TL incorrect Flashcards by Katelynn Champagne

What does pseudocholinesterase break down?

succ
mivacurium
ESTER local anesthetics

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DIC transfusion goals pregnancy

Hg > 7
plts > 50k
PTT/PT < 1.5x normal
fibrinogen > 300

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Why PEEP helps w/ acute on chronic systolic heart failure

-lowers preload -> ideal in fluid overload
-b/c less preload -> less movement of RV into LV -> better LV hemodynamics
-b/c less fluid overloaded and less pressure on LV -> CI increases and PCWP dec

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DLCO obesity

increases

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onset of action of calcitonin

4-6 hours

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onset of action of zoledronic acid

48-72 hours

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mannitol and kidney transplants

dec the risk of post transplant kidney injury

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convert u/s waves into currents to produce image

direct piezoelectric effect

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Ca and ESRD

kidney loses ability to reabsorb Ca

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MC SE dantrolene

skeletal muscle weakness

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what improvement in FEV1 do you need w/ bronchodilators to warrant chronic thearpy?

10%

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What factor decreases first and liver disease

Factor seven

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Vitamin K, depending clotting factors

10, nine, seven, two

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Lupus, anticoagulant lab results

Elevated PTT, normal PT. However, they are actually prothrombotic.

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Abdominal pain, nausea, vomiting, sweating, an acute liver failure what overdose

Acetaminophen

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Least likely to be metabolized in the lungs

Epi

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What to avoid an acute intermittent porphyria

Barbiturates, benzodiazepines, nifedipine, glucocorticoids and alcohol

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Where does the obturator nerve block occur?

Between the adductor, longus and brevis, and between the adductor brevis and adductor Magnus

Pneumonic, Alabama

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Electrolyte changes with therapeutic hypothermia

Hypokalemia, hypomagnesemia and hypophosphatemia

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Age an epidural steroid injection

No influence

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Most likely to determine success with epidural steroid injections

Short time from injury
Absence of psychopathology
Herniation plus a nerve root irritation, or compression

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Changes to CVP waveform with cardiac Tampa nod

Exaggerated X dissent and loss of y descent

Due to pressure from cardiac Tampa nod, not as big of a release and pressure with tri cuspid valve opening

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First line treatment for cyanide poisoning

Hydroxocobalamin

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Spinal stenosis, which nerve is affected first motor or sensory

Sensory

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Absolute contraindications to tracheostomy placement

Infants Surgical site infection Coagulopathy Cervical spine injury unstable

Risk factor for an allergic contrast reaction

Other medication, allergies Asthma Is less than 50 Hi cut total contrast us

EKG changes with hypocalcemia

Prolonged, QT interval

What is the primary mechanism of gas exchange for mechanical ventilation?

Convective bulk flow

Spinal epidural, is not behaving as expected what your thought process be

Sub dural injection Excessive sensory blockade, sympathetic, blockade, variable motor, black head

Over what time frame is a fructose amine test assessing

One to two weeks

High risk for aspiration, pneumonia

Aspirate volume of greater than .4 cc per kilogram. Aspirate pH of less than 2.5. Particulates in Esprit.

PO to Ivy methadone, dosing

2 to 1 so half the PO dose

Proteins, C, & S with pregnancy

Resistance to pro Tien C Decline in level of protein s

What lab value is left out of the child pew score

Creatinine

What is in the meld score?

I crush beer daily INR Creatinine Billy Rubin Dialysis

What’s in the child Pugh score

Poor another beer at 11 PT Ascites Billy Rubin Albumin Encephalopathy

Is an oxygen cylinder made of aluminum MRI safe

Yes

Is a reinforced in a tracheal tube MRI safe

What is an cryoprecipitate?

Fibrinogen Factor 13 Factor eight VWF Fibronectin

Most common complication from TPN use

Infection Second is thrombo phlebitis

Dose of Anesthesia for a caudal, block, and a 10 month old

1 cc per kilogram

Pediatric caudal, anesthesia dosing

Sacral dermatomes .5 cc per kilogram. Low thoracic dermatomes 1 cc per kilogram Mid thoracic dermatomes, 1.25 cc per kilogram.

Symptoms of multiple myeloma

Phone pain, osteolytic, destruction, hypercalcemia, anemia, immunosuppression, causing recurrent infections, renal failure, and neurologic symptoms

Lumbar plexus block blocks what

Femoral nerve Lateral femoral, cutaneous nerve Obturator nerve

Does fluorine vaporizer adjustments and hyperbaric oxygen chamber’s

Dial needs to be decreased because of increased pressure

When doing a vessel clamp during an AVM resection, what neural monitoring is best

SSEP and MEP

Side effects of prostaglandin

Apnea in pediatrics Hypotension Fever

Mediator of pulmonary hypertension, after protamine

Thromboxane

Why hypercalcemia with low aldosterone levels

Kidney cannot excrete calcium

Calculation for sodium deficit

Sodium deficit = (140- serum sodium) x total body water Total body water = weight in kilograms x 0.6

inc cerebral perfusion pressure and cerebral oxygenation

vasopressin

What vasopressor increases, cerebral, perfusion pressure and cerebral oxygenation

Vasopressin

Delirium Icu questionnaire

Acute change in mental status In attention, or easily distracted Altered level of consciousness Disorganized, thinking

Most common valvular defects

Bicuspid, aortic valve #2: Perry membranous, VSD

Which is better in cardiac arrest by phasic or monophasic defibrillation

Biphasic

What is cabergoline

Dopamine agonist for prolactinoma

Nerve block for women with uterine cancer for pain

Superior hypogastric

When is a ganglion impar block used?

Parineal cancer

RA anesthesia concerns

-diff intubation: dec ROM cervical spine -diff MV: TMJ hypomobility -inc risk of epidural hematoma: long term NSAIDs

How to dec risk of postop hoarseness in ACDF

dec ETT cuff pressure

are of deep brain stimulation in Parkinson's

Subthalamic nuclei internal globus pallidus -sub and internal b/c DBS

peds syndrome w/ unilateral face issues

goldenhar -har, half of face -assoc w/ cervical subluxation, congenital cardiac defects, micrognathia

inc risk for transient neurologic symptoms

lidocaine lithotomy positioning for knee arthroplasty outpt status

n blocked by TAP block

intercostal subcostal ilioinguinal iliohypogastric

goals for trauma

-minimal crystalloid, early blood, no required MAP! low MAP ok w/ hemorrhagic shock, better surivival outcomes

disadvantage of CSE v epidural

inc incidence of opioid- pruritis

anatomy for popliteal block

medial: semimembranosus (Ms for medial) lateral: biceps femoris tibial n more medial than common peroneal

least likely to cause drug fever

midaz

congenital heart defect assoc w/ inc aortic root dilation?

bicuspid aortic valve

transcranial doppler and CEA

intraop embolism detected in 90% of pts

GERD and BMI in pregnancy

NO assoc

SID equation

(Na + K + Mg + Ca) - (Cl + lactate)

tx for vasospasm after SAH

nimodipine

earliest fetal intraop FHR monitoring is feasible?

18-20 weeks

when is there FHR variability

25-27 weeks

protein C and S pregnancy

-protein S dec -protein C inc resistance

A alpha fibers carry what

proprioception

A beta fibers carry

touch sensation

A delta fibers carry

sharp, lacinating, easily localized pain

C fibers carry

burning pain

elective c/s dec risk of what compared to vaginal delivery

uterine rupture

what m to inject if looking for musculocutaneous n coverage

coracobrachialis

which predom in neonates parasymp or symp?

parasymp -why so responsive to atropine

Ca and ESRD

hypoCa

ATN UNa

>40