Quick Hits Flashcards by Bryan Groff

Protons, neutrons, and electrons; which are positive, negative, and neutral?

Protons - Positive charge

Neutrons - No charge

Electrons - Negative charge

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An ion with a positive charge is called? What about a negative?

Cation - positive (lost electrons)

Anion - negative (gained electrons)

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Order bonds from strongest to weakest.

Ionic
Polar covalent
Van der Waals
Covalent

Strongest
1. Covalent
2. Ionic
3. Polar covalent
4. Van der Waals

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What type of bond is water?

Polar covalent (hydrogen bonds)

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Which law describes the total pressure is equal to the sum of all partial pressures exerted by each gas mixture?

Daltons

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Which law describes gas solubility?

Henrys

At a constant temperature, the amount of gas that dissolves in a solution is directly proportional to the partial pressure of that gas over the solution

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Anesthetic emergence being prolonged is an example of which law?

Henrys

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An over pressurized vaporizer is an example of which law?

Henrys

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Increasing FiO2 increases PaO2 is an example of which law?

Henrys

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Which law describes the transfer of a gas through a tissue medium?

Ficks

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Cardiac output calculation and placental drug transfer is an example of which law?

Ficks

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Which law describes why smaller molecules diffuse faster than larger?

Grahams

The lower the molecular weight, the faster it can diffuse

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Does a decreased pressure increase or decrease solubility?

Decreases

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Does an increased pressure increase or decrease solubility?

Increases

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Does a decreased temperature increase or decrease solubility?

Increases

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Does a increased temperature increase or decrease solubility?

Decreases

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What is the universal gas law?

Pv = nrT

P=pressure
V=volume
n=number of moles
r=constant 0.0821
T=Temperature

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An O2 tank exploding is an example of which law?

Gay-Lussacs - at a constant volume the pressure and temperature of a gas are directly proportional

**Heated gas increases the pressure in a container

P/T

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LMA cuff rupture in the autoclave is an example of?

Charles - at a constant pressure, the volume and temperature are directly proportional

***Heated gas expands

V/T

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Squeezing a bag valve mask
Pneumatic
Bellows
Diaphragm contraction

are examples of?

Boyles - When temperature is held constant, the volume and pressure are inversely proportional

***** As volume decreases, the pressure increases

P*V

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Which law descries that the current passing through a conductor is directly proportional to the voltage and inversely proportional to the resistance?

Ohms

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Which law takes Ohms law and factors in diameter, viscosity, and tube length?

Poiseuille’s

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Doubling the radius of an IV increases flow by how much?

16 times

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How does fever effect blood flow?

It decreases viscosity which increases blood flow

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Tripling the radius of an IV increases flow by how much?

81 times

Quadrupling the radius of an IV increases flow by how much?

256 times

What s laminar, transitional, and turbulent flow?

Reynolds number Laminar flow < 2000 Transitional 2000-4000 Turbulent > 4000

If fluid velocity is high, what is the pressure exerted on the walls of the tube? What principle is this?

Bernoulli's Pressure is low on the walls of the tube If flow is low, then the pressure is high on the walls

What is the venturi effect? Ex?

If the pressure inside the tube falls below atmospheric pressure, then the air is entrained in the tube Jet ventilator, venturi mask, nebulizer

What is the Coanda effect?

The jet flow attaches itself to a nearby surface and follows it Like a snake Ex: mitral regurgitation

Which law describes the relationship between wall tension, internal pressure, and radius?

Law of LaPlace

What is the minimum safe distance from radiation source?

6 feet

What is the yearly maximum safe exposure for an adult? Pregnant?

5 rem .5 rem

What is the most susceptible tissue for radiation? What about pregnancy ?

Eye and thyroid Baby for pregnancy

What are three ways to limit radiation exposure?

1. Increase distance 2. Decrease duration 3. Wear shielding

Which gases are liquid at room temp?

Nitrous and CO2

What is specific heat?

Amount of heat required to increase temperature of 1gram by 1 degree C

What describes why an O2 tank feels cold when opened?

A gas stored at a high temperature when released fast Joule-Thompson effect (adiabatic process)

How to convert C to K? K to C?

C = K - 273 K = C + 273

How to convert C to F? F to C

C = (f-32) x 5/9 F = (C X 1.8) + 32

What is Avogadro's number?

1 mole of any gas is made of 6.023x10 to the 23rd atoms

Boiling of water?

212 F 100 C

1 cm H2O is equal to what in mmHg?

1cm H2O = 0.74mmHg 1mmHg = 1.36cm H2O

What type of bond are metals and acids+bases?

Ionic Complete transfer of valence electrons

What is the number one source of heat loss?

Radiation 60% - Through the skin Top of head

What is the number two source of heat loss?

Convection 30% - Cold air

What are the 4 ways to lose heat?

Radiation - 60% Convection - 30% Water loss - 20% Conduction - 5%

What is the number one way to minimize heat loss in the OR?

Forced air warmer

Hypothermia is a body temperature less than?

36 C

What is the most accurate site for temperature?

Pulmonary artery

What is the best temperature monitoring site for accuracy and extended timeframe?

Esophageal (PA is an invasive site)

How much does shivering increase O2 consumption?

500%

Best treatment options for post operative shivering?

Demerol (meperidine) Clonidine Precedex

Does a skin measurement monitor the core or peripheral temperature?

Peripheral *All others monitor core

What three things are needed for an airway fire?

Ignition Source Fuel Oxidizer

Examples of fuel for airway fire?

ETT Surgical supplies Drapes

Examples of ignition source for airway fire?

Cautery Laser

Examples of oxidizer for airway fire?

O2 Nitrous

What is the first step with an airway fire? What is a key step when doing this?

REMOVE ETT DO NOT squeeze the bag while doing so or else it'll create a blow torch

What does laser stand for?

Light Amplification Stimulated Emission Radiation

Three types of lasers?

Monochromatic - single wavelength Coherent - oscillates in same phase Collimated - narrow beam

Laser Goggles - which structures do they effect

CO2 = Clear lenses (cornea) Nd:YAG = green goggles (retina) Ruby = red goggles (retina) Argon = amber goggles (retina)

Which wavelength penetrates deep and which does not?

Long - absorb more water and do not go deep Short - absorb less water and do go deep

FiO2 during laser use?

30% or less FiO2

Should nitrous be used around lasers?

5 steps with an airway fire?

1. Remove ETT 2. Stop all gas flow 3. Remove flammable material 4. Pour water or saline 5. Use extinguisher

Burn image

Which burn will have loss of all sensation?

3rd and 4th degree?

Which burns require grafting?

2nd degree deep 3rd 4th

Which burn involves muscle? What about subq tissue?

Subq tissue - 3rd degree Muscle - 4th degree

Best type of fluid to give in the first 24 hours of a burn?

Best type of fluid to give in the second 24 hours of a burn?

D5W

Which type of fluid is avoided in the first 24 hours of a burn?

Albumin

Fluid status of a burn patient in the first 24 hours?

Hypovolemic Hemoconcentrated Edema from loss of albumin

A rising Hgb in the first few days following a burn indicates what?

Inadequate fluid resuscitation

Parkland formula for burns?

1st 24 hours - 4ml LR + % TBSA * kg 2nd 24 hours D5W

How should fluid be replaced in the first 24 after a burn?

1/2 in the first 8 hours 1/2 in the next 16 hours

Urine output goals for burns Adult Children High voltage burns

Adult - .5mL/kg/hr Child - 1mL/kg/hr Electrical- 1.5mL/kg/hr

What is a big nephrotoxin released during electrical burns?

Myoglobinemia - needs to be flushed out

How is abdominal compartment syndrome defined as?

>20mmHg AND evidence or organ dysfunction

CO binds to Hgb at what rate? How does it effect the OxyHgb curve?

200x more than O2 OxyHgb curve - to the left

Treatment for carbon monoxide poisoning?

100% FiO2 Hyperbaric

Blood gas of a carbon monoxide poisoning?

Metabolic acidosis - blood is cheery red

What is the gold standard of assessing the airway of a burn patient?

Fiberoptic bronch

Should a surgical airway be utilized in a burn patient?

Just as a last resort - increases infection rates

When do up-regulation of extra junctional receptors start in burn patients?

After the first 24 hours

Dosing of nondepolarizing NMBs in burn patients?

Increased dose due to more receptors

Hypermetabolic

Burn patients become hypermetabolic Increased HR RR O2 consumption Catabolism

PNS VS SNS in ECT treatment - 1st and 2nd phase

1st Phase - increased PNS tone (tonic) 2nd Phase - increased SNS tone (clonic)

What is the minimum seizure recommendation for ECT?

25 seconds

How does hypocapnia and hyperventilation effect seizure duration?

Increases it

Which opioid increases seizure duration?

Alfentanil with propofol

Which drugs increase seizure duration?

Etomidate Ketamine Alfentanil with propofol Aminophylline Caffeine

Which drugs have no effect on seizures?

Methohexital Precedex Clonidine

What is the gold standard of ECT?

Methohexital but does not have an effect on seizure duration

How does lithium effect NMB?

Prolongs both succ and Non depolarizers

What can MAOI's do during ECT?

Can experience a hypertensive crisis with those who receive indirect acting sympathomimetics

FACT Not all drug induced hyperthermia is MH - there are other causes

Neuroleptic malignant syndrome causes hyperthermia -why?

Caused by dopamine depletion

Serotonin syndrome causes hyperthermia -why?

Excess 5HT activity

Anticholinergic poisoning causes hyperthermia -why?

Excessive blockage of AcH

How is Anticholinergic poisoning treated?

Physostigmine

How is Serotonin syndrome treated?

Cyproheptadine

How is Neuroleptic malignant syndrome treated?

Dantrolene or bromocriptine

Which diseases have muscle rigidity?

MH Serotonin syndrome Neuroleptic malignant syndrome

Neuroleptic malignant syndrome or MH; which has a genetic link?

Neuroleptic malignant syndrome or MH; which develops acutely?

Neuroleptic malignant syndrome or MH; which is associated with psych meds?

Neuroleptic

Neuroleptic malignant syndrome or MH; which has muscle rigidity, hyperthermia, tachycardia, and acidosis?

Both

Neuroleptic malignant syndrome or MH; which is treated with dantrolene?

Both

Neuroleptic malignant syndrome or MH; which can receive NMB?

Neuroleptic

Which two perioperative drugs can lead to anticholinergic poisoning?

Atropine Scopolamine

S&S of anticholinergic poisoning?

Red, dry, hot skin Delirium Mydriasis

Normal intraocular perfusion pressure and how is it measured?

10-20mmHg MAP-IOP

What positions increase intraocular pressure?

Prone Trendelenburg

How does O2 effect IOP?

Hypoxemia - increases IOP

How does hypercarbia effect IOP?

Hypercarbia - Increases IOP

How does MAP and CVP effect IOP?

Increased MAP/CVP - Increases IOP

How does succ and Nondepolarizers effect IOP?

Succ - increases Nondepolarizers - decreases

How does anticholinergics effect IOP?

No effect

How does ketamine effect IOP and the eye?

Does not increase IOP BUT causes nystagmus and blepharospasm

How does an LMA/ETT effect IOP?

LMA - no effect ETT - increases from intubation

Which NMB should be used in an open globe injury?

Roc 1.2mg/kg Avoid succ because it can raise by 10mmHg for 10 minutes

Concerns for strabismus surgery?

Increased risk of PONV Increased risk of oculocardiac reflex

Which two drugs decrease aqueous humor production?

Timolol Acetazolamide

When should nitrous be avoided with a SF6 bubble?

Stop 15 minutes before placement of bubble Avoid for 7 days

When should nitrous be avoided with a silicone oil bubble?

0 days

When should nitrous be avoided with a air bubble?

5 days

When should nitrous be avoided with a perfluoropropane bubble?

1 month

Quick Hits Flashcards

(129 cards)