Case Related Topics

Question 1

Five factors that increase risk of difficult mask ventilation

Answer 1

Lack of teeth
Age > 55
Obesity BMI > 25
Hx of OSA/snoring
Facial hair

Question 2

Factors that increase difficulty of intubation

Answer 2

Small mouth opening < 4cm
Thyromental distance < 6cm
Limited neck mobility < 35deg
Full teeth w/ prominent incisors
Reduced mandible protrusion
Short neck
Thick neck circumference
Mallampati 3 or 4
H&N surgeries or radiation

Question 3

Emergence delirium treatment

Answer 3

Haloperidol 0.5-2mg IV

Question 4

What are the different wave forms of the CVP tracing?

Answer 4

A = Atrial contraction
X descent = RA relax
C = Closure of tricuspid (suring systole)
Y descent = ventricle relax
V = rapid filling of RA

Question 5

Distance from these insertion sites to the RA/VC junction
RIJ, RT subclav, right fem, right brachial, left brachial

Answer 5

IJ = 20
Subclav = 15
Fem = 30
Rt arm = 40
Left arm = 50

Add 10 for each sequential structure

Question 6

Pa cath pressures

Answer 6

SVC = 10
RA = 8
RV = 25/5
PA= 25/15 with dicrotic notch
Wedge = 12 (looks like Cvp)

Question 7

Induction adult doses of the following:
Etomidate
Ketamine
Fentanyl (with induction)
Remifentanil

Answer 7

Etomidate: 0.2-0.3mg/kg
Ketamine: 1-2mg/kg
Fentanyl: 1.5-2.5mcg/kg
Remi: 1-2mcg/kg

Question 8

What is the dose of succinylsholine for intubation vs laryngospasm

Answer 8

1mg/kg
20mg

Question 9

How often do you dose cefazolin vs ceftriaxone vs metronidazole and what are doses

Answer 9

1-2gm (70kg), q4hr
1gm, q12hr
500mg, q8hr

Question 10

What are doses of these non opioid meds:
Acetaminophen
Ketoralac
Ketamine

Answer 10

Tylenol (max 4g per day)
<50kg: 15mg/kg
>50kg: 1000mg

Ketorolac
15-30mg

Ketamine
0.25-1mg/kg

Question 11

Dose of precedex for anxiolytix/analgesi vs sedation

Answer 11

0.25-0.5 mcg/kg (slowly maybe in 8-12mcg boluses)

0.2-1mcg/kg/hr

Question 12

Eq for coronary perfusion pressure

Answer 12

AoDP - LVEDP = CPP

Aortic stenosis or severe LVH with diastolic dysfunction requires higher MAPs

Question 13

Measurements for severe aortic stenosis

Answer 13

Peak valvular velocity >4
Mean tans valve gradient > 40
AVA < 1cm2

Question 14

Which pressor to use for severe aortic stenosis and why

Answer 14

Phenylephrine

Increases svr and decreases HR. This will increase MAP for CPP and also decrease work load/O2 consumption of the heart