Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ane Class Practice > Special Populations Exam 1-S5 > Flashcards

Special Populations Exam 1-S5 Flashcards

1
Q

Which type of muscle is not under conscious control and is found within walls of organs and structures such as?
- esophagus
- stomach
-intestines
- bronchi
- uterus
- blood vessels

A

Smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which type of muscle contain sarcomeres and packed into highly regular repeating arrangements of bundles?
- Striated

A

Cardiac and Skeletal muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cardiac muscles connects at branching, irregular angles called ___ ___?

A

Intercalated discs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

In the neuromuscular junction which area contains acetylcholinesterase (AChAse)?

A

Synaptic cleft

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nerve stimulation is caused by depolarization and voltage gated ____ channels open?

A

Calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ACh diffuses across the synaptic cleft and binds to the _____ receptor postsynaptically?

A

nicotinic cholinergic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Only 2 ____ subunits are capable of binding ACh

A

Alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

With depolarization Action potential, ____ and ____ move IN ?

A

Sodium and Calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

With depolarization Action potential, ____ moves OUT?

A

Potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The amount of ACh released is influenced by the amount of ___?

A

Calcium that enters the nerve terminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Small concentrations of what 2 cations can compete with Calcium influx and can decrease the ACh release and impair neuromuscular transmission?

A

Magnesium
Aminoglycoside antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When the frequency of stimulation of NMJ decreases over days to severe burns, immobilization, infection, sepsis and prolonged use of NMBA can cause what?

A

UPregulation of receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chronic neostigmine use can lead to what?
- Too much ACh

A

DOWNregulation of receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

This condition is characterized by inflammation, demyelination, immune dysfunction and failure of cell repair in the CNS?
- muscle weakness
- memory loss
- optic neuritits
- personality disorders
- 8x higher in females
- chronic relapses and remissions
- peripheral nerves not affected

A

Multiple sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

This condition is an autoimmune disease characterized by T-cell mediated autoantibodies against myelin?

A

Multiple sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

This condition symptoms begin
20-40 years of age and have 2 or more attacks separated by a month, involve 2 or more areas and elevated IgG and albumin in the CSF?

A

Multiple sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is multiple sclerosis affected by pregnancy?

A

Reduced risk of exacerbations while pregnant, but increased risk of relapse in postpartum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment for Multiple Sclerosis includes which medications?

A

Interferon beta- disease modifying agent
Azathioprine, corticosteroids and IV immunoglobins for immunosuppression
Gabapentin for neuropathic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lhermitte sign on assessment is associated with what disease?

A

Multiple sclerosis
Neck flexion induced electrical sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Unthoff sign on assessment is associated with what disease?

A

Multple sclerosis
Increased body temp/hot flashes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Anesthetic implications of Multiple sclerosis include what?

A

symptoms of hyperthermia
- Avoid succinycholine due to hyperkalemia
- spinal anesthesia may exacerbate symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which condition is caused by Amyloid beta protein that creates amyloid plaques, neurofibrillary tangles, and neuronal apoptosis?
- Loss of cholinergic activity

A

Alzheimer disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment of Alzheimer disease include the use of which medications?

A

Acetycholinesterase inhibitors
- Glycopyrrolate due to quat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which condition is caused by loss of dopaminergic cells in the basal ganglia (lewy bodies)?

A

Parkinson Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which condition is associated with resting tremor, bradykinesia, shuffling gait, facial immobility and diminished inhibition of extrapyramidal motor system?

A

Parkinson Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment for Parkinson disease?

A

Levodopa
- do not stop medication for more than 6 hours (muscle rigidity, ventilation issues)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which 2 medications should you not given to patients with parkinsons?

A

Reglan and Phenergan (dopamine antagonists)
Increased risk of neuroleptic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Deep brain stimulator would be most beneficial for which type of patients?

A

Parkinsons patients due to treatment of severe tremors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which cerebral cortex motor neurons are affected with ALS?
Upper, Lower, or Mixed

A

Mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which cerebral cortex motor neurons are affected with Kennedy’s disease?
Upper, Lower, or Mixed

A

Spinobulbar muscular atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Which cerebral cortex motor neurons are affected with Friedreich’s ataxia?
Upper, Lower, or Mixed

A

Mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which cerebral cortex motor neurons are affected with Spinal muscular atrophy?
Upper, Lower, or Mixed

A

Lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which condition is this?
- males affected more
- onset 40-60 years
- selective and progressive motor neuronal death
- no treatment
- should avoid general anesthesia and avoid succinycholine
- avoid opioids and benzos due to resp depression

A

ALS
amytrophic lateral sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

This condition is caused by a sodium channel defect causing prolonged depolarization and flaccid paralysis?
- muscle weakness to tongue and eyelids
- precipitated by metabolic acidosis and cold exposure
- avoid succinycholine

A

Hyperkalemic periodic paralysis
K >5.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

This condition is caused by calcium or sodium channel defect
- chronic myopathy with aging
- precipitated by stress, hypothermia, high glucose meal
- sensitive to nondepolarizing NMBA

A

Hypokalemic periodic paralysis
K < 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

This condition is an autoimmune disorder characterized by onset of ascending skeletal muscle weakness/paralysis of the legs due to viral or bacterial infection?
- autonomic dysfunction fluctuations in HR and BP
- cardiac dysrhythmias
- weak respiratory muscles

A

Guillain-Barre syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Treatment for Guillain-Barre syndrome includes?

A

Plasma exchange, immunoglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Anesthetic considerations of Guillain-Barre syndrome include?

A

Avoid rapid movement of patient
Maintain temperature
Monitor for respiratory failure
Avoid succinycholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which condition is caused by a decrease in the number of functional postsynaptic, acetylcholine receptors in the neuromuscular junction available for acetylcholine binding?

A

Myasthenia Gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Fatigability/muscle weakness that improves with rest is the hallmark sign of what?

A

Myasthenia Gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the protein that allows AChR to cluster at the NMJ?

A

Muscle Specific Kinase (MuSK)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the major antigen in Myasthenia Gravis?

A

Acetylcholine receptor (AChR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the first notable sign of Myasthenia Gravis?

A

Weakness of extraocular muscles, diplopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

In Myasthenia Gravis, patients with thymomas can develop what?

A

Myocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

The Tensilon test in diagnosing Myasthenia Gravis is done using which medication?

A

Edrophonium
Improvement in strength = positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What represents the most common anterior mediastinal mass shift in patients with Myasthenia Gravis?

A

Thymus hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

This condition is characterized by progression to severe muscle weakness, respiratory failure, bundle branch blocks and AFIB?

A

Myasthenia Crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Pregnancy exacerbates the symptoms of ____ by 33%?
- most often in 1st trimester or 6 weeks postpartum

A

Myasthenia Gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

The newborn of a mother with Myasthenia Gravis can suffer from ____ which presents as difficulty feeding, ptosis, facial weakness, and respiratory distress 12-48hrs after birth?

A

Transient Neonatal Myasthenia

lasts for weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Difficulty swallowing
Slurring of speech
Difficulty breathing
Neck muscle weakness
are all known as what?

A

Bulbar symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the treatment of Myasthenia Gravis?

A

Oral Pyridostigmine
- quaternary, does not cross BBB
- improves muscle strength for several hours
- increases conc of ACh at postsynaptic membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Diarrhea, urination, miosis, bradycardia, emesis, lacrimation, lethargy and salivation are symptoms of what condition?

A

Cholinergic Crisis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

A thymectomy can be beneficial for treatment of which disease?

A

Myasthenia Gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Discussion for possibility of postoperative ventilation is needed for which type of patients?

A

Myasthenia Gravis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Forced vital capacity < 2.7L
Vital capacity < 4ml/kg
History of myasthenia crisis
Disease duration > 6 years
Daily Pyridostigmine 750mg or more
COPD
Bulbar symptoms
all what???

A

Factors that anticipate postoperative mechanical ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Which condition does exercise improve the muscle weakness-related symptoms?

A

Lambert-Eaton Myasthenic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What condition is an autoimmune disorder associated with paraneoplastic small cell lung cancer, IgG antibodies attack pre-synpatic calcium channels?
- Decreased release of ACh from presynaptic terminals
- No ocular involvement
- No improvement with ancticholinesterase

A

Lambert-Eaton Myasthenic Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What condition is an X-linked recessive disease in which the muscles are replaced with fat/tissue?
- Presents in childhood (3-5)
- Caused by the loss of functional Dystrophin
- Proximal muscle weakness and gait issues (Gower’s Sign)
- elevated CK levels

A

Duschenne’s Muscular Dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Which protein plays a major role in stabilization of the muscle membrane and signaling cytoskeleton and extracellular matrix?
- Loss of this protein causes DMD

A

Dystrophin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Patients with Duchenne’s Muscular dystrophy are especially sensitive to what medications?

A

Cardiac depressants
Avoid inhalational, sedatives and narcotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Which medication is an absolute contraindication to Duchenne muscular dystrophy?

A

Succinycholine
Hyperkalemia
Rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Which condition is caused by decreased in normal amounts of dystrophin. Milder than DMD and onset is around 12 years old?

A

Becker Muscular Dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Which condition is caused by mutations in 2 proteins that presents with contractures of the ankles, elbows and neck?
- progressive weakness of humeral and peroneal muscles
- Cardiomyopathy and conduction abnormalities

A

Emergy-Dreifuss Muscular Dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

These symptoms are common to all what?
- Inability of skeletal muscles to relax after stimulation
- Dysfunction of ion channels
- Reduced conductance of chloride ions
- Progressive muscle wasting with weakness

A

Myotonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Which condition is an autosomal dominant disorder that has a slow, progressive deterioration of skeletal, cardiac, and smooth muscle wasting?
- Characterized by hypoplastic, dystrophic and weak skeletal muscles and prone to persistent contraction
2 types

A

Myotonic Dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Which type of Myotonic Dystrophy?
- Congenital, childhood onset, adult onset
- Most common type
- Myotonic-protein kinase gene
- Defect in Na and Cl channel function
- Conduction defects, heart blocks
- muscle weakness begins distally
- MR, frontal baldness, and cataracts
- Diabetes

A

DM-1 Steinerts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Which type of Myotonic Dystrophy?
- Proximal myotonic myopathy and myopathy
- Less likely to have Diabetes
- Normal life expectancy

A

DM-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Which condition is associated with Sudden cardiac death related to 3rd degree block, respiratory failure or pneumonia?

A

DM-1
Myotonic Dystrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Anesthetic considerations for Myotonic Dystrophy I and II patients?

A

Have pacer avaliable due to conduction defects
CAN use inhalational agents
NO greater risk of MH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Which condition is an autosomal dominant disorder linked to RYR1 ryanodine receptor on the Sarcoplasmic Reticulum mutation resulting in a massive release of intracellular calcium within skeletal muscle?

A

Malignant Hyperthermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Triggering agents for Malignant Hyperthermia include?

A

Volatile agents
Succinycholine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Early signs of MH include?

A

Hypercarbia, Rapid increase in etCO2
Masseter muscle rigidity
Tachycardia

73
Q

Late signs of MH include?

A

Hyperthermia
Acidosis
Rhabdomyolysis

74
Q

What to do before case with a patient who has a history of MH?

A

Flush the anesthesia machine
TIVA
Have MH cart avaliable
Activated charcoal filters on expiratory and inspiratory limb

75
Q

What condition is associated with an Antipsychotic induced Dopamine blockade leading to sudden drop in CNS activity?
- Muscle rigidity (1st sign)
- Impaired heat regulation (fever)
- AMS
- Labile BP, tachypnea

A

Neuroleptic Malignant Syndrome

76
Q

Treatment for Neuroleptic Malignant Syndrome?

A

Stop offending agent
Give benzos or Dantrolene

77
Q

Which condition is associated with enzymatic deficiencies in the heme synthesis pathway?
- Accumulation of neurotoxic precursors (PBG) and (ALA)?
- 1st line screening test is urinary prophobilinogen (PBG) elevation?

A

Porphyria

78
Q

Which condition is triggered by hormone changes during menstrual cycle, fasting, infection and exposure to barbituates/etomidate?
- unexpected delayed emergence from anesthesia
- fever, tachycardia, N/V, abdominal pain, weakness, hyponatremia, resp failure?

A

Acute Intermittent Porphyria
(AIP)

79
Q

Prolonged apnea after succinycholine and 0/4 twitches minutes later can be caused by what?

A

Plasma cholinesterase disorder

80
Q

Dibucaine number 70-80?

A

Homozygous Typical
Normal response

81
Q

Dibucaine number 50-60?

A

Heterozygous Atypical
Lengthened 50-100%

82
Q

Dibucaine number 20-30?

A

Homozygous Atypical
Prolonged 4-8 hours

83
Q

What connects the anterior carotid and posterior vertebrobasilar circulation as the major intracranial arterial system?
- Collateral blood flow

A

Circle of Willis

84
Q

Venous drainage of the brain happens where?

A

Internal Jugular Veins

85
Q

The cerebral ventricular system is made up of 4 ventricles. The third ventricle is located where?

A

Diencephalon

86
Q

The cerebral ventricular system is made up of 4 ventricles. The fourth ventricle is located where?

A

Hindbrain

87
Q

Where is CSF produced?

A

Choroid Plexus of the lateral, third and fourth ventricles

88
Q

How much CSF is produced every day?

How much CSF is in circulation at any given time?

A

400-600ml

150ml

89
Q

Where is CSF reabsorbed?

A

Arachnoid Villa

90
Q

Where does the spinal cord begin?

A

Foramen magnum
continuation of the Medulla Oblongata

91
Q

How many segments does the spinal cord divide into?

A

31 segments
Cervical-8
Thoracic-12
Lumbar-5
Sacral-5
Coccygeal-1

92
Q

Somatic motor neurons travel in the ____ motor columns that innervate the upper and lower limbs?

A

Medial

93
Q

What are the major ascending tracts in the body?

A

Dorsal column- proprioception
Spinothalamic tract- pain, temp

94
Q

What is the major descending tract in the body?

A

Corticospinal tract
Controls fine movement

95
Q

What supplies blood to the anterior two-thirds of the spinal cord and medulla?

A

Anterior spinal artery

96
Q

What supplies blood to the lower two-thirds of the posterior spinal cord?

A

Artery of Adamkiewicz
T9-T12 start

97
Q

What supplies blood to the posterior one-third of the spinal cord?

A

2 Posterior spinal arteries

98
Q

What is the main substance the brain uses for energy production?

A

Glucose

99
Q

What % of cardiac output does the brain receive?

A

15%

100
Q

Cerebral perfusion pressure calculation?

A

CPP= MAP-ICP

101
Q

Normal ICP?

A

7-15 mmHg

102
Q

At what ICP does redistribution of CSF happen?

A

Above 20 mmHG

103
Q

At what ICP does vascular structures collapse?

A

40-50 mmHG

104
Q

At what ICP is there a high risk for herniation?

A

Over 50 mmHG

105
Q

Symptoms of Cushing’s Triad include what 3 things?
Reflects severe increased ICP

A

Hypertension
Bradycardia
Irregular respirations

106
Q

What protects the brain from hypo/hyperperfusion secondary to decrease/increase in CPP?

A

Cerebral autoregulation

107
Q

When it comes to Cerebral blood flow, an increase in PaCO2 will result in what?

A

1 mmHg increase in PaC02 results in 1-2 ml/min increase in CBF

108
Q

Which neuromonitoring monitor the sensory pathway through the dorsal root ganglia and posterior column?
- Sensitive to inhalational agents and nitrous

A

SSEP

109
Q

Which 2 IV drugs increase SSEP amplitude?

A

Ketamine and Etomidate

110
Q

Which neuromonitoring monitor the motor pathway including the motor cortex, corticospinal tract and peripheral nerve by transcranial stimulation?
- More sensitive to the effects of anesthetic agents
- Signals weakened or eliminated by NMBA

A

MEPs

111
Q

Which neuromonitoring monitor cortical electrical activity with scalp electrodes to detect cortical ischemia or seizure activity?
- Can also monitor depth of anesthesia
- dose dependent affects with anesthetics

A

EEG

112
Q

Which neuromonitoring monitor nerve roots and peripheral nerves by detecting muscle activity or nerve action potentials?
- Continuous monitoring and detection of neuronal structures during surgical dissection of nerve roots
- can be used to assess pedicle breach during screw placement
- ONLY affected by NMBA, not anesthetics

A

EMG

113
Q

Which neuromonitoring monitor the auditory nerve and auditory pathway through brainstem acoustic stimulation?
- used during skull base surgery
- affected by Hypothermia

A

BAEPs

114
Q

Which medications have increased latency and decreased amplitude on SSEP monitoring?

A

Propofol
high dose barbituates

115
Q

Which medications have increased amplitude on SSEP monitoring

A

Ketamine and Etomidate

116
Q

Which medications have increased latency and decreased amplitude on MEP?

A

Propofol, high dose barbituates
precedex
lidocaine

117
Q

How do volatile anesthetics affect CBF and Cerebral metabolic rate of oxygen?

A

Dose dependent reduction in CMR02 and Increase in CBF

118
Q

Which agent results in an increased CBF and increased CMR02?

A

Nitrous Oxide

119
Q

How does propofol affect the brain?

A

Reduced CMR and CBF

120
Q

How does Etomidate affect the brain?

A

Reduced CMR and CBF
Increased alpha wave amplitude on EEG

121
Q

How does Ketamine affect the brain?

A

Increases CMR and CBF
does NOT lower seizure threshold
Increases amplitude of SSEPs

122
Q

How do benzos affect the brain?

A

Reduced CMR and CBF
May reduce ICP

123
Q

How do Opioids affect the brain?

A

Not really any affect on CMR or CBF

124
Q

How do NMBA affect the brain?

A

Mild increase in ICP with succinycholine

125
Q

At what GCS would you intubate the patient?

A

< 8, intubate

126
Q

Where is the A-line leveled to approximate the circle of Willis?

A

External auditory meatus

127
Q

What surgical position is associated with these effects?
- HR and SVR lower
- upward displacement of diaphragm
- decreased FRC
- lung perfusion increased
- pregnant at increased for aortocaval compression

A

Supine

128
Q

What surgical position is associated with these effects?
- Pooling of blood in dependent extremity
- Decreased venous return
- V/Q mismatch
- possible hypoxia

A

Lateral

129
Q

What surgical position is associated with these effects?
- Decreased CO due to decreased venous return
- improved FRC if not obese
- increased intrathoracic pressure

A

Prone

130
Q

What surgical position is associated with these effects?
- Hypotension from decreased venous return
- cerebral hypoperfusion risk
-FRC increased
- Venous air embolism potential complication

A

Beach chair/seated

131
Q

Solutions containing ____ are avoided in all neurosurgical patients due to ischemic damage and cerebral edema?

A

Glucose

132
Q

What are 3 ways to cause cerebral vasoconstriction to decrease ICP?

A

Hyperventilation
Head elevation to increase drain
Keep MAC < 0.5 to avoid vasodilation

133
Q

Which drug pulls water across the blood brain barrier to restore osmolar balance?
- “brain epi”
- Caution use with CHF patients

A

Mannitol

134
Q

Which drug reduces ICP by inducing a systemic diuresis and decreases CSF production?

A

Furosemide

135
Q

What is typical symptom of a venous air embolism?
Most sensitive for diagnosis?

A

Mill-wheel murmur

TEE most sensitive

136
Q

What manuever for treatment of venous air embolism?

A

Durant’s maneuver
Left side down

137
Q

Eloquent cortex surgery is typically done by what procedure?

A

Awake Craniotomy

138
Q

What condition is most common in complete C-spine transection?
- hypotension
- bradycardia
- hypothermia
- injury above T6 level
- lose of vascular tone

A

Neurogenic shock

139
Q

A drug with a high VD value indicates what?

A

Drug is distributed more in tissue than in plasma

140
Q

What is described as a 50% decrease in plasma concentration after stopping IV infusion?

A

Context sensitive half time

141
Q

Which receptors are decreased in the elderly population?

A

B- receptors

142
Q

In the elderly population, there is stiffening of the heart ventricles, slowing of diastolic relaxation, impaired ventricular filling and diastolic dysfunction which lead to what?

A

Hypertrophy

143
Q

The loss of SA node cell automaticity leads to what syndrome?
- need for pacemaker

A

Sick sinus syndrome
Need for pacemaker

144
Q

Increased risk of MI
Surgical wound infection
Coagulopathy
Impaired drug metabolism
All are associated with what in the elderly population?

A

Hypothermia

145
Q

What are the 3 most common medications that cause postoperative delirium in elderly population?

A

Atropine
Opioids
Benzodiazepines

146
Q

Burst suppression is high risk for delirium?
T/F

A

True

147
Q

Which obesity type?
- body fat in the upper body (truncal)
- very metabolically active
- increased O2 consumption
- higher rate of CV disease
- Most dangerous

A

Android

148
Q

Which obesity type?
- fat mostly located in the hips, buttocks and thighs
- less metabolically active
- less associated with CV disease

A

Gynecoid

149
Q

BMI of
18.5-24.9

A

Normal

150
Q

BMI of
25-29.9

A

Overweight

151
Q

BMI of
30-34.9

A

Obesity Class 1

152
Q

BMI of
35-39.9

A

Obesity Class 2

153
Q

BMI of
40-49.9

A

Morbid obesity

154
Q

BMI of
50-59.9

A

Super morbid obesity

155
Q

BMI of
>60

A

Super super morbid obesity

156
Q

What is the most commonly reported pulmonary abnormality to obesity?

A

Decreased FRC and ERV

157
Q

What is the most sensitive indicator of obesity effects on the body?

A

End reserve volume

158
Q

OSA classification( # of apnea events/hr)
Normal?
Mild?
Moderate?
Severe?

A

Normal- < 5
Mild- 5-15
Moderate 15-30
Severe > 30

159
Q

Alveolar hypoventilation independent of intrinsic lung disease is associated with what syndrome?

A

Obese hypoventilation syndrome
Pickwickian

160
Q

What are the 2 most sensitive EKG monitors for ischemic events?

A

II and V5

161
Q

Abdominal obesity, glucose intolerance, HTN, dyslipidemia and increased vascular events are related to _____ _____?

A

Metabolic syndrome

162
Q

“Bull’s eye” on POCUS view is indicative of what?

A

Empty antrum- Good

163
Q

“Starry night” on POCUS view is indicative of what?

A

Clear fluid with air

164
Q

“Frosted glass” on POCUS view is indicative of what?

A

Solid food contents with air

165
Q

What is the most effective bariatric surgery for treatment of obesity that can produce 50% weight loss in patients?

A

Roux-en-Y Gastric Bypass

166
Q

If patient is receiving Heparin 5000u or Unfractionated Heparin 40mg how long should wait for epidural?

A

> 12 hours

167
Q

What is the #1 indicator of problematic intubation in obese patients?

A

Neck circumference
> 40cm

168
Q

What is the greatest at risk of developing SIDS in between how old?

A

1 month and 1 year

169
Q

How long to wait for clear liquids?

A

2 hours

170
Q

How long to wait for breast milk?

A

4 hours

171
Q

How long to wait for infant formula?

A

6 hours

172
Q

How long to wait for heavy meal?

A

8 hours

173
Q

3x 250mg vials of Ryanodex kept on hand
36 vials of Dantrolene kept on hand

A

Ryanodex -750mg
Dantrolene 720mg

174
Q

How long should patient be monitored in PACU non-OSA?

A

3 hours

175
Q

How long should patient be monitored in PACU WITH OSA?

A

7 hours

176
Q

Administration of what type of drugs can induce skeletal muscle rigidity and chest wall rigidity?

A

Opioids

177
Q

What is the most common clinical sign of myocardial ischemia?

A

Tachycardia

178
Q

What is the most common cause of delayed awakening?

A

Prolonged action of anesthesia

179
Q

The #1 cause of hypothermia in the OR is due to what?

A

Radiation

Ane Class Practice (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions