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Truelearn Advanced Exam > TL incorrect > Flashcards

TL incorrect Flashcards

1
Q

What does pseudocholinesterase break down?

A

succ
mivacurium
ESTER local anesthetics

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2
Q

DIC transfusion goals pregnancy

A

Hg > 7
plts > 50k
PTT/PT < 1.5x normal
fibrinogen > 300

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3
Q

Why PEEP helps w/ acute on chronic systolic heart failure

A

-lowers preload -> ideal in fluid overload
-b/c less preload -> less movement of RV into LV -> better LV hemodynamics
-b/c less fluid overloaded and less pressure on LV -> CI increases and PCWP dec

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4
Q

DLCO obesity

A

increases

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5
Q

onset of action of calcitonin

A

4-6 hours

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6
Q

onset of action of zoledronic acid

A

48-72 hours

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7
Q

mannitol and kidney transplants

A

dec the risk of post transplant kidney injury

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8
Q

convert u/s waves into currents to produce image

A

direct piezoelectric effect

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9
Q

Ca and ESRD

A

kidney loses ability to reabsorb Ca

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10
Q

MC SE dantrolene

A

skeletal muscle weakness

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11
Q

what improvement in FEV1 do you need w/ bronchodilators to warrant chronic thearpy?

A

10%

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12
Q

What factor decreases first and liver disease

A

Factor seven

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13
Q

Vitamin K, depending clotting factors

A

10, nine, seven, two

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14
Q

Lupus, anticoagulant lab results

A

Elevated PTT, normal PT. However, they are actually prothrombotic.

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15
Q

Abdominal pain, nausea, vomiting, sweating, an acute liver failure what overdose

A

Acetaminophen

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16
Q

Least likely to be metabolized in the lungs

A

Epi

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17
Q

What to avoid an acute intermittent porphyria

A

Barbiturates, benzodiazepines, nifedipine, glucocorticoids and alcohol

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18
Q

Where does the obturator nerve block occur?

A

Between the adductor, longus and brevis, and between the adductor brevis and adductor Magnus

Pneumonic, Alabama

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19
Q

Electrolyte changes with therapeutic hypothermia

A

Hypokalemia, hypomagnesemia and hypophosphatemia

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20
Q

Age an epidural steroid injection

A

No influence

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21
Q

Most likely to determine success with epidural steroid injections

A

Short time from injury
Absence of psychopathology
Herniation plus a nerve root irritation, or compression

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22
Q

Changes to CVP waveform with cardiac Tampa nod

A

Exaggerated X dissent and loss of y descent

Due to pressure from cardiac Tampa nod, not as big of a release and pressure with tri cuspid valve opening

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23
Q

First line treatment for cyanide poisoning

A

Hydroxocobalamin

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24
Q

Spinal stenosis, which nerve is affected first motor or sensory

A

Sensory

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25
Q

Absolute contraindications to tracheostomy placement

A

Infants
Surgical site infection
Coagulopathy
Cervical spine injury unstable

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26
Q

Risk factor for an allergic contrast reaction

A

Other medication, allergies
Asthma
Is less than 50
Hi cut total contrast us

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27
Q

EKG changes with hypocalcemia

A

Prolonged, QT interval

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28
Q

What is the primary mechanism of gas exchange for mechanical ventilation?

A

Convective bulk flow

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29
Q

Spinal epidural, is not behaving as expected what your thought process be

A

Sub dural injection
Excessive sensory blockade, sympathetic, blockade, variable motor, black head

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30
Q

Over what time frame is a fructose amine test assessing

A

One to two weeks

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31
Q

High risk for aspiration, pneumonia

A

Aspirate volume of greater than .4 cc per kilogram.
Aspirate pH of less than 2.5. Particulates in Esprit.

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32
Q

PO to Ivy methadone, dosing

A

2 to 1 so half the PO dose

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33
Q

Proteins, C, & S with pregnancy

A

Resistance to pro Tien C
Decline in level of protein s

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34
Q

What lab value is left out of the child pew score

A

Creatinine

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35
Q

What is in the meld score?

A

I crush beer daily
INR
Creatinine
Billy Rubin
Dialysis

36
Q

What’s in the child Pugh score

A

Poor another beer at 11
PT
Ascites
Billy Rubin
Albumin
Encephalopathy

37
Q

Is an oxygen cylinder made of aluminum MRI safe

A

Yes

38
Q

Is a reinforced in a tracheal tube MRI safe

A

No

39
Q

What is an cryoprecipitate?

A

Fibrinogen
Factor 13
Factor eight
VWF
 Fibronectin

40
Q

Most common complication from TPN use

A

Infection
Second is thrombo phlebitis

41
Q

Dose of Anesthesia for a caudal, block, and a 10 month old

A

1 cc per kilogram

42
Q

Pediatric caudal, anesthesia dosing

A

Sacral dermatomes .5 cc per kilogram.
Low thoracic dermatomes 1 cc per kilogram
Mid thoracic dermatomes, 1.25 cc per kilogram.

43
Q

Symptoms of multiple myeloma

A

Phone pain, osteolytic, destruction, hypercalcemia, anemia, immunosuppression, causing recurrent infections, renal failure, and neurologic symptoms

44
Q

Lumbar plexus block blocks what

A

Femoral nerve
Lateral femoral, cutaneous nerve
Obturator nerve

45
Q

Does fluorine vaporizer adjustments and hyperbaric oxygen chamber’s

A

Dial needs to be decreased because of increased pressure

46
Q

When doing a vessel clamp during an AVM resection, what neural monitoring is best

A

SSEP and MEP

47
Q

Side effects of prostaglandin

A

Apnea in pediatrics
Hypotension
Fever

48
Q

Mediator of pulmonary hypertension, after protamine

A

 Thromboxane

49
Q

Why hypercalcemia with low aldosterone levels

A

Kidney cannot excrete calcium

50
Q

Calculation for sodium deficit

A

Sodium deficit = (140- serum sodium) x total body water

Total body water = weight in kilograms x 0.6

51
Q

inc cerebral perfusion pressure and cerebral oxygenation

A

vasopressin

52
Q

What vasopressor increases, cerebral, perfusion pressure and cerebral oxygenation

A

Vasopressin

53
Q

Delirium Icu questionnaire

A

Acute change in mental status
In attention, or easily distracted
Altered level of consciousness
Disorganized, thinking

54
Q

Most common valvular defects

A

Bicuspid, aortic valve
#2: Perry membranous, VSD

55
Q

Which is better in cardiac arrest by phasic or monophasic defibrillation

A

Biphasic

56
Q

What is cabergoline

A

Dopamine agonist for prolactinoma

57
Q

Nerve block for women with uterine cancer for pain

A

Superior hypogastric

58
Q

When is a ganglion impar block used?

A

Parineal cancer

59
Q

RA anesthesia concerns

A

-diff intubation: dec ROM cervical spine
-diff MV: TMJ hypomobility
-inc risk of epidural hematoma: long term NSAIDs

60
Q

How to dec risk of postop hoarseness in ACDF

A

dec ETT cuff pressure

61
Q

are of deep brain stimulation in Parkinson’s

A

Subthalamic nuclei
internal globus pallidus
-sub and internal b/c DBS

62
Q

peds syndrome w/ unilateral face issues

A

goldenhar
-har, half of face
-assoc w/ cervical subluxation, congenital cardiac defects, micrognathia

63
Q

inc risk for transient neurologic symptoms

A

lidocaine
lithotomy
positioning for knee arthroplasty
outpt status

64
Q

n blocked by TAP block

A

intercostal
subcostal
ilioinguinal
iliohypogastric

65
Q

goals for trauma

A

-minimal crystalloid, early blood, no required MAP! low MAP ok w/ hemorrhagic shock, better surivival outcomes

66
Q

disadvantage of CSE v epidural

A

inc incidence of opioid- pruritis

67
Q

anatomy for popliteal block

A

medial: semimembranosus (Ms for medial)
lateral: biceps femoris
tibial n more medial than common peroneal

68
Q

least likely to cause drug fever

A

midaz

69
Q

congenital heart defect assoc w/ inc aortic root dilation?

A

bicuspid aortic valve

70
Q

transcranial doppler and CEA

A

intraop embolism detected in 90% of pts

71
Q

GERD and BMI in pregnancy

A

NO assoc

72
Q

SID equation

A

(Na + K + Mg + Ca) - (Cl + lactate)

73
Q

tx for vasospasm after SAH

A

nimodipine

74
Q

earliest fetal intraop FHR monitoring is feasible?

A

18-20 weeks

75
Q

when is there FHR variability

A

25-27 weeks

76
Q

protein C and S pregnancy

A

-protein S dec
-protein C inc resistance

77
Q

A alpha fibers carry what

A

proprioception

78
Q

A beta fibers carry

A

touch sensation

79
Q

A delta fibers carry

A

sharp, lacinating, easily localized pain

80
Q

C fibers carry

A

burning pain

81
Q

elective c/s dec risk of what compared to vaginal delivery

A

uterine rupture

82
Q

what m to inject if looking for musculocutaneous n coverage

A

coracobrachialis

83
Q

which predom in neonates parasymp or symp?

A

parasymp
-why so responsive to atropine

84
Q

Ca and ESRD

A

hypoCa

85
Q

ATN UNa

A

> 40

Truelearn Advanced Exam (15 decks)

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