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Anesthesiology > TrueLearn Basic 2.0 > Flashcards

TrueLearn Basic 2.0 Flashcards

1
Q

Name two nerves that make up oculocardiac reflex

A

Trigeminal nerve (ophthalmic division)

Vagus

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2
Q

Increased analgesia from morphine is associated with what enzyme polymorphism (and physical characteristic)?

A

MC1R

Red hair

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3
Q

Enzyme associated with omeprazole?

A

CYP2C19

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4
Q

Enzyme associated with Tramadol?

A

CYP2D6

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5
Q

The preoptic anterior hypothalamus plays a key role in what?

A

Temperature regulation

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6
Q

Ketamine, Methadone, Tramadol, Nitrous oxide act at what receptor?

A

NMDA

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7
Q

What is pneumonic for B-1 selective beta blockers?

A

BEAM

Bisopropol
Esmolol
Atenolol
Metoprolol

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8
Q

In liver disease what two coagulation factors are increased and why?

A

Factor VIII
vWF

They are produced in endothelial cells

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9
Q

Propofol acts on what receptor?

A

GABAa

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10
Q

breathing 100% oxygen increased the shunt fraction through what mechanism?

A

Blunting hypoxic pulmonary vasoconstriction

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11
Q

MAC requirements peak at what age?

A

3 months

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12
Q

Increasing the alpha will ______ the power.

A

Increase

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13
Q

Which opioid is believed to cause least amount of biliary sphincter tone and therefore used in biliary colic?

A

Butorphanol

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14
Q

What can be injected at the site in case of extravasation of a vasoconstrictor?

A

Phentolamine

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15
Q

NMDA receptors mediate its effects through what mechanism?

A

Increased intracellular calcium

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16
Q

The Hoffman elimination is temperature and pH dependent. How so?

A

Reactions proceeds more readily when pH and temperature are increased

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17
Q

What is the second messenger for insulin and glucagon?

A

cAMP

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18
Q

What is the term for a study that compares groups with respect to a particular intervention and the separation into groups occurs after the intervention?

A

Case-control study

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19
Q

What study can be thought of like a randomized control study without the randomization? Also like a case-control but prospective (separation into case and control BEFORE the intervention)?

A

Cohort

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20
Q

What are two risk factors of bradycardia following Succs?

A

Young age

Repeat dosing

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21
Q

Which order of kinetics is dependent on liver blood flow?

A

First order

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22
Q

What does Lithium do to both Succs and NDNMB’s?

A

Prolongs both

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23
Q

FRC is decreased in obese most likely 2/2 decrease in what volume?

A

Expiratory reserve volume

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24
Q

In pRBC’s what happens to:

pH
2,3 DPG
Potassium

over time?

A

pH: Decreases
2,3 DPG: Decreases
K+: Increases

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25
Q

Laminar flow: _______

Turbulent flow: _______

A

Viscosity: Low flow (bottom cylinder)
Density: High flow (top cylinder)

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26
Q

Nitroglycerin is a pure ____

A

Venodilator (Y in glycerin and V for vein)

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27
Q

How does burn affect dosing of NDNMBs?

A

It increases the dosing requirement because the number of ACh receptors in NMJ are increased

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28
Q

What is maxi dosing of Acetaminophen?

Adults?
Peds?

A

Adults 4 g/day (FDA now 2.6)

Peds: 50-75 mg/kg/day

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29
Q

Why does Chloroprocaine have a rapid onset?

A

Concentration. It is rapidly metabolized and doesn’t have systemic toxicity so higher concentrations can be used.

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30
Q

Benzodiazepines can have some muscle relaxation effects by what mechanism?

A

Centrally acting GABA potentiation (spinal cord)

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31
Q

Patients with IgA deficiency are at increased risk for what after transfusion?

A

Anaphylaxis

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32
Q

Which cell type is most dependent on insulin for glucose uptake?

A

Cardiac myocytes

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33
Q

Sudden rise in ETCO2 after normal equilibration during laparoscopic surgery is indicative of what?

A

Subcutaneous emphysema

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34
Q

After how many days is an MI considered “old”?

A

More than 30 days

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35
Q

What muscle is most resistant to neuromuscular blockade and can be monitored with TOF?

A

Corrugator supercilii muscle

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36
Q

What is the primary cause of low bicarb in high anion gap metabolic acidosis?

A

Buffering excess hydrogen ions

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37
Q

What isotonic solution will actually lower serum osmolarity if much is administered?

A

LR

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38
Q

What is the benefit of epinephrine during ALCS?

A

Alpha mediated vasoconstriction leading to increased coronary and cerebral perfusion pressure

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39
Q

St. John’s Wort induces what enzyme?

A

CYP450 3A4

St Johns plays ball and is number 34

40
Q

What is mechanism and onset time of Ranitidine?

A

H2 blocker. 1 hour

41
Q

How is metabolic demand for Oxygen calculated?

A

3-3.5 mL/kg/min

42
Q

List order of sensitivity of nerve fibers to local anesthetics

A

BAC. B-A-C

43
Q

Carotid body chemoreceptors detect what?

A

Arteril PaO2

44
Q

What electrolyte abnormality affects Digoxin and how?

A

Hypokalemia increases to affect of Digoxin

45
Q

What is treatment for post operative delirium 2/2 Scopalamine? Why?

A

Physostigmine. It’s an anticholinesterase that can cross the blood brain barrier

46
Q

In a full O2 cylinder how much O2 and at what psig is in it?

A

660 L at 2200 psig

47
Q

Which nail polish color is least likely to interfere with pulse oximetry?

A

Red

48
Q

CO2 gas cylinder is color coded as what?

A

Gray

49
Q

In elective non cardiac surgery, according to ACC/AHA, how much time should wait after MI with the following interventions:

Ballon angioplasty
BMS
No intervention
DES implantation

A
  • 14 days
  • 30 days
  • 60 days
  • 180 days
50
Q

What is used to calcualte a MELD score?

A

INR, bilirubin, Creatinine

51
Q

Classic presentation of TRALI

A

Bilateral patchy infiltrates without evidence of heart failure

52
Q

How do you calculate power?

A

1-Beta

53
Q

What is in cryoprecipitate? (5 things)

A

Fibrinogen, fibronectin, factor VIII, factor XIII, vWF

54
Q

Name the vasodilator that actually increases renal perfussion

A

Fenoldopam

55
Q

How does Neostigmine affect Succs?

A

Prolongs the block, because neostigmine is an acetylcholinesterase inhibitor. This also inhibits butyrylcholinesterase which degrades Succs

56
Q

Which patient is at highest risk of emergence reactions with Ketamine?

A

Older females receiving large bolus doses

57
Q

How do you treat an acute dystonic reaction?

A

Benadryl

58
Q

What is the difference between the carotid body and carotid sinus?

A

Sinus is a mechanoreceptor (think “sinus pressure”)

Body is a chemoreceptor

59
Q

What is INITIAL hemodynamic changes after giving bolus dosing of Dexmedetomidine?

A

Increased BP leading to DECREASED HR and CO

60
Q

What is pneumonic for systemic absorption of regional anesthesia?

A

ICEBALLS

Intercostal
Caudal
Epidural
Brachial plexus
Axillary
Lower Limb
Subcutaneous
61
Q

1 ml of liquid volatile anesthetic equals approximately how much vapor?

A

200 ml

62
Q

What is the formula for calculating amount of liquid volatile consumed?

A

3FGF (L/min)%vapor

63
Q

What is approximate calculation of FRC?

A

30 ml/kg

64
Q

What type of data is evaluated with Chi-square?

A

Categorical

65
Q

Turbulent flow is promoted by (4):

A
  1. Decreased viscosity
  2. Increased density
  3. Increased flow rate
  4. Increased diameter
66
Q

What is most common cause of mortality 2/2 transfusion?

A

TRALI

67
Q

A simple face mask with flows of 5-10L provide FiO2 at what percentage?

A

35-50%

68
Q

Hetastarch has what effect on coagulation? Hint: platelets

A

Decreases glycoprotein IIa-IIIb availability

69
Q

Aspirin inhibits platelet aggregation by inhibiting the formation of what?

A

Thromboxane

70
Q

What is the common and reliable sign of cyanide toxicity?

A

Anion gap metabolic acidosis

71
Q

What is the time to onset and peak effect following placement of a fentanyl patch?

A

Onset: 6-8 hrs
Peak: 30 hrs

72
Q

What are the 2 hemodynamic goals for aortic stenosis?

A
  1. Maintain/increase afterload (improve CPP)

2. Reduce HR (55-70 bpm)

73
Q

What patient should receive stress dose steroids?

A

Patient previously taking >10 mg Prednisone/day but stopped less than 3 months ago

74
Q

One lung ventilation has the largest relative effect on speed on induction with which volatile?

A

Desflurane

75
Q

Define diastasis

A

Rest phase of diastole. The time between the filling of the LV and the atrial contraction.

76
Q

What is the effect of volatile on CBF and CMRO2

A

Decreases CMRO2
Increases CBF

This is termed “uncoupling.” Usually these two move in parallel, however volatiles vasodilator cerebral vasculature increasing CBF even though CMRO2 has decreased

77
Q

In the context of drugs, what is the definition of efficacy?

A

The maximal effect of the drug. it is independent of dose(remember the dose-response curves. It’s the top of the curve)

78
Q

What is the onset time for epidural chloroprocaine?

A

6-12 min

79
Q

On arterial lab draws, what is the relationship between temperature and:

  1. Partial pressure of gas
  2. pH
A
  1. Directly proportional

2. Indirectly proportional

80
Q

What is the effect on PEEP on the following in the setting of acute systolic HF?

CVP
PAP
CI-Why?
PCWP

A

Increases:
CVP
PAP
CI

Decreases:
PCWP

In regards to CI: In systolic HF the patient is volume overloaded. The decreased preload due to PEEP improves CO, as well as increased transmural pressure

81
Q

PCWP is a surrogate measurement for what?

A

LVEDP

82
Q

What is a type I error, what is a Type II error?

A

Type I: Incorrectly accepting the alternative hypothesis

Type II: Incorrectly accepting the null hypothesis

83
Q

Name two drug classes that shorten NM blockade

A
  1. Anticonvulsants (carbamazepine, phenytoin)

2. Anticholinergics (Neostigmine)

84
Q

How do you adjust the intubating dose of NMBDs in the setting of cirrhosis? Why?

A

Increase the dose. This is because of increased volume of distribution is increased in the setting of increased free water (such as cirrhosis). NMBDs are highly water soluble

85
Q

What pulmonary parameter is decreased the most following epidural placement and why?

A

Peak expiratory pressure, because this is dependent on chest wall musculature

86
Q

What is the vapor pressure of:
Desflurane
Sevoflurane
Isoflurane

A

Des: 681
Iso: 240
Sevo: 160

87
Q

Define lusitropy

A

Myocardial relaxation

88
Q

Regarding penicillin allergy, a hemolytic reaction is what type of allergic reaction?

A

Type II, IgM and IgG mediated

89
Q

A change in PCO2 of 1 mmHg changes CBF by how much?

A

1-2 ml/100g/min

90
Q

What are two physiologic goals in treating hypotension in severe AS?

A

Increase or maintain afterload, decrease HR

91
Q

Carotid body chemoreceptors signal CNS through what nerve?

A

glossopharyngeal

92
Q

What is treatment for TRALI?

A

Supportive: Fluids and pressors

93
Q

What are cardiovascular effects of isoflurane?

A

Increased HR

Decreased SVR

94
Q

A desflurane vaporizer taken to altitude and set at 6% will yield what MAC?

A

.5

95
Q

Findings for CO poisoning:

SpO2
SaO2
PaO2

And acid/base

A

100%
100%
100

Metabolic acidosis

96
Q

Injection of local into the glossopharyngeal fold anesthetizes what nerve (awake fiber)?

A

Glossopharyngeal

Anesthesiology (12 decks)

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