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Flashcards in Anesthesia Deck (50)
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1

Max dose of epinephrine non-cardiac / cardiac

.2mg / 0.04mg

2

Sulfa allergy has greater incidence to which class of local anesthetic

Esters

3

Max dose 2% lidocaine

4.4mg/kg or 300mg

4

Max dose 4% articaine

1.3mg/kg or 90mg

5

How many mg of 1% anesthetic in 1.7ml

17mg

6

How many mg of epi in 1:100,000 1.7ml

0.02mg

7

Which vasocontrictor additive in LA has alpha agonism resulting in increased MAP and reflex braycardia (good for tachycardic patients)

Levonordefrin

8

Which vasocontrictor additive in LA has beta agonism and is better for hypertensive patients

Epinephrine

9

NPO time for breast milk

4hrs

10

Role and mechanism of Train of Four

- Depolarizing --> uniform decrease in twitch amplitude in TOF - Non depolarizing --> sum of twitches based on % of receptors occupied. 1 twitch 95%, 2 twitches 85%, 3 twitches 80%, 4 twitches 75% makes sense because minimum 25% available receptors for NMJ function

11

Role and mechanism of Tetanic nerve stimulator

Depolarizing --> no fade in muscle response with tetany (if there is fade then there has been prolonged exposure to succinylcholine or phase 2 blockade) - Non depolarizing --> fade with tetany

12

Why is Sp02 falsely elevated in CO poisoning and heavy smokers?

CO poisoning and heavy smokers have increased carboxyhemoglobin which falsely elevates SpO2

13

Which leads most sensitive to ST elevation

Lead II Lead V5

14

Which volatile agent has airway irritation

Desflurane

15

Which volatile agent has slow onset

Isoflurane

16

While volatile agent may be contraindicated in renal patient?

Sevoflurane (compound A)

17

What hemodynamic effects do all volatile agents have

hypotension tachycardia decreased contractility decreased systemic vascular resistance

18

What ventilation effects do volatile agents have? (Exception-Isoflurane)

Tachypnea Hypercapnea Decreased Tv Decreased minute ventilation

19

Mechanism of Miosis with opioid

CN III parasympathetic agonist

20

Site of propofol metabolism

liver

21

All IV sedation agents decrease cerebral blood flow and ICP except

Ketamine

22

Mechanism of neostigmine

Build up of ACh within NMJ. It is an acetyl cholinesterase inhibitor

23

Dose of neostigmine

0.03-0.07 mg/kg

24

Contraindications of Succinylcholine

Recent burn/crush injury NMJ disease Narrow angle glaucoma Malignant hyperthermia Skeletal muscle myopathies

25

Which two neuromuscular blocking agents are best for renal or hepatic failure patients

Atracurium Cisatracurium (Hoffman Elimination)

26

s/s cocaine intoxication

HTN, Tachy, hallucinations, convulsions, HA, Angina, CVA

27

Tx cocaine intoxication

B-blockers Nitrates CCB

28

Cocaine half-life

30-90 mins

29

Main difference between cocaine detox and EtOH detox

EtOH detox also has HTN/Tachycardia

30

Age/gender most common for thyroid storm

Women 20-40 yrs