Review deck

Question 1

The circle of Willis is made up of

Answer 1

vertebral & internal carotid flow

Question 2

Normal ICP is

Answer 2

5 to 15

Question 3

Calculation of CPP is

Answer 3

CPP= MAP-ICP

CVP may be substituted for ICP

Question 4

Increased CPP causes cerebral _________

Answer 4

vasoconstriction limiting CBF

Question 5

Normal CPP is

Answer 5

80-100 mmHg

* consider what you would need to keep MAP at to achieve this

Question 6

CBF remains constant at a MAP of

Answer 6

60-160 due to autoregulation

Question 7

Total volume of CSF is

Answer 7

150 mL

Question 8

The role of CSF is to

Answer 8

protect CNS from trauma

Question 9

The Monro-Kellie hypothesis:

Answer 9

blood, CSF, and brain tissue are in a state of volume equilibrium such that any increase in volume of one of the cranial constituents must be compensated by a decrease in volume of another to prevent a rise in ICP

Question 10

Cushing’s triad:

Answer 10

irregular respirations
hypertension
bradycardia

Question 11

If a cerebral aneurysm rupture occurs, give ______ for brain protection

Answer 11

propofol

Question 12

Adverse effects of Mannitol include

Answer 12

acidosis

pulmonary edema

Question 13

Avoid giving this drug to patients with head trauma

Answer 13

ketamine

Question 14

_______ is a good drug to give for patients with burns who have to undergo repeat dressing changes

Answer 14

ketamine

Question 15

If a patient is on phenytoin, a NMBD will

Answer 15

last longer

Question 16

Describe the sensitivity of VAE monitoring from most sensitive to least sensitive

Answer 16

TEE
precordial doppler
ETCO2
PAP
CVP 
MAP

Question 17

A concern with intubating a patient with maxillofacial injuries is

Answer 17

putting a breathing tube into the brain

-can also cause sinusitis & meningitis

Question 18

For a patient after pituitary tumor removal who develops diabetes insipidus, treat with

Answer 18

vasopressin or desmopressin

Question 19

This treatment can be used for vasospasm and ruptured cerebral aneurysm

Answer 19

triple H:
hypertension (SBP 160-200 mmHg)
hemodilution with Hct 33%
hypervolemia with CVP >10 mmHg

Question 20

Considerations for neuro surgery include:

Answer 20

do not give benzos preoperatively
want them to be able to wake up early to participate in neuro exam
keep ETCO2 at 30

Question 21

Describe the following as 1st, 2nd, 3rd, or 4th degree burns:
very painful
extends to bones & ligaments
destruction of epidermis
may result in contractures

Answer 21

painful-2nd
bones & ligaments-4th
destruction of epidermis- 1st
contractures-3rd

Question 22

Describe the rule of 9’s to estimate percent burn of patient.

Answer 22

head- 9%
arms- 9% each
legs-18% each
torso- 18% each 
groin- 1%

Question 23

Treatment for CO poisoning includes

Answer 23

100% fiO2 & hyperbaric chamber

Question 24

CO has _________ affinity for hemoglobin as ______ and shifts the oxygen dissociation curve ______

Answer 24

200 x
O2
LEFT

Question 25

S/s of inhalational injury include

Answer 25

facial burns singed facial hair hoarseness difficulty swallowing

Question 26

After 24-48 hours, patients with burn injuries experience a

Answer 26

hyperdynamic state where CO is 2x higher

Question 27

Fluid resuscitation goals for patients with burns include

Answer 27

``` UO: 0.5-1.0 mL/kg/hr HR: 80-140 MAP: adults >60 mmHg base deficit <2 Normal Hct ```

Question 28

For each % area that is excised, blood loss is

Answer 28

200-400 mL

Question 29

Patients who have undergone burns should not receive

Answer 29

succinylcholine 24 hours to 1 year post-burn to avoid massive release of K+, ventricular dysrythmias, and cardiac arrest

Question 30

Patients with flail chest benefit from

Answer 30

epidural or paravertebral blocks

Question 31

The primary survey for trauma victims includes

Answer 31

rapid evaluation for functions crucial to survival and includes ABCDE (airway patency, breathing, circulation, disability, and exposure)

Question 32

Emergency intubation for patients with potential C-spine injury includes

Answer 32

100% O2 administered | simple chin lift with manual in-line stabilization

Question 33

If a pregnant trauma patient comes in,

Answer 33

primary focus is mom OB consult for management lay them left lateral decubitus in the 2nd or third trimester if Rh negative will need to give Rhogam if fetus is positive

Question 34

Cardiac tamponade s/s is

Answer 34

Beck's triad: narrow pulse pressure, JVD, muffled heart sounds, & hypotension

Question 35

Indications for ETT intubation for trauma patient include

Answer 35

GCS <8 | facilitate workup in uncooperative patient

Question 36

For a trauma patient with a head injury & lower BP, you can give

Answer 36

etomidate

Question 37

Needle decompression for tension pneumothorax is at:

Answer 37

2nd intercostal space midclavicular line | 5th intercostal space midaxillary line

Question 38

Hallmark symptoms of tension pneumothorax include

Answer 38

hypotension, hypoxemia, tachycardia, increased CVP, diminished BS on the affected side JVD & tracheal deviation

Question 39

Goals for early fluid resuscitation for trauma patient do not include

Answer 39

SBP >100 mmHg

Question 40

The lethal triad post blood administration is

Answer 40

acidosis, hypothermia, coagulopathy

Question 41

Hypothermia causes worsening of

Answer 41

acid base disorders coagulopathy shifts oxygen hemoglobin curve to the left decreases metabolism of drugs, impairs platelet, and clotting enzyme function

Question 42

The modified Brooke formula is

Answer 42

2 mLs x TB surface area burned x weight | then give over 24 hours: 1/2 in first 8, 1/4th in next 8, 1/4th in last 8