Random4 Flashcards
lung and lung mechanics in infancy
compliant chest wall. very small elastic recoil 2/2 poor intercostal muscle tone. very pliable ribs
why do circle systems have higher resistant?
valves, longer tubing, CO2 absorption
what volatile decreases systemic BP mainly by reducing CO?
halothane (minimal change to SVR)
NO leads to no change in arterial bp
the drop in BP caused by agents directly realted to decrease in SVR but CO relatively mantained
fast conducting nociceptive fibers
alpha-delta (pain, temp, touch)
other nociceptive: C fibers (unmyelinated)
differential blockade: Sympathetic People Matter
what does alpha-beta fibers do?
touch, pressure
side effect of dantrolene
elevated LFTs
respiratory changes of obesity
marked decrease in ERV (up to 60%) leading to decrease in compliance and FRC. Decrease in FRC leads to airway closure and decreased PaO2
amiodarone used for
refractory ventricular arrhythmias, sustained SVT, antiarrythmic in CHF
side effects of amiodarone
bradycardia, hypotension. risk factors patient >60, high dose
hypothyroid (20%)
rare but fatal - hyperthyroid - high output CHF
prolonged QT
hepatically metabolized. can potentiate warfarin therapy
how do cholinesterase inhibitors affect paralytics?
increase resistance to NDMB (roc)
potentiate depolarizing blockade
treatment of central anticholinergic syndrome
1-2mg physostigmine
what 2 neuromuscular diseases have NOT shown upregulation in ACh receptors?
MG and lambert-eaton
MG: antibody to Nicotinic Ach receptor
terbutaline’s relationship with potassium
shifts K intracellularly (like other B2 agonists)
equation of desflurane at different atm pressures
required dial setting = normal setting (volume %) * 760 / (ambient pressure)
dual gas blender - heated and pressurized
INVERSELY proportional to altitude
volatiles delivered through variable bypass vaporizer will deliver waht?
approx. the same MAC at higher or lower altitudes
how is mivacurium metabolized?
plasma cholinesterases (aka pseudocholinesterase/butyrylcholinesterase) -> can be prolonged in deficiencies (A/K variants most common)
what is echothiophate and what’s it relationship to succs?
anticholinesterase used to treat refractory glaucoma (miosis) -> inhibits pseudocholinesterase so can potentiate succs
4-6 weeks after discontinuing eye drop to return function to normal!
treatment of acute dystonia
anticholinergic (#1), benzos, beta-blockers
antihistamines, dopamine receptor agonists, alpha adrenergic agonists
primary determinant of myocardial oxygen consumption
heart rate
changes in SEPs during regional cortical ischemia
decreased amplitude, increased latency
opiates produce minimal changes in waveforms
change in SEPs with ketamine and etomidate
increased amplitude
also seem with return to normothermia after cooling and spine surgery
TOF with paralyzed muscle
iNCREASED nerve stimulation
PREsynaptic depolarization is triggered by
Ca+ influx ->ACh release -> open K+ channels, K efflux restores membrane potential
POSTsynaptic depolarization is triggered by
ACh travels across cleft, depolarizes endplate -> opens Na channels (Na influx) which generate AP in muscle
