Term
| What are Clopidogrel and Ticlodipine? How do they work? |
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Definition
| Anti-platelets. Inhibit platelet aggregation by blocking adenosine diphosphate receptors. |
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Term
| What are Abciximab and Eptifibatide? How do they work? |
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Definition
| Inhibit platelet adhesion, activation, and aggregation by antagozing platelet glycoprotein IIb/IIIa receptors. |
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Term
| What are the VPs of Des, N2O, Sevo, Enflurane, Iso, Halothane? |
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Definition
Des 669
N20 ---
Sevo 157
Enflurane 172
Isoflurane 238
Halothane 242 |
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Term
| How do you intubate for TEF? |
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Definition
| Go right main stem, then pull back til breath sounds are heard on left. Then rotate bevel to face anterior. Keep precordial stethoscope over left side and if breath sounds are lost you've slipped back right mainstem. TEF pt's have chance of subglottic stenosis (so need smaller ETT). |
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Term
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Definition
| CP pts do NOT have an exaggerated hyperkalemic response to succinylcholine, nor are they more susceptible to malignant hyperthermia. Severe gastric reflux though! |
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Term
| Drugs that cause Lupus symptoms.. |
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Definition
| Hydralazine, Phenytoin, Isoniazid. |
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Term
| How do you emergently reverse warfarin? |
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Definition
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Term
| Carcinoid tumor resection. Name 4 drugs to avoid... Why? |
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Definition
| Avoid Sux, Thiopental, Atracurium, Morphine or any drug that releases HISTAMINE. |
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Term
| Trendelenburg patient... why doesn't CBF increase? |
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Definition
| Offset by venous and CSF pressure, actually results in net decrease in arterial blood flow to brain. |
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Term
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Definition
| Infrared gas monitors are small and portable, they have a quick response time, a short warm-up time, and do not need to be connected to a scavenger because the analyzed gases can be returned to the circuit. |
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Term
| Cushing's disease. Cortisol? Potassium? glucose? NDMR? Why steroid injection pre-op? |
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Definition
| Patients with Cushing's disease have increased serum cortisol levels resulting in hypokalemia, hyperglycemia, and skeletal muscle relaxation which may require a decreased non-depolarizing muscle relaxant dose. Because bilateral adrenalectomy results in rapidly falling cortisol levels, steroid replacement therapy should be initiated prior to or during surgery. |
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Term
| Thoracic aortic aneurysm repair. Where do you put a-line? |
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Definition
| Right radial as clamp might be placed between left common carotid and left subclavian blocking everything downstream. |
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Term
| What NDMR undergoes NO metabolism at all. |
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Definition
| Rocuronium. Excreted by liver, and a little by kidneys. |
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Term
| How is atracurium metabolized? |
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Definition
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Term
| What percent of cardiac output goes to brain? How many ml/min? |
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Definition
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Term
| Superior to inferior order of INTERCOSTAL neurovascular bundle... |
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Definition
| bone, vein, artery, nerve |
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Term
| What is normal intraocular pressure? Higher in morning or night? |
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Definition
| 10-20 mmHg, >22 mmHg is ocular HTN. Intraocular pressure is higher in the morning. |
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Term
| Normal phos level? What happens is hypophosphatemia? |
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Definition
| 2.7 - 4.5 mg/dL. Hypophos (~1.8) may lead to parasthesias, myopathy, delirium, seizures, coma. |
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Term
| What is primary goal of mgmt of pulmonic stenosis? |
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Definition
| Avoid increases in myocardial o2 demand. Avoid tachycardia, avoid increases in contractility. |
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Term
| Explain PCWP, CO, and SVR in a pt with hypovolemic shock. |
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Definition
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Term
| Platelets release _________ which causes vasoconstriction |
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Definition
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Term
| Platelets are derived from ____karyocytes in the ____ ______ |
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Definition
| MEGAkaryocytes in the BONE MARROW. |
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Term
| Platelets release _______ which activates other nearby platelets. |
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Definition
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Term
| Speeds of intrinsic vs extrinsic clottings paths? Activating factor? |
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Definition
Extrinsic FAST. 15 seconds. Tissue Factor (III)
Intrinsix SLOW. 1-6 minutes. factor XII. |
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Term
| How does hypocalcemia affect clotting? |
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Definition
| Impaired clotting. Calcium required at nearly every step of extrinsic and intrinsic paths. |
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Term
| Max dose of Lido? W/ and W/o epi. Calc for 70 kg pt. |
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Definition
Max dose w/o epi: 4.5 mg/kg
Max dose w/ epi: 7 mg/kg
4900 mg/kg with epi |
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Term
| Ropivicaine and bupivicaine max dose with and without epi. |
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Definition
| Basically 3 mg/kg with or without. |
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Term
| Max dose etidocaine with and without epi. |
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Definition
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Term
| Cocaine dose with/without epi |
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Definition
| 1/5 mg/kg DO NOT USE EPI. |
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Term
| How long do you have to wait to use N2O if pt had opthalm surgery and gas bubble in eye? |
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Definition
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Term
| How long should herbals be stopped before elective surgery? |
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Definition
| 7-14 days. Longer the better. |
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Term
| 70 kg pt has been NPO for 10 hours. How do you replete? |
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Definition
110ml/hr NPO loss so 1100 cc lost in 10 hours.
Replete 2:1:1
Give 550 cc first hour, 275 each of next 2 hours. |
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Term
| How does hypercarbia/hypercapnea affect local anesthetics CNS toxicity? How does protein binding affect it? |
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Definition
| Hypercarbia increases risk of CNS toxicity. Less protein bound drug will increase effect of drug also. |
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Term
| What bones are you lifting when you do a jaw thrust? |
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Definition
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Term
| What is the maximum size ETT that can pass through a size 3 LMA. |
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Definition
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Term
| What does cimetidine inhibit? Name some drugs inhibited.. |
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Definition
| Cimetidine inhibits P450!! All amide anesthetics, Labetalol, phenytoin, etc. |
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Term
| If your pt cannot adduct their thumb what nerve is injured? |
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Definition
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Term
| Oculocardiac reflex bradycardia during strabismus surgery is exacerbated by ______carbia. |
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Definition
Hypercarbia = worse bradycardia
"Slow breathing = slow HR" |
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