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SUM '20 Final Exams Prep > Pharmacology II Exams > Flashcards

Pharmacology II Exams Flashcards

1
Q

Phenobarbital may not protect against ________seizure

A

Nonconvulsive primary generalized seizures

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2
Q

cerebellum controlls?

A

balance

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3
Q

Drugs that the metabolism of theophylline is inhibited by (choose 2):

A

Erythromycin

Cimetidine

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4
Q

Most potent H2 - receptor antagonists:

A

Femotidine

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5
Q

Theophylline partially blocks effects of NMBD by?

A

inhibition of phosphodiesterase

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6
Q

Gabapentin is eliminated by?

A

renal

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7
Q

adding Ketamine and theophylline together does what?

A

decreases seizure threshold

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8
Q

strongest predictor of PONV?

A

gender

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9
Q

MOA for benzos with PONV?

A

Decreasing synthesis and release of dopamine

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10
Q

Metoclopramide blocks _____ on receptor sites at CRTZ

A

dopamine

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11
Q

Clobazam is unique due to?

A

No sedation with long term use

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12
Q

According to ERAS, which patient would need a decrease in the dose of gabapentin from 600 mg to 300 mg?

A

30 year old female with OSA

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13
Q

Which of the following is true?

Levodopa replenishes dopamine stores in

A

the basal ganglia

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14
Q

The objective in treating Parkinson’s disease is to? (choose 2)

A

Decrease debilitating symptoms

Palliative Nature

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15
Q

80% of the dopamine in the brain is in the? (choose 2)

A

Caudate nucleus

Putamen

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16
Q

Gabapentin is given for?

A

partial and generalized seizures

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17
Q

All of the following are part of the afferent pathway involved in vomiting stimulation except?

A

Histaminergic pathway

works through
chemoreceptor trigger zone, cerebral cortex labyrinthovestibular center neurovegetative system

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18
Q

Which of the following medications is most effective in lowering triglycerides?

A

Fenofibrate (fibrates)

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19
Q

Mainstay treatment for hyperlipidemia?

A

Statins (lovastatin)

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20
Q

B2 effects with epinephrine? (choose 2)

A
  • In presence of betablocker, bronchoconstriction due to alpha bronchial constriction
  • Reduces vasoactive mediators for asthma
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21
Q

Antidepressant increase suicidal ideation in which two patient populations? (choose 2)

A

Adolescents

Children

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22
Q

Beta blocker with vasodilating effect?

A

Nobivolol (bystolic)

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23
Q

Levodopa question with newly started levodopa asking about symptoms?

A

Have you had a low blood pressure?

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24
Q

A drug that has effect of syncope w/ first dose, anticholinergic effects, and priapism?

A

prazosin (minipress)

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25
Q

Which drug is least protein bound?

A

gabapentin

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26
Q

What is seen with malnutrition or renal or hepatic disease, can result in increased plasma concentrations of unbound anti-epileptic drugs, resulting in toxicity?

A

Hypoalbuminemia

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27
Q

In pregnancy, hypoalbuminemia is due to ___ which offsets effect.

A

Progressive increase in central volume

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28
Q

Initial treatments for levodopa hypotension? (choose 2)

A

Compression stockings

Fluids

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29
Q

Patient with CAD, DM and CVA, getting a surgery done, what would the prudent SRNA assure?

A

Assure they are on a beta blocker

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30
Q

Only agent requiring routine monitoring?

A

Phenytoin

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31
Q

Gabapentin MOA?

A

enhanced GABA activity

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32
Q

Seizure medication for laboring pregnant woman?

A

Clobazam

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33
Q

Which is a pro drug?

A

Fenofibrate

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34
Q

Benzodiazepines increase the frequency of GABA mediated channels.

What does phenobarbital and other barbiturates do?

A

Increased duration of ion channel opening

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35
Q

Most Common adverse effect of statins?

A

myalgia

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36
Q

Phenobarbital principle site of action?

A

Chloride Ion Channel (Flood p. 347 Table 13.2)

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37
Q

Which of the following is naturally occurring?

A

Lovastatin

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38
Q

Which of the following is located outside the blood brain barrier, has contact with CSF, and allows substances in blood and CSF to interact?

A

CTZ

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39
Q

Teratogenesis occurs within

A

8 weeks

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40
Q

In which of the following is myopathy frequent?

A

Lovastatin

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41
Q

The astute SRNA knows that they will have to monitor blood glucose levels with what kind of drip?

A

epinephrine

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42
Q

Most common cholesterol in plasma?

A

LDL

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43
Q

Mrs. Smith was told to stop taking all her medications 4 days before surgery (including levodopa). What signs or symptoms would you expect to see the day of surgery?

A

Neuroleptic malignant like syndrome

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44
Q

New seizure drug’s elimination half time is 24hrs. How often do you expect medication given?

A

Q 12 hrs

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45
Q

Niacin most common side effect?

A

Flushing

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46
Q

Intubating someone what do you need to be careful about if they take which med?

A

Amlodipine

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47
Q

All these work on the vomiting center except

A

Alpha-gaminobutric acid

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48
Q

Hydrolysis of triglycerides occurs where?

A

Pancreas and small intestine

or intestinal endothelium
Flood p. 542

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49
Q

Anatomical sites that activate the vomiting center include all EXCEPT?

A

Not included: Hypothalamus

Anatomic sites that activate the vomiting center include: -vestibular apparatus,

  • thalamus,
  • cerebral cortex, and
  • neurons within the GI tract (Flood, p. 693)
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50
Q

Which is true of niacin?

A

Hyperglycemia and abnormal glucose tolerance may occur in nondiabetic patients

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51
Q

The vomiting efferent signals via cranial nerves? (choose 3)

A

V, VII, IX, X, and XII

5, 7, 9, 10 & 12

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52
Q

Histamine receptor antagonist?

A

Promethazine

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53
Q

MOA of macrolides:

A

Prokinetic properties are attributed to their binding to motilin receptors in the stomach and doudenum

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54
Q

Early postop nausea occurs?

A

within 6 hours

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55
Q

The vomiting center is located in the?

A

medulla

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56
Q

Risk for PONV:

A

35 female lap procedure

4 year old Female strabismus surgery

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57
Q

What symptoms are associated with scopolamine 24- 48 hours?

A

visual disturbances

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58
Q

Prolong QT? (choose 3)

A

Metoclopramide
Droperidol
Ondansteron

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59
Q

What drug increases Triglycerides?

A

Cholestyramine

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60
Q

Medication for patients actively vomiting pt in PACU?

A

Dopamine antagonist

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61
Q

Controversial but believed to increase PONV?

A

Neostigmine

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62
Q

Medication to avoid with restless leg syndrome?

A

Reglan (metoclopramide)

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63
Q

Which drug has a serotogenic effect?

A

zofran

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64
Q

Reglan works by???? (choose 2)

A

Dopamine antagonist

Blocks histamine

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65
Q

Reglan works by?? (choose 3) (How does it work/ what does it do to the body/ it’s job)

A

Contract lowers esophageal sphincter
Increases small intestinal mobility
Relaxations of pylorus

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66
Q

MOA of Phenytoin?

A

Sodium channel blockade

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67
Q

Which of the following is an early complication with parenteral nutrition

A

Hypophosphatemia

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68
Q

Pyroxidine would be used in caution with what disease

A

parkinson’s disease

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69
Q

A deficiency in this vitamin would cause changes in hematopoiesis system and nervous system

A

Vitamin B12 Deficiency

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70
Q

Which of the following is an example of a fat soluble vitamin

A

Vitamin A

DEAK

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71
Q

You would caution the use of what drug with a patient taking St. John’s Wart?

A

Serotonin Antagonist

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72
Q

What medication was taken off the shelf because it causes prolonged QT, MI, stroke death.

A

Ephedra

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73
Q

True or False: Levodopa replenishes dopamine stores in the Medulla?

A

False, replenishes dopamine stores in the basal ganglia

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74
Q

Which of the following medications is most effective in lowering triglycerides?

A

Fenofibrate (Fibrates)

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75
Q

Which is a pro drug?

A

Fenofibrate

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76
Q

In neonates, doses of 1mg or greater may cause hemolytic anemia and increase the plasma concentrations of unbound bilirubin, thus increasing the risk of kernicterus.

A

Phytonadione

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77
Q

Antidepressant increase suicidal ideation in which two patient populations? (choose 2)

A

Adolescents

Children

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78
Q

Levodopa question with newly started levodopa asking about symptoms?

A

Have you had a low blood pressure?

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79
Q

Which is least protein bound?

A

Gabapentin

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80
Q

The vominting center is located in the?

A

medulla

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81
Q

Deficiency can cause of vitamin A can lead to

A

Night blindness

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82
Q

What factor is not synthesized by vitamin K

A

XII

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83
Q

This deficiency can lead to rickets

A

Vitamin D

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84
Q

Which of the following is not associated with enteral feeding

A

Decreased absorption in the small intestine

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85
Q

All of the following interfere with Warfarin EXCEPT

A

Golden Seal

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86
Q

Which of the following stimulates the release of Growth Hormone

A

Stress

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87
Q

What is the initial building block of corticosteroid synthesis

A

Cholesterol

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88
Q

Corticotropin releasing hormone and ACTH are: (Choose 2) (concentration and time of day)

A

High in the am

Low in the pm

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89
Q

Which of the following is released from the zona glomerulosa:

A

aldosterone

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90
Q

Which of the following is NOT true regarding absence of ACTH choose 2

A

Hyperpigmentation is associated with a low ACTH from primary adrenal insuffiency
Pallor is associated with Hyperpituitarism …

from ppt:
Hyperpigmentation in presence of adrenal insufficiency from primary adrenal gland disease reflects high concentrations of ACTH in plasma as the anterior pituitary attempts to stimulate corticosteroid secretion.

Pallor is the hallmark of HYPOpituitarism.

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91
Q

Estrogen most common side effect

A

Nausea

Yes, FLood p. 773 - “the most frequent unpleasant symptom with the use of estrogen is nausea”

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92
Q

Choose three things vasopressin does

A

Vasoconstriction
Reabsorption of water
Release of corticotropin

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93
Q

What is the side effect of iodine?

A

angioedema

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94
Q

When is radioactive iodine contraindicated?

A

26 year old parturient

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95
Q

What is given for DI?

A

DDAVP

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96
Q

What is the Prohormone to T3

A

T4 is a prohormone to T3

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97
Q

AVP and oxytocin are secreted from the ______ and transported via _____ to the ____.

A

Hypothalamus,
axons,
posterior pituitary

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98
Q

PTH has targeted effects on: (Choose 2)

A

Kidneys

GI

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99
Q

According to the ADA and WHO classification of diabetes which of the following is TRUE (Choose 2)

A

The underlying disease etiology

Not classified by age of onset

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100
Q

A patient diabetic patient with liver cirrhosis would more than likely be prescribed what sulfonylurea:

A

Acetohexamide

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101
Q

Consequences with diabetes usually resolves with a blood level less than:

A

200 mg/dL

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102
Q

Which of the following describes endocrine glands that secrete hormones adjacent to the site of origin:

A

Paracrine

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103
Q

Which of the following is the longest acting Sulfonylurea:

A

Chlorpropamide

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104
Q

All of the following are side effects of chronic corticosteroid therapy EXCEPT:

A

Acromegaly

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105
Q

What is the level of daily insulin secretion in a normal patient:

A

40 U/Day

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106
Q

True or False: Insulin is metabolized in the portal vein of the liver by second pass?

A

False

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107
Q

Which of the following does NOT cause hypoglycemia:

A

Metformin

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108
Q

What causes lactic acidosis

A

Metformin

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109
Q

he liver is _____ in insulin and uses _____ to produce _______ and be used as an energy source for skeletal and cardiac muscle

A

Insufficient, free fatty acids, ketones

110
Q

First thing you see with thyroid dysfunction

A

Cardiac changes

111
Q

Which of the following causes an aberrant production of AVP:

A

Oat cell carcinoma

112
Q

This has reactions similar to disulfiram

A

Chlorpropamide

113
Q

What would you expect in a patient with hyper/hypothyroidism: (Not the exact question but something about thyroid disease and anesthesia)

A

No alterations in MAC because there is no affect on O2

brain consumption

114
Q

Which of the following is true regarding thyroid disease:

A

Hyperthyroidism causes 100% increase in O2 consumption

115
Q

pancreatic cells come from

A

Beta

116
Q

PTH increases

A

Renal absorption of calcium and inhibits renal reabsorption of phosphate.

117
Q

You would except the O2 consumption in a patient with hyperthyroidism to increase by:

A

100%

118
Q

Glucocorticoids permissive actions allow individual for response to stress

A

At low physiologic steroid concentrations

119
Q

What is the cause of DI?

A

Inadequate secretion of vasopressin by posterior pituitary

120
Q

Permissive action of glucocorticoids:

A

Occur at low physiological steroid concentrations and prepares the individual for stress

121
Q

The Thyroid receives innervation from the:

A

Autonomic nervous system (Flood page 738)

122
Q

How many parathyroid glands secrete PTH?

A

4 (Flood 739)

123
Q

PTH has what kind of relationship with calcium?

A

Inverse (Flood 739)

124
Q

Early nutritional support is proactive therapy: What 4 things does it help with?

A

Reduces disease severity

Diminish complications

Decrease Length of Stay

Favorably impacts patient outcome after severe injury

125
Q

Greatest risk of hypoglycemia occurs with drugs with the longest elimination half times (choose 2)

A

Chlorpropamide and glyburide

126
Q

The most common setting for symptomatic hypocalcemia is

A

within 12-24 hrs after surgery, particularly after total of or subtotal thyridectomy of 4 gland parathyroid exploration or removal.

127
Q

hypocalcemia can cause:

A

Neuromuscular irritability

128
Q

What can DDAVP NOT treat?

A

Nephrogenic diabetes insipidus

129
Q

Pyridoxine b6 can cause what toxic effect?

A

Neurotoxicity

130
Q

Folic acid deficiency can cause

A

Megaloblastic anemia

131
Q

Vitamin A is important for:

A

retina, integrity of mucous and epithelial surfaces, bone development and growth, reproduction, and embryonic development.

132
Q

Hypothalamic and pituitary secretion is ______

A

Pulsatile

133
Q

The most abundant anterior pituitary hormone is

A

Growth hormone (Somatotropin)

134
Q

What hormone stimulates linear bone growth?

A

Growth hormone (Somatotropin)

135
Q

PTH also increases renal tubular absorption of _______; inhibits renal re-absorption of _______.

A

Calcium, Phosphate

136
Q

Normal Fibrinogen level in parturients?

A

> 400

137
Q

Antithrombin affects the following factors:

A

12 (XII),11 (XI),10 (X), 9 (IX)

138
Q

At what Hgb level would you plan to transfuse?

A

a. There is no single minimum acceptable hemoglobin level for transfusion

139
Q

Half life of Fibrinogen:

A

~3.7 days

140
Q

Clopidogrel (Choose 2):

A

a. Most widely used agent

b. Inability to adequately inhibit P2Y12-dependent platelet function, so resistance occurs in 20% to 30% of patients

141
Q

Prodrugs:

A

Clopidogrel

dabigatran etexilate

142
Q

Primary factor of Extrinsic pathway?

A

7 (VII)

143
Q

What is needed to start the extrinsic pathway? (Choose 2):

A

a. Tissue Factor (Thromboplastin/Factor III)

b. Trauma

144
Q

Major factor in the common pathway?

A

10 (X)

145
Q

Factors can act as: (2)

A

a. Proteases

b. Catalysts to convert inactive to active form

146
Q
  1. Which of the following is true regarding hemophilia (Choose 2)
A

a. VIII and Hemophilia A

b. IX and Hemophilia B

147
Q

What is not true of vWF?

A

Used prophylactically

148
Q

Cryoprecipitate should not be given for DIC because it lacks factor:

A

V (5)

149
Q

Which of the following is true (choose 3) (what do you know about protein C, S, and Thrombin?)

A

a. Protein C and Protein S together break down 5a and 8a
b. Thrombin to activate Protein C
c. Protein C binds to protein S

150
Q

When can HIT occur?

What do the antibodies to heparin bind to?

A

a. Can occur 4-5 days after heparin therapy

b. Antibodies to heparin form and bind factor IV (calcium)

151
Q

Primary Hemostasis is:

A

platelet activation by injury to where platelets attach to damaged endothelium

152
Q
  1. Inflammatory response that includes cytokine release is true of which of the following:
A

d. Procoagulant response

153
Q

Factor IX is the _____ factor and is stored in the _____

A

Christmas, liver

154
Q

Inactive enzymatic precursor

A

Zymogen

155
Q

NOT true regarding coagulation testing (most common lab test, and PT or PTT?)

A

Most common lab test

PTT measures extrinsic

156
Q

Which of the following according to ____ would require PRBC transfusion?

A

9 (all other levels were > 10)

157
Q

What factors are included in Cryo?

A

Fibrinogen and vWF

XIII and VIII

158
Q

While there is no literature to prove this, it is possible that storage of PRBCs can cause storage lesions after being stored:

A

14-21 days

159
Q

Which of the following should be considered in the decision to transfuse? (Choose 3)

A

a. Target organ ischemia
b. Decreased cardiac reserve and increased myocardial oxygen consumption
c. Ability to transport O2

160
Q
  1. A patient that is 50 kg would need how much cryo to increase fibrinogen 50-70 mg/dL
A

5 units (1 unit Cryo for every 10 kg of body weight)

161
Q
  1. Which of the following is true regarding TRALI (Choose 2)
A

a. Onset within 6 hours of transfusion

b. Pulmonary artery occlusion less than or equal to 18 mm Hg

162
Q

Which of the following is true regarding TACO?

A

a. Elevated JVP
b. High BNP
c. Pulmonary Edema

163
Q
  1. True regarding FFP (Choose 3):
A

a. FFP can be frozen after 8 and 24 hours
b. After thawed, FFP can be stored an additional 4 days
c. FFP is what is left after RBCs and Platelets are removed

164
Q

Which drug’s elimination half-time is 12-24 hrs?

A

Abciximab (Reopro)

165
Q

TXA: Choose 3

A

a. inhibits plasmin at higher doses
b. most of the efficacy data are reported with TXA
c. Synthetic antifibrinolytic

166
Q
  1. A patient is scheduled for surgery at 0800, they received their last dose of LMWH at midnight. What time would you reschedule their surgery for?
A

1200 noon (12hrs)

167
Q

What would you consider lab values to be in DIC (Choose 2):

A

a. Decreased platelets and fibrinogen

b. Increased PTT and D-Dimer

168
Q
  1. What is a cause of chronic DIC? (I just put the key words in to jog someone’s memory) All I know is that you can have normal labs with chronic
A

Tumor or large aneurysm with normal clotting labs (PT and PTT)

169
Q

If a patient has an immediate reaction after heparin dosing you would expect?

A

HIT

170
Q

What drug is an irreversible thrombin inhibitor that can possibly produce antibodies and need to be monitored with aPTT?

A

Lepirudin

171
Q

What is true about heparin rebound?

A

a. 2-3 hours after 1st dose of Protamine

b. Can occur after initial dose of Protamine

172
Q

The influence of renal and hepatic disease with heparin is:

A

Less than with other anticoagulants

173
Q

In acute anemia, compensatory mechanisms rely on?

A

Cardiac reserve

174
Q

DDVAP dose?

A

0.3mg/kg over 15-30mins

175
Q

ASA guidelines for hemoglobin levels that require transfusion (This was two separate questions)

A

a. 5 (<6 in young healthy patient)

b. 9 (all other answers were >10, which are outside of guideline range for transfusion)

176
Q

DIC involves (Choose 2):

A

a. Too much clotting

b. Too little clotting

177
Q
  1. You are performing pre-op for a patient who has been on warfarin for 5 days; what lab would you check (that is only related to warfarin) and what, if anything, would you plan to give?
A

Check PT and give FFP

178
Q

Patient received 10,000 units of heparin an hour prior; How much protamine do you give?

A

Patient still has 5,000 units of circulating heparin after one hour (heparin HALF life is one hour), and 1 mg protamine for every 100 units heparin (5,000/100 equals 50) = 50 mg protamine

179
Q

What lab values would you expect to see in a patient with antiphospholipid syndrome: (Choose 2):

A

a. Prolonged PT, PTT, but patient is actually
* * hypercoagulable**
c. Caused by lupus anticoagulant antibody

180
Q

Factors can be (Pick 2):

A

a. Proteases

b. Catalysts for transforming inactive into an active state

181
Q

What is a zygomer:

A

inactive enzymatic precursor

182
Q

What starts the Intrinsic pathway:

A

Factor 12

183
Q

Correct sequence of intrinsic pathway: (choose 2)

A

a. 12 → kallikrein → 12a → ,11 → 11a

b. Occurs in the blood

184
Q

What is true about heparin (Choose 2):

A

a. IV onset is immediate

b. Effects are produced by binding to antithrombin (AT)

185
Q
  1. Patient on heparin infusion planning to go to surgery shortly; aPTT level is 157; what should you do?
A

Omit a dose

186
Q

ACT is good for (Choose 2):

A

a. Heparin doses of > 1unit/mL

b. High doses of heparin

187
Q

ACT is affected by:

A

a. Hypothermia, presence of contact activation inhibitors Aprotinin, may have been one more answer

188
Q

Aprotinin:

A

use Kaolin ACT

189
Q

Target ACT in CABG:

A

350-400

190
Q

Which is not true of Arixtra? (fondaparinux)

a. It is a synthetic anticoagulant (true)
b. Half-life of 15 hours (true)
c. Metabolism does not occur and the drug is eliminated by the kidneys (true)
d. It is naturally occurring

A

d. It is naturally occurring

191
Q

Question about PEs:

A

a. 3rd MCC of death in traumas who survive first 24 hrs

b. PE occur 2-22% of pts in major trauma

192
Q

What drug Inhibits vitamin K epoxide reductase that converts the vitamin K-dependent coagulation proteins (Factors II, VII, IX and X) into active forms in Oral or IV

A

Warfarin

193
Q

What is true about warfarin? (Choose 2):

A

a. peak effect in 36-72 hours

b. 97% protein (albumin) bound

194
Q

When to stop anticoagulants:

A

1-3 days pre-op to give prothrombin time to return to within 20% of normal range

195
Q

What is true about Xarelto: Is this a choose 3?

A

a. >10,000 fold greater selectivity for factor Xa than for other related serine protease
b. Does not require AT as a cofactor
c. Has non-heparin-like molecule and may be suitable for pts with HIT

196
Q

PCC compared to FFPs

A

a. quicker INR correction
b. have a lower infusion volume
c. and are more readily available without crossmatching

197
Q

TXA dose:

A

Loading dose of 1gm over 10 mins then 1 gram over 8 hours

198
Q

Question about aprotinin

A

a. Polypeptide serine protease inhibitor

Used for low risk CABG in canada-used for compassionate use in US

199
Q

vWB: using DDAVP (Pick 2)

A

a. Will be ineffective in treatment of types 2 - 3 (the severe forms)
b. Will only be effective in mild form of vWB (type 1)

200
Q

Source of factor III:

A

Platelets

201
Q

What lab work would you expect to see in vitamin K deficiency?

A

Prolonged (increased) PT

202
Q

What is true regarding propofol?

A

a. Baroreceptor reflex control of HR may be depressed by propofol
b. Stimulation produced by by direct laryngoscopy and in intubation of the trachea reverses the blood pressure effects of propofol

203
Q

Propofol half life?

A

0.5-1.5 hours

204
Q

Succinylcholine half life?

A

47 sec

205
Q

What is true regarding cisatracurium? Pick 3

A

a. Hoffman elimination accounts for 77% of metabolism
b. Small amount is eliminated by renal
c. At regular doses it does not release histamine

206
Q

Tylenol hepatic metabolism by?

A

a. NAPQ1 (N-acetyl-p-benzoquinonneimine)

207
Q

Dosage of etomidate for a patient weighing ____ lbs?

A

0.2-0.4 mg/kg

208
Q

Dosage of ketamine for a patient weighing __162___ lbs?

A

1-2 mg/kg

209
Q

Profound block of Rocuronium can be reversed with how much sugammedex?

A

8 mg/kg

210
Q

Sugammadex work on all of the following drugs except?

A

Cisatracurium

211
Q

Sugammadex make 1:1 complexes, with greatest to least effects on?

A

Roc > Vec&raquo_space; Pan

212
Q
  1. Clearance of propofol from the plasma exceeds hepatic blood flow… elimination/metabolism?
A

a. Oxidative metabolism by cytochrome P450

b. Lungs by first pass

213
Q
  1. Dose of Neostigmine for reversal?
A

40 mcg- 70 mcg/kg

214
Q

Succ dosing causing bradycardia occurs within ___ min of repeated dose?

A

5

215
Q

Do not mix meds with propofol, but sometimes _______ is used.

A

Lidocaine

216
Q

Dose of Glyco when using neostigmine for reversal

A

7 to 15 mcg/kg

217
Q

Phenylephrine is similar to?

A

Norepinephrine

218
Q

Who is at greatest risk for postop hyperglycemia after 1 dose of dexamethasone?

A

Obesity

219
Q

4 year old with Propofol bradycardia?

A

epinephrine (p 165)

220
Q

Propofol

A

a. decreased cerebral metabolic rate for oxygen

b. Large doses of propofol to decrease cpp

221
Q

Relatively selective modulator of GABAA has activity at glycine receptors.

A

Propofol

222
Q

Paradoxical vocal cord motion?

A

midazolam 0.5-1mg

223
Q

What is given orally 30 mins before induction to children?

A

Midazolam 0.5mg/kg

224
Q

Esmolol initial dose?

A

0.5 mg/kg

225
Q

Select 3 about Fentanyl?

A

a. prolonged elimination half time by cardiopulmonary bypass
b. 75% of initial Fentanyl first pass pulmonary uptake
c. Rapid onset and shorter duration of action than morphine

226
Q

Fentanyl when given in a single dose, compared to morphine?

A

a. Has a shorter duration

b. Has a rapid onset

227
Q

question about which drug has larger Vd?

A

Fentanyl greater lipid solubility

228
Q
  1. Max dose of propofol in patient weighing 218 lbs (99 kg)?
A

1.5-2.5 mg/kg

229
Q

Elimination of vecuronium (Choose 2):

A

a. Has parent compound present in bile

b. Primarily eliminated by the liver/elimination half time is dependent on hepatic blood flow

230
Q

Anaphylaxis from propofol most likely from patients who also have an allergy to which type of med?

A

NMBDs

231
Q

Responsible for hydrolysis of esmolol?

A

Plasma esterase

232
Q

When giving etomidate, need to be cautious with patients who have which condition?

A

Seizures

233
Q

Elimination of succinylcholine follows?

A

First order kinetics

234
Q

In what patients is there a risk of hyperglycemia from administration of dexamethasone?

A

Obesity

235
Q

Succinylcholine increases intragastric pressure by:

A

Increased vagal tone

236
Q

Ketamine

A

Cerebral vasodilator

Increases SBP

237
Q

Vecuronium metabolism/elimination:

A

More liver metabolism (70%) than renal

238
Q

What 2 conditions can increase chances of hyperkalemia when using Succinylcholine:

A

a. G.B. syndrome

b. Severe Metabolic acidosis

239
Q

Ephedrine has a duration of action ___times than epinephrine

A

10 times

240
Q

Vecuronium eliminantion.

A

The liver is the principal organ of elimination

241
Q

Which is true of precursors?

A

Dopamine is the precursor to epinephrine and epinephrine is precursor to norepinephrine

242
Q

Esmolol as treatment for cocaine toxicity can lead to: (flood 483)

A

CV Collapse

243
Q

Etomidate is known… or you would use it cautiously because it can result in: (flood-171)

A

Adrenocortical suppression

244
Q

The SRNA would make a DART how? (hammon)

A

3ml total = 2 ml Succ (40mg), 1ml Atropine (0.4mg) in an IM injection

245
Q

Succs is metabolized by (flood-325)

A
  • butyrylcholinesterase

- plasma cholinesterase

246
Q

Sufentanil has an 84-100% of chest wall rigidity making ventilation difficult. Give? (flood-223)

A

Neuromuscular blocking drug

Opioid antagonism-naloxone

247
Q

Pick two for propofol (flood-163)

A
  1. Compared with thiopental, propofol decreases the prevalence of wheezing after induction of anesthesia
  2. Metabisulfite may cause bronchoconstriction in asthmatic patients
248
Q

Something about cisatracurium differences from atracurium (flood-330)

A

cisatracurium is about four to five times as potent as atracurium

249
Q

Which is true regarding Ephedrine? (flood-459)

A

Synthetic indirect acting sympathomimetic

250
Q

Rapid administration of Phenylephrine, 1 mcg/kg IV (flood-460)

A

to GA pts with CAD can cause transient impairment of Left ventricular globe function

251
Q

Usual dose of Succ:

A

1mg/kg

252
Q

Rocuronium is primarily eliminated by

A

liver

and excreted in bile

253
Q

Propofol does all of the following EXCEPT:

A

Relief of acute nociceptive pain

(It IS an Antiemetic, antipruritic, and an anticonvulsant)

254
Q

Levodopa is converted to Dopamine by:

A

L-amino-acid decarboxylase (dopa decarboxylase enzyme)

255
Q

identify the hypophyseal fossa in sella turcia of:

A

sphenoid bone

256
Q

A total thyroidectomy and subsequent absence of calcitonin does what (p. 739)

A

Does not measurable influence the plasma concentrations of calcium because of the predominance of parathyroid hormone

257
Q

What patient type would you use Pyridoxine with caution in: (p. 724)

A

Parkinson Disease

258
Q

elimination half time of glucagon

A

3-6mins

259
Q

Sulfonylureas cross the placenta and can produce (p. 754)

A

Fetal hypoglycemia

260
Q

question about platelets Storage
There remains a permissive bacterial growth as platelets:

Reducing donor exposures by

A
  • are stored at 22C

- apheresis platelets. (It used to come from multiple sources increasing the risk of exposure

261
Q

normal platelet

A

150,000-400,000

262
Q

Thawed Plasma maintains normal levels of all factors except

A

VIII which falls to 60%

Factor V falls to 80% of normal

263
Q

10-15ml/kg of FFP will result in a rise of most coagulation proteins by

A

25-30%

264
Q

DIC treatment (flood 624)

A

Remove underlying cause-institute anticoagulation in efforts to reduce further consumption of coag factors.

265
Q

platelets

Lab test determine platelet

A

count NOT function

266
Q

protamine found

A

found from Salmon sperm

  • strong positive alkaline
267
Q

Act values can be misleading during CABG due to

A

Hypothermia and hemodilution during CABG

268
Q

What has a greater risk DVT

A

Hip surgery is greater than general surgery

269
Q

First isolated from leeches

A

Lepirudin and Desirudin

270
Q

aPTT =

A

activated partial thromboplastin time

normal = 30-35sec

271
Q

PT =

A

prothrombin time

SUM '20 Final Exams Prep (7 decks)

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