APEX > Day Before Studying > Flashcards

Day Before Studying Flashcards

(236 cards)

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1
Q

modified brooke

A

2 mL of LR /kg/%TBSA

(1/2 in the first 8 hours)

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2
Q

Parkland

A

4 mL LR /kg / % TBSA

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3
Q

Reynolds #

A

density x diameter x velocity/viscosity

< 2,000 = laminar
> 4,000 = turbulent

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4
Q

Anion Gap

A

Normal 8 - 12

Na - (Cl + HCO3)

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5
Q

Plasma osmolarity

A

2xNa + Glucose/18 + BUN/2.8

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6
Q

distance square law

A

1 / D2

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7
Q

VO2

A

(CaO2 - CvO2) x CO x 10

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8
Q

SVO2

A

SaO2 - VO2 / DO2

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9
Q

SPO2

A

oxy / deoxy + oxy

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10
Q

static compliance

A

TV/pplat - PEEP

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11
Q

dynamic compliance

A

TV/PIP - PEEP

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12
Q

Therapeutic Index

A

LD50/ED50

a high therapeutic index = high safety margin

a low therapeutic index = low safety margin

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13
Q

extraction ratio

A

arterial - venous / arterial

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14
Q

loading dose

A

Vd x (desired concentration/ bioavailability)

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15
Q

EF

A

EDV - ESV / EDV
x 100

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16
Q

SV

A

EDV - ESV

or CO x 1000/HR

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17
Q

coronary perfusion pressure

A

AoDBP - LVEDP

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18
Q

PVR

A

mPAP - PAOP / CO
x 80

  • 150 - 250 dynes/s/cm^-5
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19
Q

wall stress

A

intraventricular pressure x radius / ventricular thickness

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20
Q

how to set vaporizers in a weird altitude

A

% x 760 / new altitude

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21
Q

child ETT size (cuffed vs uncuffed)

A

cuffed = age / 4 + 3.5
uncuffed = age/4 + 4

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22
Q

DO2

A

CaO2 x 10 x CO

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23
Q

CaO2

A

(1.34 x Hgb x SaO2) + (0.003 x PaO2)

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24
Q

A-a gradient

A

5 - 15

PAO2 - PaO2

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25
PAO2 (aka alveolar gas equation)
FiO2 x (Pb - PH2O) - PaCO2/RQ
26
Law of LaPlace sphere
Tension = pressure x radius /2
27
Law of LaPlace cylinder
Tension = pressure x radius
28
Bohr Equation
Vd/Vt = PaCO2 - PeCO2 / PaCO2
29
Alveolar ventilation
RR x (Tv - Vd)
30
To prove negligence what 4 things have to be proven
1. duty 2. breech of duty 3. causation 4. harm
31
metals safe in MRI
aluminum copper titanium stainless steel
32
samter's triad
asthma allergic rhinitis polyps
33
maximum ortho tourniquet time
2 hours
34
Fat embolus syndrome
longer onset than BCIS triad of 1. changes in LOC 2. respiratory failure 3. petechiae
35
methotrexate
antimetabolite - bone marrow suppression
36
5 - fluorouracil
antimetabolite bone marrow suppression
37
doxorubicin
antitumor antibiotic cardiotoxic
38
bleomycin
antitumor antibiotic pulmonary fibrosis keep fio2 low
39
vincristine & vinblastine
peripheral neuropathy tubulin binding drugs
40
cisplatin
alkylating agent nephrotoxic and ototoxic
41
gastrin
G-cells secrete gastric acid
42
Secretin
S cells secrete pancreatic bicarbonate
43
Cholecystikinin
I cells Gallbladder contraction/bile release
44
Somatostatin
D cells decreases all GI function
45
common allergic triggers in OR
paralytics (sux > roc) latex abx
46
Types of hypersensitivity reactions
Type I: anaphylaxis, asthma, IGE Type II: cell mediated, antibody mediated, IGG & IGM (ABO & HIT) Type III: immune complex (snake venom) Type IV: delayed sensitivity
47
what do mast cells and basophils release
histamine, leukotrienes, prostaglandins
48
laser goggles & colors
CO2 - clear (cornea) NdYAG - green Ruby - red Amber - argon
49
what is normal IOP
10 - 20 mmHg
50
airway fire
oxidizer ignition fuel
51
Metabolic syndrome (obesity)
fasting glucose > 110 triglycerides > 150 waist > 40 (men) > 35 (women) HDL <40 (men) <50 (women) BP > 135/85
52
ulnar injury
claw hand can't abduct pinky finger
53
median injury
benediction, ape hand can't oppose thumb
54
radial
UE tourniquet, NIBP wrist drop
55
avogadros $
6.023 x 10^23 = 1 mole
56
dalton's law
P1 + P2 + P3 = Ptot
57
henry's law
at constant temperature, the amount of gas that dissolves in a solution is proportional to the partial pressure of that gas over the solution
58
graham's law
molecular weight of a gas determines how fast it can move through a membrane
59
how much more soluble is co2 than o2
20 x
60
what is specific heat
the amount of heat required to increase the temperature of 1 g of a substance by 1 degree celsius
61
latent heat of vaporization
number of calories required to convert 1 gm of a substance to vapor without a change in temperature in the liquid
62
1 mm Hg = ___ cm H2O
1.36
63
1 cm H2O = ___ mmHg
0.74
64
1 atm =
760 TORR = 760 mmHg = 100 kPa = 1,033 cmH2O = 14.7 PSI = 1 BAR
65
how much does MAC decrease with age
6% per decade after 40
66
what is Virchow's triad
venous stasis hypercoagulability endothelial dysfunction
67
one MET =
3.5 mL/kg/m and each MET decreases mortality by 11%
68
post tonsillectomy bleeding
occurs within 6 hours of surgery
69
Catch 22
aka DiGeorge syndrome C- cardiac defects A- abnormal face T- thymic hypoplasia C- Cleft palate H- Hypocalcemia 22q11 gene deletion
70
CHARGE
C- colboma H- heart defect A- choanal atresia R- retarded growth G- GU problems E- Ear anomalies
71
Laryngotracheobronchitis
Croup viral, gradual onset < 2 y.o. mild fever, inspiratory stridor, barking cough tx: oxygen, racemic epi, steroids, humidification, fluids STEEPLE SIGN
72
Epiglottitis
bacterial, rapid onset age 2 - 5 drooling, dysphagia, dysphonia ENT for induction O2, intubation, abx thumb sign
73
Neonates GFR
reaches adult levels at 8 - 24 months
74
Neonates renal tubular function
full concentrating ability at 24 months
75
Sevo MAC values
0 - 6 months 3.2% 6 - 12 months 2.5%
76
VACTERL
Vertebral anomalies Anal imperforate Cardiac defects TEF esophageal atresia renal dysplasia limb anomalies
77
Lecithin/Sphingomyelin
> 2 = mature lungs
78
cyanotic shunts
TOF transposition of the great arteries total anomalous pulmonary venous circuit truncus arteriosus tricuspid valve abnormality (ebstein's anomaly)
79
right to left shunt inhalation
slower affects desflurane the most IV induction is faster
80
left to right shunt and induction
doesn't affect inhalation prolongs IV
81
TOF features
Overriding aorta VSD RVH RVOTO
82
what drugs do not cross placenta
glyco paralytics insulin heparin
83
first stage of labor
latent - up to 2 cm active - 2 - 10 cm T10 - L1
84
second stage of labor
10 cm - delivery of fetus S2 - S4
85
MAC changes with pregnancy
30 - 40% decrease at 8 - 12 weeks
86
normal FHR
110 - 160
87
1 mg/dL mag
seizures
88
5 mg/dL
drowsiness
89
8 mg/dL
loss of DTRs
90
15 mg/dL
respiratory depression
91
when are pregnant patients full stomachs
18 weeks
92
what is the absorbed volume in TURP? EBL
10 - 30 mL/m 2 - 5 mL/m (EBL)
93
portal vein vs hepatic artery
portal vein = 75% Q, 50% OXYGEN hepatic artery = 25% Q, OXYGEN 50%
94
duration of action in order of insulins
humalog humulin R humulin N lantus
95
zona glomerulosa
aldosterone
96
zona fasiculata
glucocorticoids
97
zona reticularis
androgens
98
which exogenous steroid has equal glucocorticoid and mineralocorticoid effects
cortisol
99
which steroids do not have mineralocorticoid effects
dexamethasone, betamethasone, triamcinolone
100
which steroid resembles coritsol the most
prednisone
101
what are carcinoid s/s
tachycardia labile BP abdominal pain
102
carbonic anhydrase inhibitors
dorzolamide, acetozolamide acidosis acts at PCT
103
osmotic diuretics
mannitol, isorbide, glycerin PCT and ascending LOH
104
loop diuretics
furosemide, erythyric acid, bumex ascending LOH
105
thiazides
HCTZ, indapamide Distal tubule hypercalcemia, hyperglycemia
106
potassium sparing diuretics
spironolactone, triamterene, amiloride collecting ducts
107
proximal convoluted tubule
65% of the sodium is absorbed water, potassium, chloride follow
108
descending LOH
separates handing of sodium and water to concentrate urine highly permeable to water (20% reabsorbed) concentrates NaCl
109
ascending LOH
not permeable to water more sodium is removed
110
distal convoluted tubule
impermeable to water except for in the presence of ADH and aldosterone aldosterone - water and sodium reabsorbed, potassium excreted ADH - increases water reabsorption PTH: promotes calcium reabsorption
111
intrinsic pathway
longer measures PTT heparain contact activation pathway
112
extrinsic pathway
shorter PT/INR warfarin
113
vit k dependent factors
2, 7, 9, 10
114
normal aptt
25 - 35s
115
normal PT
12 - 15s
116
normal ACT
90 - 120s
117
Type 1 VWDx
mild-moderate reduction in vWF produced
118
Type 2 vwdx
vwf doesn't work well
119
type 3 vwdx
severe reduction in the amount of vwf produced
120
hemophiliia a vs b
a = 8 b = 9
121
name the clotting factors
1. fibrin 2. thrombin 3. tissue factor 4. calcium 5. labile factor 7. stable factor 8. antihemophilia 9. christmas tree 10. stuart prower 11. plasma thromboplastin antecedent 12. hageman 13. fibrin stabilizing factor
122
TBW
42 L
123
ECF
14 L 11 L = ISF 3 L = plasma
124
ICF
28 L
125
magnesium dosing for pre-e patient
4 g over 10 m 1 g/hr for 24 hours
126
increased anion gap
Methanol Uremia DKA Paraldehyde Isonizad Lactate Ethanol Salicylate
127
normal anion gap acidosis
Hyperalimentation Acetazolamide Renal tubular acidosis Diarrhea Ureteral diversion Pancreatic fistula
128
acute resp vs chronic resp. acidosis and paco2
acute = 0.08 decrease in pH per 10 mmHg co2 chronic = 0.03 decrease in pH per 10 mmHg co2 increase
129
metabolic acidosis paco2 changes
paco2 decreases 1 - 1.5 mmHg per HCO3 decrease of 1
130
metabolic alkalosis paco2 changes
paco2 increases 0.5 -1 per HCO3 increase 1
131
platelet lifespan
8 - 12 days
132
Erector spinae muscles
iliocostalis longissimus spinalis
133
how many pairs of spinal nerves
31
134
autonomic blockade
2 - 6 higher than sensory
135
sensory blockade
2 higher than motor
136
foot and ankle nerves
saphenous sural superficial peroneal deep peroneal posterior tibial
137
sacral plexus gives rise to what 5 nerves
superior gluteal inferior gluteal posterior cutaneous pudendal sciatic
138
lumbar plexus gives rise to
iliohypogastric ilioinguinal gentifemoral LFC obturator femoral
139
infraclavicular picture
3 o clock = medial 6 o clock = posterior 9 o clock = lateral
140
epidural needles
tuohy = 30 hustead = 15 crawford = 0
141
non cutting pencil point needles
pencil point - sprotte, whitacre rounded bevel - green
142
cutting tip needles
quincke pitkin
143
conus medullaris
adult - L1, L2 infant - L3
144
dural sac ends
adult - S2 (superior iliac spines) infant - S3
145
total CSF volume & mL/hr
150 30 mL/hr
146
CSF s/g
1.002 - 1.009
147
CSF pressure
5 - 15 mmHg
148
max cerebral v/c
PaCO2 @ 25
149
max cerebral v/d
PaCO2 @ 80 - 100 mmHg
150
at what PaO2 does vasodilation occur
< 50 - 60 mmHg
151
spinal cord circ
2 posterior 1 anterior 6 - 8 radicular
152
dantrolene dosing for MH
2.5 mg/kg Q 5 - 10 M
153
DANTROLENE vial
20 mg dantrolene 3 g mannitol 60 mL of preservative free water
154
PSNS output
CN 3, 7, 9, 10
155
CSF flow
Lateral Foramen of Monroe 3rd ventricle Aqueduct of Silvius 4th ventricle Foramen of Luschka Foramen of Magendie Arachnoid Villi
156
when do you measure ICP
< 7 GCS
157
upper motor neuron injury
above decussation: contralateral spastic paralysis below decussation: ipsilateral spastic paralysis
158
lower motor neuron injury
flaccid paralysis ipsilateral
159
tensilon test
1 - 2 mg edrophonium MG patient (gets better) = myasthenic crisis
160
MG vs LEMS
MG best in morning, worse throughout the day LEMS worst in morning, better throughout day.
161
Name the cranial nerves
1. olfactory 2. optic 3. oculomotor 4. trochlear 5. trigeminal (V1 opth. V2. max. V3 mand) 6. abducens 7. facial (temporal, zygomatic, mandibular, buccal, cervical) 8. vestibulococlear 9. GPN 10. vagus 11. spinal accessory 12. hypoglossal
162
Beta waves
light anesthesia, awake
163
Alpha waves
awake but restful
164
Theta
GA and kids sleeping
165
Delta
GA or brain ischemia or deep sleep
166
burst suppression
GA, hypothermia, CBP, cerebral ischemia
167
pacer position
1. chamber paced 2. chamber sensed 3. response to sensing 4. programmability 5. multiple sites paced
168
a wave
RA contraction just after P waave
169
c wave
mitral valve elevation just after QRS
170
x descent
RA relaxation St
171
v wave
filling of RA at the beginning of T
172
y descent
tricuspid valve opens after T wave ends
173
mapleson a
apl near patient awake patient
174
mapleson b
both APL and FGF at patient
175
mapleson c
simple cpr B - corrugated tubing
176
mapleson D
opposite of A best for dead patients (think mechanically ventilated) FGF near patient aka BAIN
177
mapleson E
no bag no apl arye's t-piece
178
mapleson F
jackson reese best for infants no apl valve
179
semi open circuit
FGF > MvE NO REBREATHING
180
semi closed circuit
FGF < MVE rebreathing unidirectional valves
181
closed circuit
very low FGF, complete rebreathing, APL valve closed
182
normal axis deviation
-30 to + 90 I = + avF = +
183
left axis deviation
I = + avf = - - 30 to -90
184
right axis deviation
I = - avF = + 90 - 180
185
extreme right axis deviation
I = - avF = - 180 to - 90
186
what are the 3 internodal tracts
anterior - bachmann middle - wenckbache posterior - thorel
187
increased resitance =
increased PIP normal pPlat
188
decreased compliance
increased PIP and pPLAT
189
bellow's ventilator determined by
bellows movement on expiration *ascending bellows are safer*
190
when does line isolation monitor alarms
if all currents exceed 2 - 5 mA
191
macroshock vs microshock vfibb
macroshock = 100 mA microshock = 100 microamps 1000x difference
192
what is the max allowable current leak in the OR
10 microamps
193
yearly maximum exposure of REM
adult = 5 fetus = 0.5, 0.05 rem/mo
194
p wave
0.08 - 0.012s
195
PR interval
0.12 - 0.20s
196
Q wave
< 0.04s
197
QRS
<0.1s
198
where is esophageal doppler located
35 cm from incisors
199
normal SVO2
65 - 75%
200
BP arm positioning
Q 10 cm = 7.4 mmHg Q inch = 2 mmHg change
201
BP bladder ideal length & width
length = 80% width = 40%
202
SPO2 and PaO2 correlations
90 = 60 80 = 50 70 = 40 50 - 26.5
203
red vs near-infrared light
red - 660 - deoxy near infrared - 940 - oxy
204
when does barotrauma occur
plateau pressure > 35 cmH2O
205
NIOSH recs.
halogenated < 2ppm nitrous < 25 ppm together < 0.5, < 25
206
cylinder #s
660/1900PSI (O2) 625/1900PSI (AIR) 1590L/745 PSI (N2O) n2o full at 20.7lbs empty at 14.1 lbs
207
components of low pressure system
thorpe tubes CGO vaporizers check valve (if present)
208
components of high pressure system
hanger yoke yoke block with check valves cylinder pressure regulator cylinder gauge
209
components of the intermediate pressure system (7)
pipeline inlets pressure gauges oxygen pressure failure device oxygen second stage regulator oxygen flush vlave ventilator power inlet flowmeter valves
210
what is the dose of nmb for intubating
ED95 2 - 3 x
211
dibucaine numbers
70 - 80 typical homozygous 50 - 60 heteroxygous 20 - 30 atypical homozygous
212
best place to measure recovery
adductor pollicis (ulnar n) flexor hallucis (post tib)
213
best place to measure onset
orbicularis occuli corrugator supericili facial nerve
214
max dose of tumescent lido
55 mg/kg peaks in 12h, out of system at 36h
215
lipid emulsion for LAST
1.5 mL/kg 0.25 mL/kg/m
216
pka amides
bupi/ropi/levo 8.1 lido/prilocaine 7.9 mepivacaine 7.6
217
ester pka
procaine 8.9 chlor. 8.7 tetracaine 8.5
218
procaine dosing
7 mg/kg 350 - 600 mg
219
mepivacaine dosing
7 mg/kg 400 mg
220
prilocaine dosing
8 mg/kg < 70 = 500 mg > 70 = 600 mg
221
albumin binds with
acidic drugs
222
alpha 1 glycoprotein binds with
basic drugs
223
zero order kinetics
phenytoin alcohol warfarin theophylline aspirin heparin
224
enzyme inducers
ethan (ethanol) took (tobacco) physics (phenytoin) because (barbs&benzos) riley (rifampin) kelley (ketamine) cares (carbamazepine)
225
enzyme inhibitors
snakes (SSRIS) grappling (grapefruit juice) ominiously (omeprazole) is (isonizid) everything (erythromycin) kosher (ketoconazoles)
226
n2o vs nitrogen soluble
34x
227
n2o and air bubbles
S56 = 7 - 10d air = 5d perflurorpropane = 30d silicone oil = none
228
nerve ischemia concern
amplitude decr'd 50% latency increased 10%
229
order of blockade
B (preganglionic ANS) C (postganglionic ANS & slow pain, temperature, touch) Gamma & Delta (muscle tone, fast pain, temp, touch) Beta & Alpha (touch, pressure, sk. muscle motor, propioception)
230
LA onset, potency, DOA
onset = pka potency = lipid solubility DOA = protein binding
231
blood gas partition
des = 0.42 n2o = 0.46 sevo = 0.65 iso = 1.4
232
vapor pressure gases
n2o = 38, 770 des = 669 iso = 238 sevo = 157
233
lipophilic Vd
> 0.6 mL/kg
234
steady state
5 1/2 times
235
drug cleared
5 1/2 times
236
co affinity for hgb
200x
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