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NCE Review Material > Random Topics > Flashcards

Random Topics Flashcards

1
Q

Match the Radial, Ulnar and median nerve damage to the observed result?

A

Radial: wrist drop
Ulnar: Claw Hand
Median: Thumb Opposition

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2
Q

Conditions with cervical spine anomalies

A

“Kid Try Gold”
Klippel Fleil
Trisomy 21
Goldenhar

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3
Q

Conditions with a small underdeveloped chin

A 
"Please Get That Chin"
Pierre-Robbins
Goldenhar
Treacher Collins
Cri Du Chat
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4
Q

Conditions with Macroglossia

A

“Big Tongue”
Beckwith
Trisomy 21

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5
Q

Things that increase MAC

A 
Chronic EtOH
Increased CNS Neurotransmitters
Hypernatremia
Infants 1-6 months
Hyperthermia
Red Hair
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6
Q

Things that decrease MAC

A 
Acute EtOH
IV Anesthetics 
N2O
Opioids
Hyponatremia
Older Age
Prematurity
Hypothermia
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7
Q

What are some causes of Low EtCO2

A

Hyperventilation (Pain, light anesthesia, metabolic acidosis)
Decrease CO2 production (Hypothermia)
Increased Alveolar dead space (Hypotension, PE)

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8
Q

How many Liters are in E-Cylinders based on gas

A

Air: 625L / 2000 PSI
O2: 660L / 2000 PSI
N2O 1590L / 745 PSI

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9
Q

Formula for dissolved O2

A

PaO2 x 0.003

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10
Q

Formula fo CaO2

A

CaO2 = (FiO2 x Hgb x 1.34) + (PaO2 x 0.003)

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11
Q

Formula for DO2

A

DO2 = CO x 10 x [(Hgb x Sa02 x 1.34) + (0.003 x Pa02)]

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12
Q

What is a priority in a patient with pyloric stenosis?

A

Correct volume status and electrolyte abnormalities
(medical NOT surgical emergency)
- Volume: 20 mL/kg
-

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13
Q

What are some post operative complications with pyloric stenosis?

A

Postoperative apnea

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14
Q

What is the function of the Lateral Spinothalamic Tract?

A

Pain and Temp

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15
Q

What is the function of the Ventral Spinothalamic Tract?

A

Crude Touch and pressure

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16
Q

What is responsible for fine touch and proprioception?

A

The Dorsal Column: Cuneatus and Gracilis

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17
Q

A common complication of ET intubation in pediatrics

A

Post- Intubation “Croup”

Facts about Croup Laryngeotracheal Bronchitis

  • Barking Cough
  • younger kids
  • Viral
  • Low fever
  • Racemic Epi and Humidified O2
  • Steeple sign
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18
Q

What are some complications of Bone cement?

A
  • The First sign under GA is DECREASE EtCO2
  • Emboli
  • Bradycardia
  • Hypotension ( dec SVR)
  • pHTN (Inc PVR)
  • Hypoxia
  • Cardiac Arrest
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19
Q

Which procedure has the greatest risk of Bone Cement Implantation Syndrome (BCIS)?

A

Hip Arthroplasty

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20
Q

What is the First Line treatment for BCIS? Bone cement

A

100% FiO2
IV Hydration
Phenylephrine
(Treated as RT heart failure)

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21
Q

What hormones are secreted from Carcinoid tumors?

A

Histamine
Serotonin
Kinins & Kallikrein

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22
Q

Signs of Carcinoid crisis

A 
Bronchoconstriction
Flushing (head and neck)
Supraventricular Tachydysrhythmias 
HTN/Hypotension
Vasodilation/Vasoconstriciton
Increased GI motility (ABD Pain, Diarrhea)
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23
Q

Drugs to avoid in patients with a carcinoid tumor?

A
  • Sympathomimetics: Ketamine and ephedrine
  • Histamine: Succ, Atracurium, morphine, meperidine, Thiopental
  • Exogenous catecholamines
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24
Q

Drugs used in the treatment of carcinoid tumors?

A
  • Octreotide/Ianreotide (somatostatin)
  • Ondansetron (5HT3 Antagonist)
  • Diphenhydramine + Rinatedine or Cimetidine (Antihistamines H1 & H2)
  • Steroids
  • Phenylephrine or vasopression for hypotension
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25
Q

What are the location of the nerves relative to the axillary artery?

A

Median Nerve: Anterior and medial
Ulnar Nerve: Posterior and Medial
Radial Nerve: Posterior and lateral
MSC Nerve: Anterior and Lateral

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26
Q

What coagulation issue occur with pre-eclampsia?

A

1) Thrombocytopenia
- consumptive
2) Increase thomboxane (by 7x)
3) decrease Prostacyclin

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27
Q

What is the most important site of pain modulation?

A

Rexed Lamina II & III (Substantia gelatinosa) of the Dorsal Horn
- the descending pathway begins in the periaqueductal grey and rostroventral Medulla

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28
Q

What are the pain inhibiting neurotransmitters?

A

Spinal: GABA and Glycine

Descending Pathway: NE, 5-HT3, and Endorphins

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29
Q

Pain is augmented by?

A

Wind-Up

Central Sensitization

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30
Q

What nerve is in charge of mastication?

A

Trigeminal V3 (Mandibular)

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31
Q

What are branches of the trigeminal nerve?

A

CN V

  • V1: Opthalmic
  • V2: Maxillary
  • V3: Mandibular
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32
Q

What TV do you use in the neonate?

A

6 mL/kg

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33
Q

How do you confirm ETT placement in the neonate?

A

EtCO2
Chest Rise
Condensation in the tube
Increasing SaO2

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34
Q

Anesthetic management of MS?

A
  • Aspiration Risk (D/t cranial nerve involvement)
  • Avoid Hyperthermia and stress
  • Succ can cause life-threatening hyperkalemia
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35
Q

What are the management techniques for Hypertrophic Cardiomyopathy?

A

Increase Preload (Volume/Phenylephrine)
Increase Afterload (Aortic Pressure): Phenylephrine
Decrease HR
Decrease Contractility

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36
Q

What medications Decrease PVR?

A 
NO
NTG
PDEi (Sildenafil)
Prostaglandins
CCB
ACEi
Fentanyl (Treats pain)
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37
Q

What drugs INCREASE PVR?

A

N2O
Ketamine
Desflurane

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38
Q

What parameters increase PVR?

A 
Hypoxia
Hypercarbia
Acidosis
Hypothemia
SNS stimulation
Pain
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39
Q

What causes problems after aortic cross clamp removal?

A 
Hypovolemia
- Decrease venous return (preload)
Dec Contractility
Dec SVR
Dec Preload/Afterload
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40
Q

What is the normal MA in a TEG and what does it measure?

A

Measures Clot strength
MA: 50-60
Evaluates platelets( PLT + DDAVP)

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41
Q

What is the normal R time in a TEG and what does is measure?

A

Time to begin forming clot
R: 6-8 min
Coagulation factors (give FFP)

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42
Q

What is the normal K time in a TEG and what does is measure?

A

Time till clot has achieved fixed strength
K: 3-7 min
Fibrinogen (Cryo)

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43
Q

What is the normal Alpha Angle in a TEG and what does is measure?

A

Speed of fibrin accumulation
Alpha Angle: 50-60 degrees
Fibrinogen (Cryo)

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44
Q

What is the normal A60 in a TEG and what does is measure?

A 
A60: MA-5
Excess fibrinolysis (TXA)
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45
Q

What is the Max dose for neostigmine?

A

MAX: 5mg or 5000 mcg
range: 0.02-0.07 mg/kg

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46
Q

What are similar respiratory mechanisms changes in pediatric and elderly?

A
  • Minute Ventilation (Increase)
  • Closing Capacity (Increase)
  • Residual volume (Increase)
  • Vital Capacity (Decrease)
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47
Q

What drugs are dosed based in IBW?

A
  • Propofol (Induction)
  • Vecuronium/Rocuronium
  • Sufentanil
  • Remifentanil
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48
Q

What effect does the prone position have on hemodynamics?

A
  • Improved V/Q
  • Decreased venous pressure
  • Improved venous return
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49
Q

What are some problems seen with hydralazine?

A

Reflex tachycardia

Lupus like symptoms

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50
Q

What are some problems with Sodium Nitroprusside?

A

Cyanide Toxicity

Methemoglobinemia

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51
Q

How does CO change during pregnancy?

A

Increases by 40 %

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52
Q

How does CO change during labor?

A

1st stage: 20%
2nd stage: 50%
3rd stage: 80%

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53
Q

When does CO return to prelabor values?

A

24-48 hours

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54
Q

When does CO return to pre-pregnancy values?

A

2 weeks

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55
Q

How does BP change during pregnancy?

A

Decreased diastolic BP

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56
Q

how do lung volumes change during pregnancy?

A

Decrease

  • FRC
  • RV
  • ERV
  • TLC
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57
Q

What clotting factors are decreased in pregnancy?

A
  • Protein C & S

- XI & XIII

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58
Q

What effect does increased thromboxane have in pregnancy?

A

Increased

  • platelet aggregation
  • Vasoconstriction
  • Uterine Activity

Decreased
- Uteroplacental Blood Flow

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59
Q

At what level does the Dural Sac end in Peds?

A

S3

S2 in 1 y/o

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60
Q

At what level does the spinal cord end in the neonate?

A

L3

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61
Q

What are the terminal branches of the brachial plexus?

A 
MSC
Radial
Median
Ulnar
Axillary
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62
Q

List the cords?

A

Lateral
Posterior
Medial

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63
Q

List the trunks?

A

Superior
Middle
Inferior

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64
Q

The posterior Cord gives rise to the ________

A

Radial

Axillary

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65
Q

The lateral Cord gives rise to the _________

A

MSC

Median

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66
Q

The medial cord gives rise to the __________

A

Ulnar

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67
Q

What is the formula for Coronary perfusion pressure?

A

CPP = AoDBP - LVEDP (aka PAOP, PAWP, PCWP)

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68
Q

Relative indications for OLV?

A

Surgical Exposure
Pulmonary Edema s/p CABG
Severe Hypoxemia

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69
Q

Procedure risk factors of Ischemic Optic Neuropathy

A 
Prone
Wilson Frame
Long duration of anesthesia
large blood loss
low colloid to crystalloid ratio
hypotension
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70
Q

Landmarks for the Popliteal nerve block

A

Popliteal triangle

  • semimembranous muscle (also the Semitendinosus) medially
  • Biceps Femoris Laterally
  • popliteal crease as the base
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71
Q

What are the disadvatages to the Beir Block (IV regional anesthesia)

A

LAST
Tourniquette Pain
No Post Operative Analgesia

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72
Q

Anatomical landmarks to the median nerve block at the wrist

A

Flexor Capri Radialis tendon (Thumb/lateral)

Palmaris Longus Tendon (Pinky/Medial)

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73
Q

What is the formula for Cerebral PP?

A

CPP = MAP - ICP or CVP (whichever is higher)

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74
Q

What agents can be use in hyperthyroid patients to treat signs of hyperthyroidism?

A

The 4 B’s

  • BB: Esmolol, Propranolol
  • Block Synthesis: PTU, Methimazole, Carbimazole, potassium iodide
  • Block Release: radioactive iodine, potassium Iodide
  • Block T4 to T3 conversion: Propranolol, PTU, Glucocorticoids
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75
Q

What drugs exacerbate Neuroleptic Malignant Syndrome (NMS)?

A

Dopamine Antagonists:

  • Metoclopramide
  • Haloperidol
  • Risperidol
  • Chlorpromazine
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76
Q

What is the treatment for NMS?

A 
Dantrolene
Bromocriptine
Supportive Care
ECT 
- Succ is safe
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77
Q

LMA cuff volume by size?

A 
LMA 5: 40
LMA 4: 30
LMA 3: 20
LMA 2.5: 14
LMA 2: 10
LMA 1.5: 7
LMA 1.: 4
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78
Q

What causes systolic dysfunction?

A

Eccentric hypertrophy (Regurgitation) : Volume issue

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79
Q

What causes diastolic dysfunction?

A

Concentric hypertrophy (LV thickening): Pressure (AS)

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80
Q

What does SIADH cause?

A

Hypervolemic Hypotonic Hyponatremia

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81
Q

What are some drugs that prolong the QT interval?

A 
Ondasetron
Methadone
Droperidol
Haloperidol
Halogenated anesthetics (Sevo)
Amiodarone
Quinidine
82
Q

Metabolic disturbances that prolong Qt interval?

A

Hypokalemia
Hypocalcemia
Hypomagnesemia

83
Q

List some Opioid agonist antagonist

A

(Kappa Agonist/ Mu Antagonist)
Nalbuphine
Butorphanol

84
Q

List a partial opioid agonist that is not reversed by Naloxone ?

A

Buprenorphine

Partial Mu Agonist

85
Q

Drugs that inhibit COX

A

Non-Selective
- ASA, Ketorolac, Diclofenac, Naproxen, Ibuprophen, Indomethacin

Selective COX-2
- Coxib ending (celecoxib)

86
Q

The O2 flush valve bypasses what?

A

The Low pressure system

  • Vaporizer
  • Check Valve
  • Thorpe Tube
87
Q

What is the first step in the pre-anesthesia checkout?

A

Verify auxiliary oxygen cylinder and self inflating manual ventilation device are available and functioning
- AKA check emergency equipment

88
Q

What patients do you not give ergot alkaloids?

A

Ergot Alkaloid = Methergine

- to patients with HTN (aka preeclampsia, PIH,)

89
Q

What patients do you not give Carbapost/hemabate?

A

Asthamtics

90
Q

What BP indicates severe pre-eclampsia?

A

> 160 SBP
110 DBP
(d/t increased thromboxane)

91
Q

What are some postoperative considerations for the obese patient?

A

Minimize meds that suppress the respiratory system (d/t OSA)

- use short acting drugs, avoid opioids/benzos

92
Q

What is the parkland formula?

A

4ml x % BSA burned x kg = volume of fluid to give

93
Q

What does the Train of Four correlate with?

A

70% blockade

94
Q

What are the best indicators of adequate recovery from NMB?

A

50% blockade

  • Bite Tongue blade against force
  • Head Lift > 5second
  • Hand grip > 5 seconds
  • Negative Insp Force > -40 cm H2O
95
Q

What does the TV of 5mL/kg correlate with? (in reference to nuero blockade)

A

80% blockade

96
Q

What nerve can be missed with an inter scalene block?

A

Ulnar Nerve (C8-T1)

97
Q

Complications from inter scalene block?

A

Horners Syndrome (Very Horny PAM)
Phrenic Nerve Paralysis (100% of the time)
Missed Ulnar Nerve

98
Q

How does the BP change above or below the heart?

A
  • for every 10 cm a change of 7.4 mmHg (or 1cm = .74mmHg)

- for every 1 inch a chance of 2 mmHg

99
Q

What are some of the risk associated with Jet ventilation?

A 
Pneumothorax (most common)
Barotrauma
Sub Q emphysema/ Mediastinal Emphysema
Hemorrhage
Aspiration
tracheal injury
Esophgeal injury
(At risk of Hypercapnia)
100
Q

What effect does hyperventilation have on electrolytes?

A

Decreases K and Ca (less ionized bc it binds to proteins)

101
Q

Hematologic changes seen with a pneumoperitoneum?

A
  • Increased: SVR, MAP, PVR, A-a gradient (V/Q Mismatch), ICP, CPP, Afterload
  • Decreased: Splenic and RBF, FRC, Venous return
  • CO Maintained or decreased
102
Q

What are some relative contraindications to lithotripsy?

A 
AICD/PPM
Calcified aneurysm of aorta or renal artery
Untreated UTI
Obstruction beyond renal stone
Morbid Obesity
103
Q

What are some absolute contraindications to lithotripsy?

A

Risk of bleeding (Coagulopathy)

Pregnancy

104
Q

What are complications from mediastinoscopy?

A

Most Common:

  • Hemorrhage
  • tension Pneumothorax (usually right sided)

Others

  • Phrenic or RLN damage
  • Chylothorax (thoracic duct)
  • Innominate artery compression (Decreased cerebral and carotid Blood Flow)
  • reflex Bradycardia
105
Q

What are the absolute contraindications to mediastinoscopy?

A

Previous mediastinoscopy

106
Q

What are the RELATIVE contraindications to mediastinoscopy?

A

Tracheal deviation
Thoracic Aortic Aneurysm
SVC obstruction

107
Q

What is a significant risk of TIPS procedure?

A

Hemorrhage

- tachycardia, desaturation

108
Q

Function of Alpha cells in the pancreas

A

Alpha-2 cells decrease insulin release from pancreatic islet cells

109
Q

What is the dose for bupivicaine?

A
  1. 5 mg/kg

- 3.0 mg/kg with Epi

110
Q

What is the MOA of LMWH?

A

Factor Xa Inhibitor

  • Enoxaparin
  • Dalteparin
  • Tinzaparin
111
Q

What are the guidelines for neuraxial anesthesia with LMWH?

A

Once daily: wait 12 hrs
Twice daily: wait 24 hours

Hold 12 hours before removing catheter
- may continue 2 hours after removal

112
Q

What are the criteria for GAP Acidosis?What are the causes?

A 
Anion Gap > 14
MUDPILES
- Methanol
- Uremia
- Diabetic Ketoacidosis
- Paraldehyde
- Isonazid
- Lactic acidosis (cyanide poisoning)
- Ethanol
- Salicylates
113
Q

What are some causes of NON-anion gap acidosis?

A

HARDUP (think increased output conditions)

  • Hypoaldosteronism
  • Acetazolamide
  • Renal Tubular Acidosis
  • Diarrhea
  • Ureterosigmoid Fistula
  • Pancreatic Fistula

Also Large volume resuscitation with NaCl

114
Q

What ligament extends from the foramen magnum to the sacral hiatus?

A

Ligamentum Flavum

115
Q

What are the landmarks for the sciatic nerve block?

A

Greater trochanter (Hip)
Sacral Hiatus
Posterior Superior Illiac Spine (PSIS)

116
Q

What is Virchows Triad?

A

3 categories that are thought to contribute to thrombosis

  • Venous Stasis
  • Hypercoagulability
  • Endothelial Injury
117
Q

Why do peds need a higher dose of Succinylcholine?

A

Increase ECV

118
Q

What is the MOA of Methadone?

A

NMDA Antagonist*
Mu Agonist
MAOI

119
Q

What is a complication from meperidine?

A

QT prolongation

120
Q

Meperidine works on which receptor to stop shivering?

A

Kappa*

Its has mixed Mu and Kappa effects

121
Q

What is the problem with meperidine metabolism

A

Active metabolite Noremeperedine causes seizure

- DO not give to elderly or renal patients

122
Q

What conditions is omphalocele associated with?

A

Beckwith-Weidmen*
Trisomy 21
Cardiac Defects

123
Q

What are the signs and symptoms of diaphragmatic Hernia?

A 
Cyanosis*
Dyspnea*
Dextrocardia*
scaphoid abdomen
pHTN
Pulmonary hypoplasia
124
Q

What can cause uterine atony?

A 
Macrosomia (Lg fetus)*
Forceps Delivery* (Instrumentated Labor)
multiparty 
Multiple gestation
Polyhydraminos
Prolonged Pitocin Infusion
125
Q

What factors are in Cryoprecipitate?

A

Fibrinogen (Factor I),

Factor VIII,

Factor XIII,

vWF,

Fibronectin

126
Q

What Factors increase in pregnancy?

A

fibrinogen (Factor I)*

everything except XI, XIII, Protein C & S

127
Q

What are the facto of Quaternary NMB’s?

A

Highly Ionized

DO NOT cross the placenta

128
Q

What is a Rhizotomy?

A

Ablates neural impulses so it does not reach the spinal cord*
- Severs Nerve roots in the spinal cord

129
Q

What is a side effect of vasogenic twitching with epilepsy?

130
Q

What are some consideration for patients undergoing strabismus surgery?

A

Increased risk of

  • MH (Masseter Spasm*)
  • PONV
  • Occulocardiac reflex
131
Q

What is commonly used for pain?

A

Antidepressants*

132
Q

What is commonly used for chronic pain?

A 
GABA Agonist (Gabapentin)*
SSRI's*
133
Q

What is the best indication for a lighter stylet?

A

Unstable Cervical spine*
Anterior Airway*
Blood in airway
small mouth opening

134
Q 
What is the function of each:
CMAC
Glidescope
King 
Air Traq
A

C-MAC: can use as DL
Glide: 60 Degree angle
King: 90 Degree
Air Traq: Prisms and Lenses

135
Q

What is the most common complication from Liposuction?

136
Q

Max dose for tumescent anesthesia?

137
Q 
What is the muscle response for the following nerves
Radial
Musculocutaneous
Tibial 
Peroneal
A

Radial: Triceps contraction
MSC: Biceps contraction
Tibial: Plantar Flexion
Peroneal: Dorsiflexion

138
Q

Respondeat superior, which is “borrowed servant” is under what?

A

Vicariouse Liability

139
Q

In what population does succinylcholine cause increased potassium?

A 
ALS
GBS
MH
MS
DMD
Charcot Marie Tooth
Hyperkalemic Periodic Paralysis
140
Q

In what population is it safe to give succinylcholine?

A

Myasthenia Gravis*
PArkinsons*
Eaton Lambert (decrease dose d/t increased sensitivity)

141
Q

What is responsible for the fast onset of intrathecal opioids?

A

Lipid solubility

142
Q

What effect of EPI would be blocked by phentolamine but not metoprolol?

A

Pancreatic Islet Cells (Alpha 2)

143
Q

What do you mix dantrolene with?

A

Bacteriostatic water

144
Q

What is the purpose of the two vertical bars on the LMA?

A

prevents epiglottis from blocking the airway

145
Q

What does elevated ALT and AST indicate?

A

Hepatocellular injury *

- ALT is specific to the Liver

146
Q

Why would conjugate bilirubin be increased?

A

Billiary obstruction

147
Q

What are some signs of Cirrhosis?

A

Decreased effect plasma volume,

Decreased oncotic pressure,

Hyponatremia

148
Q

What is in the inter vascular space but not in the intersistial space?

A

Plasma proteins

149
Q

What is not made by the liver?

A

Immunoglobulins

150
Q

What happens in DIC?

A
  • Increased Pt, PTT, D-Dimer and fibrin spilt products*
  • Decreased Fibrinogen (factor I), antithrombin and platelets*
  • Increased fibrin and microvascular thrombosis*
151
Q

What nerve innervates the medial aspect of the upper arm?

A

The intercostalbrachialis*

152
Q

What is a sign of endobronchial intubation

A

Normal EtCO2 but increase PIP and decrease SpO2*

153
Q

What are 2 thoracolumbar conditions that will make intubation difficult?

A

Kyphoscoliosis*

Large Chest *

154
Q

Which fibers have golgi body spindles?

A

A-Alpha (Muscle)*

155
Q

Why is epidural dosing less for pregnancy?

A

Engorged epidural vein*
increased sensitivity to LA*
Increased spread

156
Q

Why do we decrease spinal dose in pregnancy?

A

Decreased CSF volume*

157
Q

What is the most common complication from Jet ventilation?

A

Pneumothorax*

158
Q

What meds would require an decreased dose in liver disease?

A

Succ and roc

159
Q

Which cells secrete Heparin?

160
Q

ST elevation indicates what type of ischemia?

A

Transmural ischemia

161
Q

What is the best monitor after no TOF?

A

Post-Tetany

162
Q

Patient in the prone position and an object is resting on the posterior lateral aspect of the arm, what nerve can be injured?

163
Q

The patient is post cardiac surgery and becomes tachycardia with nothing draining from the chest tube, you should suspect?

A

Cardiac Tampnade

164
Q

Hypovolemia in pediatrics can cause?

A

Increased dead space

165
Q

Patient has transection at C4, what muscles will help with respiration?

A

Cervical Stap Muscles

166
Q

Which muscle is least resistant to NMB?

167
Q

Where does the dural sac end in the neonate?

168
Q

What interrupts non shivery thermogenesis?

169
Q

pKa 6.2 Bicarb to carbonate ratio is 20:1, What its the pH?

A

pH = pKa + Log (base/acid)

pH 7.4

170
Q

Define IRV?

A

The amount of gas that can be forcibly inhaled after tidal breath

171
Q

Define each:
Half Life:
Half time
Terminal half-life time:

A
  • Half Life: The time is takes for 50% of the drug to be removed from the body after rapid IV injection
  • Half time: The time is takes for 50% of the drug to be removed from the plasma during the elimination phase
  • Terminal half-life time: time it takes for the drug concentration in the blood to fallibly 1/2 of its current value
172
Q

How do lung volumes change during pregnancy?

A 
Increase VT*
Increased IRV*
Increase MV
Decreased ERV
Decreased RV
Decreased FRC
173
Q

Where to block the median nerve at the upper arm?

A

Elbow: at the lateral humerus epicondyle lateral to the brachiocephalic artery
- Medial to the brachial artery at the antecubital fossa

174
Q

What do you do if pipeline pressure fails?

A

Disconnect pipeline, turn tank on

175
Q

What nerve branches do u need to block for surgery of the dorsal of the foot?

A

Sciatic (to get Sural and peroneal))

Common peroneal

176
Q

What artery can be damaged during transphenoidal surgery?

A

INTERNAL CAROTID

177
Q

What is the concern with hypotension during lithotomy?

A

Compartment syndrome

178
Q

releasing the TQT produces what changes?

A 
Inc EtCO2
Dec Temp
Dec BP 
Dec SpO2
Dec pH (Metabolic Acidosis)
179
Q

What causes the release of renin?

A

Low Na*
SNS Activation
Decreased renal perfusion pressure (PEEP, Hemorrhage)

180
Q

What does a cobb angle of 70 degrees indicate?

A

Decreased VC

181
Q

What is a side effect of tocolytics?

A

Pulmonary edema

182
Q

What are some disadvantages of SubQ defibrillator?

A

No standard pacing successive shocks

183
Q

CV changes in supine position?

A

Inc CO

Inc preload

184
Q

What drugs increase the required dose of NMB, pick 2?

A
  • Rifampin (inducer)

- Carbamazepime, Barbs, ethanol, Tamoxifen

185
Q

Minimum distance of monopoler cautery from pacer?

186
Q

What is the cardiac output to each tissue group?

A

Vessel Rich Group 75%
Muscle 19%
Fat 6%
Vessel Poor < 1%

187
Q

What would effect NIMS tube with EMG monitoring

A

Succ and Roc

Lido LTA

188
Q

Why do we use Mag drip for ERAS?

A

Decrease post op opioids

189
Q

What is the biggest concern with pituitary surgery (hypothalamus)?

A

Diabetes Insipidus (DI): lack of ADH

190
Q

What drugs not to use with porphyria?

A 
Phenytoin*
Lidocaine*
Thiopental*
Etomidate
barbs
191
Q 
List the arterial waveform seen witch each condition
Left heart Failure
Cardiac tamponade 
Aortic Stenosis
Aortic Regurgitation
A

Left heart Failure: Pulsus Alternans ( beat to beat variability)

Cardiac tamponade : Pulsus Paradoxus

Aortic Stenosis: Pulsus Parvus (looks like A)

Aortic Regurgitation: Bisurfens Puslse (looks like M)

192
Q

Disadvantages of measuring stump pressures?

A

Embolic stroke

Not routinely used

193
Q

Nerve injury with sternal retraction?

A

Brachial Plexus that manifest in as Ulnar nerve issue

194
Q

What must be proved for malpractice claim?

A

Duty

Breach of duty

Causation

Damages

195
Q

Primary method of heat loss in burn patients

A

Evaporation

196
Q

Systolic filling correlates with what part of the CVP waveform?

197
Q

what is hemophilia A

A

Factor 8 deficiency (give cryo)

198
Q

What is a consideration with patients on doxorubicin?

A

Cardiotoxicity- get Echo for EF

199
Q

What condition will have sustained muscle contraction after succinylcholine?

A

Myotonic Dystrophy

200
Q

When to give FFP?

A

PT and/or PTT 1.5 normal

201
Q

What is a treatment for apnea in peds

A

caffeine and theophylline

NCE Review Material (8 decks)

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