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Basic > ACE > Flashcards

ACE Flashcards

1
Q

Most common complication of OB paracervical block

A

-fetal bradycardia

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2
Q

U/S PNX

A

lung point

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3
Q

Intra-aortic ballon pump

A
  • he primary purpose of IABP therapy is to improve myocardial perfusion during diastole by improving coronary blood flow. It also reduces left ventricular afterload, thus decreasing left ventricular work.
  • The most accurate way to correctly time IABP counterpulsation is to initiate inflation immediately as the dicrotic notch is detected. Deflation of the IABP balloon should take place just before the systolic upstroke
  • helium in balloon
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4
Q

Peds, % blood loss before hypotension

A

40%

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5
Q

Shortest half life of benzos (versed, lorazepam, diazepam, alprazolam)

A

versed

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6
Q

Methylphenidate perioperative concerns

A

increased cardiovascular instability, altered anesthesia requirements, and lowering of the seizure threshold. Methylphenidate use is associated with an increased minimum alveolar concentration (MAC) and thus a decreased sensitivity to volatile anesthetics. Time to emergence from general anesthesia is not increased in patients taking methylphenidate

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7
Q

Carcinoid heart disease

A

Carcinoid heart disease typically produces tricuspid regurgitation and mixed pulmonic stenosis and regurgitation, resulting in right heart failure.

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8
Q

OI associations

A

-platelet dysfunction, easy trauma, pectus excavatum, heat intolerance, increases thyroid hormone

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9
Q

Dementia drugs interactions

A

-Anticholinesterase medications are also frequently used in the treatment of dementia (eg, donepezil). These medications may prolong paralysis from succinylcholine and impact nondepolarizing muscle relaxants by decreasing or reversing their effects

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10
Q

Most predictve on unsuccessful mask

A

-neck radiation changes

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11
Q

Fractional flow reserve

A

< .8 likely to improve with PCI or stent

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12
Q

Pregnancy s/p renal transplant

A

However, some complications of pregnancy are higher in transplant recipients, such as preeclampsia (27.0% vs 3.8%) and gestational diabetes (8% vs 3.9%). Also higher are the rates of cesarean delivery (56.9% vs 31.9%) and preterm delivery (45.6% vs 12.5%

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13
Q

presedex context sensitive halflife for 40 yo

A

50 minutes

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14
Q

post ROSC hypothermia

A

32°C to 34°C and 34°C to 36°C

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15
Q

MH susceptibility

A

There is a wide range of disorders associated with mutations in the RYR1 gene (eg, central core disease, King–Denborough syndrome, periodic paralysis, and idiopathic hyperCKemia).

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16
Q

Stellate ganglion block

A
  • In 80% of patients, the stellate ganglion is formed by the inferior cervical and the first thoracic ganglion. The anterior approach is most commonly used for SGB
  • Left-sided SGB has been noted to be more effective at managing ventricular arrhythmias. If left SGB fails, a right SGB can be added, but this should be restricted to intubated patients, as bilateral phrenic nerve paralysis is possible
  • LA injected anterior to longus colli muscle
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17
Q

TIPS procedure

A

shunt between hepatic vein and portal vein

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18
Q

Aortic coarctation

A

headache, epistaxis, lower extremity claudication, and hypertension. Upper extremity systolic hypertension (with normal diastolic pressure) and lower extremity hypotension are also common. These individuals exhibit extensive collateral circulation

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19
Q

cancer drugs that interact with pseudochilinesterase

A

nitrogen mustards

eg, mechlorethamine, cyclophosphamide, melphalan, and chlorambucil

20
Q

treatment for heparin resistance

A

administration of recombinant human antithrombin, additional heparin, or fresh frozen plasma (FFP)

21
Q

thorasic scoliosis PFTs

A
  • follow restrictive pattern

- decrease in FVC

22
Q

PONV acupuncture

A

Pericardium-6

- 4 cm proximal to the distal wrist crease, between the palmaris longus and flexor carpi radialis tendons

23
Q

Parkinsons and PONV

A

Haloperidol, metoclopramide, and promethazine are all dopamine antagonists and have proved efficacious in treating PONV. However, dopamine antagonists may exacerbate symptoms in patients with Parkinson disease and should therefore be avoided in such patients.

24
Q

cerebral edema in tumor

A
  • Vasogenic cerebral edema occurs when tight endothelial junctions of the blood–brain barrier are compromised, such as with tumor growth
  • Intravenous steroids, such as dexamethasone, selectively target vasogenic cerebral edema by stabilizing the blood–brain barrier
25
Q

Most appropriate way to report drug dosage

A

mean drug dose +/- SEM

26
Q

elective procedure s/p stroke

A

wait 6 weeks

27
Q

Serotonin syndrome

A 
Signs and symptoms of altered mental status include:
Agitation
Disorientation
Anxiety
Visual hallucinations
Signs of neuromuscular overactivity include:
Myoclonus
Tremor
Hyperreflexia
Muscle rigidity
Positive akathisia
Nystagmus
Trismus
Signs of autonomic instability include:
Hypertension
Tachycardia
Hyperthermia
Mydriasis
28
Q

button battery

A

honey 10ml q 10 minutes

29
Q

Epsilon waves on EKG

A

Epsilon waves on 12-lead electrocardiogram are considered characteristic of rrhythmogenic right ventricular cardiomyopathy (ARVC)
-The disorder is often familial and typically autosomal dominant with variable expressivity

30
Q

Vd in old people

A

The volumes of distribution for drugs change with age, depending on whether they are fat soluble or water soluble. The volume of distribution of fat-soluble drugs is increased in the elderly, leading to a longer elimination half-life compared to younger patients. For water-soluble drugs, the volume of distribution is decreased in the elderly, leading to higher plasma concentrations compared to younger patients.

31
Q

gabapentin MOA

A

Gabapentin and pregabalin are best described as calcium-channel antagonists

32
Q

caudal block landmarks

A

PSIS for equilateral traingle with the sacral hiatus

33
Q

cirhotic cardiomyopathy

A

CCM is characterized by diastolic dysfunction, impaired contractile response to β-adrenergic stimulation, prolonged QT interval (>440 ms), and other evidence of autonomic dysfunction such as a decreased ability to increase heart rate in response to exercise.

34
Q

most common side effect of precedex infusion

A

hypotension

35
Q

interferes with hormononal birth control

A

suggamadex, rifampin, aprepitant

36
Q

heparin resistant associations

A

Thrombocytosis (platelet count above 300,000 to 450,000 per microliter)
Release of platelet factor 4, often due to subclinical thrombotic processes
Sepsis
Preoperative heparin infusion
Hypereosinophilia
Consumptive coagulopathy

37
Q

Horners syndrome

A

Ptosis
Miosis (Figure 2)
Bloodshot conjunctiva (due to vasodilation)
Pseudoenopthalmos (the eye appears sunken, but has not actually changed position in the orbit)
Nasal congestion
Anhidrosis

38
Q

drugs that interfere with DBS placemetnq

A

beta blockers

39
Q

methylergonovine avoided in

A

CAD, HTN

40
Q

prostagladin avoided in

A

asthmatics

41
Q

superior hypogastric nerve block

A

uterus and lower pelvic tissue

42
Q

Celiac plexus

A

The celiac plexus is the largest autonomic plexus located in the retroperitoneum. It is composed of the left and right celiac ganglia, the superior mesenteric ganglia, and the aorticorenal ganglia, with fibers from presynaptic sympathetic nerves carried by the greater, lesser, and least splanchnic nerves.

43
Q

tumescent liposuction

A

The safe dose of lidocaine using the tumescent technique (with epinephrine) has been reported to be 35 mg/kg, with some advocating as high as 55 mg/kg
-The dilute epinephrine dose causes a constriction of the blood vessels, leading to a peak lidocaine dose occurring 12 to 14 hours after the procedure.

44
Q

Xenon anesthesia

A

does not trigger MH, doesnt destroy ozone, , no hepatic damage. Increase in PONV and cost

45
Q

Tramadol

A

Tramadol is a weak μ-opioid receptor agonist and a serotonin and norepinephrine reuptake inhibitor. Due to the latter effects, tramadol has additional risks not associated with other opioids, including serotonin syndrome and seizures.

Basic (6 decks)

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