RANDOM/ PRODIGY TRIVIA/VALLEY BOOK 2

Question 1

Where is the DORSAL RESPIRATORY GROUP located

Answer 1

Medulla

Question 2

Ventral Respiratory Group can influence both

Answer 2

Inspiratory and expiratory

Question 3

Pneumotaxic located in (thinkPP)

Answer 3

PONS

Question 4

Pneumotaxic center now called

Answer 4

PRG (Pontine Respiratory GROUP)

Question 5

Peripheral chemoreceptors are found MOSTLY in the

Answer 5

Carotid bodies but also in aortic bodies

Question 6

Peripheral chemoreceptors responds to

Answer 6

Decreased PaO2 < 60 mmHg
Increased H+ (low pH)
increased PaCO2

Question 7

Peripheral chemoreceptors ARE MOST RESPONSIVE TO

Answer 7

Decrease in arterial blood O2, when PaO2, falls below 60mmHg

Question 8

The glossopharyngeal nerve carries afferent information from the

Answer 8

CAROTID BODIES

Question 9

VAGUS nerve carries afferent information from the

Answer 9

AORITC BODIES and LUNG STRETCH receptors

Question 10

Central chemoreceptors response to

Answer 10

Hydrogen ions

Question 11

WHat normally drives Co2

Answer 11

VENTILATON

Question 12

The pleural membranes couple the

Answer 12

Lungs to the chest wall

Question 13

What is intrapleural pressure

Answer 13

The pressure in the space between the inside of the chest wall and the lungs

Question 14

Intrapleural pressure is always

Answer 14

NEGATIVE (subatmospheric) during normal Tidal breathing.

Question 15

Intrapleural pressure becomes more negative during ______and more less negative during

Answer 15

during inspiration; Expiration

Question 16

Intrapulmonary pressure is ______during inspiration and______during expiration .

Answer 16

negative, positive

Question 17

When does INTRAPLEURAL PRESSURE BECOMES POSITIVE

Answer 17

Forced expiration OR during exp effort against a closed glottis, such as the Valsava maneuver.

Question 18

1 atm = ____mmhg = _____cm H2O

Answer 18

760; 1033 cm H2O

Question 19

MV is normally____

Answer 19

4Lmin

Question 20

CO is normally

Answer 20

5L min

Question 21

The average V/Q for the lungs is

Answer 21

0.8

Question 22

In the upright position, the dependent lung is at the

Answer 22

Base

Question 23

In the upright position, the nondependent lung is at the

Answer 23

APEX

Question 24

When the patient in the lateral decubitus position is anesthesized and paralyzed what occurs

Answer 24

a V/Q mismatch develops, ventilation is the non-dependent lung increases (because the dependent lung is difficult to insufflate) but the distribution of blood flow does not changes, compared to the awake, spontaneously breathing patient.

Question 25

Always decreases whenever there is a V/Q mismatch

Answer 25

PaO2

Question 26

The decrease in PaO2 seen with V/Q mismatch may be accompanied with

Answer 26

Hypocapnia, Normocapnia Hypercapnia

Question 27

A-A gradient change with age

Answer 27

PAO2 - PaO2 = 0.21 x (age + 2.5)

Question 28

Estimating PaO2

Answer 28

Multiple percent O2 in the inspirate gas mixture by 5 ( EX: 0.6 FiO2 is 60 x 5 = 300mmhg

Question 29

Estimating PAO2

Answer 29

Multiple percent O2 in the inspirate gas mixture by 5

Question 30

When V/Q is 0 there is

Answer 30

ABSOLUTE right to Left shunt

Question 31

Normal PAO2 - PaO2 when breathing room air

Answer 31

5-15 mmHg

Question 32

Normal PAO2 - PaO2 when 100 % O2

Answer 32

100 mmHg

Question 33

Do you CPAP the dependent or nondependent lung

Answer 33

the NONDEPENDENT

Question 34

Do you PEEP the dependent or nondependent lung

Answer 34

DEPENDENT

Question 35

Most effective intervention for the NONdependent lung

Answer 35

CPAP

Question 36

West zone describe _______in the lung

Answer 36

PERFUSION

Question 37

West zone are not

Answer 37

Anatomically fixed zones, they are variable, functional zones, dependent upon body position

Question 38

Compared with zone 1, zone 3 is

Answer 38

Better ventilated, better perfused has a lower V/Q ratio

Question 39

Zone 1 vs Zone 3 negative intrapleural pressure

Answer 39

less negative intrapleural pressure

Question 40

Zone 1 vs Zone 3 size alveoli

Answer 40

Zone 3 smaller alveoli

Question 41

The zone 4 lung requires

Answer 41

4th pressure, P interstitial fluid

Question 42

Zone1, 2, 3 , 4

Answer 42

Zone 1: PA>Pa.Pv Zone 2: Pa> PA>Pv Zone 3: Pa> Pv> PA Zone 4: Pa>Pisf>Pv> PA

Question 43

Zone 4 mnemonic

Answer 43

aiVA

Question 44

The patient is preoxygenated to

Answer 44

Fill the FRC with O2,

Question 45

What is oxygen consumption

Answer 45

250 ml O2/min

Question 46

Found in the FRC

Answer 46

2500 ml so divided by 250 per min, you have 10 minutes

Question 47

In response to alveolar hypoxia, The alveolar arterioles constrict

Answer 47

thereby decreasing shunt blood flow

Question 48

When does VA inhibit HPV

Answer 48

>1 MAC

Question 49

Cannot be measured by spirometry

Answer 49

FRC, RV and TLC

Question 50

Ratio that is useful in distinguishing between restrictive and obstructive disease

Answer 50

FEV1/FRC

Question 51

What is the best lung volume test for assessing for small airway disease>

Answer 51

FEF 25-75 (MMEF) MidMaximal expiratory flow

Question 52

Normal FEV1/FVC

Answer 52

4 L / 5 L =0.8 FEV1/FVC ratio

Question 53

Obstructive FEV1/FVC Examples

Answer 53

FEV1 = 1.3 L/ FVC 3.1 | FEV1/FRC ratio is 0.42 (42%)

Question 54

Obstructive disease is present when

Answer 54

Both FEV1 and FVC are low

Question 55

What is the Normal FEV1/FVC ratio

Answer 55

> 0.7

Question 56

Restrictive disease is present when

Answer 56

both FEV1 and FVC are LOW but the RATION is equal or greater than 0.7

Question 57

For restrictive and obstructive disease always calculate

Answer 57

the FEV1/FRC ratio

Question 58

Criteria to cancel case FEV1 and FEV1/FRC ratio

Answer 58

If FEV1 < 2L and FEV1/FRC ratio < 50% more sophisticated lung fuction tests are needed.

Question 59

Restricted loop are associated with

Answer 59

smaller volume

Question 60

Intrapleural pressure increases with

Answer 60

FORCED VITAL EXPIRATION or VALSAVA maneuvers.

Question 61

During forced expiration , intrapleural pressure becomes

Answer 61

Positive

Question 62

AS liquid flow through a tube, the pressure Increases or decreases

Answer 62

DECREASES (falls)

Question 63

In the airway pressure

Answer 63

decreases, as gas flow along the bronchioles. THIS IS THE PHYSICAL BASES or airway closure.

Question 64

US 65-45

Answer 64

Upright closing capacity = FRC upright at 65 | Sitting -----------------------= --------- sitting at 45

Question 65

Lung compliance with aging

Answer 65

INCREASES

Question 66

FRC with aginst

Answer 66

Increases

Question 67

Except for the cricothyroid muscle, the instrinsic muscles of the larynx are innervated by WHAT MOTOR NERVE/

Answer 67

RLN

Question 68

Oxyhemoglobin curve becomes steep when PaO2 falls below

Answer 68

60 mmhg

Question 69

The patient is given meperidine for premedication , what happens to the oxyhemoglobin dissociation curve and the Co2 Blood dissociation curve?

Answer 69

Oxyhgb curve to the right | CO2 shifts left

Question 70

What is the PaO2 when the SaO2 is 90%?

Answer 70

Think 40-90 rule 40mmHg - 70% SPO2 50mmHg - 80% SPO2 60mmHg - 90% SPO2

Question 71

What % of Co2 is carried in the blood as bicarbonate?

Answer 71

90%

Question 72

What enzyme (s) is (are) responsible for producing Bicarbonate in the rbc?

Answer 72

Carbonic Anhydrase

Question 73

If PaCo2 is 30 mmhg how much Co2 is dissolved in blood . Give answer to 2 decimal places

Answer 73

30 x 0.067 = 2.01 mL

Question 74

Peripheral chemoreceptors are most sensitive to

Answer 74

Decreased PaO2 (< 60 mmHg )

Question 75

What nerve carries sensory information from the carotid and what nerve carries sensory information from the aortic bodies?

Answer 75

Carotid - Glossopharyngeal | Aortic - VAVUS

Question 76

What nerve carries sensory information from the carotid and what nerve carries sensory information from the aortic bodies?

Answer 76

Carotid - Glossopharyngeal Aortic - VAVUS CGAV

Question 77

Where are ventilation and perfusion greatest in the normal healthy lung in the awake individuals?

Answer 77

Ventilation greatest in the Dependent lung | Perfusion greatest in the DEPENDENT lung

Question 78

Compare PACO2 in the base with PACO2 in the apex when the patient is in the prone position?

Answer 78

PACO2 is the same in the base of the supplies

Question 79

Compared with non-dependent lung each of the following is greater in dependent lung, except:

Answer 79

ALVEOLAR DIAMETER

Question 80

Compared with non-dependent lung each of the following is greater in dependent lung

Answer 80

Ventilation Perfusion PACO2

Question 81

A patient breathing room air has a PaO2 of 45 mmHg , a PAO2 of 80 mmhg and a PaCO2 of 75 mmHg what is the problem?

Answer 81

There is a Ventilation;perfusion abnormality.

Question 82

What is the problem if the patient has a segment of the lung with a ventilation:perfusion ratio of zero?

Answer 82

Patient has a RIGHT to LEFT SHUNT

Question 83

The patient's spirometric recordings reveal an FEV1 of 2L and an FVC of 4 L that values indicates

Answer 83

Obstructive disease (ratio is 50%)

Question 84

For obstruction loop : top is _________ and bottom is _______

Answer 84

Expiratory bottom is Inspiratory (it's flipped compared to volume capacity graph)

Question 85

To remember if the APEX triangle points more toward EXPIRTORY it

Answer 85

Extrathoracic obstruction

Question 86

What happens to pulmonary (lung) compliance and chest wall compliance as you age?

Answer 86

Pulmonary compliance increase | Chest wall compliance decrease

Question 87

Vd is

Answer 87

Theoretical volume, Drug in body / concentration in plasma

Question 88

Clearance (Cl) is

Answer 88

Theoretical volume of plasma completed cleared of drug in a given period of time.

Question 89

Elimination half life vs elimination half time

Answer 89

half life --> time it takes for the total amount of drug, in the body to decrease by one half. elimination half time --> plasma concentration of a drug to fall by one-half.

Question 90

What the BODY does to the drug

Answer 90

PharmacoKINETICS

Question 91

Time is

Answer 91

CONCENTRATION

Question 92

Life is

Answer 92

AMOUNT

Question 93

TCLA

Answer 93

Time-->concentration | Life --> Amount

Question 94

Constant amount of drug eliminated per unit of time

Answer 94

Zero Order kinetics

Question 95

Drugs that undergo zero order kinteics

Answer 95

Phenytoin, Alcohol, ASA

Question 96

When the plasma concentration of any drugs exceeds the capacity of metabolizing enzymes

Answer 96

Zero Order kinteics.

Question 97

First order kinetics (think FF)

Answer 97

CONSTANT FRACTION

Question 98

Alpha phase is

Answer 98

Distribution

Question 99

bEta phase is

Answer 99

ELIMINATION (B-e)

Question 100

T 1/2 B (half time Beta) =

Answer 100

0.693 Vd/ Cl

Question 101

How many half lives are required to eliminates at LEAST 98% of a drug?

Answer 101

6

Question 102

Type I phase reaction

Answer 102

Oxidation Reduction Hydrolysis Methylation

Question 103

What is the important pathway of metabolism for PROCAINAMIDE , hydralazine and isoniazid

Answer 103

ACETYLATION

Question 104

Acid better absorbed in

Answer 104

Acidic

Question 105

Basic better absorbed in

Answer 105

Basic

Question 106

For acid , if pH < pka = | if pH > pKa =

Answer 106

Nonionized | IONIZED

Question 107

For basic, if pH< Pka= | if pH>pKa

Answer 107

Ionized | Nonionized

Question 108

ANother way to say that a substance has accepted a hYDROGEN H+ ion is to say that the susbtance in

Answer 108

PROTONATED>

Question 109

What combination will most facilitate trapping of LA by the fetus?

Answer 109

Maternal alkalosis AND fetal acidosis

Question 110

What combination will most PREVENT PASSAGE of LA to the UTERUS

Answer 110

Fetal ACIDOSIS

Question 111

Weak acids and weak bases are provided in solution as

Answer 111

SALTS

Question 112

Weak acids name has the

Answer 112

Cation first (calcium..., mag this, sodium this)

Question 113

Weak bases name has the

Answer 113

anion last (drug chloride, drug sulfate)

Question 114

Propofol is a (weak acid or weak base)

Answer 114

WEAK ACID

Question 115

Propofol in physiologic ph

Answer 115

99.98 % nonionized.

Question 116

All LAs are

Answer 116

Weak bases

Question 117

Base + acid

Answer 117

MORE IONIZED

Question 118

In general the lower the pKa of the local anesthetic, the_____the proportion of LA in ______form

Answer 118

GREATER the proportion of LA in NONIONIZED form at physiologic pH of 7.4 and FASTER ONSET OF BLOC

Question 119

Potency of LA is based on

Answer 119

LIPID solubility (SLP)

Question 120

>90 % protein binding La

Answer 120

Ropivacaine 94% | Bupivacaine 95%

Question 121

The duration of ACTION is longer for LA that exhibit ______protein and _______lipid solubility

Answer 121

GREATEST PROTEIN BINDING and HIGHEST LIPID SOLUBILITY

Question 122

More important than lipid solubility when it comes to duration of action

Answer 122

PROTEIN BINDING

Question 123

LA absorption : generally

Answer 123

the greater the tissue blood flow, the greater the rate of absorption

Question 124

Mnemonic to remember absorptbion

Answer 124

IvTicPEBSubAC IV -->Tracheal -->Intercostal---> Paracervical --> Epidural --> Brachial plexus --> Subarachonid,sciatic fem -->Subcutaneous.

Question 125

Sympathetic block compared to sensory block

Answer 125

2-6 dermatomes HIGHER than sensory block

Question 126

MOTOR block compared to sensory block

Answer 126

2 dermatomes lower than sensory bloc

Question 127

For myelinated axons, _____nodes of Ranvier must be blocked to stop nerve conduction

Answer 127

2-3 nodes

Question 128

The greater the frequency of action potentials, the

Answer 128

Faster the nerve is blocked, by local anesthetic

Question 129

The LA must attach to the sodium channel when it is in the

Answer 129

INACTIVATED STATE

Question 130

Both required to a conduciton block

Answer 130

Both nonionized, and ionized forms of LA the nonionized cross the lipid bilary the ionized form attaches to the inside of sodium channel and LOCKS it shut in the INACTIVATED STATE

Question 131

Key target of LA is the

Answer 131

Voltage-gated sodium channels.

Question 132

LA degree of blockade depends on both

Answer 132

Concentration and volume.

Question 133

Max dose of bupivacaine w/ EPI

Answer 133

2.5 mg/kg

Question 134

Max dose of bupivacaine w/O EPI

Answer 134

2mg/kg

Question 135

Max single dose of Bupivacaine

Answer 135

175 mg

Question 136

Max single dose LIDOCAINE

Answer 136

300 mg

Question 137

Max single dose of ROPIVACAINE

Answer 137

200

Question 138

Max dose of Lidocaine w/o epinephrine is

Answer 138

4.5 mg/kg

Question 139

Max dose of Lidocaine w/ epinephrine is

Answer 139

7mg/kg

Question 140

Ropivacaine dose per kg

Answer 140

3 mg/kg

Question 141

Lidocaine plasma concentration 1-5 mcg/ml

Answer 141

Analgesia therapeutic

Question 142

What is the therapeutic lidocaine plasma concentration?

Answer 142

1-5 mcg/ml

Question 143

Lidocaine plasma concentration 5-10 mcg/ml

Answer 143

``` Light headedness Tinnitus Visual disturbances' Tongue numbness Muscle twitching ```

Question 144

The recommended maximum leakage current allowed in operating room equipment is:

Answer 144

10 μA

Question 145

Lidocaine plasma concentration 10-15 mcg/ml

Answer 145

Seizures | Convulsions

Question 146

Lidocaine plasma concentration 15-25 mcg/ml

Answer 146

Unconsciousness Coma Respiratory arrest

Question 147

Lidocaine plasma concentration >25 mcg/ml

Answer 147

Cardiovascular depression

Question 148

Drug will be eliminated slowly it is back

Answer 148

Clearance is small and Vd is large

Question 149

Potency is directly related to

Answer 149

Lipid solubility

Question 150

MAC to potency

Answer 150

INVERSELY related to potency

Question 151

Oil gas partition coefficeints

Answer 151

NDSIEH (nitrous, des, sevo, iso, enflu, halothane) | 1.4, 18, 55, 98,98, 224

Question 152

Greatest sensitization to catecholamines occur with

Answer 152

Halothane.

Question 153

Oil gas partition coefficients is a measure of

Answer 153

LIPID SOLUBILITY

Question 154

Decrease CO induction is

Answer 154

FAST

Question 155

Increase CO induction is

Answer 155

SLOW

Question 156

Sevoflurane decrease arterial BP and SVR vs des/iso

Answer 156

Greater decrease with des and iso than sevo

Question 157

Solubility of a gas and temperature

Answer 157

Inverse relationship | as temperature increases, solubility decreases

Question 158

More inhlational agent will dissolve in blood if the patient is

Answer 158

HYPOTHERMIC

Question 159

More inhlational agent will dissolve in blood if the patient is HYPOTHERMIC , what explains this phenomenon

Answer 159

Le Chatelier's principle.

Question 160

Blood/ Gas coefficient HIGH to low

Answer 160

``` HIS ND Halothane 2.54 Isoflurane 1.46 Sevoflurane 0.69 Nitrous oxide 0.46 Desflurane 0.42 ```

Question 161

Alveoli are

Answer 161

WINDOWS TO THE BRAIN

Question 162

Speed of uptake of anesthetic and elimination from the brain is________ related to blood solubility

Answer 162

INVERSELY RELATED

Question 163

Mirror the brain partial pressure at steady state.

Answer 163

Alveolar partial pressure of the anesthetic

Question 164

The CNS effects after bolus injection of an IV anesthetic are terminated primarily by

Answer 164

REDISTRIBUTION

Question 165

Diazepam and protein binding

Answer 165

98%

Question 166

2 that ketamine causes

Answer 166

nystagmus | Hypertonous

Question 167

IV anesthetic with bronchodilation properties

Answer 167

Ketamine

Question 168

Meperidine to morphine potency

Answer 168

1/10th

Question 169

Meperidine metabolite

Answer 169

Normeperidine

Question 170

Phenylpiperidine derivative

Answer 170

Fentanyl, meperidine

Question 171

Fentanyl to morphine potency

Answer 171

Fentanyl 75-125x more potent

Question 172

Fentanyl what organ serve as inactive storage site?

Answer 172

LUNGS with 75% of the INITIAL DOSE UNDERGOING FIRST PASS PULMONARY UPTAKE.

Question 173

Meperidine crosses placenta

Answer 173

YES ALL OPIOIDS DO

Question 174

Thienyl analogue of fentanyl

Answer 174

Sufentanil

Question 175

Sufentanil potency

Answer 175

5-10x more than fentanyl

Question 176

Alfentanil potency

Answer 176

1/5 to 1/10 less potent than fentanyl

Question 177

VP pressure measure at

Answer 177

20C

Question 178

VP pressure of gases: HIGH to low (DHIES)

Answer 178

``` Desflurane Halothane Isoflurane Enflurane Sevoflurane ```

Question 179

VP pressure of gases: Des (mmHg)

Answer 179

669

Question 180

VP pressure of gases: Halothane

Answer 180

244

Question 181

VP pressure of gases: Isoflurane

Answer 181

240

Question 182

VP pressure of gases: Enflurane

Answer 182

172

Question 183

VP pressure of gases: Sevo

Answer 183

157 -170

Question 184

Vapor pressure and output MNEMONIC (HLH)

Answer 184

Higher vapor pressure agent PLACED in a vaporizer with LOWER vapor pressure agent , the concentration of agent delivered to the patient will be HIGHER than the dial setting

Question 185

Vapor pressure and output MNEMONIC (LHL)

Answer 185

Lower vapor pressure agent placed in a vaporizer with HIGHER vapor pressure agent, the concentration of agent delivered to the patient will be LOWER than the dial setting.

Question 186

The partial pressure of saturated water vapor at 37C is

Answer 186

47 mmHg

Question 187

Law of LAPLACE

Answer 187

T = (P x r) /2

Question 188

Law that. applied to blood vessels

Answer 188

Law of Laplace

Question 189

LAW of laplace explains why smaller alveoli empty into

Answer 189

LARGE ALVEOLI causing atelectasis in patients with ARDS

Question 190

POISEUILLE"S law

Answer 190

Q = Pi r^4 Change in P/ 8 n L

Question 191

Diffusion hypoxia explains by which law

Answer 191

GRAHAM's

Question 192

Boyles is the

Answer 192

VP (Volume/Pressure relationship)

Question 193

Charles goes into

Answer 193

Vtach (Volume to Temperature)

Question 194

Gay Lussac's law is the

Answer 194

PT (pressure to Temp)

Question 195

Is uterine blood flow autoregulated

Answer 195

NO

Question 196

TI =

Answer 196

TD50/ED 50

Question 197

What is the number that shows how much a gas will dissolve in a liquid at a certain temperature?

Answer 197

OSTWALD.

Question 198

A principle for calculating CO from oxygen uptake or CO elimination and Oxygen or CO2 concentration in arterial and venous blood

Answer 198

Fick principle

Question 199

Describe behavior of non-ideal gases

Answer 199

Van der waal

Question 200

Gas pressure is inversely proportion to gas volume at constant Temperature?

Answer 200

Boyle's

Question 201

Total pressure of a mixture of gases is equal to the sum of all partial pressure

Answer 201

DALTON"s

Question 202

6.02 x 10 ^23

Answer 202

AVOGADRO

Question 203

Gas pressure increase if temperature increases and volume does not change.

Answer 203

Gay-lussac

Question 204

One mole of ideal gas occupies 22. 4 L at 0C and 1 atm

Answer 204

Avogadro

Question 205

Law": Volume increases when temperature increases , if pressure is constant

Answer 205

Charles

Question 206

Twice as much O2 will dissolve in arterial blood if alveolar pressure of O2 is doubled

Answer 206

HENRY's LAW

Question 207

if alveolar pressure of O2 is doubled, how much O2 will dissove

Answer 207

twice as much

Question 208

Number revealing laminar vs turbulent flow

Answer 208

Reynolds

Question 209

Concentration effect which law

Answer 209

FICK's law of diffusion

Question 210

Explained how pressure, tube radius, length and fluid viscosity contribute to laminar flow

Answer 210

Hagen-Poiseuille law

Question 211

Tension in the wall of blood vessel is_______ to the radius

Answer 211

PROPORTIONAL

Question 212

Tension in the wall of blood vessel is proportional to the radius which law

Answer 212

Laplace

Question 213

The lateral pressure of fluid flowing through a CONSTRICTED SEGMENT of tubing is decrease

Answer 213

Bernoulli principe

Question 214

What law explains normal tidal breathing?

Answer 214

Boyles'

Question 215

Muscle relaxants are what kind of compounds

Answer 215

Quarternary ammonium

Question 216

Desflurane, enflurane isoflurane and sevoflurane are

Answer 216

halogenated ETHERS

Question 217

SVR = MAP - CVP/CO x80 which law permits this calculation

Answer 217

OHM's LAW

Question 218

Salt form or a weak acid naming examples

Answer 218

Sodium "drug" example

Question 219

If ph of stomach is 2.0 which orally admininstered drug will be most NONIONIZED

Answer 219

A weak acid with pKa 6.2

Question 220

A local anesthetics is a

Answer 220

WEAK BASE with a PKA greater than 7.4

Question 221

4-8 mesh soda lime prevents

Answer 221

Channeling while providing an adequate surface area for CO2 absorption.

Question 222

What is the partial pressure of a gas if its concentration is 5%?

Answer 222

38 mmHg (760 mmHg x 5/ 100)

Question 223

If a gas exerts a partial pressure of 15 mmHg its concentration is ____%

Answer 223

2.0 % (1.97 % to be exact) set up proportion 760mmHg/100% = 15 mmHg/ x

Question 224

In the reaction of CO2 with soda lime the final producs are

Answer 224

CARBONATES

Question 225

Which pulmonary function test uses boyle's law?

Answer 225

Plethysmotraphy for determination of FRC

Question 226

THE GENERATION OF colloid osmotic pressure in the plasma is the principle function of

Answer 226

Albumin

Question 227

A 3% stock solution of drug is available. You need to make 50 ml of a 0.6 mg/ml solution. How many mL will you take from stock solution to make the dilute solution

Answer 227

1ml 0.6 mg = 1 ml for 50 ml you need 30 mg 3% solution is 30 mg/ml

Question 228

Sevoflurane is added to a flask sitting on a table, what is the concentration of sevoflurane above the liquid?

Answer 228

22%

Question 229

The lipid bilayer of the cell membrane is most IMPERMEABLE to what

Answer 229

Charged ion such as Potassium ions

Question 230

Between gases not including Nitrous which one has the lowest Blood gas coefficient

Answer 230

Desflurane

Question 231

What is the relative humidity of alveolar gas?

Answer 231

100%

Question 232

When the tank pressure gauge on a tank of N2O begins to fall, the tank

Answer 232

NO LONGER CONTAINS N2O liquid form

Question 233

The rotator flowmeter is an example of

Answer 233

Variable orifice flowmeter

Question 234

An agent with a Blood gas partition of 12 an an oil gas partition coefficient of 0.5 builds up ______and ____potency

Answer 234

Slowly; and lacks potency

Question 235

Substance that most readily cross the placenta or blood/brain barrier?

Answer 235

highly lipid soluble, NONIONIZED

Question 236

Lowest oil:gas partition coefficient

Answer 236

Desflurane

Question 237

Immediately after onset of 50% N2O administration, the volume of the stomach may

Answer 237

Increase

Question 238

If flow is laminar and the radius of a tube is tripled , the flow through the tube will increase

Answer 238

``` 81 fold HOw: Lets assume to radius you started with was 2 so r^4 of 2 is 16 Now: radius tripled (2 x3 =6 ) so r^4 of 6 is 1296 ``` When you divide 1296 / 16 = 81

Question 239

What can be measured with a wright respirometer?

Answer 239

Tidal Volume

Question 240

1: 500,000 concentration is _____mcg/ml

Answer 240

2 mcg/ml. (remember all ratio divide 1,000,000 by the :xxxxxxx )

Question 241

What property of helium makes it a useful agent?

Answer 241

LOW DENSITY (makes flow more laminar)

Question 242

When halothane is added to a flask containing 100% O2, the new concentration of O2 will be

Answer 242

68% How: use VP of desflurane which is 244 mmHg /760 mmHg x 100 % = 32% 100%-32% = 68% for O2

Question 243

The cylinder of N2O cools after it is turned on , what explains this cooling?

Answer 243

Joule-Thompson effect

Question 244

Tension in the blood vessel wall will be lowest in the

Answer 244

Capillary

Question 245

During diastole, the tension in the LV wall increases, what explains this

Answer 245

Law of laplace

Question 246

When you put an ETT in an autoclave, the cuff expans, this is an application of

Answer 246

Charles LAW

Question 247

When the length of an IV needle is doubled, what happens to flow from the IV bag, and what law applies?

Answer 247

Flow is halved, Hagen-poiseuilles' law applies

Question 248

How much Co2 is dissolved in arterial blood when PaCo2 is 70 mmHg

Answer 248

4.69 mL CO2/ 100 mL blood

Question 249

When is the partial pressure of CO2 increases, more hydrogen ions and bicarbonate ions are produced: Which law or principle applies?

Answer 249

Le Chatelier's principle

Question 250

The reaction of CO2 with soda lime is a

Answer 250

NEUTRALIZATION

Question 251

What is the concentration of a solution in % if 250mg is added to 50ml of water?

Answer 251

250/50 = 5 mg/ml ``` the way i do it I know 2% lidocaine is 20 mg /ml 2 % = 20 mg/ml x = 5 mg/ml (5 x2) / 20 = 0.5% ```

Question 252

Soda lime greatest concentration is

Answer 252

Calcium Hydroxide Ca(OH)2

Question 253

Which law explains atelectasis with patient with ARDS

Answer 253

LAPLACE

Question 254

If MAP is 100mmHg , CVP is 10mmHg, CO is 4.5L/min , the resistance to flow through the Systemic circulation in dynes-cm^-5 is

Answer 254

1600 | Formula is : MAP-CVP/CO x 80

Question 255

When flow is turbulent, the resistance to flow is dependent on what property of the fluid?

Answer 255

DENSITY

Question 256

What important changes occurs when laminar flow changes to turbulent flow?

Answer 256

Resistance increases

Question 257

Carbonic anhydrase inhibitors decrease the ability of the kidneys to reabsorb bicarbonate, resulting a

Answer 257

hyperchloremic acidosis.

Question 258

Carbonic anhydrase inhibitors would be avoided in patients with

Answer 258

acidosis, especially a normal-anionic-gap acidosis

Question 259

As a result, because bicarbonate is filtered by the ciliary process in the formation of aqueous humor,

Answer 259

carbonic anhydrase inhibitors reduce the formation of aqueous humor and can be used to decrease intraocular pressure

Question 260

Bicarbonate is filtered by the

Answer 260

ciliary process in the formation of aqueous humor,

Question 261

A bourdon gauge reads 100 psi, what is the pressure inside the cylinder ? 1 atm= 14.5 psi

Answer 261

114.5 psi. (it is the pressure GAUGE reading + 14.5)

Question 262

If your tire gauge reads 34 psi (pounds per square inch), then the absolute pressure is

Answer 262

34 psi plus 14.7 psi = 48.7

Question 263

2 bubbles, one with a radius of 2mm called P(s) and the other one with a radius of 4mm P (L) how does the pressure inside the large bubble compared to the pressure inside the small bubble (Ps)

Answer 263

The pressure of the large bubble is half the pressure of the small bubble

Question 264

VP from Low to HIGH (SEI-HD) | 170-172-240-244-669

Answer 264

``` Sevoflurane, 170 mmHg Enflurane, 172 mmHg Isoflurane, 240 mmHg Halothane, 244 mmHg Desflurane, 669 mmHg ```

Question 265

What happens to alveoli that do not have surfactant?

Answer 265

Smaller alveoli collapse into larger ones.

Question 266

Parameters used to calculate reynold's number ?

Answer 266

Velocity of the fluid Viscosity Diameter of the tube

Question 267

With laminar flow the gas flow rate is

Answer 267

directly proportional to the pressure gradient along the tube

Question 268

Nebulizers use

Answer 268

venturi tubes

Question 269

As an E-cylinder of oxygen empties, ice crystals form near the outlet, this is explained by what?

Answer 269

Joule-Thompson

Question 270

What explains why opening a cylinder slower , allow the expanding gas to draw energy from the environment to maintain an equal distribution of energy, we observe no changes in temperature of the gas

Answer 270

2nd law of Thermodynamics (Entropy)

Question 271

Rapid expansion of a gas causes the temperature to ________as explains by the ______Effect

Answer 271

decrease ; Joule-Thompson Effect

Question 272

Reynolds number formula is

Answer 272

Vpd/n v: velocity d: diameter p density

Question 273

When sevoflurane is accidentally placed in a halothane vaporizer and the dial is set a 1% , the % delivered will be

Answer 273

less than 2%

Question 274

What volume will be occupied by 16 g (half a mole) of O2 at standard temperature and pressure (Assume o2 is an ideal gas?

Answer 274

11.2 ( Full mole at STP is 22.4)

Question 275

When Nitrous is turned on, gas bubbles in the body expand, what law applies?

Answer 275

Fick's Law of diffusion

Question 276

What is the partial pressure of isoflurane when the concentration delivered to the patient is 1.5%?

Answer 276

760 mmHg x 1.5% = 11.4 mmHg

Question 277

The desflurane vaporizer is electrically heated to _______which creates a vapor pressure of ________inside the vaporizer, regardless of ambient pressure

Answer 277

39 degrees centigrade, 2 atmospheres

Question 278

For desflurane, The number on the dial reflects the percentage that will be delivered. So at any altitude, when you dial 5%, it will give you _______ But when that 5% desflurane leaves the vaporizer at high altitude, what happens?

Answer 278

It will give you 5%; is delivered to the patient is 5% of a decreased ambient pressure, so the partial pressure of desflurane in the alveoli will be much less that it would be at sea level. Thus, you will need to dial a higher concentration at high elevation to attain the same clinical effect as at sea level with desflurane (Tec-9) vaporizer.

Question 279

If desflurane is HIGH ALTITUDE, when you dial 5%, the vaporizer will give you______%. The partial pressure delivered will be ______

Answer 279

5% , the

Question 280

Desflurane at HIGH altitude

Answer 280

dial a HIGHER concentration at HIGHER elevation to attain the same clinical effect ,

Question 281

For gases, What is physiologically important is the

Answer 281

partial pressure (mm Hg), not the concentration.

Question 282

What determines whether a patient is anesthetized,

Answer 282

The partial pressure of the anesthetic agent

Question 283

Does the partial pressure of the anesthetic change with altitude?

Answer 283

Does not change at different altitudes.

Question 284

At a higher altitude where the barometric pressure is _______of that at sea level. The amount of isoflurane Vapor output ______due to ______barometric pressure.

Answer 284

½ that at sea level, the amount of isoflurane vapor output increases due to the lower barometric pressure. Therefore, the settings that delivered 2% isoflurane now deliver 4% isoflurane. However, according to Dalton’s law, the partial pressure of isoflurane delivered would be approximately the same at both altitudes since 2% isoflurane at 760mm Hg (15.2 mm Hg) is the same as 4% isoflurane at 380mm Hg (15.2 mm Hg).

Question 285

What conditions will optimize the amount of gas dissolved in a liquid?

Answer 285

INCREASED PARIAL PRESSURE | DECREASED TEMPERATURE

Question 286

The buildup of an inhalational anesthetic in the brain is fastest for an agent that has

Answer 286

Low blood solubility

Question 287

The most potent inhalational anesthetics have

Answer 287

HIGH lipid solubility

Question 288

If the Ostwald blood: gas partition coefficient is 2, then each liter of blood will have as many molecules as one liter of alveolar gas?

Answer 288

TWICE

Question 289

If the partial pressure of a gas over a liquid doubles, the amount of gas dissolved in the liquid

Answer 289

DOUBLES

Question 290

Henry's law

Answer 290

gas law that states that the amount of dissolved gas in a liquid is proportional to its partial pressure above the liquid. The proportionality factor is called Henry's law constant.

Question 291

Which gas can be liquified at room temperature?

Answer 291

Nitrous oxide

Question 292

When a gas cylinder connected to an anesthetic machine is turned on quickly and the pressure in the connecting pipes and gauges rises rapidly, the process is

Answer 292

ADIABATIC and temperature increases substantially

Question 293

What is Adiabatic changes?

Answer 293

Rapid expansion OR compression of a gas WITHOUT equillibration of energy with the surrounding environment NO increase or decrease in energy. BUT THE TEMPERATURE WILL BE HIGHER

Question 294

Medical air at atmospheric pressure is composed of _____and _____? what are the partial pressures and how are they calculated ?

Answer 294

Nitrogen and Oxygen 79% x 760 mmHg = 600.4mmHg 21% x 760mm Hg= 159.6 mmHg

Question 295

Which inhalational anesthetic has a blood:gas partition coefficient of 1.4?

Answer 295

Isoflurane

Question 296

Recovery from which of the following inhalational agents will be fastest?

Answer 296

Desflurane

Question 297

What happens to pressure in the middle ear when the N2O is turned off?

Answer 297

It decreases

Question 298

Substance "X" will diffuse at a faster rate across the alveolar-capillary wall than substance "Y" if substance " X is more _________

Answer 298

Lipid soluble

Question 299

The rate of diffusion of a gas accross the alveolar capillary membrane is inversely proportional to the

Answer 299

THICKNESS OF THE MEMBRANE

Question 300

The factors that determine the amount of gas diffusing across the alveolar capillary membrane are described by

Answer 300

FICK's LAW

Question 301

Which of the following substances does not penetrate the BBB?

Answer 301

Mannitol

Question 302

Graham's law

Answer 302

Rate of effusion of a gas is INVERSELY PROPORTIONAL To the square root of its molecular weight.

Question 303

N2 and N2O are diffusing through the air (not across a membrane). N2 will diffuse fast than N2O. Whose law applies>

Answer 303

GRAHAM's LAW

Question 304

IV infusion of which of the following substances would be most effective in promoting the osmotic movement of water into the circulation from the extracellular space>

Answer 304

ALbumin

Question 305

The pressure in a cylinder of O2 decreases at it empties, what law applies?

Answer 305

IDEAL

Question 306

When a full E-cylinder of Oxygen is brought from the loading dock where the temperature is 40C to the OR where the temperature is set at 21C. the pressure in the cylinder will increase or decrease, whose law applies?

Answer 306

pressure will decrease, GAY lussacs law (P1/T1 = P2/T2)

Question 307

Helium/oxygen mixture are used medically for

Answer 307

UPPER AIRWAY OBSTRUCTION

Question 308

What is the water vapor pressure in the alveoli?

Answer 308

47 mmHg

Question 309

The clinically significant different between N2 and N2O is their

Answer 309

BLOOD SOLUBILITIES

Question 310

When the partial pressure of O2 in arterial blood increase from 100 to 600mmHg the amount of dissolved O2 increases BY how much.?

Answer 310

100 x 0.003 = 0.3 600 x 0.003 = 1.8 1.8 - 0.3 = 1.5 mL O2/100ml blood

Question 311

What 2 parameters are used to calculate RESISTANCE to flow through a tube?

Answer 311

UM NOT SURE That's the right answer (PRESSURE and gradient) per valley

Question 312

In venturi tube, the lateral pressure upstream from the narrowing is

Answer 312

GREATER than in the narrowed region

Question 313

High temperature may be generated when empty cylinders are

Answer 313

Transfilled from larger cylinders

Question 314

High temperature may be generated when empty cylinders are Transfilled from larger cylinders . This is called the

Answer 314

ADIABATIC EFFECT

Question 315

The Joule-Thompson effect describes the decrease in temperature when a

Answer 315

Gas exiting a compressed cylinder expands freely

Question 316

Soda lime consists of silica, water

Answer 316

Sodium hydroxide Potassium hydroxide Calcium hydroxide

Question 317

What law permits calculation of resistance to flow through at tube?

Answer 317

Omh's LAW

Question 318

If isoflurane is placed in an enflurane vaporizer and the dial is set at 2% what will be the delivered concentration of isoflurane?

Answer 318

Greater than 2%

Question 319

The Jet ventilator operates on

Answer 319

Le chatelier's principle

Question 320

A mechanism used to reduce the pressure of a gas as it rises from a compressed gas cylinder to a usable, nearly constant pressure is a.

Answer 320

REGULATOR

Question 321

The greater the distance between an Xray source and the anesthetist , the lower the intensity of exposure tot the xrays. The law describing this is the

Answer 321

INVERSE SQUARE LAW

Question 322

The density of a gas determines

Answer 322

ITS FLOW THROUGH an ORIFICE

Question 323

In the supine individual, the pressure in the dorsalis pedis is greater than in the aorta. This is explained by

Answer 323

The SUPERIMPOSITION PRINCIPLE

Question 324

Which of the following principles is utilized in the delivery of a gas through a side arm port?

Answer 324

Bernoulli's

Question 325

The partial pressure of Oxygen in air at one atmosphere is

Answer 325

159mmHg

Question 326

The mass spectometer is reading 5% for ETCO2, what is approximate equivalent in mmHg?

Answer 326

38 mmHg (0.05x760)

Question 327

Lipid bilayer is made up of

Answer 327

Cholesterol Phospholipids Proteins Symmetrical

Question 328

Competitive antagonists attach to receptors and

Answer 328

Prevents attachment of agonists

Question 329

Flow is 5L/min, (2.5L /min O2, and 2.5L/min of N2O) through a copper kettle vaporizer, and a 2% concentration of halothane is achieved. If N2o runs out, the halothane concentration delivered to the patient will be?

Answer 329

4%

Question 330

If halothane is added to a flask sitting on a lab bench containing 100% O2, what will be the resulting partial pressure of O2 in the gas above the halothane liquid?

Answer 330

760mmhg-243 (halothane) =517

Question 331

If isoflurane is placed in an enflurane and you set the dial at 2% what will happen the % of anesthetic delivered?

Answer 331

A higher concentration of isoflurane will be delivered than the 2% dialed in (HLH)

Question 332

Purity of gases

Answer 332

Pharmacopeia + National formulary

Question 333

O2 has a critical temperature _____room temperature

Answer 333

BELOW

Question 334

Standards for medical devices and gases set by

Answer 334

FDA

Question 335

Sets basic performance and SAFETY REQUIREMENTS for components of anesthesia machines, endotracheal tubes, and connections, pressure and vaccum and gas pressure regulators

Answer 335

American National Standards Institutes (ANSI)(

Question 336

Each cylinder test by interior hydrostatic pressure once every

Answer 336

5 years

Question 337

ALl cylinders must be marked according to

Answer 337

Interstate commerce commissions regulations.

Question 338

The cylinder should be open slightly for a moment to

Answer 338

clear the outlet of possible dust. CRACKING the cylinder

Question 339

Can generate heat and cause combustion with cylinder

Answer 339

ADIABATIC heat of compression.

Question 340

The cylinder safety device is a simple plus of

Answer 340

SOFT METAL ALLOY called WOOD's metal,

Question 341

At what temperature would the wood's metal melt

Answer 341

200F

Question 342

Prevents cylinder gas from escaping machine through pipeline supply hoses?

Answer 342

Check valve in DISS

Question 343

Check valve in pipeline inlet assembly is a

Answer 343

Floating valve and seats according to pressure.

Question 344

What is the name of the gauge that shows Oxygen tank pressure?

Answer 344

Bourdon

Question 345

In a dual hanger yoke system, what prevents one cylinder from emptying into the other?

Answer 345

There is a free-floating valve for each cylinder and the Oxygen E cylinder with the greater pressure closes the free-floating valve of the other

Question 346

The 1st and 2nd stage regulator are what kind of valve

Answer 346

DIAPHRAGM

Question 347

1st stage regular decrease pressure to

Answer 347

45psig

Question 348

Cylinder vs pipeline pressure

Answer 348

Cylinder pressure decreased to slighly less than pipeline pressure to prevent depletion of cylinder contents when attached to pipeline.

Question 349

2nd stage regulator

Answer 349

Reduces pressure from 50psig to 16

Question 350

Oxygen flush valve flow rate____at what pressure ___

Answer 350

35-75 ml/min; 50 psig

Question 351

Oxygen failure cut off valve, where do O2 and N2O mix

Answer 351

They don't mix

Question 352

Gases are joined for the first time in the

Answer 352

COMMON MANIFOLD

Question 353

Oxygen failure cutoff valve : oxygen pressure must be maintain at least

Answer 353

25 psig to keep valve open

Question 354

Fail safe systems analyze O2 pipeline content?

Answer 354

NO they only analyze pressure.

Question 355

Does the fail-safe protect from cross over pipeline

Answer 355

NO

Question 356

Read ball float at the

Answer 356

middle

Question 357

Thorpe tube largest at the

Answer 357

TOP

Question 358

What happens if inspiratory valve sticks open?

Answer 358

Exp volume will exhaust through the insp limb. ETCO2 waveform will be elevated.

Question 359

What happens if expiratory valve sticks open?

Answer 359

Insp volume will not enter the ETT but instead will bypass and exhaust through the exp limb.

Question 360

Desflurane boils at

Answer 360

22.8C.

Question 361

What happen when the vaporizer is tipped then leveled?

Answer 361

Liquid vapor will get into the VAPORIZER CHAMBER and the carrier flow will carry MORE AGENT to the patient

Question 362

What happen when the vaporizer is tipped then leveled?

Answer 362

Liquid vapor will get into the VAPORIZER CHAMBER and the carrier flow will carry MORE AGENT to the patient. MORE AGENT picked up means HIGHER CONCENTRATION of agent delivered to the patient. It may be a lethal dose.

Question 363

Largely eliminated the tipping problem?

Answer 363

Cassette vaporizer and TEC 6

Question 364

Low pressure is ___psi

Answer 364

16 psi

Question 365

Yoke check valve is part of _____pressure system

Answer 365

HIGH

Question 366

Vaporizer check valves part of ____pressure system

Answer 366

Low.

Question 367

When does scavenging occur?

Answer 367

After exhalation

Question 368

2 actions in case of a suspected pipeline crossover

Answer 368

turn on back up O2 | Disconnect pipeline

Question 369

Oxygen FLUSH valve is

Answer 369

BALL/SPRING valve

Question 370

PRIMARY function of ANY free floating valve is to

Answer 370

Prevent gases from leaking out of the system.

Question 371

Ball and spring valve function

Answer 371

ALL OR NONE | Permits gas flow after you have made a connection.

Question 372

Open system reservoir, rebreathing

Answer 372

No reservoir, no rebreathing

Question 373

Examples of open system

Answer 373

Nasal cannula | simple face mask

Question 374

Open drop ether an ______system

Answer 374

Open

Question 375

Insufflation is an example of what type of breathing system?

Answer 375

Open

Question 376

The only system without reservoir is

Answer 376

OPEN

Question 377

This breathing system requires INCREASES GAS FLOW

Answer 377

SEMI OPEN

Question 378

Semi Closed and rebreathing , reservoir

Answer 378

Partial rebreathing | Reservoir

Question 379

Mapleson worst for controlled ventilation

Answer 379

Mapleson A

Question 380

Mapleson BEST for spontaneous ventilation

Answer 380

Mapleson A

Question 381

Mapleson E

Answer 381

NO bag and valve

Question 382

Maplesons mnemonic

Answer 382

``` A- APL by the patient B- Both APL and FGF by the Patient C- No corrugation D- APL Distant from the patient E- no bagee no valvee F- F***No valve ```

Question 383

The most common CIRCUIT SYSTEM used today

Answer 383

BAIN circuit, which is a modified Mapleson D.

Question 384

In the BAIN circuit, FGF is through a

Answer 384

SMOOTH tube not the corrugated tubing

Question 385

Mapleson used in both spontaneous and controlled ventilation

Answer 385

BAIN

Question 386

BAIN: FGF must be

Answer 386

2.5 X patient's MV

Question 387

During controlled ventilation: best to least maplson

Answer 387

DFE>BC>A

Question 388

Best mapleson preventing rebreathing during spontaneous ventilation

Answer 388

A>DFE>CB

Question 389

LMA and coughing

Answer 389

less coughing on ermergence | Less risk of bronchospasm

Question 390

LMA and airway reflexes

Answer 390

contraindicated with intact airway reflexes due to the risk of laryngospasm

Question 391

LMA classic can it be used to facilitate fiberoptic or blind oral intubation

Answer 391

YES : LARGEST tube allowed is 6.0

Question 392

LMA to establish an _____airway

Answer 392

EMERGENCY

Question 393

The RODS mnemonic is used to

Answer 393

Identify difficulty extraglottic device situation

Question 394

RODS stands for

Answer 394

Restricted mouth opening Obstruction Distorted airway or disrupted airway Stiff lung or stiff cervical spine

Question 395

Peak airway pressure and LMA?

Answer 395

PAP < 20 cmH20 indicated

Question 396

Initial cuff pressures will vary with the patient

Answer 396

LMA size, head position, anesthetic depth

Question 397

LMA cuff pressure shouldd not exceed

Answer 397

60cm H20

Question 398

What is the MOST COMMON ADVERSE EFFECT of Using LMA

Answer 398

SORE THROAT

Question 399

FASTRACH LMA features

Answer 399

CURVED RIGID AIRWAY tube Integrated GUIDING HANDLE EPIGLOTTIS ELEVATING BAR GUIDING RAMP

Question 400

What part of the FASTTRACH LMA is used for insertion , reposition and removal?

Answer 400

The Intergrated handle at the proximal end of the barrel.

Question 401

The position of the FASTrach LMA can be optimized by

Answer 401

LaAN P(Lateral - anterior Posterior manipulation by using the INTERGRATED handle.

Question 402

What is the CHANDY maneuver?

Answer 402

lateral , anterior posterior manipulation of the handle.

Question 403

What is the LMA Proseal

Answer 403

The first DOUBLE lumen SGA

Question 404

The 2nd lumen of the LMA proseal is used for

Answer 404

Diagnosis of malposition passive emptying of stomach Active emptying of stomach

Question 405

The LMA proseal vs LMA supreme

Answer 405

LMA supreme is a single use version of the proseal

Question 406

When selecting an LMA proseal , you should

Answer 406

SIZE DOWN from the LMA classic size

Question 407

KING Laryngeal tube: cuffs

Answer 407

SMALL ESOPHAGEAL CUFF | Larger HYPOPHARYNGEAL CUFF

Question 408

After insertion of King Laryngeal cuff

Answer 408

BOTh CUFF INFLATED by injecting air into JUST ONE inFLATION PORT

Question 409

King Laryngeal tube if ventilation is inadequate

Answer 409

tube too deep

Question 410

Cannot intubate cannot ventilate tube

Answer 410

Esophageal tracheal combitube ( ETC)

Question 411

Adverse effects of SGAs

Answer 411

Aspiration | Sore throate

Question 412

Single use SGAs/

Answer 412

Most SGAs are not disposable, single use.

Question 413

SGA specific cleaner

Answer 413

Endozime

Question 414

Max use per LMA

Answer 414

40

Question 415

When fully inserted the LMA rest agains the

Answer 415

UPPER esophageal sphincter

Question 416

Largest ETT tube through size 3-6 LMA

Answer 416

3- 6.0 mm 4- 6.00 5 -7mm 6- 7mm

Question 417

LMA size and largest ETT size 1-2.5> how to remember?

Answer 417

``` Add "2.5 to each size" Size 1 + 2.5 = 3.5 Size 1.5 + 2.5 = 4 Size 2 + 2.5 = 4.5 Size 2.5 + 2.5 = 5 ```

Question 418

Neonates to children up to 30 kg (<5, 5-10, 10-20, 20-30) Max cuff volume

Answer 418

4, 7, 10, 14

Question 419

LMA size 3 - 6 max cuff volume

Answer 419

3, 4, 5, 6 | 20,30,40,50

Question 420

Fiberoptic size (mm) for LMA neonate <5kg up to 30kg

Answer 420

2.7, 3, 3.5, 4.0

Question 421

Which nerve when stimulated will cause laryngospasm?

Answer 421

Stimulation of vagus nerve during light anesthesia (S

Question 422

LMA vs ETT bronchospasm and laryngospasm is

Answer 422

LESS with ETT

Question 423

BIS with low probability of explicit recall

Answer 423

70-60

Question 424

GA BIS

Answer 424

40-60

Question 425

DEEP hypnotic state BIS

Answer 425

40-20

Question 426

FLAT LINE EEG BIS

Answer 426

0-10

Question 427

Light anesthesia BIS

Answer 427

90-70

Question 428

Large V wave

Answer 428

TR RV failure Constrictive pericarditis Tamponade.

Question 429

RA pressure range

Answer 429

1-8mmhg

Question 430

Hypovolemia CVP_____PCWP____

Answer 430

Low low

Question 431

LV failure CVP ________ PCWP ____

Answer 431

Normal or high | High

Question 432

Cardiac Tamponate: CVP ______PCWP___

Answer 432

High; high

Question 433

PE: CVP_______PCWP

Answer 433

High; nomral

Question 434

Max wedge time

Answer 434

15 seconds

Question 435

Insertion site PAC

Answer 435

1. Su (Subclavian) 2. RIJ (Right IJ) 3. LIJ (Left IJ) 4. RA (Right Antecubital) 5. LA(Left Antecubital) 6. Femoral ``` To RIGHT ATRIUM 15 (+10 for RV, + 15 for PA) 20 (+10 for RV, + 15 for PA) 25 (+10 for RV, + 15 for PA) 40 (+10 for RV, + 15 for PA) 45 (+10 for RV, + 15 for PA) 50 (+10 for RV, + 15 for PA) ```

Question 436

Aline upstrokes reflects 2

Answer 436

Contractility and SVR

Question 437

Upstroke is faster is contractility is_____and SVR is_____

Answer 437

Increased; decreasd

Question 438

Function of valve is to change pressure

Answer 438

Diaphragm

Question 439

This valve regulates the flow of N2O vial oxygen pressure

Answer 439

Fail safe valve

Question 440

Free floating valve

Answer 440

Cylinder valve

Question 441

Pulse ox is used to assess

Answer 441

Oxygenation

Question 442

May cause falsely elevated pulse ox reading

Answer 442

Methemoglobin

Question 443

Assessing a patient's CO2 elimination by END tideal CO2 measurement is called

Answer 443

CAPNOMETRY

Question 444

DISS PREVENTS accidental misconnections by altering

Answer 444

Size of connection, type of pipe thread

Question 445

CYLINDER REGULATOR first stage convert cylinder pressure to

Answer 445

45 pSI

Question 446

The most fragile part of the gas machine is the

Answer 446

FLOW TUBES

Question 447

Cauda equina extends

Answer 447

L1 to S5

Question 448

Epidural space widest at

Answer 448

L2

Question 449

Narrowest at level

Answer 449

C5

Question 450

The epidural space is a

Answer 450

POTENTIAL SPACE that is bound by the DURA and LIGAMENTUM FLAVUM

Question 451

The principle site of action of neuraxial blockade is the

Answer 451

NERVE ROOT within the spinal cord.

Question 452

The best means for treating HYPOTENSION during spinal anesthesia is

Answer 452

PHYSIOLOGIC not pharmacologic. GIVE IV FLUIDS if not normovolemic, if NORMOVOLEMIC give ephedrine.

Question 453

Fibrinolytic or thrombolytic no neuraxial for

Answer 453

10 days

Question 454

Heparinization can occur

Answer 454

1 hour after catheter removal

Question 455

Clavicles level

Answer 455

C4

Question 456

Skin to epidural space average adult

Answer 456

4-6cm

Question 457

Order of sensitivity to LA block is

Answer 457

large myelinated > smaller myelinated > unmyelinated

Question 458

To assess lost of temperature sensation: most sensitive indicator

Answer 458

ALCOHOL swab to assess loss of temperature sensation is the most sensitive indicator of initial onset of sensory block. PINPRICK MOST ACCURATE OVERALL>

Question 459

Anechoic

Answer 459

Appears black on image

Question 460

Hyperechoic

Answer 460

Appears bright

Question 461

HOW MUCH TO INJECT FOR AXILLARY BLOCK

Answer 461

40 ML

Question 462

CERVICAL PLEXUS BLOCK

Answer 462

4 ML

Question 463

HOW MUCH TO INJECT FOR ISB ?

Answer 463

40 ML

Question 464

SUPRACLAVICULAR + INFRACLAVICULAR

Answer 464

20-30 ML

Question 465

Medial RADIAl nerve how much

Answer 465

4 ML

Question 466

Ankle BLOCK

Answer 466

``` Posterior tibial DEEP PERONEAL SURAL Saphenous Superficial PERONEAL ```

Question 467

Common nerve aka

Answer 467

fibular nerve

Question 468

Responsible for pain and temperature

Answer 468

C and unmyelinated

Question 469

The most common causative organism in epidural abscesses is

Answer 469

Staphylococcus aureus

Question 470

The posterior dermatomes located at L4 correst to

Answer 470

Intercristal line Tuffers line Superior iliac crest

Question 471

Hypobaric

Answer 471

sterile water

Question 472

Isobaric

Answer 472

CSF

Question 473

Hyperbaric

Answer 473

Dextrose

Question 474

To avoid catheter migration during or following the combined spinal epidural anesthetic, which spinal needle gauge size would be appropriate

Answer 474

28Ga

Question 475

3 in one block is (LOM)

Answer 475

Lateral femoral cutaneous Obturator Femoral

Question 476

1sst and 2nd most common nerve injury post op

Answer 476

Ulnar nerve | Brachial plexus.

Question 477

Claw hand associated with

Answer 477

Ulnar nerve injury

Question 478

Foot drop associated with

Answer 478

Lithotomy

Question 479

Results in permanent vision loss

Answer 479

Ischemic optic neuropathy

Question 480

Left arm abducted > 90 degrees

Answer 480

Brachial plexus

Question 481

Opposition of the first and fifth finger is preclcuded

Answer 481

median nerve injury

Question 482

Weakened skeletal muscle below the knee is a symptom of what injury

Answer 482

SCIATIC

Question 483

Most common injured nerve of the lower extremity

Answer 483

common peroneal

Question 484

Plantar flexion for a long time which nerve at risk

Answer 484

anterior tibial

Question 485

Compression of this nerve against the pelvic brim

Answer 485

Femoral

Question 486

Saphenous nerve is a branch of the

Answer 486

FEMORAL

Question 487

Unable to adduct leg, decrease sensation medial thigh

Answer 487

OBTURATOR ( saphenous is only sensory)

Question 488

IM injection vein in UPPER outer quadrant of the buttock to prevent injury to the

Answer 488

SCIATIC

Question 489

3 nerves causing foot drop

Answer 489

Sciatic Common peroneal Anterior tibial.

Question 490

Pregnancy and FRC

Answer 490

Decreased by 20%

Question 491

Lungs that remains unchanged

Answer 491

TLC, VC, IC

Question 492

Ventilation and pregnancy

Answer 492

MV increases 45% | Alveolar ventilation increase 45%

Question 493

Oxygen consumption

Answer 493

Increase 20% to 30% at rest | 100% in 2nd stage of labor

Question 494

HR and pregnancy

Answer 494

Increase 20-30%

Question 495

CO increases mainly due to

Answer 495

increase in SV

Question 496

Coagulation and fibrinogen in pregnancy

Answer 496

increased

Question 497

Considered full stomach starting week

Answer 497

12

Question 498

Dilutional anemia is due to

Answer 498

Increased in Plasma volume to a greater extend than Red blood cell volume.

Question 499

CO , SV, HR

Answer 499

CO up 40-50% SV up 20-50% HR up 20-

Question 500

Decreased factor in pregnancy

Answer 500

11 and 13

Question 501

Unchanged factor

Answer 501

2 and 5

Question 502

UBF at term is

Answer 502

700-800ml/min

Question 503

2 factors causing decrease UBFl

Answer 503

decrease perfusion pressure

Question 504

Pregnancy GFR, CO and RBF

Answer 504

ALL increased

Question 505

BUN and CR in pregnancy

Answer 505

Normal due to increase in RBF and GFR

Question 506

GFR increase by____% by ____th gestational week and remains elevated until delivery

Answer 506

50% ;16th,

Question 507

Uterine artery pressure is determined by

Answer 507

Maternal systemic arterial pressure.

Question 508

Definitive treatment for preeclampsia is

Answer 508

DELIVERY of the fetus

Question 509

Diagnosis of preeclampsia can be made if

Answer 509

Thrombocytopenia <100000, Cr, 1.1

Question 510

BEST Indicator of coagulopathy in the pre-eclamptic patient

Answer 510

PLATELET COUNT ON ADMISSION

Question 511

Earliest sign of magnesium toxicity ?

Answer 511

Marked depresion of DTRs.

Question 512

Level needed to be secured for a c-section

Answer 512

T-4

Question 513

How much of the total uterine blood flow goes to the intervillous space?

Answer 513

550ml/min

Question 514

Plasma fibrinogen DIC

Answer 514

<150 (in pregnancy 400-650)

Question 515

Most serious in GASTROCHISIS

Answer 515

Dehydration and infection

Question 516

high fever croup vs epiglotittis

Answer 516

Epiglottitis

Question 517

Rapid vs slow progress croup vs epiglotittis

Answer 517

Rapid epiglottitis

Question 518

Within umbilical vs lateral to umbilitus

Answer 518

Omphalocele(within) | Gastrochisis (Lateral )

Question 519

Omphalocele mortality related to

Answer 519

CaRdiac and chromosomal abnormalities.

Question 520

No amnion with

Answer 520

Gastrochisis

Question 521

Cystic fibrosis: resp pattern

Answer 521

Obstruction pattern

Question 522

Early symptoms NOT SIGN of MH

Answer 522

Masseter spasm | Tachycardia

Question 523

Early SIGN of MH

Answer 523

Increased ETCO2 peaked t waves on ECG HYPERKALEMIA

Question 524

Hallmark of intravascular fluid depletion in neonate and infants is

Answer 524

Hypotension without tachycardia

Question 525

Major cause of perioperative morbidity and mortality in pediatric patients

Answer 525

Hypoxia

Question 526

Congenital diaphragmatic hernia profound arterial hypoxemia is due to

Answer 526

RIGHT TO LEFT SHUNT

Question 527

Pediatric major mechanism for heat production

Answer 527

Nonshivering thermogenesis

Question 528

Concern for paradoxical air embolism may occur in the neonate because of

Answer 528

Patent foramen ovale

Question 529

Correct ETT tube is confirmed by

Answer 529

Bilateral breath sounds

Question 530

In a patient with congenital diaphragmatic hernia, peak inspiratory airway pressure be

Answer 530

20

Question 531

A child is born with congenital diaphragmatic hernia, which pathways allow blood to bypass the lung completely

Answer 531

Patent Foramen of fallot | Patent ductus arteriosus

Question 532

PRevent hypothermia with gastrochisis vs omphalocele

Answer 532

Gastrochisis

Question 533

Correct dose of dandrolene

Answer 533

2-3 mg/kg every 5-10 minutes

Question 534

Obese surgical patients leads that are best to detect cardiac ischemia

Answer 534

Lead V5, Lead I

Question 535

Do not exceed this PEEP for obese patient

Answer 535

15cmH2o

Question 536

What is the most common cause of postoperative mortality after bariatric surgery?

Answer 536

THROMBOEMBOLISM

Question 537

Appropriate pre-op anesthetic plan for cardiac tamponade

Answer 537

Positive inotrope

Question 538

Accidental SUBARACHNOID injection occurs during intended epidural, RAPID early sign is

Answer 538

DYSPNEA

Question 539

Max dose of dandrolene treat MH

Answer 539

10 mg/kg

Question 540

In PACU patient stated that she remembers some stuff you should

Answer 540

Tell the patient what happened

Question 541

Stimulation of what receptor explains why arterial diastolic BP may decrease when epinephrine is administered with a local anesthetic?

Answer 541

Beta 2 adrenergic receptor

Question 542

At NMJ, aminophylline

Answer 542

INCREASES THE RELEASE OF ACH from the motor nerve terminal

Question 543

Votalge gated sodium channel is in the INACTIVATED state in all but which of the following situation>

Answer 543

Severe hypokalemia

Question 544

Patient cannot ADDUCT the thumb what nerve is blocked by LAs

Answer 544

ULNAR

Question 545

Aspiration is a risk associated with anesthesia for patients with each of the following diseases except

Answer 545

MS

Question 546

Immediate deliver if decelerations are

Answer 546

LATE with no beat to beat variability

Question 547

Applying pressure for the patient who has already lost consciousness how much pressure in KG?

Answer 547

4 kg

Question 548

ANSI standards for reservoir bag require that the pressure not exceed _____when the bag is distended how many times its normal capacity ?

Answer 548

50cm H2O ; 4

Question 549

The American national standards institute Z79.9 1979 was replaced in ________ with

Answer 549

1988; American Society for TESTING and materials F1161-88 standard.

Question 550

2 year old ETT tube + suction catheter

Answer 550

4.0 at 8F

Question 551

Muscle that DILATES the vocal cords

Answer 551

Posterior cricoarytenoids (thought thryroarytenoids)

Question 552

Hypoxemia during one-lung anesthesia is most effectively treated by:

Answer 552

periodic inflation of the collapsed lung with oxygen, early ligation of the ipsilateral pulmonary artery and CPAP to the collapsed lung offer consistently effective improvement in oxygenation. The application of PEEP to the ventilated lung, changes in the ventilatory parameters and oxygen insufflation to the collapsed lung may offer marginal improvement in oxygenation.

Question 553

FEV 1 of 2L and FVC of 2.5 L suggest

Answer 553

RESTRICTIVE (ratio is 0.8 but volumes are low )

Question 554

What happens to blood flow and the diameter of arterial blood vessels in ischemia region of the brain when the patient is hyperventilated?

Answer 554

Blood flow increase | Arterial vessel diameter NO CHANGE

Question 555

Produce the GREATER blockade when in the epidural space?

Answer 555

3% Chlorprocaine

Question 556

In chronic respiratory acidosis, the PaCO2 is

Answer 556

elevated above the upper limit of the reference range, with a normal or near-normal pH secondary to renal compensation and an elevated serum bicarbonate levels (ie, >30 mEq/L).

Question 557

Incidence of PERIOPERATIVE reinfarction for a patient who had an MI 7 months ago is

Answer 557

5%

Question 558

Protamine dose and bond

Answer 558

1.1 -1.3 mg per 100 units of heaprin. IONIC BOND

Question 559

3 in 1 block FOL

Answer 559

Femoral Obturator Lateral femoral cutaneous nerve.

Question 560

Hernial sac Gastrochisis

Answer 560

ABSENT

Question 561

Is a Hernial sac present with omphalocele?

Answer 561

Yes it's Present

Question 562

Congenital abnormalities gastrochisis

Answer 562

PRESENT

Question 563

Omphalocele congenital abnormalities

Answer 563

Absent

Question 564

TEC 6 VAPORIZER calibrated in LA is brought to colorado springs, the % delivered willbe

Answer 564

HIGHER than the dial setting.

Question 565

Concentration and dose of mannitol is

Answer 565

20%, 1g/kg

Question 566

Who is responsible for quality assurance?

Answer 566

The hospital

Question 567

What drug would you not give in the perioperative period to the patient undergoing surgery for pheochromocytoma

Answer 567

DROPERINOL.However, droperidol when used in pheochromocytoma, has been reported to produce a paradoxical hypertensive response.

Question 568

Most SENSITIVE for VAE?

Answer 568

TEE

Question 569

What drug for altering hemodynamic status should generally be avoided in the patient with idiopathy subaortic hypertrophic stenosis?

Answer 569

NITROGLYCERIN (REDUCE CO)

Question 570

Drugs to be avoided in the patient with cystic fibrosis?

Answer 570

ATROPINE

Question 571

INCREASE with aging

Answer 571

PaCO2

Question 572

Vital capacity with aging

Answer 572

Decreases

Question 573

Bladder cancer removal procedure

Answer 573

Controlled Cystectomy

Question 574

Bladder cancer removal procedure

Answer 574

Radical Cystectomy

Question 575

Needed for RADICAL CYSTECTOMY

Answer 575

Controlled hypotension

Question 576

Pulmonary parameters that decrease in geriatric

Answer 576

Total lung capacity.

Question 577

breast milk fasting

Answer 577

4 hours

Question 578

3 months to 3 years EBV

Answer 578

75-80ml

Question 579

At what point during pregnancy does the maternal intragastric pressure increase, often resulting in heartburn?

Answer 579

3rd trimester

Question 580

Breathing circuit pressure is limited to

Answer 580

125cm H2O

Question 581

Which of the following are part of the intrinsic laryngeal muscles

Answer 581

Cricothyroid Oblique artytenoid Thyroarytenoid

Question 582

Prominent pathophysiologic derangements associated with MR?

Answer 582

LV volume overload

Question 583

End result of INCREASED in HR in patient with Mitral stenosis?

Answer 583

PULMONARY EDEMA

Question 584

Signs and symptoms of RA include

Answer 584

Pain on swallowing

Question 585

HYPERVENTILATION produces which electrolyte disturbance

Answer 585

HYPOCALCEMIA

Question 586

Not a Quaternary ammonium

Answer 586

Physostigmine

Question 587

How many unidirectional valves does the semiclosed anesthetic breathing system have?

Answer 587

2

Question 588

Compare the difference between MEANS of three of more NORMALLY DISTRIBUTED DATA SETS would be

Answer 588

ANALYSIS of VARIANCE

Question 589

Not a contraindication to Jet ventilation

Answer 589

Patient under 2 years of age.

Question 590

IMPORTANT CV effect of pneumoperitoneum

Answer 590

Distention of the vagus nerve during insufflation

Question 591

2, 3 DPG is which biochemical pathway

Answer 591

GLYCOLYSIS

Question 592

Nominal data

Answer 592

yes or no Eye color Blood type Male or female without providing any quantitative value.

Question 593

Interval data

Answer 593

statistical research, school grading, scientific studies and probability

Question 594

Ordinal data?

Answer 594

well-known example of ordinal data is the Likert scale.

Question 595

Ordinal data example

Answer 595

Age, gender

Question 596

Test is most appropriate to evaluate the difference between expected and observed frequencies from nominal data?

Answer 596

Chi-squared analysis

Question 597

Electrolyte disturbances are expected during WHIPPLE ? low CKM

Answer 597

HYPOCALCEMIA HYPOKALEMIA HYPOMAGNESEMIA

Question 598

Nerve supplies motor innervation to the superior oblique muscle of the eye?

Answer 598

TROCHLEAR

Question 599

St john's wort is an inducer, what else should you know about it?

Answer 599

CNS Stimulation

Question 600

Echinacea is associated with

Answer 600

Immunosuppression | Hepatic dysfunction

Question 601

Black Cohosh is associated with

Answer 601

Hypotension

Question 602

Garlic, Ginseng, Ginger , Gingko all associated with

Answer 602

increased bleeding

Question 603

Ginseng is associated with increased bleeding, what else should you know about it?

Answer 603

CNS stimulation

Question 604

Hoodia herbal supplements is associated with

Answer 604

Altered glucose control

Question 605

Kava herbal supplements anesthetic considerations:

Answer 605

CNS depression, decreased MAC

Question 606

Valerian herbal supplements anesthetic considerations:

Answer 606

CNS depression, decreased MAC

Question 607

Herbal meds and supplements are stopped

Answer 607

2 weeks before surgery.

Question 608

Herbal meds and supplements: REGULATED by FDA

Answer 608

No!!!

Question 609

Catechol-O-methyltransferase (COMT) metabolizes epinephrine to and

Answer 609

metanephrine

Question 610

Catechol-O-methyltransferase (COMT) metabolizes | norepinephrine to

Answer 610

normetanephrine.

Question 611

Subsequently, monamine oxidase (MAO) further metabolizes metanephrine and normetanephrine to

Answer 611

vanillymandelic acid (VMA).

Question 612

What enzyme further metabolizes metanephrine and normetanephrine to

Answer 612

vanillymandelic acid (VMA).

Question 613

The sensory neuropathies associated with HIV include.

Answer 613

distal sensory polyneuropathy and antiretroviral toxic neuropathy (ATN) secondary to the treatment

Question 614

Occurs in 10% to 35% of patients who are seropositive for human immunodeficiency virus (HIV).

Answer 614

Symptomatic neuropathy o

Question 615

Occurs in 10% to 35% of patients who are seropositive for human immunodeficiency virus (HIV).

Answer 615

Symptomatic neuropathy

Question 616

Characteristics of human immunodeficiency virus neuropathy include:

Answer 616

Distal polyneuropathy | Allodynia

Question 617

The clinical features of HIV sensory neuropathy typically include.

Answer 617

painful allodynia and hyperalgesia. The onset is gradual and most commonly involves the lower extremities

Question 618

The neuropathy and dysesthesia associated with HIV progress from the

Answer 618

distal to the more proximal structures.

Question 619

Postintubation croup: is secondary to

Answer 619

inflammation of subglottic structures

Question 620

Postintubation croup usually occurs at the

Answer 620

level of the cricoid, since this is the narrowest part of the pediatric airway.

Question 621

Postintubation croup is associated with

Answer 621

early childhood (1 - 4 years).

Question 622

Unlike laryngospasm, postintubation croup is seen

Answer 622

some time after extubation, usually within 3 hours.

Question 623

Evoked motor response of the tibial nerve using a nerve stim would most expected to elicit

Answer 623

Plantar flexion at the ankle and foot inversion

Question 624

Intraosseous access for babies

Answer 624

Tibial 1-2 cm below but also medial to the tibial tuberosity

Question 625

Highest sensitivity vs highest specificity for pheochromocytoma tests

Answer 625

Highest specificity is Urinary VMA | Highest sensitivity is Plasma free metanephrines.

Question 626

The web space between first and 2nd toes are innervated by

Answer 626

Deep peroneal nerve

Question 627

Child with Epiglotittis induction of anesthesia should occur where?

Answer 627

In the operating room with the presence of a skilled surgeon as well as advanced airway management equipment

Question 628

Child with Epiglotittis induction of anesthesia preferred method and whY?

Answer 628

Inhalation induction, allows for spontaneous ventilation . MAINTAINING INTACT AIRWAY TAKES PRIORITY since patient at high risk for airway compromise.

Question 629

Most common complication occuring in the PACU

Answer 629

NAUSEA

Question 630

Most common complication following a retrobulbar block prior to cataract surgery

Answer 630

HEMATOMA because of close proximity of the ophtalmic artery

Question 631

Most important aspect of a successful TAP BLOCK

Answer 631

Using adequate volume of LA. Spread throughout a fascial plane

Question 632

Blood loss spinal vs GA for THA

Answer 632

Less blood loss with spinal

Question 633

Spinal stenosis patients report pain that

Answer 633

Exacerbates by standing or walking

Question 634

Hallmark of spinal stenosis

Answer 634

relief of symptoms with bending forward.

Question 635

The apneic oxygenation technique affords adequate oxygen delivery, but progressive respiratory acidosis limits the use of this technique to 10 - 20 minutes in most patients. Arterial PaCO2 rises

Answer 635

rises 6 mm Hg in the first minute followed by a rise of 3 - 4 mm Hg during each subsequent minute. In this patient this will produce a 27 - 34 mm Hg increase, resulting in a PaCO2 of 67 to 74 mm Hg.

Question 636

Insulin secretion is increased by

Answer 636

stimulation of the parasympathetic nervous system through the vagus nerves.

Question 637

Key elements in the AANA's definition of wellness include: (Select 3)

Answer 637

effective adaptation, resilience, coping mechanisms

Question 638

IntraOcular pressure with succinylcholine

Answer 638

Increase

Question 639

IntraOcular pressure with hypoxemia

Answer 639

increase

Question 640

IntraOcular pressure with laryngoscopy

Answer 640

increase

Question 641

The most powerful inspiratory muscles are the

Answer 641

external intercostals.

Question 642

Raise the sternum and contribute to inspiration_______ as do the _______and ______

Answer 642

The sternocleidomastoid muscles ; anterior serratus and scalene muscles.

Question 643

The primary muscles of expiration are the

Answer 643

abdominus rectus muscles and the internal intercostals.

Question 644

A patient is undergoing a pulmonary function test in which they are asked to inhale and exhale as deeply as possible for 15 seconds. What is the test called?

Answer 644

Maximum voluntary ventilation

Question 645

Because the partial pressure of oxygen in the alveoli is higher than it is in the blood, it will move across the pulmonary capillary membrane into the blood by

Answer 645

diffusion.

Question 646

The carotid bodies are capable of sending messages to the central respiratory centers to increase ventilation via the

Answer 646

glossopharyngeal nerve

Question 647

Under what structure does the right recurrent laryngeal nerve pass?

Answer 647

Innominate artery

Question 648

These are the only causes of true hyperventilation (where the patient's minute ventilation increases to the point that respiratory alkalosis results). They are:

Answer 648

arterial hypoxemia metabolic acidosis, and central nervous system alteration.

Question 649

Respiratory Alkalosis electrolyte disturbances: | K+; Ca2+, BP, Phosphate , _____and ______

Answer 649

hypokalemia, hypocalcemia, hypotension, hypophosphatemia, cardiac dysrhythmias, and potentiation of digoxin toxicity. 

Question 650

Serotonin is a vasoconstrictor in most vascular beds, but has vasodilatory properties in the

Answer 650

vasculature of the heart and skeletal muscle.

Question 651

Local anesthetics produce an ordered progression of blockade of

Answer 651

``` Temperature sensation first Proprioception (kinesthetic sense) Motor function Sharp pain Light touch. ```

Question 652

The primary mechanism by which gastroesophageal reflux occurs is a

Answer 652

transient lowering of the lower esophageal sphincter pressure, not a chronic decrease in the lower esophageal sphincter pressure.

Question 653

NSAIDs fundamentally inhibit the synthesis of

Answer 653

Prostaglandins

Question 654

Which of the following calcium channel blockers would be most effective at relieving chest pain due to myocardial ischemia? (select two)

Answer 654

nifedipine | nicardipine

Question 655

The profound hypotension seen with spinal shock is related to the level at which the lesion is located (cervical injuries produce more severe hypotension than do lumbar injuries) and is due primarily to a

Answer 655

drop in preload caused by dilation of the capacitance vessels.

Question 656

Pt had a stroke about 3 months ago ,should you proceed with surgery?

Answer 656

Patients who have a perioperative stroke are eight times more likely to die within 30 days of surgery. Because of this, elective surgery should be delayed for at least 9 months following a stroke

Question 657

Injecting 2 mL of local anesthetic at the base of the palatoglossal arch will anesthetize which branches of the glossopharyngeal nerve? (select two)

Answer 657

Pharyngeal and lingual

Question 658

Upon what factors does the composition of the inspired gas mixture a patient receives depend? (select four)

Answer 658

The vaporizer dial setting The fresh gas flow rate The volume of the breathing circuit Gas absorption by the circuit

Question 659

The response of the orbicularis oculi most closely represents that of the

Answer 659

adductor pollicis

Question 660

Monitoring the corrugator supercilii muscles will most closely parallel that of what muscles?

Answer 660

the laryngeal adductor muscles.

Question 661

At an increased altitude, an older Tec isoflurane vaporizer will deliver

Answer 661

a higher volume percent than the dial setting. For example, at 10,000 feet the atmospheric pressure is about a third less at 500 mmHg. If we turn on our isoflurane vaporizer at 0.89%, the decrease in ambient pressure results in a doubling in the volume percent output of the gas from 0.89% to 1.75%. But, if we multiply that 1.75% times 500 mmHg (the new atmospheric pressure) we get a partial pressure of isoflurane of 8.77 mmHg. So despite a huge jump in the percent output, the partial pressure doesn't increase that much.

Question 662

A decrease in the in the single twitch response isn't seen until what % of the receptors are blocked? When does the response disappear?

Answer 662

75-80% of the receptors are blocked, and the response disappears when 90% of the receptors are blocked

Question 663

Which alteration would be consistent with the development of a leak in the bellows in a system using an oxygen-driven ventilator? (select two)

Answer 663

An increase in the FiO2 | An increase in peak inspiratory pressure

Question 664

At standard pressure, the boiling points for inhalation anesthetics in degrees Celsius are: Desflurane-Isoflurane-48.5, Halothane-50.2, Enflurane-56.5, and Sevoflurane-58.5.

Answer 664

22.8,

Question 665

At standard pressure, the boiling points for inhalation anesthetics in degrees Celsius are : ISO

Answer 665

48.5

Question 666

At standard pressure, the boiling points for inhalation anesthetics in degrees Celsius are : Halothane-

Answer 666

50.2,

Question 667

At standard pressure, the boiling points for inhalation anesthetics in degrees Celsius are :Enflurane

Answer 667

56.5,

Question 668

At standard pressure, the boiling points for inhalation anesthetics in degrees Celsius are Sevoflurane

Answer 668

-58.5.

Question 669

At standard pressure, the boiling points for inhalation anesthetics in degrees Celsius are : HIGH to low mnemonic

Answer 669

DI -HES

Question 670

Rh(D) immune globulin is administered to prevent Rh sensitization in

Answer 670

Rh-negative women.

Question 671

Induction of general anesthesia for which of the following procedures carries the highest risk for aspiration?

Answer 671

Zencker's Diverticulostomy

Question 672

Zencker's Diverticulostomy induction

Answer 672

Always RSI

Question 673

Contraindication to the administration of intravenous contrast media : women

Answer 673

Pregnancy is

Question 674

The onset of neuromuscular blocking agents is prolonged in the elderly primarily because of (select two)

Answer 674

an increase in circulatory time | a decrease in skeletal muscle blood flow

Question 675

What are the three most common entry sites for an amniotic fluid embolism?

Answer 675

Placenta Endocervical veins Uterine trauma site

Question 676

What hemodynamic change would you expect to see when the anhepatic phase of a liver transplant is initiated?

Answer 676

Hypotension

Question 677

What is the drug of choice for the treatment of acute myocardial ischemia?

Answer 677

Nitroglycerin

Question 678

The formula for PBW for males is:

Answer 678

PBW (male kg) = 50 + 0.91 X (height (cm) - 152.4).

Question 679

The formula for PBW for females is:

Answer 679

PBW (female kg) = 45.5 + 0.91 X (height (cm) - 152.4).

Question 680

The PR interval should be measured from the ___ of the P wave to the ___ of the QRS.

Answer 680

beginning, beginning

Question 681

What are the only intravenous anesthetics that can produce burst suppression?

Answer 681

Etomidate and propofol

Question 682

When inserting an Eschmann stylet during intubation, the stylet should be advanced into the trachea until

Answer 682

the 25 cm marking is at the lip