SEE 2025 (Apex) > Misc. Topics > Flashcards

Misc. Topics Flashcards

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1
Q

Four mechanisms of heat transfer in order of importance:

A

Radiation > Convection > Evaporation > Conduction

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2
Q

Most effective method of perioperative warming?

A

Forced air warmer

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3
Q

1 source of heat loss in the OR?

A

Radiation (infrared)

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4
Q

Best spot for measuring core temp with minimal risk ?

A

esophageal

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5
Q

Meds used for post-op shivering?

A

Meperidine, clonidine, dexmedetomidine

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6
Q

Shivering increases O2 consumption by how much?

A

400-500%

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7
Q

Rule of 9s for burns:

A

Head = 10%
Trunk = 36%
Arm = 9%
Leg = 18%
Perineum = 1%

These are all front and back

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8
Q

Parkland formula:
1st 24 hours?
Second 24 hours?

A

1st: Crystalloid -> 4mL LR x % TBSA burned x kg
Colloid –> none

2nd: D5W maintenance rate
Colloid–> 0.5mL x %TBSA x kg

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9
Q

Abdominal compartment syndrome =

A

intraabdominal pressure > 20mmHg

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10
Q

Dose of NDNMBS for burns?

A

increased 2-3 fold because there are more receptors

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11
Q

When does upregulation of extrajunctional receptors begin after burn?

A

after 24 hours

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12
Q

Succs for burns?

A

safe in first 24 hours and then after can cause lethal hyperkalemia

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13
Q

Burns: good choice for analgesia?

A

Ketamine

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14
Q

Heat loss is in burn patient? %?

A

60% radiation
25% evaporation
12% convection
3% conduction

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15
Q

Hypocarbia ____ the seizure duration

A

increases

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16
Q

Absolute contraindications to ECT?

A

pheochromocytoma
unstable C-spine
brain tumor
MI in past 4-6 months

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17
Q

Key relative contraindications of ECT:

A

pregnancy
pacemaker/ICD
CHF
glaucoma

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18
Q

_______ during induction can produce a better quality seizure.

A

Hyperventilation
>25 seconds is best

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19
Q

______ is the gold standard induction agent for ECT.

A

Methohexital

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20
Q

_____ prolongs the duration of action of _____ AND ____

A

Succs and NDNMBs

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21
Q

Neuroleptic malignant syndrome caused by :

Tx?

A

dopamine depletion

dantrolene, bromocriptine

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22
Q

Serotonin syndrome caused by ….

Tx?

A

excess 5-HT activity

cyprohepatdine

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23
Q

Anticholinergic poisoning is casued by:

Tx?

A

excess ACh blockade

physostigmine

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24
Q

Nitrous oxide is contraindicated for ___ after SF6 bubble is placed.

A

7-10 days

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25
_____ increases IOP by 5-15 mmHg for up to 10 mins
Succs
26
Is succs okay to use in a patient with an open eye injury and a full stomach?
YES
27
_____ is caused by chronically elevated IOP that leads to retinay artery compression
Glaucoma
28
Anesthetic considerations for strabismus surgery:
PONV and onculocardiac reflux --> bradycardia
29
Normal IOP:
10-20 mmHG
30
Aqueous humor is produced by the ____ ____ and reabsorbed by the _____ __ ____.
ciliary process canal of Schlemm
31
When should you d/c N2O before the SF6 bubble is placed?
15 mins before
32
Landmarks for TAP block:
1. external oblique 2. latissimuss dorsi muscle 3. iliac crest
33
TAP block coverage:
T9-L1
34
Complictions of TAP block:
peritoneal puncture liver hematoma
35
Pain stimulus due to a stimulus that does not normally produce pain:
Allodynia
36
Abnormal and unpleasant sense of touch:
Dysesthesia
37
Managment of cancer pain of the upper abdomen:
celiac plexus block
38
Most common side effect of prophylactic abx?
pseudomembranous colitis
39
Most common allergic reactions for abx?
Beta-lactams
40
When can the patient with a PCN allergy receive a cephalosporin?
if the reaction was NOT IgE mediated
41
To reduce histamine release and hypotension, vanc should be administered at a rate of __-__ mg/kg over __.
10-15 1 hour
42
What abx are contraindicated during pregnancy?
chloramphenicol, erythromycin, fluroroquinolones and tetracycylines
43
______ acts by disrupting bacterial cell wall synthesis.
Vancomycin and cephalosporins
44
Abx of choice for active MRSA?
Vanco
45
Prophylactic abx administered ___ mins of surgical incision. Vanc?
60 120
46
Anaohylaxis causes degranulation of _____ and ____ cells.
basophils and mast cells
47
Basophil and mast cell degranulation can be stopped with _____.
Epi
48
Hypersensitivity: Type 1 = Type 2 = Type 3 = Type 4 =
Type 1 = Immediate hypersensitivity -->Anaphylaxis Type 2 = Antibody-Mediated -->ABO incompatibility Type 3 = Immune Complex Mediated --> Snake Bite Type 4 = Graft-vs-host reaction
49
Chemotherapeutic agent and side effect: Bleomycin --> Cisplatin --> Doxorubicin -->
Bleomycin --> Pulmonary toxicity Cisplatin --> Renal toxicity Doxorubicin --> Cardiac toxicity
50
2 chemotherapeutics that cause bone marrow suppression?
5-fluoracil and Methotrexate
51
_____ ______ can cause extrapyramidal symptoms
Dopamine antagonists butyrophenes, phenothiazines, metoclopramide
52
______ is contraindicatedc with bowel obstruction
Metoclopramide
53
When is transdermal scopolamine best applied before surgery?
> 4 hours before induction of anesthesia
54
_____ __ mg IM may reduce PONV by maintaining BP and cerebral perfusion
Ephedrine 25 mg IM
55
5-HT3 antagonists:
Ondasetron
56
Neurokinin-1 Antagonists
Arepitant
57
Dopamine Antagonists:
Droperidol Haloperidol Metoclopramide Prochlorperazine
58
Antihistamines:
Benadryl hydroxyzine promethazine
59
Triad of Fat Embolism Syndrome:
respiratory insufficiency neurologic changes petechial rash
60
_____ increaes intramedullary pressure in the bone and can produce microemboli that travel to the lungs
Methyl methacrylate
61
Greatest risk of FES timeframe?
first 72 hours of injury which is why prompt stabilization is important
62
Bone cement can cause ____ heart failure
Right V/Q mismatch from microemboli in lung
63
Residual methyl mathacrylate can enter systemic circulation where it causes:
Bradycardia dyshryhtmias hypotension pulmonary HTN hypoxia BCIS
64
When used for a bier block, the tourniquet must remain inflated for at least ____ mins after local is injected.
20 mins
65
Highest risk procedure for BCIS?
Hip arthroplasty
66
Firsy signs of BCIS in the awake patient? under GA?
awake --> dyspnea and altered mental state GA --> decreased ETCO2
67
Bier block tourniquet: upper extremity --> lower -->
250 mmHg or 100 mmHg over SBP 250-400 mmHg
68
Samters Triad (aspirin exacerbated respiratory disease) :
asthma allergic rhinits nasal polyp
69
Inhibition of COX-1 enzyme impairs....
platelet function gastric irritation decrease renal blood flow
70
Inhibition of COX-2 enzyme produces:
analgesia anti-inflammatory antipyretic theres a ceiling effect
71
_____ 30 mg is equianalgesic to morphine 10 mg
Ketoralac can only be taken for 5 days
72
May mimic Conn's syndrome:
Licorice
73
Valerian ____ MAC
decreases
74
St John's Wort causes .... with MAOIs
Serotonin Syndrome
75
Aldrete scoring measures:
Activity Respiration Circulation Consciousness Oxygen saturation ARCCO 0-2 points are messured in 5 areas
76
Aldrete score of __ or greater suggests readiness for discharge
9
77
Aldrete: BP +/- __ mmHG of prep value = 2 points
20 mmHg
78
Aldrete: SPO2 > % on RA
92% = 2 points 1 point = >90% but needs O2
79
____ is increased in the patientg with Zollinger-Ellison syndrome (____ sectreting tumor, increases stomach acid --> gastric ulceration)
Gastrin
80
Opioids may cause cancer through suppression of which cell type?
NK cells
81
For every degree below normal temperature, oxygen consumption is reduced by:
5-7%
82
Which substances are located in the Chemoreceptor trigger zone (CTZ)?
Serotonin (5-HT3s) Dopamine (D2 receptor) Substance P (NK-1 receptor)
83
5-HT3 receptor antagonists treat PONV by their effects on:
nucleus tractus solitaris vagus nerve
84
Block for liver cancer
celiac plexus
85
block for uterine cancer
superior hypogastric block
86
Esophageal probe placement depth?
Distal 1/3 - 1/4 of the esophagus (38-42 cm)
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