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PBR2 Flashcards

1
Q

amiloride mechanism

A

potassium sparing diuretic, directly decreases cGMP gated sodium channel activity, decreases lithium entry into tubular cells (reverse lithium-induced nephrogenic DI)

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2
Q

spironolactone/eplerenone

A

potassium sparing diuretics that competitively inhibit mineralocorticoid receptor

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3
Q

pacemaker indication

A

long QT, SA/AV node disease, reduce outflow obstruction with HOCM, treat dilated CM, mobitz type II because usually progresses to complete

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4
Q

ultrasound

A

attenuate least - water (echo lucent)

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5
Q

L5 distribution

A

lateral aspect of knee, dorsum of foot

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6
Q

dose dependent effects on SSEPs

A

barbs, propofol, volatiles, benzos, nitrous

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7
Q

leak for neonate ETT

A

15-25 cm H2O

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8
Q

type II error

A

failing to reject the null when it is actually false

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9
Q

barb use with aneurysm clipping

A

indicated when prolonged vessel occlusion is unavoidable and when EEG slowing occurs with occlusion - reduces metabolic activity (ischemic protection)

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10
Q

nitrous and CMRO2

A

increases metabolic rate, vasodilator - increases ICP

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11
Q

CBF and PaO2

A

CBF remains constant at a PaO2 greater than 50

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12
Q

Higher chance of latex allergy

A

mango, kiwi, chestnut, avocado, passion fruit, and banana

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13
Q

NMB recovery signs most reliable

A

sustained head lift for 5 seconds, sustained leg lift for 5 seconds, sustained handgrip for 5 seconds, maximum inspiratory pressure 40 to 50 cm H2O or greater

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14
Q

CCB and dantrolene

A

lethal ventricular fibrillation due to hyperkalemia in anesthetized swine

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15
Q

Garlic, ginkgo, and ginseng how long to wait

A

Garlic 7 days, ginseng 24 hours, and Ginkgo lasts 36 hours

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16
Q

rapid shallow breathing index

A

RSBI = respiratory rate/tidal volume; less than 100/105 with max FiO2 0.4

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17
Q

Phenoxybenzamine and pheo

A

Reduction in mortality is potentially reduced from 40-60% to 0-6% with the preoperative implementation of alpha-adrenergic receptor blockade, typically performed 10-14 days prior to surgery

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18
Q

Protein binding in preg

A

Maternal and fetal albumin levels are comparable; as opposed to alpha-1-acid glycoprotein which is at much higher levels in maternal plasma; bound to albumin more likely to cross placenta

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19
Q

Decreased preeclampsia risk

A

Cigarette smoking

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20
Q

LIM can detect

A

high current fow >2mA

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21
Q

most anesthesia drugs transported across placenta

A

via diffusion

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22
Q

increase intraocular pressure

A

hypercapnea, decreased PaO2, elevated CVP, succhinylcholine, some anticholinergics (IV atropine does not)

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23
Q

acquired antithrombin deficiency

A

nephrotic syndrome, cirrhosis, DIC (may have resistance to heparin)

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24
Q

pulmonary artery rupture risk

A

age >60, pHTN, hypothermia, anticoagulation, overinflation of balloon

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25
compartment syndrome symptoms
sensory deficits before motor, manifest distal to involved compartment
26
brain dead and acetylcholine
lack release of endogenous acetylcholine - need to use direct agonists like isoproterenol to treat bradycardia
27
RBC salvage contraindications
ruptured AAA, infection, GI perforation, malignancy (can use for patient with alloantibodies which may make transfusion difficult)
28
HOCM treatment
CCB, beta blockers
29
ass with increased K after suc
massive trauma, encephalitis, ruptured cerebral aneurysms, metabolic acidosis & hypovolemia
30
additional amiodarone se
thyroid dysfunction (drug has lots of iodine), peripheral neuropathy, bradyarrhythmias
31
lidocaine arrhythmia use
useful for ventricular not supraventricular
32
brain death criteria
coma, absent motor activity, absent brain stem, absence of ventilatory effort despite CO2 60 or 20 above baseline
33
zero lumbar drain
phlebostatic axis at level of right atrium
34
classic hemodynamics of constrictive pericarditis
equalization of ventricular diastolic pressure
35
jet ventilation risks
barotrauma, pneumothorax, gastric distention, hypoxia
36
R (reaction time)
time zero to the beginning of clot formation, signifies contributions of the intrinsic and extrinsic coagulation cascades, and the final common pathway to fibrin formation ((1-3 minutes is normal for use of Tissue Factor activator, 7-14 minutes for Celite, Kaolin)
37
K (coagulation time)
measure of speed of clot formation and strengthening, equal to the time from amplitude 2mm to 20mm, relies on fibrinogen
38
alpha angle
measure speed of clot formation, this relies on fibrinogen, normal is 45-55 degrees.
39
MA (maximal amplitude)
measures maximal clot strength, equal to the max width of TEG, represents clot strength as determined by platelet number and function, as well as fibrin cross-linking to form a stable clot, normal is 50-60mm; after MA measures clot lysis
40
continuous wave Doppler vs pulsed wave
continuous uses 2 crystals and prevents determination of maximal velocity; pulsed uses 1 crystal and high velocities are often measured as negative (aliasing)
41
circumflex branch leads
I and aVL
42
V1 uses
ileus, abd distention, esophageal varices, shock, Vfib/PEA
43
V2 uses
DI and vWF def
44
hypocalcemia
prolonged QT and ST, inverted T, bradycardia
45
wall tension equation
= (pressure x radius)/(2 x wall thickness)
46
heparin rebound after protamine
heparin can bind to protein which protects it from binding with protamine, when these dissociate can get rebound
47
HOCM presentation
dyspnea, angina, dizziness, sinus tachy, double-impulse peripheral pulse, hypotension, low JVP, heart failure stigmata, murmurs (LV obstruction and MR)
48
CPB and coagulation
platelet dysfunction common cause of post CPB bleeding - return to norm 2-4 hr post
49
recombinant factor VIIa
binds onto tissue factor and initiates coagulation by amplifying factor IX and X leading to thrombin generation, used to decrease massive hemorrhage
50
antibiotics - no NMB
PCN and cephalosporins
51
Hering Breuer reflex
when pulmonary stretch receptors sense overinflation - inspiration is inhibited so expiration can occur
52
high frequency ultrasound
poor penetration (cannot be used for deep structures)
53
ultrasound attenuation
proportional to frequency and path length of ultrasound wave
54
morphine IV:PO conversion
1:3
55
most common postpartum foot drop
lumbosacral trunk damage - weakness of ankle dorsiflexion and dermatome L5 sensory loss - 2/2 head compression by pelvic brim by head
56
increased potassium with suc
hypovolemia and metabolic acidosis, severe abd infections, closed head injury, major trauma, neuromuscular disease
57
garlic discontinued
1 week before surgery
58
valerian root discontinued
tapered over several weeks or will see symptoms similar to benzo withdrawal
59
ginseng drug interaction
interferes with warfarin anticoag - may need more warfarin to achieve same results
60
herbals interfere with coag
ginger, gingko, ginseng, garlic, saw palmetto
61
kava/valerian
potentiate sedation
62
echinacea
interfere with effectiveness of immunosuppressants
63
st. john's wort
induction of cytochrome p450, delayed emergence
64
GBS treatment
plasmapheresis - can have hypotension and pulmonary edema, IVIG - less side effects, corticosteroids do not help
65
myasthenia clue
disease >6 yrs, pyridostigmine >750 mg daily, preop vital capacity <3 L, pulmonary disease unrelated to myasthenia

Anesthesia (16 decks)

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