UBP Book 1

Question 1

STOP-BANG

Answer 1

S = snore loudly
T = tired during day
O = observed apnea
P = pressure (HTN)

B = BMI > 35
A = age > 50
N = neck circumference > 40cm
G = gender male

Question 2

Berlin Definition for ARDS

Answer 2

• Timing within 1 week of clinical insult
• CXR with diffuse bilateral opacities not fully explained by effusions, lobar/lung collapse, or nodules
• Respiratory failure not fully explained by cardiac failure/fluid overload
• Risk factor for ARDS present OR echo excluding hydrostatic edema
• P/F <300 with PEEP > 5

Question 3

Half life IV narcan

Answer 3

30-60 min

Question 4

Aldrete score

Answer 4

Activity (moving extremities to command): 2 extremities = 1, 4 extremities = 2

Breathing: dyspnea/shallow = 1, normal = 2

Consciousness: arousable to voice = 1, fully awake = 2

BP: 20-50% pre anes level =1, <20% pre anes level = 2

SpO2: >90% on O2 = 1, >92% on RA = 2

Need score 9 or 10 for discharge

Question 5

Pre-eclampsia criteria

Answer 5

After 20 weeks gestation

• SBP > 140 or DBP > 90 (two measurements 4 hrs apart)
• OR SBP > 160 or DBP > 110 once (note: this = severe features)

AND

• proteinuria (>300mcg in 24 hrs or Pr/Cr > 0.3 or 2+ protein on dipstick)

OR new onset thrombocytopenia, renal insufficiency, liver dysfunction, pulm edema or CNS changes (note: presence of these = severe features)

• plt <100
• Cr >1.1 or 2x baseline
• LFT 2x normal
• pulm edema
• HA or visual changes

Question 6

Eclampsia

Answer 6

The convulsive manifestation of hypertensive disorders of pregnancy

• generalized seizure not attributable to other causes

Question 7

Down syndrome associations

Answer 7

• macroglossia
• tonsillar/adenoid hypertrophy
• micrognathia
• short neck
• OSA
• cervical instability/lax joints
• CHD (mostly endocardial cushion defects)
• risk for pulm HTN if L to R shunt
• subglottic stenosis

Question 8

RCRI

Answer 8

• intraperitoneal, intrathoracic, or supraingular vascular
• ischemic heart disease or CHF
• CVA/TIA
• Insulin
• Cr > 2

Think 4-6-10-15
(Approximate risk of MACE per 0-1-2-3+ points)

Question 9

GCS scoring

Answer 9

E4V5M6

E4=spontaneously open
E3=open to VOICE
E2=open to PAIN
E1=no response

V5=oriented
V4=confused
V3=inappropriate
V2=incomprehensible
V1=no response

M6=follows commands
M5=localizes to pain
M4=withdraws from pain
M3=decorticate (flexion)
M2=deceberate (extension)
M1=no response

Mild 13-15
Moderate 9-12
Severe <8 (coma)

Question 10

Myasthenia Gravis associations

Answer 10

FATIGUABLE skeletal muscle “I’m so tired I’m going to die” (grave)

• Bulbar/respiratory muscle weakness = aspiration risk, post op respiratory failure
• very sensitive to NDMR (use 1/10 dose), resistant to sux
• Risk of perioperative myasthenic or cholinergic crises
• Thymoma & possible anterior mediastinal mass
• Myocarditis causing cardiomyopathy, atrial fibrillation, heart block
• May be on steroids, immunosuppressants, anticholinesterases

Question 11

TEF types

Answer 11

Type C: EA with distal TEF (most common) (stomach connected to trachea)
Type A: EA with no TEF
Type B: EA with proximal TEF (mouth connected to trachea) (Boca)
Type D: EA with proximal and distal TEF (esophagus takes a Detour through the trachea)
Type E: TEF with no EA (just a fistula) (EH)

Question 12

Complications of prematurity

Answer 12

Birth before 37 weeks GA

• respiratory distress syndrome
• persistent pulm HTN
• apneic spells
• bronchopulmonary dysplasia
• tracheomalasia
• NEC
• retinopathy of prematurity
• IVH
• immature hepatic fxn
• impaired glucose regulation
• increased susceptibility to hypothermia