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Truelearn Advanced Exam > ACE exam 5 > Flashcards

ACE exam 5 Flashcards

1
Q

optimal depth for ETT through trach

A

5-6 cm

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2
Q

Kawasaki dx, cardiac concerns?

A

coronary artery aneusyms

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3
Q

damage to which plexus after spine surgery in men cause retrograde ejaculation

A

superior hypogastric plexus

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4
Q

Epoprostenol

A

Prostaglandin that is used for pulm HTN

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5
Q

NG and pulm HTN

A

slight dec in PVR, however vasodilation more in large vessels -> not used in pulm HTN

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6
Q

Nifedipine and pulm HTN

A

great choice! pulm HTN

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7
Q

Tx for pulm HTN

A

inh Nitric oxide
Iloprost
Epoprostenol l(prostacyclin) -> used in critially ill PHTN
Nifedipine
Bosentan
Sildenafil
Ramipril

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8
Q

What is a bayonet artifcat

A

speed of u/s through muscle and adipose is different, so longer for the u/s to reach th eneedl ethrough adipose -> so it looks like the needle is slanted

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9
Q

Inc risk of oculocardiac reflex

A

-lower age
-propofol based anesthetic
-hypercarbia
-hypoxia

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10
Q

which pressure is closest to alveolar pressure

A

plateau pressure

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11
Q

what pressure means lung volume

A

mean airway pressure

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12
Q

Treatment of HTN W/ acute cocaine intoxication

A

Nicardipine

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13
Q

if kid swallows battery when to do operation?

A

911 now

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14
Q

First Ig to body’s immune def in blood

A

IgM

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15
Q

Slip error

A

occurs during routine familiar task that requires no thought
-drawing up the wrong medication into a labeled syringe

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16
Q

lapse error

A

occurs during a multistep task and is due to a memory failure
-ex: forgetting to flush port of central line

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17
Q

latent error

A

occurs upstream of event and is not direct cause of the error
-equipment failure, organizational process or room layout
-ex: layout of cart hard to find 911 meds

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18
Q

what medication inc SSEPs

A

ketamine

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19
Q

biggest contributor to LVOT obstruction in HOCM

A

systolic anterior motion of the mV

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20
Q

Inc CBF

A

hypercarbia
hypoxia
**no change w/ metabolic alk or acidosis

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21
Q

benefit of prone positioning

A

dec atelectasis in dorsal regions of lungs

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22
Q

risk of prone

A

high freq of pressure ulcers
-diplacement of ETT

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23
Q

Inc in CVP that occurs w/ inspiration, what dx?

A

Constrictive pericarditis

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24
Q

jaundice newborns 12-48 hours after birth

A

physiologic jaundice

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25
Q

jaundice new borns 36 hrs of birth to beyond 10 days

A

pathologic jaundice

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26
Q

jaundeice 4-7 after birth

A

breast milk jaundice

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27
Q

ES liver dx

A

inc cardiac output
low SVR
prolonged QT interval

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28
Q

APGAR

A

Appearance
Pulse
Grimace
Activity
Respiration

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29
Q

RF for postop neuropathies

A

men
extremes of weight
preexisting neuro symp
DM
PVD
alcohol
tobacco
arthritis

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30
Q

ACh Receptor downregulation

A

Myasthenia gravis
AChE poisoning
organophosphate poisoning

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31
Q

what population is slipped capital femoral epiphysis most ljikely to occur

A

obese adolescents

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32
Q

mitral valve TEE w/ 2 straight lines and circle

A

mechanical valve

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33
Q

RF w/ metformin

A

severe lactic acidosis
-pts w/ liver dysfxn, dehydrated, HF, sepsis, or AKI at risk

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34
Q

Pain relief from Mg

A

NMDA antagonist

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35
Q

VL v DL in trauma, what part of VL is better?

A

view of laryngeal structures

36
Q

what synapses on sphenopalatine ganglion?

A

preganglionic parasympathetic

37
Q

what tocolytic does NOT cause pulm edema?

A

Indomethacin
COX inh!!

38
Q

NSAID effect on kidney

A

vasoconstriction of afferent arteriole

39
Q

what medication is most likely to cause necrotis skin issues if prob w/ IV catheter?

A

Promethazine

40
Q

QI Process measures

A

determine if specific steps or parts of the system that have been implemented are working as planned

41
Q

QI outcome measures

A

focus on the impact of the change that has been implemented

42
Q

Balancing measures

A

review the process chcange and ensure that other outcomes are not adversely affected

43
Q

high ICP, low BP, how to treat high ICP

A

hypertonic saline

44
Q

to limit risk w/ cautery

A

smoke evacuators on field

45
Q

MC postop complication of pituitary tumor removal

A

Dec ADH

46
Q

coronary vasospasm tx

A

CCB or NG

47
Q

Complete suppresion of EEG temp

A

18-20 degrees

48
Q

Pringle Maneuver hemodynamics

A

Dec CI
Inc SVR
Inc MAP

49
Q

International color for oxygen

A

white

50
Q

why more in office anesthesia?

A

Dec cost

51
Q

When is surgical MI most likely to occur?

A

w/i 72 hours after surgery

52
Q

Greatest contributor of heat loss in anesthesia

A

radiation

53
Q

best way to minimize post op CABG renal issues

A

maintain euvolemia

54
Q

lowest acoustic impedence in u/s

A

air
then fat
then blood

55
Q

most likely to improve pts perception of visit?

A

SIT DOWN

56
Q

What does AKI cuase?

A

diffuse release of inflammatory mediators throughout body

57
Q

RF for low cardiac output syndrome after cardiac surgery

A

Age > 65
LVEF < 50%
ON pump CABG
DM CKD
long CPB duration
911 surgery

58
Q

indicators beir block worked

A

motor block
sensation of heat
paresthesias
pale skin
numbness

59
Q

INc HR dennervated heart

A

isoproteronol

60
Q

what prolongs durationn of naloxegol

A

ketoconazole

61
Q

Highest CO2 conc

A

reservoir bag

62
Q

uncuffed ETT airway resistasnce

A

dec compared to cuffed ETT

63
Q

hallmark symp of pulm artery catheter causing pulm artery rupture

A

hemoptysis

64
Q

RF for PAC pulm a rupture

A

advanced age
hypothermia
anticoagulation
preexisting pulm HTN

65
Q

acute cannibas intox, effect on intraop temp

A

hypothermic

66
Q

holliday and segar method of choosing maintenance fluids

A

4-2-1

67
Q

what could a bair hugger not fix?

A

the rate of death

-but less surgical site infxns and shivering, less blood loss and less cardiac complications

68
Q

Reversal agent for dabigatran

A

Idarucizumab

69
Q

relative contraindication for LVAD

A

PFO
-LVAD will dec pressure in L side of heart, could case a R to L shunt

70
Q

MCC of acute liver failure in the US

A

acetaminophen poisoning

71
Q

Pompe dx

A

impedes breakdown of glycogen into glucose
-issues w/ heart and skeletal muscle
-HOCM, weakness of skeletal and resp muscles
-juvenile form: enlargement of the tongue intubation difficutl

72
Q

RF for epidural hematoma w/ LMWH

A

female
>65
2x daily
<12 hrs after catheter
renal insuff

73
Q

MOA summatriptan

A

serotonin agonist

74
Q

what neuro dx exacerbated w/ inc in temp

A

MS

75
Q

best meds to use w/ poor CYP2D6 metabolizers

A

hydromorphone
morphine
oxymorphone

76
Q

Pt w/ AICD and PM dpt and needs surgery, next step

A

reprogram the device

77
Q

ASA req to be an expert witness

A

actively practicing anesthesia
license to opractice medicine

78
Q

EPO made wehre

A

kidneys

79
Q

Why does N95 work better than surgical mask

A

tight fit

80
Q

Inc risk of postop a fib

A

esophageal, thoracic, or abd surgery

81
Q

how long does national practitioner data bank maintain its info?

A

permanently

82
Q

most likely to injure phrenic n

A

radiofreq ablation

83
Q

to determine myocardial viability

A

cardiac MRI

84
Q

trigeminal neuralgia autonomia: parasymp activation

A

lacrimation, conjunctival injxn, nasal congestion, forehead sweating

85
Q

why obese people when table unlocked fall up

A

change in fulcrum

86
Q

protect brain w aortic arch surgery

A

deep hypothermia

87
Q

place infrared sensory for CPB whwere?

A

Glabellum
forehead

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