TrueLearn ITE Flashcards
- What does Bupivacaine do to the heart?
a. Blocks sodium-gated channels which leads to delayed repolarization and arrhythmias
- What is the effect of tobacco use on the oxyhemoblogin curve?
a. Shift left (decrease oxygen perfusion)
- What is most effective treatment for neuraxial opioid-induced pruritus?
Nalbuphine
What causes persistent fetal circulation in neonate?
Acidosis and hypoxia which cause increased pulmonary vascular resistance and pulmonary hypertension and persistence of right to left shunt.
What is Milrinone’s effect?
Increased inotropy and cardiac output while also decreasing pulmonary and systemic vascular resistance.
What is preferred pharmacologic treatment for atropine resistant bradycardia?
Epinephrine
What is second line pressor in septic shock, after Norepinephrine?
Epinephrine
A dot on the left of a MIGET graph represents what?
Pure shunt
What is key feature of MIGET graph for COPD/asthma?
No pure shunt
In bilateral carotid endarterectomy care must be taken with opioids, why?
Because carotid body denervation can happen. If it does central chemoreceptors solely respond to hypoxia and acidosis. Opioids blunt this and severe respiratory depression can occur.
How should bronchospasm be initially treated?
Hand ventilation with 100% FiO2 and deepening of anesthesia
What is mechanism of action of terbutaline? Effect?
Beta 2 agonist. Causes bronchial smooth muscle relaxation and bronchodilation
What is the primary effect of furosemide in the acute CHF?
Decreases venous resistance thereby decreasing mean systemic pressure
Redistribution of most anesthetic drugs occurs to where?
Skeletal muscle
What does hypothermia decrease?
Oxygen consumption, CO, respiratory effort, drug clearance, insulin secretion, clotting/platelet function, immune response, P50
How do you treat seizures in LAST (local anesthetic systemic toxicity)?
Benzos (Versed)
What is the hepatic arterial buffer response?
Hepatic artery vasodilation in response to reduced portal venous flow
What can happen after large bolus of dexmedetomidine?
Hypertension
A sharp rightward deflection of spirometry at end of pressure-volume loop is indicative of what?
Pulmonary overdistension
What two lung parameters are unchanged in obesity?
Closing capacity (volume at which small airways begin to close) and residual volume
What is the key unique physiology in patients with hypoplastic left heart palliated with the Fontan procedure?
Passive pulmonary blood flow
What are the 5 primary causes of hypoxemia?
Decreased PO2. Hypoventilation. V/Q mismatch. Impaired diffusion. Right to left shunt.
What are three reasons for increased incidence of aspiration pneumonitis in obstetric patients?
- high incidence difficult airway 2. Lower gastric fluid pH 3. Increased intraabdominal pressure
Name 4 drugs with low hepatic extraction ratio
Diazepam. Methadone. Rocuronium. Thiopental.