Brainscape's Knowledge GenomeTM

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


See full index

Anesthesiology > True Learn #1 > Flashcards

True Learn #1 Flashcards

1
Q

What medications can cause acute dystonic reactions and what is the treatment?

A

Metoclopramide and prochlorperazine (DA antagonism) or antipsychotics
Tx: diphenhydramine or benztropine or benzos

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

How much does cerebral blood flow change with every one Celsius decrease in temperature?

A

6% decrease

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

How much does cerebral blood flow change with every 1 mmHg change in PaCO2?

A

Increase in PaCO2 by 1 mmHg = 3% increase in CBF (linear increase until ~80 mmHg)

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

At what PaO2 value does cerebral blood flow drastically increase?

A

PaO2

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

What percentage of receptors are blocked when you have 1 twitch? 2 twitches? 3? 4?

A

1: >90% blocked
2: 80-90% blocked
3: 70-80% blocked
4: 65-70% blocked

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

What is the gold standard used for assessing neuromuscular blockade?

A

Train of four ratio

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

What train of four ratio correlates to a sustained head lift for 5 seconds?

A

T4:T1 height ratio of 0.75

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

What are some common side effects of sodium bicarbonate?

A
  1. Increased EtCO2
  2. Hypokalemia
  3. Hypotension
  4. Cerebral vasodilation, increased ICP
  5. Transient hypocalcemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What patients need to have perioperative corticosteroid supplementation?

A

Those who are taking > 10 mg/day prednisone or previously taking >10 mg/day whose last dose was

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

What are hormonal side effects noted with chronic opioid therapy?

A

Decreased testosterone/estrogen/cortisol/LH/FSH, increased prolactin

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

What is the purpose of a vasoconstrictor prior to attempts at nasal intubations?

A
  1. Minimize mucosal bleeding

2. Increases diameter of the nasal passages

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

What does the glossopharyngeal nerve innervate?

A

Sensory to posterior 1/3 of tongue, vallecula, anterior surface of epiglottis, and posterior and lateral walls of the pharynx

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

What does the superior laryngeal nerve innervate?

A

Sensory from the lower pharynx to the upper part of the larynx (including glottis surface of epiglottis and the aryepiglottic folds)

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

What does the recurrent laryngeal nerve innervate?

A

Sensory to the mucosa below vocal cords

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

What nerve does the superior laryngeal nerve branch from? The recurrent laryngeal?

A

Both come from the vagus nerve (CN X)

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

What does blinding study participants eliminate?

A

Participant bias (Hawthorne effect: groups being studied act differently than they normally would)

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

What are some complications of brachial artery catheterization?

A
  1. Thrombosis
  2. Infection
  3. Median nerve injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the typical PaO2 value of an O2 sat of 50%?

A

27 mmHg

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

Which drug is metabolized by RBC esterases: esmolol, atenolol, metoprolol, labetalol, propranolol?

A

Esmolol

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

Name some cardioselective (beta-1) blockers

A

BEAM: bisoprolol, esmolol, atenolol, metoprolol

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

Which drug is renally cleared: esmolol, atenolol, metoprolol, labetalol, propranolol?

A

Atenolol (“ATNolol”)

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

What is the formula for static respiratory system compliance?

A

Cs = Vt / (Ppl - PEEP)
Vt: tidal volume
Ppl: plateau pressure

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

What is the pathophysiology of negative-pressure pulmonary edema?

A
  1. Pulmonary capillary fluid entrainment into the airways from negative intrathoracic pressure
  2. Reduced hydrostatic pressure of the pulmonary interstitium
  3. Increased trans-capillary pressure gradiant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the pathophysiology of tetanus?

A

Block release of GABA causing generalized muscle spasms

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

How long must the suction bulb remain collapsed to pass a negative pressure leak test?

A

10 seconds or longer

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

What does the negative pressure test tell us?

A

The integrity of the low pressure circuit (flow control valves to common gas outlet) + differentiate between leaks in the machine and leaks in the breathing system

27
Q

A patient with a 40% total body surface area burn 1 week ago with hypoalbuminemia will have lower dose requirements of which med: fentanyl, midazolam, rocuronium, insulin

A

Midazolam: highly albumin bound so hypoalbuminemia -> more free fraction of benzos
Note: due to increased extrajunctional Ach receptors, they develop resistance to non-depolarizing NMBs

28
Q

What is the formula for specificity? Sensitivity?

A

Spec: TN / (TN + FP)
Sens: TP / (TP + FN)
(Horizontal is patient with or without disease, vertical is test results)

29
Q

Do barbiturates or inhaled anesthetic gases uncouple cerebral blood flow and CMRO2?

A

Barbiturates do not (will decrease CBF and CMRO2)

Inhaled anesthetics > 1 MAC will increase CBF and decrease CMRO2 (uncouples)

30
Q

What is the mechanism of action of nicardipine?

A

Arteriolar vasodilator (decreases LV afterload and SVR with minimal effect on preload), dihydropyridine CCB

31
Q

What is the mechanism of action of nesiritide?

A

Recombinant form of BNP -> down-regulates RAAS causing arterial and venous dilation + natriuresis + diuresis

32
Q

What is the mechanism of action of sodium nitroprusside?

A

Converts nitric oxide in smooth muscle to increased cGMP -> arteriolar & venous dilator

33
Q

What is the mechanism of action of nitroglycerin?

A

Activates cGMP production, venous dilator

34
Q

Increasing cardiac output does what to the anesthetic uptake of soluble gases?

A

Increases the uptake of soluble gases more than insoluble gases (isoflurane more than sevoflurane and desflurane); this is different from onset of anesthesia

35
Q

What is the vapor pressures at 20C of the following: desflurane, isoflurane, sevoflurane

A

Des: 669 mmHg
Iso: 238 mmHg
Sevo: 157 mmHg

36
Q

What are the benefits of leukoreduced blood products ?

A
  1. Decreased febrile reactions
  2. Decreased inflammatory mediators
  3. Decreased CMV transmission
37
Q

What is the treatment for hypoparathyroidism?

A

Vitamin D supplementation (to keep serum Ca levels normal)

38
Q

What is the mechanism of action of PTH?

A
  1. Stimulates kidneys to increase Ca reabsorption
  2. Increases bone resorption of Ca (more Ca in serum)
  3. Increases renal production of calcitriol (makes the intestines increase Ca absorption)
    * it does this and also trashes phosphate
39
Q

Which cells are most dependent on insulin for glucose uptake: cardiac myocytes, cerebral neurons, hepatocytes, leukocytes

A

Cardiac myocytes

Cerebral neurons rely on insulin-independent GLUT3 transporters

40
Q

Why would a patient with COPD hypoventilate if they are given supplemental O2?

A

COPD patients rely heavily on hypoxic pulmonary vasoconstriction; O2 will inhibit HPV

41
Q

What is the Haldane effect?

A

Oxygen induced a rightward shift of the CO2 dissociation curve -> increases pCO2 (normally patients will hyperventilate but COPD patients cannot)

42
Q

What is the line isolation monitor?

A

It protects persons from electrocution that turns a grounded system (only takes one fault to cause electrocution) to a protected system (takes 2 faults)

43
Q

What should you do if the line isolation monitor goes off in your room?

A

Unplug the last item that was plugged in

44
Q

What is Henry’s Law?

A

At constant temp, the concentration of gas dissolved is directly proportional to the partial pressure of the gas (concentration is proportional to pressure)

45
Q

What is Boyle’s Law?

A

At constant temp, P1V1 = P2V2

46
Q

What is Gay-Lussac’s Law?

A

P1/T1 = P2/T2

47
Q

What is the mechanism of action of digoxin?

A

Inhibition of Na/K ATPase pump -> sodium comes into cell and potassium leaves cell now -> Na-Ca exchange pump works more, pumping the sodium out for calcium into the cell -> more Ca = more contractility

48
Q

What problems arise with the use of hetastarches?

A
  1. Dilutional reduction of Factor VIII and vWF (50-80%)
  2. Prolongation of PTT
  3. Platelet dysfunction
49
Q

What conditions up-regulate acetylcholine receptors? How does succinylcholine affect these conditions?

A

MS, ALS, burns, stroke, spinal cord injury, Guillain-Barre syndrome, prolonged immobility, and muscular dystrophies; beware of hyperkalemia with succinylcholine use

50
Q

What conditions down-regulate acetylcholine receptors? How does succinylcholine affect these conditions?

A

Myasthenia gravis, anti-cholinesterase poisoning, organophosphate poisoning; MG is resistant to succinylcholine

51
Q

How much does succinylcholine increase K+ in a healthy patient?

A

~0.5 mEq/L

52
Q

What happens if you activate an NMDA receptor?

A

Non-specific ion channel gets activated, allowing for calcium to enter the cell (increases intracellular calcium)

53
Q

Where does the supraspinous ligament run from?

A

C7 to the sacrum

54
Q

What is the median time to maximum plasma fentanyl concentration with a transdermal fentanyl patch? What is the onset time?

A

~30 hours until peak; 6-8 hours until onset

55
Q

What is the null hypothesis? Alternative hypothesis?

A

Null: there is no difference between the variables in question
Alt: a difference does exist between the variables

56
Q

What is a type I error? Type II error?

A

I: Null hypothesis is incorrectly rejected (false positive)
II: Null hypothesis is incorrectly accepted (false negative)

57
Q

How can you increase power in a study?

A
  1. Increase alpha (the smaller the alpha, the greater the chance of a false negative)
  2. Decrease population variability
  3. Increase sample size
  4. Make the difference between the conditions greater
58
Q

Administration of FFP is not recommended in which of the situations: Hemophilia A, major trauma with blood loss, heparin resistance, TTP

A

Hemophilia A (would need too much FFP, use factor VIII concentrate or cryoprecipitate)

59
Q

Why would you use FFP for heparin resistance?

A

Heparin binds to AT3 and those with heparin resistance have AT3 deficiencies -> thus you give the patient AT3 for heparin to work on

60
Q

What is the formula for coronary perfusion pressure of the left ventricle?

A

CPP(LV) = Aortic diastolic pressure - LVEDP

61
Q

What is the average FRC in an adult?

A

~30 cc/kg

62
Q

What type of surgery puts the patient at highest risk of anterior ischemic optic neuropathy? Posterior?

A

Anterior: cardiac surgery
Posterior: spinal surgery (prone)

63
Q

What is the formula for the standard error of the mean?

A

Standard deviation / square root of sample size

64
Q

During airway manipulation, stimulation of which nerve is responsible for laryngospasm?

A

Internal branch of the superior laryngeal nerve

Anesthesiology (21 decks)

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