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1
Q

Which nerve is at risk of injury when a face mask strap is used?

A

7

facial

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2
Q

What is the internal diameter of an anesthesia face mask connector?

A

22 mm

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3
Q

What observational assessment is the best means for assessing effectiveness of bag-and-mask ventilation?

A

chest rise

condensation

compliance

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4
Q

What is the appripriate starting rate for infusion of nitroglycerin?

A

0.5 mcg/kg/min

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5
Q

Which cardiac dysrhythmia most often produces inability of an NIBP machine to obtain systolic and diastolic blood pressure measurements?

A

A-fib

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6
Q

Why is a reservoir bag included as a component of an anesthesia breathing circuit?

A

Peak inspiratory flow demands

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7
Q

Below what MAC level will sevoflurane not increase heart rate?

A

MAC > 1.5

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8
Q

What prior surgical procedures represent a contraindication for IV catheter placement in an upper extremity?

For NIBP measurement in an upper extremity?

A

mastectomy w/ lymph node dissection

AV fistula

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9
Q

Comparing blood pressure measurements taken on an upper arm and the ipsilateral calf, how will the systolic and diastolic values compare?

A

If recumbant, systolic is increased

diastolic is decreased

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10
Q

Name one contraindication to hetastartch administration.

A

coagulopathies if delivery > 1 L / 24 hours

another is allergy reaction

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11
Q

What blocks 60-cycle interference?

A

band pass filter

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12
Q

When performing bag-and-mask ventilation in an adult, which fingers must be applied only to the bony rim of the mandible?

A

3 and 4

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13
Q

Time constant of gases and liquids

A

volume
flow

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14
Q

If IV catheter is in the SVC, where is it?

A

superior vena cava, joining of the left and right brachiocephalic venins to the right atrium

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15
Q

A 200 lb patient is breathing oxygen 2 L/min, air 3L/min, and sevoflurane 2.4% via ETT.

Vt is 600 ml , resp = 10 breaths/minute, FRC is 4000 ml

What is the time constant?

A

FRC
VA= (VT-VD)* RR

4000
(600-200)*10

1 min

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16
Q

If time constant = 1 minute, what percent change in inspired sevoflurance will have occurred at the end of the time comstant?

A

100 - 36.78 = 63%

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17
Q

How many time constants are required for a 95% change?

A

3 time constants

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18
Q

For a safe, cost effective preparation for an elective case, how many endotracheal tubes should be opened?

A

1

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19
Q

A 29 y/o woman is schedules to undergo BTL. What is BTL?

A

bilateral tubal ligation

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20
Q

What is the osmolarity of saline 3%?

A

308/0.9 * 3 = 1027 mOsm

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21
Q

What are the complications associated with excess administration of saline IVFs?

A

edema
pulmonary edema
electrolyte abnormalities

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22
Q

What are contraindications to administering lactated ringer’s solution?

A

low pH

lowers pH so causes acidosis
has Ca, lactate, K, Cl, Na
hypotonic at 273 mOsm/L

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23
Q

What are contraindications to using a NIBP cuff?

A

extremities with vascular abnormalities
dialysis shunts
IV lines

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24
Q

How do you size a BP cuff?

A

Width is 40% of arm circumference

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25
How do you detect oxygen flow of a hand-operated, self-inflating bag?
listen at the distal end
26
What is the concentration of epinephrine?
1g/100,000ml 10 mcg
27
What is the I, II, III, and IV Korotkoff sounds?
I = snap II = murmur III = thump IV = muffle
28
What is an hypo-osmolar crystalloid IV solution?
LR is slightly above
29
During bag-mask verntilation, stay below what peak airway pressure to avoid insufflating the stomach?
20 cm H20
30
What is the affect of hypothermia on non-depolarizing neuromuscular blockers?
prolongs the blockade by decreasing metabolism
31
What is the osmolarity of NS 3%?
308/0.9 \* 3 1027mOsm
32
What location is prone to infection regarding CVP catheters?
subclavian
33
What does the acronym SVC mean?
superior vena cava
34
What is the starting dosage rate of IV NTG infusion?
0.5 mcg/kg/min
35
What is the distribution of LR 30 minutes after infusion?
1/3 remains in the plasma after 30 minutes
36
Physical exam findings that would be a clue for difficult bag-mask ventilation?
edentulous beard micrognathism
37
Reasons you are unable to bag-mask ventilate:
obstructing bad seal
38
How do you perioperatively manage a patient with pulmonary TB?
look up
39
How do you store drug vials?
look up
40
How do you increase IVF flow rate through an 18 gauge IV catheter?
raise the bag height
41
What is the lung capacity involved in preoxygenation?
FRC
42
During induction of anesthesia, what breath-to-breath end point are you trying to achieve with bag-mask ventilation?
good Vt
43
What is the correct action to be taken when a patient is being seen in preop clinic prior to elective knee arthroscopy is suspected of having active pulmonary tuberculosis?
delay the case until it clears
44
Why is a reservoir bag included as a component of an anesthesia breathing circuit?
Meets peak inspiratory flow requirements
45
Name the veins appropriate for insertion of a CVP catheter and list site-specific considerations (if any)?
femoral- DVT EJV- hydrothorax IJV- hydrothorax cephalic subclavian- PTX basilic
46
What attribute of CVP catheters is associated with increasing risk of infection?
number of lumens
47
For vascular access procedures, a safe, effective alternative preparation for an iodine allergic patient would be?
chlorhexadine 4%
48
Following IV injection of muscle relaxant, what is your temporal end-point for intubation during an RSI?
look up
49
Which muscle relaxant would you select in order to provide neuromuscular blockage during rapid-sequence induction of a patient with ESRD?
K normal: SUX, redose with CIS K elevated: ROC, redose with CIS
50
If aseptic technique is employed consistently, how long can a multidose drug vial continue to be used?
until expiration date
51
An epinephrine infusion is connected to the main IVF tubing 4.25 ml from the IV catheter's entry point into a CVP catheter. IVF flow rate is 120 ml/hr. When the epi infusion rate is decreased, how long will it take for there to be a 95% change in epi concentration in the SVC?
t = V / flow rate 4.25 ml / 2 ml/min = 2.125 min
52
What is the Sellick maneuver?
RSI - cricoid pressure
53
What IVFs contain magnesium?
Normosol Plasmalyte 3mEq/L
54
What are communicable disease risks for pregnant personnel?
look up Cytomegalovirus?
55
Where is the basilic vein?
medial side
56
Where is the cephalic vein?
lateral side
57
NIBP monitors display 3 blood pressure parameters: systolic, diastolic, and mean. Explain how each value is determined by the device. What will most likely happen to the reported BP values when the following conditions exist? HTN hypotension sinus tachycardia atrial fibrillation ventricular fibrillation
HTN- get all 3 hypotension- get mean sinus tachycardia- only mean atrial fibrillation- only mean ventricular fibrillation- get nothing
58
What electrolytes are found in LR?
Na Cl K Ca Lactate
59
What electrolytes are found in Plasma-Lyte?
Na Cl K Mg
60
Name the types of crystalloids:
D5W 0.9 Sodium Chloride LR Plasma-Lyte
61
Name the types of colloid:
Hetastarch Dextran Albumin 3% Sodium Chloride 5% Sodium Chloride
62
When do we replace fluids?
hourly requirements insensible loss through open wound "third spacing" blood loss
63
What are contraindications for placing peripheral IVs? (6)
massive edema burns or injuries abdominal trauma areas of infection indwelling fistula side of mastectomy

Comp 5 Exam (2 decks)

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