount of dissolved O2 in the blood to be calculated?

A

Henry’s Law

64
Q

What kind of sensations do A(beta) fibers transmit?

A
  • Proprioception (as well as A(alpha))
  • Touch
  • Pressure
65
Q

What kind of sensations do A(delta) fibers transmit? Which neurotransmitter does it release? What is an example?

A
  • Acute pain (sharp pain, temperature, and touch)
  • Substance P
  • Needle prick
66
Q

What kind of sensation do C fibers transmit? Which neurotransmitter does it release? What is an example?

A
  • Chronic pain (throbbing pain, temperature)
  • Glutamate
  • Polyneuropathies
67
Q

What type of response does stimulation of the Alpha-1 adrenergic receptor elicit? What is an example?

A
  • An excitatory response

- Arterial and venous vasoconstriction

68
Q

Where does the spinal cord end in neonates? In adults?

A
  • At L3

- In adults at L1

69
Q

What is another name for a 2nd degree AV block- Mobitz type I? What are its characteristics? What is it associated with?

A
  • Wenkebach
  • A progressive increase in PR interval from beat-to-beat until an entire beat is dropped
  • A progressive shortening of the R-R interval
70
Q

Describe the characteristics of a 2nd degree AV block- Mobitz type II?

A
  • More rare and more serious than Mobitz type I
  • A sudden appearance of a non-conducted P wave
  • P waves are normal, but some are not followed by a QRS complex
71
Q

What are the signs of Left Heart Failure?

A
  • Decreased CO
  • Increased preload
  • Cardiac Index of 18
72
Q

Nitroprusside, Nitroglycerine, and Hydralazine produce vasodilation by acting on what?

A

Increasing cGMP

73
Q

What is the most common reported complication of epidural blood patch?

A
  1. Backache (35%)
  2. Temperature elevation (5%)
  3. Neck ache (0.9%)
  4. Radicular pain
74
Q

Define assault

A

Unlawful threat of actions by a person intended to inflict by force corporal injury

75
Q

Define battery

A

Unlawful constraint or physical violence inflicted on a person without their consent

76
Q

How do arteriole (Pa), alveolar (PA), and venous (Pv) pressure relate in zone 3 of the lungs

A

Pa>Pv>PA

77
Q

In the upright spontaneously breathing person, perfusion is greatest in the base of the lungs. Ventilation is greatest where?

A
  • Apex
78
Q

In the upright spontaneously breathing person, perfusion is greatest in the base of the lungs. Ventilation is greatest where?

A

Apex

79
Q

Describe Hypoxic pulmonary vasoconstriction (HPV)?

A

Decreases shunt and increases PaO2 by constricting pulmonary arteries where there is presence of hypoxia, redirected blood flow to areas rich in oxygen

80
Q

What is the formula to estimate ETT in children?

A

(Age / 4) + 4

81
Q

Which type of alveolar cells produce surfactant in order to decrease alveolar friction?

A

Type II pneumocytes (cuboidal in shape)

82
Q

What type of shunt is a Patent Ductus Arteriosus?

A

Left to Right

83
Q

Which of the following is not a hallmark of congenital diaphragmatic hernia?

       - Hypoxia
       - Scaphoid abdomen
       - Bowel in thorax
       - Right pneumothorax
A

Right pneumothorax

84
Q

What are the hallmark signs and symptoms of Acute Epiglotitis? What is usually the etiology?

A
  • Run HIGH FEVER
  • Difficulty swallowing d/t edema
  • Infectious involvement
  • Inspiratory STRIDOR
  • DROOLING
  • LETHARGY
  • Sitting forward
  • H. Influenza
85
Q

Which of the following is NOT TRUE regarding Pyloric Stenosis?

  • Hypokalemia
  • Hyponatremia
  • Metabolic alkalosis
  • Hyperchloremia
A

Hypochloremia

86
Q

Where do benzodiazapines work in the brain?

A

At the Reticular Activating System (RAS)

87
Q

Which local anesthetic is least likely to cross placenta?

A

Chloroprocaine

88
Q

How does smoking cessation 2 days prior to surgery help?

A

Decreases carboxyhemoglobin

89
Q

Where does aldosterone work?

A

Distal tubules and collecting duct

90
Q

What decreases cerebral perfusion pressure (MAP-ICP)?

A

DECREASED MAP

INCREASED ICP

Comp Exam Study (1 decks)

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