1
Q
What structure receives the majority of venous return from the myocardium?
A
The coronary sinus
2
Q
Where should the needle be placed when performing a caudal anesthetic?
A
Midline through the sacral hiatus into the epidural space
3
Q
What effect do volatile anesthetics have on intraocular pressure?
A
They lower intraocular pressure
4
Q
What is the primary mechanism of heat loss in the operating room?
A
Radiation
5
Q
During laparoscopic cholecystectomy, what is the first response to acute ETCO2 rise with hypotension?
A
Ask the surgeon to release the pneumoperitoneum
6
Q
What device does the polarographic oxygen analyzer represent?
A
The Clark electrode
7
Q
What is the most sensitive method for assessing cerebral perfusion during carotid endarterectomy?
A
EEG
Obviously awake patient is most
8
Q
Which herbal medications increase bleeding risk during surgery?
A
Garlic | Fish oil
Gingko, Garlic, Ginseng, Ginger, Feverfew
9
Q
What compensatory mechanism buffers increases in intracranial pressure?
A
Displacement of CSF into the spinal canal
10
Q
Where do carbonic anhydrase inhibitors work?
A
Proximal convoluted tubule
Acetazolamide
11
Q
Where do loop diuretics work?
A
Ascending loop of Henle
12
Q
**
Where do Thiazide diuretics work?
A
Distal convoluted tubule
13
Q
Where do potassium sparing diuretics work?
A
Collecting duct
14
Q
Pulse oximetry is based on what physical law?
A
Beer-Lambert Law
15
Q
What advantage does the LMA ProSeal have compared to the classic LMA?
A
Active gastric suctioning
16
Q
What is the effect of declining temperature on full E-cylinders?
A
Decrease in tank pressure in both cylinders
17
Q
What is the most common cause of chronic liver disease in the USA?
A
Non-alcoholic fatty liver disease
18
Q
What factors cause falsely elevated thermodilution cardiac output?
A
Pulmonic insufficiency | VSD | ASD | Tricuspid regurgitation | Recirculation of injectate
19
Q
What effect does postoperative shivering have on O2 and CO2 use?
A
Increases O2 consumption and CO2 production up to 200%
20
Q
What is the appropriate treatment for widened QRS and prolonged QTc during massive transfusion?
A
IV calcium gluconate
21
Q
What is a risk factor for pregnancy-induced hypertension?
A
Diabetes mellitus
22
Q
What advantages does a piston ventilator provide?
A
Improved tidal volume accuracy | Fresh gas decoupling
23
Q
What condition is associated with decreased plasma cholinesterase activity?
A
Pregnancy
24
Q
What does a rhythm strip with widened QRS and normal PR interval indicate?
A
Intraventricular conduction delay
25
What beneficial property does dexmedetomidine have?
Analgesic effects
26
Between which vertebrae is the largest interlaminar space?
L5–S1
27
What is the correct treatment for bradycardia and hypotension in a heart transplant patient?
Isoproterenol
28
What characteristics are associated with cluster headaches?
More common in men | Associated with Horner’s syndrome
29
What are the correct matches for the acid–base disorders?
Vomiting = Metabolic alkalosis | Renal failure = Metabolic acidosis | Pain/anxiety = Respiratory alkalosis | Fentanyl abuse = Respiratory acidosis
30
What conditions are associated with cauda equina syndrome?
Hyperbaric 5% lidocaine | Micropore catheters | Maldistribution of local anesthetic
31
Which local anesthetic is appropriate for IV regional anesthesia?
0.5% lidocaine
32
For which conditions is vasodilator therapy indicated?
CHF | RV failure | Aortic insufficiency
33
Which drug maintains ductus arteriosus patency in TGA?
PGE1 infusion
34
What is the partial pressure of oxygen in a 2:1 N2O:O2 mixture at sea level?
253.33 mmHg
35
Which drugs may be administered via the neonatal ETT?
Epinephrine | Naloxone
36
What is the best management for toxicity presenting as hypotension and widened QRS after local anesthetic with epinephrine?
Terminate case | Provide hemodynamic support | Obtain EKG
37
Which physical derangements are associated with hyperparathyroidism?
Heart block | Nephrolithiasis
38
How is a Class I upper-lip-bite test defined?
Lower incisors protrude past upper | Bite above vermillion border
39
What is significant about patient comorbidities in ERCP?
Significant comorbidities are frequently present
40
What is the most likely cause of metabolic acidosis with respiratory compensation in a diabetic patient?
Lactic acidosis
41
What airway and hemodynamic risks are associated with Trisomy 21?
Atlanto-occipital subluxation | Post-extubation croup | Paradoxic air embolus
42
What does accepting a remittitur mean in malpractice cases?
Plaintiff agrees to reduced award
43
Why are modern vaporizers resistant to the pumping effect?
Unidirectional valves prevent retrograde flow
44
What is the most common transfusion-related complication?
Febrile reaction
45
What is the definitive treatment for post–dural puncture headache?
Autologous blood patch
46
What effect does mitral stenosis have on PAOP?
Overestimates LVEDP
47
What advantage does the CTrach LMA provide?
Direct visualization of the larynx after insertion
48
What current can cause VF via microshock?
100 microamps
49
Injection between the anterior tibial artery and lateral malleolus blocks what?
Superficial peroneal nerve branches
50
What symptom is characteristic of PDPH?
Postural changes in headache intensity
51
Respiratory bronchioles correspond to which airway generations?
17–19
52
What factors determine anesthetic gas transfer from blood to alveoli?
Surface area | Partial pressure gradients | Membrane thickness
53
What complications may carboprost cause?
Bronchoconstriction | Increased PVR
54
What does SSEP monitoring assess?
Dorsal (posterior) spinal cord columns
55
Which statement about renal function in the elderly is true?
Serum creatinine stays normal due to low muscle mass
56
What is the best treatment for epidural fentanyl-induced pruritus?
IV naloxone
57
Proportioning systems ensure a minimum oxygen concentration of what?
23–25%
58
What is a classic symptom of insulin overdose?
Diaphoresis
59
How does PONV incidence in elderly patients compare to younger patients?
Lower incidence
60
During OLV, what is the most effective method to restore oxygen saturation?
Periodic reinflation of the collapsed lung
61
Which type of hip fracture has the least blood loss?
Subcapital | Transcervical
62
Which hormones are exclusively under nervous control?
Vasopressin | Catecholamines | Oxytocin
63
What are the correct matches for the ECG strips shown?
ECG1–4 as depicted
64
What is the largest constituent of soda lime?
Calcium hydroxide
65
Which airway device is best when blood obscures visualization?
Intubating LMA
66
Post-lap chole hypoxia with right-sided rhonchi suggests what diagnosis?
Aspiration pneumonitis
67
How much volume does one mole of gas occupy at STP?
22.4 L
68
What is the BMI of a 200-kg, 6-foot-tall patient?
59.8
69
What is the earliest and most sensitive sign of malignant hyperthermia?
Rise in ETCO2
70
What method reduces evaporative heat loss?
Humidified anesthetic circuit
71
What is the pressure relationship in West lung zone II?
Pa > PA > Pv
72
What percentage of cardiac output perfuses coronary arteries?
5%
73
What is the estimated blood loss for a 1-hour TURP?
200 mL
74
Which image represents Mallampati Class II?
Mallampati II (as shown)
75
What cautery precautions apply to patients with pacemakers?
Return pad far | Short cautery bursts | Use bipolar when possible
76
What is the CPP for BP 140/80 and ICP 25?
75 mmHg
77
Which drugs inhibit COX?
Acetaminophen | Ketorolac | Aspirin
78
Rapid opening of an O2 cylinder causes heat due to what?
Adiabatic expansion
79
What plasma volume expansion occurs with 100 mL of 25% albumin?
~400 mL
80
What drug treats hypertension and tachycardia unresponsive to anesthesia depth?
Esmolol
81
Which intervention should be avoided in premature neonates?
FiO2 > 0.5
82
A nitrous cylinder reading 744 psi contains approximately what volume?
253 L
83
What is the free water deficit in a 70-kg patient with Na 153?
3.9 L
84
What are the fastest conducting fibers in the heart?
His–Purkinje system
85
Placenta increta involves implantation into what tissue?
Myometrium
86
What size and depth of uncuffed ETT is appropriate for an 8-year-old?
6 mm | 16 cm
87
Which crystalloid fluids are hypotonic?
D5W | 0.45% saline
88
What condition does a wide, low diastolic pressure–volume loop indicate?
Aortic insufficiency
89
Retrograde cardioplegia is administered through what structure?
Coronary sinus
90
What drugs should be used for hemodynamic control in HOCM?
Esmolol for hypertension | Phenylephrine for hypotension
91
What technology analyzes gases by mass-to-charge ratios?
Mass spectrometry
92
What vessels contribute to physiologic shunt?
Thebesian veins | Bronchial veins | Pleural veins
93
Which sedative may reduce Parkinsonian tremor during cataract surgery?
Diphenhydramine
94
What is the purpose of the oxygen yoke check valve?
Prevent cross-filling | Prevent gas loss | Allow tank exchange
95
How does aging affect the ventilatory response to hypercapnia?
Decreases by ~50%
96
What condition is suggested by proptosis and increased IOP after retrobulbar block?
Retrobulbar hemorrhage
97
What is the safest airway strategy in rheumatoid arthritis?
Awake fiberoptic intubation
98
What ventilator issue causes high ETCO2 with low exhaled volume?
Incompetent pressure-relief valve
99
Which medication is used for bleeding prophylaxis in von Willebrand disease?
Desmopressin
100
Which lead best monitors narrow QRS arrhythmias?
Lead II
101
Which ventilator mode matches the waveform with spontaneous breaths between mandatory breaths?
SIMV
102
Which antiemetic is safe in Parkinson disease?
Diphenhydramine
103
Which medication best attenuates the initial cardiovascular response to ECT?
Glycopyrrolate
104
What hemoglobin level should be avoided in sickle cell patients?
> 11 g/dL
105
What lab value decreases in severe hepatocellular dysfunction?
Serum albumin
106
By how much does CMRO2 decrease at 27°C?
~50%
107
What matches the biophysical fetal heart rate changes?
Variable = Cord compression | Late = Placental insufficiency | Early = Head compression | ↓ Variability = Epidural
108
What is the most common cause of heparin resistance?
Antithrombin III deficiency
109
What effect does fetal hemoglobin have on pulse oximetry accuracy?
Minimal effect
110
What are the hemodynamic goals in aortic insufficiency?
Mild vasodilation | Adequate preload | Modest tachycardia
111
Which medication should be used cautiously in a cyclosporine patient?
Pancuronium
112
Which diagram structure corresponds to the ligamentum flavum?
C
113
What is the normal FRC in a term neonate after initial lung expansion?
70 mL
114
What factors predict postoperative ventilation need in myasthenia gravis?
Pyridostigmine > 850 mg/day | Pulmonary disease
115
Which epidural opioid has the longest duration?
Morphine
116
What is the hepatic artery to portal vein blood flow ratio?
1:3
117
Which breathing circuit components contribute to dead space?
Y-connector | ETT | Facemask
118
Which components belong to the intermediate-pressure system?
Flush valve | Flowmeter valves | Oxygen pressure-failure device
119
How should carcinoid syndrome be managed perioperatively?
Volume expansion | Octreotide | Avoid catecholamines | Avoid histamine release | Avoid hypercapnia
120
Pressure support ventilation is useful under what condition?
Only with spontaneous breathing
121
What are the benefits of intraoperative glucose control in diabetes?
Improved wound healing | Reduced infection | Improved fetal outcomes
122
How does halving the distance to a C-arm affect scatter radiation exposure?
Increases exposure fourfold
123
What does an optimally damped arterial line look like on square-wave test?
Bounces ~1 block apart
124
What improvement occurs 24 hours after smoking cessation?
Carboxyhemoglobin returns to normal
125
What does a claims-made malpractice policy cover?
Claims filed only while policy is active
Apex
flashcards
Decks in class (14)
# Cards
-
Apex Respiratory Flashcards174
-
Colloids19
-
Lab values5
-
Acid-Base10
-
CCAR #3125
-
Diuretics17
-
Random NMB / Reversal Pharm Stuff21
-
Random Stuff - Mostly Steps in Order For Things23
-
Literally Just Monitors I Keep Forgetting3
-
Random Stuff From Apex Mock NCE 631
-
Known topics Flashies117
-
Apex Mock 100 #372
-
Apex Respiratory Phys RE34
-
SNS6
