random facts Flashcards
the effect of almost all anesthetics on latency and amplitude during EP monitoring? exceptions?
increase latency and decrease amplitude
EOK
etomidate, opioids, ketamine
etomidate and ketamine enhance SSEPs
describe open vs closed breathing system in terms of rebreathing and reservoir
System—Rebreathing, reservoir
Open – no, no
Semi-open – no, yes (mapleson)
Semi-closed – partial, yes
Closed – complete, yes
BIS scores that indicate burst suppression and deep hypnotic state?
BIS 20- burst
BIS 30- deep hypnotic state
Evoked potentials most to least effected by anesthesia
VEP>SSEP>BAEP (auditory)
visual (most) > sensory> auditory (least)
Most affected by anesthesia -visual evoked potentials (VEP)
motor is not effected but no NMBA
Which cardiac defects require PDA to provide Aortic blood flow
HIS
* hypoplastic L heart
* severe AS
* interrupted aortic arch (diGeorge)
Which cardiac defects require PDA to provide pulmonary blood flow?
- pulmonary atresia
- tricuspid atresia
- TOF
list R to L cyanotic shunts. management goals?
- TOF
- tricuspid atresia (Ebsteins anomaly)
- transposition of great vessels
- truncus arteriosus
- Total Anomalous pulmonary venous connection
- Eisenmenger syndrome
- HLHS/ single ventricle
Right to Left (5Ts)
management: inc SVR, dec PVR
list L to R acyanotic shunt
- VSD
- ASD
- PDA
- CoA
- Endocardial cushion defects
- Anomalous coronary arteries
dec SVR, inc PVR
things that decrease PVR
*high fiO2
*low PaCO2
*alkalosis
*spontaneous ventilation
*Low PEEP
*nitric oxide
*NTG
*low hgb/low hct
*adequate anesthesia
LOWER PVR- alkaLOsis, LOW peep
what factors result in a score of 1 on the Aldrete scale (0-2)?
1- Able to move two extremities voluntarily or on command
1- Dyspnea/ shallow breathing; oral airway; inadequate
1- Blood pressure +/- 20% to 50% of the preanesthetic level
1- arousable to voice
1- SpO2 > 90% but needs supplemental O2
Relative potency of benzos from most to least potent. which Benz has longest half-life?
Relative potency: Lorazepam > Midazolam > Diazepam
half-life: Diazepam > Lorazepam > Midazolam
diazepam is the least potent but lasts the longest
what does the dibucaine number represent
how many normal plasma cholinesterase are inhibited
80% normal are inhibited- homo typical
50% normal are inhibited - hetero atypical
20% normal are inhibited - homo atypical
max doses of
bupivicaine
ropivicaine
lidocaine
mepivicaine
175 bupivicaine 2.5 mg/kg
200 ropivicaine 3mg/kg
300 lidocaine 4.5mg/kg
400 mepivicaine 7mg/kg
what nerves are blocked in a TAP block
intercostal
subcostal
ilioinguinal
iliohypogastric
How does the Na-K ATPase pump actively pumps electrons? (i.e. what moves in and what moves out)
3 sodium out
2 potassium in
3o-2i ATPase
gastroschisis facts (at higher risk for 2 things)
- inc risk for fluid and heat loss
- 150-300ml/kg/day
- urgent surgery within 24 hours
- risk with prematurity (omphalocele is trisomy 21, beckwith-weidemann, and cardiac defects)
where do you put pulse ox with repair of gastroschesis/omphalocele if you want to measure impaired venous return (inc pressure when abdominal contents placed back in abdominal cavity can decrease venous return)
lower extremity
