Random2 Flashcards
trans-tracheal blocks
recurrent laryngeal via cricothyroid membrane (vocal cords and trachea)
how to decrease tissue necrosis caused by agents like levophed, propofol infiltration
phentolamine, 5-10mg in 10-15ml saline
two classes of antithrombotic drugs
antiplatelet prevent platelet activation and/or aggregation
anticoagulations primarily reduce fibrin formation
what is the dominant system in bronchial airway constriction?
parasympathetic
negligible SNS innervation and SNS actually COUNTERACTS bronchoconstriction
Heme effects of hyperthyroidism
thrombocytopenia, anemia
what is the only muscarinic receptor to function under the SNS?
sweat gland innervation
sympathetic preganglion -> muscarinic receptor -> sympathetic postganglion -> nicotinic receptor
what is the only muscarinic receptor to function under the SNS?
sweat gland innervation
eccrine: primary form of sweating. everywhere but lips, tip of penis, clitoris -> cholinergic -> muscarinic
apocrine large, armpits, don’t help with cooling -> adrenergic -> alpha 1
sympathetic preganglion -> muscarinic receptor -> sympathetic postganglion -> nicotinic receptor
** this is different because typitically it is NE/Epi that are released by postganglionic fibers in SNS
For PSNS innervation: PSNS preganglionic (loong)-> nicotinic) -> postganglionic (short) -> muscarinic
biggest risk of LIJ vs RIJ?
chylothorax -> thoracic duct drains by LIJ and left subclavian
dx: high triglyceride and high T-lymphocyte count after thoracentesis
similar rates of complications:
infection, brachial plexus injury, hemothorax
determinants of myocardial oxygen supply
oxygen content and blood flow
NOT affected by left ventricular systolic pressure. associated instead with changing DEMAND (not supply)
HR: LV perfused during diastole
CPP: AoDP - LVEDP
Coronary Vascular Resistance (bad: vasospasm, atherosclerosis. good: nitro)
natural licorice can cause what?
hypokalemia
mimics hyperaldosteronism (Na retention, hypertension, hypoK, metabolic alkalosis)
MOA of Sarin
inhibits acetylcholinesterase
MOA of botulism toxin
prevents release of Ach vesicles into synaptic cleft -> muscle paralysis. Acts at axon terminal of NMJ
tetanus is RETROGRADE
Botulism - the 4 D’s: diplopia, dysarthria, dysphagia, dyspnea
Prothrombin/INR measures which pathway
extrinsic (WEPT - warfarin, extrinsic, PT)
factor 7 - shortest halflife (4-6hr)
best measure of synthetic liver function
prolonged by: vitamin K deficiency, liver dysfunction, anticoagulants
difference between conjugated and unconjugated bilirubin?
unconjugated: heme breakdown product. water-insoluble. neurotoxin. can be taken up by liver and combined with glucaronic acid
conjugated: increased in liver or biliary disease
vitamin K dependent factors
2, 7, 9, 10
intrathoracic obstructions (distal tracheal tumor, mediastinal mass) impact which part of flow-volume loop?
expiratory
because during expiration, which is positive pressure, airway diameter is further decreased, degree of obstruction is enhanced,
extrathoracic obstructions (proximal tracheal tumor, vocal cord paralysis, glottic structures) impact which part of flow-volume loop?
inspiratory
what impacts both inspiratory and expiratory phases?
FIXED airway obstruction - like tracheal stenosis, foreign body, large airway tumor. smushed on both ends
what are the synthetic opiates and what effect do they have on synergistic volatile admin?
fentanyl, alfentanil, sufenta, remi
they decrease MAC more than morphine/dilaudid would
preservation of total hepatic blood flow at 1 MAC from most to least
sevo > iso > halothane
which lead, when used alone, is most sensitive for detecting ischemia?
v5
v2-5 most monitored bc most at risk
when using TWO - II and v4 most sensitive (with II and v5 right behind)
what lead is most sensitive for rhythm monitoring?
II because it gives the largest p-wave
benzos mechanism
centrally acting GABA potentiation (which controls chloride channels)
had a heart attack, no intervention. how long to wait until noncardiac surgery?
60 days
balloon angio = 14 days
BMS = 30 days while continuining DAPT
DES = 180 days
