*My APEX > From practice tests #2 > Flashcards

From practice tests #2 Flashcards

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1
Q

Technique to decrease local anesthetic from opthalmic to systemic

A
  • Keep eye shut for 1 min
  • avoid blinking
  • press medial canthus
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2
Q

WBC function:

  • T lymphocytes
  • B lymphocytes
  • Neutrophils
  • Basophils
  • Eosinophils
A
  • Cell mediated (no antibodies)
  • Humoral immunity (antibodies)
  • Bacterial/Fungal (most abundant)
  • Histamine, serotonin, heparin, bradykinin (hypersensitivity)
  • Parasites
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3
Q

Disease caused by a prion? Leads to?

A

Creutzfelt-Jakob

  • Leads to Dementia and encephalopathy
  • Caught from animal protein, implants, cadavar pituitary hormones
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4
Q

Vanco must be started within how long of incision?

A

120 mins

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5
Q

Rigid bronchoscope: 4 ways to ventilate, EtCO2, Airway

A

Ventilate

  • Spontaneous
  • Apneic
  • PPV (requires ventilating bronchoscope)
  • Jet ventilation (best with TIVA)

innacurate EtCO2

Airway not secure

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6
Q

Greatest risk of VAE during mediastinoscopy when?

A

During spont. breathing

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7
Q

What is the “Hold up” sign?

A

When using a bougie, its when hitting the carina (35-40cm)

Confirms placement

-Bougies are also good for NT intubation, or through supraglottic airway

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8
Q

Giving “chest rigidity” causing opioids, the difficult ventilation is actually from? Due to?

A

Laryngeal muscle contraction

From increased dopamine or decreased GABA

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9
Q

Sniffing position alignment

A

Cervical flexion - aligns pharyngeal/Laryngeal

A-O extention - aligns Pharyngeal/Oral

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10
Q

Most potent glucocorticoid? the rest that are glucocorticoid only?

A
  • Dexamethasone
  • Betamethasone
  • Triamcolone
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11
Q

Has = glucocorticoid/mineralocorticoid effects

A
  • Cortisol
  • Cortisone
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12
Q

Drugs with Glucorticoid > mineralocorticoid effects

A
  • Prednisone
  • Methylprednisone
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13
Q

Drug with mineralacorticoid > glucocorticoid effects

A
  • Fludricortisone
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14
Q

Post-op tonsil bleed timing

A

75% < 6 hours

25% < 24 hours

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15
Q

Loading dose for Mg for seizure prophylaxis (eclampsia)?

Target Mg levels?

A

4-6 Grams over 10 mins, then 1-2 G/hr

Target plasma: 2-3.5

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16
Q

Cells of the GI tract:

  • Gastrin
  • Cholecystokinin
  • Secretin
  • Gastric inhibitory peptide
A
  • G cells
  • I cells
  • S cells
  • K cells
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17
Q

Lasers: Shortwave vs Longwave

A

Shortwave:

  • Deeper
  • Retina
  • RAN - Ruby, Argon, ND:YaG lasers

Longwave:

  • Shallow
  • More H20
  • Cornea/sclera
  • CO2 laser
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18
Q

1 site of metastasis in Breast Cancer

A

Bone

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19
Q

Mastectomy

A
  • hypercalcemia
  • possible low spo2 if isosulfan blue is injected into sentinal node
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20
Q

Effects of bone cement:

A
  • First sign: decreased EtCO2
  • Hypotension
  • Hypoxemia (air/fat emboli)
  • Increased PVR
  • Cardiac Arrest
  • LOC during regional
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21
Q

Superior Hypogastric plexus

A
  • Innervates pelvic organs
  • Block helps in Cancer pain
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22
Q

ASA chance of mortality per 10,000

A
  1. 0.04
  2. 0.5
  3. 2.7
  4. 5.5
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23
Q

Nerve injured when arms pronated in supine position

A

Ulnar

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24
Q

most to least common closed claims cases (categories of anatomic/anesthetic fault)

A
  1. Regional
  2. Respiratory
  3. Cardiac
  4. Equipment
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25
Neurotransmitter and their target receptor: * Substance P * Glutamate * Serotonin * Glycine Which are excitatory/inhibitory?
Excitatory * Substance P - Neurokinin 1 (NK1) * Glutamate - NMDA Inhibitory * Serotonin - 5HT * Glycine - Chloride linked GlyR
26
Grey matter lamina dorsal/ventral?
1-6 Dorsal 7-9 Ventral
27
Drugs metabolized by Pseudocholinesterase
* Ester anesthetics (cocaine is Pseudocholinesterase + liver) * Mivacurium/Succinylcholine
28
Tumescent local anesthetic contains:
* Dilutent (NaCl) * Lidocaine (0.05-0.1%) * Epi * Bicarb (sometimes) Peaks 12 hours DOA 36 hours
29
Oxybarbiturates and Thiobarbiturates? Best anticonvulsant?
Oxybarbs: * Methohexital * Phenobarbital (best anticonvulsant) * Socobarbital Thiobarbs: * Thiopental * Thiamylal
30
Reduces gas pressure between O2 tank and intermediate system?
Regulator
31
Bourdin gauge can calculate which gases? Why?
* Nitrogen * Helium Liquid in canister
32
Axis deviation
**_L_**eads **_L_**eaving each other _L_ axis deviation * Normal: -30 to +90 * Left: \< -30 (extreme is -90 or less) * Right: \> +90
33
Semi-open Circuits
* Bain * Mapleson * Jackson-Reese
34
Name circuits
35
Antiarrhythmics action * Class I * Class II * Class III * Class IV
* Decrease phase 0 (NA channel blockers) * decrease rate depolarization through SA, phase 4 (Beta blockers) * prolongs repolarization, phase 3 (K channel blockers) * decrease action potential (Ca channel blocker)
36
Multiple Sclerosis
* avoid spinal (epidural/PNB ok) * Avoid hyperthermia, Succ, stress * pt on long term steroids (may need stress dose)
37
disease of abnormal calcium sequestration
Myotonic Dystrophy
38
Hyper/Hypo-K periodic paralysis, what Ion channels?
HyperK - Na channel HypoK - Ca channel
39
Cyclosporins effect which organ the most?
Kidney
40
Diseases causing kyphosis secondarily cause what?
Aortic Regurg \*Think ankylosing spondylitis, RA, spina bifida, osteoporosis, muscular dsytrophy, Ehlers-Danlos, Marfans
41
Disruption of _____ in which LeFort fractures?
* Cribiform plate * Lefort II, III
42
5 and dime reflex (oculocardiac) effects which receptors?
M2 on SA/AV nodes
43
Which reflex still intact in heart transplant?
Bainbridge
44
Herbal alpha 2 blocker? Treats what?
Yohimbe treats orthostatic hypotension
45
RMP and TP of SA node? Another name for SA node?
RMP -60 TP -45 Keith-Flack node
46
Supplies SA node?
RCA (in 50-60% ppl) Cx (in 40-50% ppl)
47
Decreases supply and increases demand of heart?
Increased * HR * Preload Decreased * Aortic diastolic BP
48
Most common cause of mitral stenosis? Others?
Endocarditis RA, SLE, Carcinoid syndrome
49
Where do Cranial nerves originate from?
Midbrain * 3-4 Brain stem * Pons: 5-8 * Medulla: 9-12
50
Hypercarbia effects
Direct effects: * Myocaridial depressant * local vasodilation SNS effects: * Vasoconstriction * Increased contractility * increasesed serum K+
51
Secretion: Adrenal medulla vs adrenal cortex
Medulla * Epinephrine * Norepinephrine Cortex (zona glomerulas, fasciculata, reticularis) * Aldosterone * Glucocorticoids * Androgens
52
Thyroarytenoids
They relax But also ADDuct the VC, closing airway
53
Additives to Bier block to extend sensory block?
* Toradol * Tramadol * Clonidine
54
Match to area of anatomy: * Lower motor neuron * Upper motor neuron * 2nd order neuron, medial lemniscal * 2nd order neuron, spinothalamic
* Ventral horn * precentral gyrus in Cerebral cortex * gracilis nucleus in Medulla/brainstem (think medial medulla) * Dorsal horn (think **_spino_**thalamic - 1st and 2nd neuron in spinal cord)
55
ETT cuff pressures less than? in what unit of measure?
\<25 **cmH2O**
56
C and K temp conversions C and F conversions
C = K - 273.15 K = C + 273.15 C = (F-32) x 5/9 F = (Cx1.8) + 32
57
Measurement conversions mmHg to cmH20 1 atm and others
1 mmhg = 1.36 cmH2O 1 atm = 100 kpa, 1033 cmH2O, 14.7 lbs/inch²
58
FRC and atelectasis?
an increased FRC is protective against atelectasis (COPD, elderly) Doesnt mean it cant be caused by other means...
59
Cricoid pressure is known to?
Decrease LES sphincter tone
60
Where are M2 receptors?
Cardiac
61
Increased risk of LAST
* Hypercarbia * Hyperkalemia * Resp/Metabolic acidosis
62
Soda lime: Exhaustion vs dessication
Exhaustion: * Color change (Change in pH \<10.3) * ability to absorb CO2 Dessication * dried out (no H2O, typically 13-20% saturated) * Risk of Compound A and Carbon monoxide
63
CSF vs Blood
CSF * More acidic (due to lower protein levels decrease H+ buffer) * less Glucose, K+
64
Which volatile attenuates baroreceptor reflex the least?
Isoflurane
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