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DSouza 2015 > Neuro > Flashcards

Neuro Flashcards

(51 cards)

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1
Q

Depolarization of nerve is due to the … of Na … the cell

However depolarization of SA node is due to the entry of … into pacemaker cell

A

Entry of Na into cell

Ca

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2
Q

The concentration of Cl, Mg, and PCO2 is higher/lower in CSF compared to the plasma concentration?

A

Higher

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3
Q

During ECT treatment there is initial parasympathetic stimulation followed by sympathetic stimulation. Initial arrhythmias is … followed by ….

A

Bradycardia then tachycardia

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4
Q

The purpose of using succinylcholine during ECT treatment is to ….

A

Avoid fractures during seizure activity

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5
Q

Drugs increases seizure duration of ECT?

A

Etomidate, Caffeine, Aminophylline

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6
Q

Drugs decreases seizures duration of ECT duration?

A

Thiopental, propofol, midazam, lidocaine, diltiazem, esmolol

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7
Q

I’m a patient with failed prior ECT treatment, due to shorter seizure duration, …. should be used

A

Etomidate

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8
Q

Propfol and thiopental effect on seizure

A

Decreases its duration and increases threshold

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9
Q

Ketamine and lidocaine effect on seizure duration

A

Decreases its duration

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10
Q

Etomidate effect on seizure

A

Prolongs it’s duration

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11
Q

Absolute CI for ECT

A

Pheochromocytoma

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12
Q

Relative CI for ECT

A

Pregnancy
Cardiac conduction defects
Aortic and cerebral aneurysm
Recent CVA

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13
Q

Is AICD CI for ECT?

A

No. It should be deactivated prior to ECT and interrogation done after ECT ttx

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14
Q

Most sensitive evoked potential to anesthetic

A

VEP

VEP > MEP > SSEP > BAEP

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15
Q

Most resistance evoked potential to anesthetic

A

Brain stem Auditory evoked potential

BAEP

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16
Q

Thiopental + propofol + isoflurane effect on SSEP amplitude…. and it …. SSEP latency

A

They decrease amplitude and increase latency

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17
Q

…. unique in increasing both amplitude and latency of the SSEP

A

Etomidate

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18
Q

Ketamine and N2O increases or decreases SSEP amplitude and it latency

A

Both effect amplitude only.

Ketamine increases it

N2O decreases it

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19
Q

Persistent vegetative state vs coma?

A

If ptn can be partially aroused -> vegetative

Cannot aroused with painful stimuli, light/sound -> coma

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20
Q

Brain death causes absent cortical and brain stem function, however … are active

A

Spinal reflexes

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21
Q

Choice of treating bradycardia in brain dead ptn?

Study These Flashcards
A

Direct acting drugs (isoproterenol, epi). And pacing

The indirect (atropine) ineffective

22
Q

Most common abnormality in brain dead patients?

Study These Flashcards
A

HyperNa from DI

23
Q

EEG waves of awake? Relax state? And sleep?

Study These Flashcards
A

Beta -> awake
Alpha -> relaxed
Theta -> sleep and anesthesia

Delta -> Deep anesthesia

24
Q

Burst suppression on EEG waves is the goal of …. administration and overdose of those meds will causes … on EEG

Study These Flashcards
A

Barbiturates/ propfol

Avoid the electrical silence EEG

25
Signs of cerebral ischemia on EEG
``` Slowing waves (theta and delta) Changes in spectral edge Burst suppression Loss of evoked potentials Isoelectric EEG ```
26
What dose slowing of spectral edge frequency on EEG hints for?
Cerebral ischemia | Deepening anesthesia
27
Spike and dome activity on EEG?
Epileptic activity
28
So N2O increases CMRO2 which leads to increase CBF and propfol/thiopental dose the opposite. What about isoflurane?
decreases CMRO2 but increases CBF
29
Decreases PaO2 has no effect on CBF until it reaches .... below this level CBF increases
60 mmHg below this a steep increase in CBF
30
PaCO2 curve become flat below .... and above .... on CBF/pressure curve. In between an increase in each PaCO2 causes increase CBF by .../100gm of the brain tissue
Below 25 mmHg and above 100 mmHg a flat line 1 mmHg PaCO2 increase causes increase of 1mL/100 g of brain tissue (2% increase)
31
Normal CBF .../100gm of brain tissue ...% of CO ... mL per minute
50 mL 15% 750 mL
32
CMRO2 is ~ .../ 100gm of brain tissue
3-4 mL
33
The organ that consumes highest amount of O2 per fm:tissue is ....
Myocardium
34
... has the highest blood flow per gm of the tissue
Carotid body
35
.... circulation is not auto regulated
Uterine
36
CBF auto regulation shifted to right in .... and left in ....
Chronic HTN Neonates and they have narrow range of MAP
37
Isoflurane produces .... waves on EEG at ... MAC
Isoelectric at 2 MAC
38
The best measure for ICP control during resection of Supranational tumor is .... and maintaining.... and avoiding ....?
Mannitol and maintaining normocarbia. Avoiding hyperventilating to not further decreasing CBF to compromised brain tissue area???
39
Complications of hypertonic mannitol?
Volume expansion Hyperosmolality HypoNa Likely occur in RF or large doses
40
The goal of anesthetic during clipping of intracranial aneurysm?
Maintenance of CPP and transmural pressure gradient (TMPG) Sudden increase in MAP or decrease in ICP will change in TMPG and will make aneurysm vulnerable for rupture
41
When is the optimal time to unclamped the lumber drain during intracranial aneurysm repair?
After surgeon opens the dura. If it’s unclamped before a sudden decrease in ICP May result in change in TMPG and the aneurysm rupture
42
DI vs SIADH vs cerebral salt wasting
Differentiated by Volume status and serum Na DI hypovolemia + hyperNa SIADH hypervolemia + hypoNa CSW. Down down both hypoV hypoNa
43
During posterior fossa craniotomy, the pressure transducer should be zeroed at the level of
External auditory meatus
44
... most sensitive method to detect Air embolism and .... is second most sensitive
TEE Percordial doppler
45
The risk of air embolism is higher in .... and ... positions
Sitting and reverse trendelenburg
46
During air embolism the ..., ..., ... falls as there is decreased perfusion through the lung
EtCO2, N2O, nitrogen
47
The tip of multiorifice CVP catheter to aspirate air in air embolism situation should be ..
2 cm below SVC-RA junction
48
Management of air embolism?
Flood the surgical field with normal saline. Compress the internal jugular. Place in left lateral decubitus, trendelenburg to prevent the embolism to go to RV into plum artery
49
A bradycardia results from stimulation of ... during post fossa craniotomy and best managed by ...
vasomotor center Stop stimulation
50
Bradycardia during squint surgery due to stimulation of
Occlucardiac reflex
51
Oculocardiac reflex pathway ophthalmic division of trigeminal (... and ...) -> ... ganglion -> ... ganglion -> vagus nerve.
ophthalmic division of trigeminal (long and short ciliary nerves) -> ciliary ganglion -> Gasserian ganglion -> vagus nerve.

DSouza 2015 (21 decks)

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