Brainscape's Knowledge GenomeTM

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


See full index

AP III Test 3 > Test 3 > Flashcards

Test 3 Flashcards

1
Q

Bezold jarish reflex triad

A

HotN, bradycardia, coronary artery dilation

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

when is bezold jarish most often seen?

A

awake pt with interscalene block

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

tourniquet pain starts after?

A

30min, or 45-60min for GA

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

what fiber types involved in tourniquet pain?

A

c fibers and a delta

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

Tourniquet placment pressues and max time

A

LE:
max 2 hours, 100-150 above SBP

UE: Max 90min, 50-75 above SBP

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

Bleeding ammount in trachanteric/subtrochanteric hip fx?

A

1200ml

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

bleeding ammount in intracapsular hip fx?

A

800ml

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

Off NSAIDs for how long before spinal?

A

no delay

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

off coumadin for how long before spinal?

A

INR 1.4 after 5 days

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

off plavix for how long before spinal?

A

7 days

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

off Ticlid for how long before spinal?

A

14 days

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

Off xarelto/rivaroxaban for how long before spinal?

A

3 days

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

When is surigical correcton done for scoliosis? ANd what is the goal?

A

when cobb angle is greater than 50%
stop cardiac and resp compromise

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

S/s of VAE

A

unexplain HoTN, and increased ET nitrogen

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

VAE tx

A

wound irrigated with saleine, DC N20, pressors, aspiration of air from CVP, lay pt right side up

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

Tell me about BAEP

A

brainstem auditory evoked potentials
used in resections of acoustic neuromas
uses sound waves to stimulate cochlea

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

SSEP key info

A

somatosensory evoked potentials
stimulate peripheral nerves, impulse goes up spinal cord via dorsal root.

monitors the afferent sensory pathway

the failure of SSEPs to reliably predict post-op deficits is well documented

you can have motor deficits with unchagned SSEPs

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

blood supply for afferent sensory pathway?

A

post spinal arteries

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

EMG info

A

Electromyogram
used to record electrical activity of muscles, used to find the cause of weakness, paralysis, or muscle twitching

doesn’t show brain or spinal cord disease

During spinal surgery for stenosis/degneration: used to protect nerve roots; extremely sensitive to nerve root irritation

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

MEP

A

stimulate spinal cord above operative site and recording resonse below operative site

monitors descending motor pathways supplied by anterior spinal artery

monitors motor tracts, especially corticospinal tract

MEPs are the gold standard for monitoring motor pathways

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

Anesthetic plan for SSEP

A

avoid N2o
avoid VA >1 MAC

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

anesthetic plan for EMG

A

limit NMB to 2-4 twitches
With NIMs tube, no NMB past intubation

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

anesthetic plan for MEPs

A

TIVA or balanced technique with VA < 0.6 mac

propofol 75-150mcg.kg/min

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

Drugs that affect SSEPs

A

VA senstive > 1 MAC
N20 sensitive decease amplitiude

opiods mild depression no change in amplitude or latency

midazolam: mild depression: ^ latency and decrased amplitude

ketamine desierable

Propofol amplitude depression with induction but rapid recovery

NMBs: insenstive, may improve responses due to less EMG interference

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

Drugs that effect Transcranial MEPs

A

VA >0.6 MAC
N20 sensitive
midazolam less desirable, CMAP depression
muscle relaxants, senstive and usually avoided

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

define amplitue and latency

A

amplitude: height
latency length

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

change in evoked potentials means what?

A

worsening situation; critical decrease in amplitude or increase in latency indicates early warning of structures in danger.

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

acute increase of only ___ to ___ ml of fluid can cause tamponade?

A

40-50ml

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

What is kussmauls sign?

A

JVD in inspiration

30
Q

how often is pulsus pradoxus present?

A

75% in actue tamponade and only 30% in chronic pericardial effuseion

31
Q

what do both kussmauls and pulsus pradoxus represent?

A

ventricular discordance or apposing resonses of the RV and LV to filling during the resp cycle

32
Q

what is becks triad? How often is it seen?

A

distended neck veins, HotN, muffled heart tones

only seen in 1/3 of actue tamponade patients

33
Q

Pressure volume loop in tamponade?

A

short and shifted to the left

34
Q

three word acronym for mgnmt of tamponade?

A

Fast Tight Full
Goals: tachycardia, vasoconstriction, and volume

35
Q

What treatments can reverse remodeling in HF?

A

ACE-I
Beta blockers
cardiac reschyronization
Dont drink alcohol

36
Q

restrictive cardiomyopathy affects filling or systole?

A

filling. Systolic fxn usually normal

37
Q

most common type of cardiomyopathy?

A

dilated cardiomyopathy

38
Q

SVT and vertricular dysrhythmias common in which cardiomyopathy?

A

dilated

39
Q

When is EF > 80%?

A

HOCM

40
Q

pathcy scaring is seen when?

A

HOCM

41
Q

when do you see speckled ventricle?

A

restrictive cardiomyopathy

42
Q

How does lying down affect symptoms of HOCM?

A

releives them

43
Q

how does valsava affect symptoms of HOCM?

A

aggravates them

44
Q

SNS stimulation redisributes blood from where to where?

A

from kidneys, splanchnic and skeletal circulation to vital organs

45
Q

mild tachycardia can be helpful in which type of HF?

A

systolic

46
Q

How does ANP protect CV system? What is the caveat?

A

by decreasing RAAS and SNS
over time response to ANP is blunted

47
Q

are ANP and BNP antiinflammatory?

A

yes

48
Q

Why are opiods benficial in anesthetic mgmt of HF?

A

they temper teh SNS

49
Q

what is gold standard/1st lean tx for pericarditis?

A

NSAIDS1

50
Q

cholchicine in pericarditis is associated with what?

A

less relapse

51
Q

why don’t we like to use steroids in pericarditis?

A

frequently cause relapse once discontinued, so only use if other therapies don’t work.

52
Q

resistance pericarditis may respond to what?

A

Imuran / azathiprine

53
Q

tell me about dresslers syndrome

A

delayed form of pericarditis that occurs week sto months after myocardial event, it is often auto-immune

54
Q

3 thigns that can move oxyhgb dissasociate curve to the right

A

sickle cell, materanl hbg, renal failure

55
Q

3 things that can move oxyhgb diss curve to the left?

A

fetal hbg, carboxyhgb, methgb

56
Q

heart O2 extraction ratio

A

55-70%

57
Q

brain o2 extraction ratio

A

30-35%

58
Q

how to calculate O2 transport?

A

Hct/viscosity

59
Q

how long can platlets be stored at room temp?

A

5 days

60
Q

do platletse need to be ABO compattible?

A

No, but preffered

61
Q

can platlets be warmed?

A

no

62
Q

what size filter for platlets vs RBCs?

A

170micron for platlets and 20-40 for blood

63
Q

effective coagulationc an occur with clotting factors as low as?

A

20-30% of normal

64
Q

the four factors found in cryo?

A

fibrinogen
vWF
F 8
F13

65
Q

waht is used for uremeic bleeding not responsive to DDVAP?

A

cryo

66
Q

how fast does TRALI occur?

A

within 6hrs of transufsion

67
Q

2 causes of acutue hemolytic reactions?

A

presence of antibodies from prior exposure

transfusion of white cells or white cell antibodies

68
Q

main cause of sepsis from bacterial contamination with tranfusions?

A

platlets&raquo_space; RBC > FFP & Cryo

69
Q

1 unit of regular insulin lowers BG by how much?

A

25-30mg/dl

70
Q

what rate for D5 infusion?

A

1.5ml/kg/hr

71
Q

how much does 1ml of D50 raise BG?

A

by 2mg/dl

72
Q
A

AP III Test 3 (1 decks)

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