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1
Q

With what protein does calcium combine to initiate contraction in skeletal or cardiac muscle?

A

Troponin

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2
Q

What is one of the earliest and most sensitive signs of MH?

A

Sudden severe increase in eTCO2 capnography

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3
Q

Which drugs should be avoided with Parkinson’s Disease?

A

Any drugs that inhibit dopamine (Droperidol, Reglan, possibly Opioids)

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4
Q

C1 is also known as the ______.

A

Atlas

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5
Q

C2 is also known as the ______.

A

Axis

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6
Q

What does the legal term “Libel” mean?

A

Defamation of another person by written means

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7
Q

What is stated in the American Disabilities Act of 1990?

A

Requires reasonable accommodation for removing chemically dependent employees

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8
Q

What is the most common cause for lawsuit related to OB?

A

Maternal death

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9
Q

Who is responsible for quality assurance?

A

Each hospital department or service is responsible for monitoring quality assurance in their area which is required by JCAHO

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10
Q

List 3 congenital defects in which there is a RIGHT to LEFT shunt?

A
  1. Tetrology of Fallot
  2. Pulmonary Atresia (w/ ventricle/septal defect)
  3. PFO (Patent Foramen Ovale)
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11
Q

What is the EBV (estimated blood volume) for an infant less than 3 months in age?

A

90 mL/kg (Valley p. 416)

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12
Q

What is the EBV (estimated blood volume) for a premature newborn?

A

100-120 mL/kg (Valley p. 416)

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13
Q

What is the EBV (estimated blood volume) for an infant 3 to 12 months in age?

A

80 mL/kg (Valley p. 416)

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14
Q

What is the EBV (estimated blood volume) for an infant greater than 12 months in age?

A

70 mL/kg (Valley p. 416)

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15
Q

What is the dose of Atropine for reflex bradycardia?

A

0.03 mg/kg

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16
Q

What type of valve is an O2 Flush Valve?

A

Ball & Spring Valve

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17
Q

Which nerve is located in the coracobrachialis muscle?

A

Musculocutaneous

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18
Q

Where are the high points located in the spinal cord?

A

High points are located at C3 & L3

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19
Q

Where are the low points located in the spinal cord?

A

Low points are located at T6 & S2

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20
Q

In which Lung Zone has a lower V/Q ratio than Zone 1, is better perfused and better ventilated?

A

Zone 3

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21
Q

In which Lung Zone should the tip of a Pulmonary Artery Catheter (PAC) ideally be placed?

A

Zone 3

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22
Q

What type of murmur will you most likely hear with Idiopathic Hypertrophic Subaortic Stenosis or IHSS? Why?

A

Mitral Regurgitation

Because of the dysfunction of the anterior leaflet of the mitral valve

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23
Q

What changes would you see in a Pressure Volume Loop after giving Phenylephrine? Why?

A

The Pressure Volume Loop shift UP (greater pressures) and RIGHT (greater volumes)

  • Increase SVR (primarily)
  • Increase in arterial blood pressure
  • Increase in afterload
  • Decrease in stroke volume (SV)
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24
Q

What is the most important spinal nerve tract for relaying pain and temperature sensation to the brain?

A

Lateral Spinothalamic Tract

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25
Neuromuscular Blockers are ____% ionized at normal pH, they are also highly bound to ______. They (do/ do not) cross the placenta. They (do/ do not) cross the BBB.
- 100% - Protein - Do not - Do not
26
Abnormally low circulating levels of maternal thyroxine result in what condition in infants & children?
Cretinism (severe stunted physical and mental growth)
27
What are signs and symptoms of Hypothyroidism in an adult?
- Myxedema (usually Exophthalmos) - Slow mental function and movements - Weight gain - Dry skin - Intolerant to COLD - Depressed ventilatory responses - Renal disease - Abnormal cardiac conductivity (decrease cardiac function)
28
What is Chvostek's sign?
Hyperirritable contracture of the facial muscle produced by tapping the facial nerve (CN7) as it passes through the parotid gland. Indicator of HYPOCALCEMIA
29
How does maternal blood circulate through the placenta?
Blood is initially carried in the UTERINE ARTERIES, then dispersed into the INTERVILLOUS SPACE then passes the FETAL VILLI before draining back to the VEINS of the UTERINE WALL
30
How many artery/veins are their in the umbilical cord?
2 ARTERIES | 1 VEIN
31
A transtracheal block requires ___ mL of ___% Lidocaine
- 4 mL | - 4 %
32
How many liters are their in full e-cylinder tank of N2O? What is the PSI?
- 1590 L | - 750 psi
33
How many liters are their in a full e-cylinder tank of O2? What is the PSI?
- 660 L | - 2200 psi
34
How many liters are their in a full e-cylinder tank of Air? What is the PSI?
- 625 L | - 1800 psi
35
What is the cause of Central Diabetes Insipidus?
The posterior pituitary failing to release ADH
36
What is the cause of Nephrogenic Diabetes Insipidus?
When renal tubules fail to respond to ADH
37
What is normal serum osmolality?
300 mOsm/kg | 270-310 mOsm/kg
38
Which electrolyte controls RESTING MEMBRANE POTENTIAL?
Potassium
39
Which electrolyte controls THRESHOLD?
Calcium
40
In the Adrenal Cortex are what 3 zones? These zones excrete?
Zone of Glomerulosa - Aldosterone (mineralcorticoid) Zone of Fascsiculata- Cortisol (glucocorticoid) Zone of Reticularis- Androgens (sex hormones)
41
The Adrenal Medulla secrete __________. These are ______, _______, and ______.
- Catacholamines - Epinephrine - Norepinephrine - Dopamine
42
The Adrenal Medulla secrete __________. These are ______, _______, and ______.
- Catacholamines - Epinephrine (80%) - Norepinephrine (20%) - Dopamine
43
Ion trapping occurs with maternal _______ and fetal ______.
- Maternal ALKALOSIS | - Fetal ACIDOSIS
44
Name a potassium sparing diuretic? Where do potassium sparing diuretics act on in tubules?
- Spironolactone (Aldactone) | - LATE DISTAL TUBULES and COLLECTING DUCTS
45
Name a loop diuretic? Where do loop diuretics act on in tubules?
- Furosemide (Lasix) | - Loop of Henle
46
Name a diuretic that works on the proximal tubules?
Diamox
47
Name a diuretic that works on the proximal tubules?
Mannitol and Diamox
48
Papilledema involves which cranial nerve? Why?
Optic Nerve (CN2) The dura of the brain extends as a sheath around the optic nerve. When pressure increases in the CSF, it increases in the optic nerve sheath Papilledema = Edema and Hyperemia of the OPTIC DISK when ICP increases
49
Capillary integrity, allowing colloids to remain in the intravascular compartment, return in the burn patient after how long?
24 to 48 hours
50
What is Ptosis? What is Diplopia? These are the most common initial symptoms of what disease process?
- Drooping eyelid - Double vision - Myasthenia Gravis
51
Which drugs do not cross the placenta?
- Heparin - Insulin - Glycopyrrolate (Robinul) - Succinylcholine - NDMB's
52
Administration of which local anesthetic can lead to the development of methemoglobinemia? What is its metabolite?
- Prilocaine | - O-toluidine
53
What are the wavelengths of light for pulse oximetry (SpO2)?
RED/ DeOXygenated hemoglobin/ 660 nm | INFRARED/ oxygenated hemoglobin/ 940 nm
54
What are the wavelengths and absorption of light for pulse oximetry (SpO2)?
RED/ DeOXygenated hemoglobin/ 660 nm | INFRARED/ oxygenated hemoglobin/ 940 nm
55
Which regional block is a high risk for pneumothorax?
Supraclavicular block
56
What nerve is NOT INCLUDED in an axillary block and requires a separate block?
Musculocutaneous
57
Negative pressure during caudal anesthetic is detectable after going through what structure?
Sacrococcygeal ligament
58
What drugs should you avoid in a patient with a carcinoid tumor because of histamine release?
- Morphine - Atracurium - Curare - Mivacurium - Trimethaphan
59
What electrolytes are in Lactated Ringer's?
- Sodium - Potassium - Chloride - Calcium - Lactate
60
Which part of the spinal cord is the blunt, tapering tip?
The Conus Medularis
61
What are the Stages of Labor and Pain Pathways?
1st Stage- T10-L1 2nd Stage- T10-S4 3rd Stage- Deliver of baby & Placenta
62
What is the Haldane Effect? How does it relate to Oxygen on the Carbon Dioxide (CO2) Disassociation Curve?
- The Haldane Effect describes how a change in partial pressure of oxygen (PO2) in the blood influences the blood on the CO2 Disassociation Curve - As PO2 INCREASES, the CO2 curve shifts DOWN/RIGHT - As PO2 DECREASES, the CO2 curve shift UP/LEFT
63
Who's law permits the amount of dissolved O2 in the blood to be calculated?
Henry's Law
64
What kind of sensations do A(beta) fibers transmit?
- Proprioception (as well as A(alpha)) - Touch - Pressure
65
What kind of sensations do A(delta) fibers transmit? Which neurotransmitter does it release? What is an example?
- Acute pain (sharp pain, temperature, and touch) - Substance P - Needle prick
66
What kind of sensation do C fibers transmit? Which neurotransmitter does it release? What is an example?
- Chronic pain (throbbing pain, temperature) - Glutamate - Polyneuropathies
67
What type of response does stimulation of the Alpha-1 adrenergic receptor elicit? What is an example?
- An excitatory response | - Arterial and venous vasoconstriction
68
Where does the spinal cord end in neonates? In adults?
- At L3 | - In adults at L1
69
What is another name for a 2nd degree AV block- Mobitz type I? What are its characteristics? What is it associated with?
- Wenkebach - A progressive increase in PR interval from beat-to-beat until an entire beat is dropped - A progressive shortening of the R-R interval
70
Describe the characteristics of a 2nd degree AV block- Mobitz type II?
- More rare and more serious than Mobitz type I - A sudden appearance of a non-conducted P wave - P waves are normal, but some are not followed by a QRS complex
71
What are the signs of Left Heart Failure?
- Decreased CO - Increased preload - Cardiac Index of 18
72
Nitroprusside, Nitroglycerine, and Hydralazine produce vasodilation by acting on what?
Increasing cGMP
73
What is the most common reported complication of epidural blood patch?
1. Backache (35%) 2. Temperature elevation (5%) 3. Neck ache (0.9%) 4. Radicular pain
74
Define assault
Unlawful threat of actions by a person intended to inflict by force corporal injury
75
Define battery
Unlawful constraint or physical violence inflicted on a person without their consent
76
How do arteriole (Pa), alveolar (PA), and venous (Pv) pressure relate in zone 3 of the lungs
Pa>Pv>PA
77
In the upright spontaneously breathing person, perfusion is greatest in the base of the lungs. Ventilation is greatest where?
- Apex
78
In the upright spontaneously breathing person, perfusion is greatest in the base of the lungs. Ventilation is greatest where?
Apex
79
Describe Hypoxic pulmonary vasoconstriction (HPV)?
Decreases shunt and increases PaO2 by constricting pulmonary arteries where there is presence of hypoxia, redirected blood flow to areas rich in oxygen
80
What is the formula to estimate ETT in children?
(Age / 4) + 4
81
Which type of alveolar cells produce surfactant in order to decrease alveolar friction?
Type II pneumocytes (cuboidal in shape)
82
What type of shunt is a Patent Ductus Arteriosus?
Left to Right
83
Which of the following is not a hallmark of congenital diaphragmatic hernia? - Hypoxia - Scaphoid abdomen - Bowel in thorax - Right pneumothorax
Right pneumothorax
84
What are the hallmark signs and symptoms of Acute Epiglotitis? What is usually the etiology?
- Run HIGH FEVER - Difficulty swallowing d/t edema - Infectious involvement - Inspiratory STRIDOR - DROOLING - LETHARGY - Sitting forward - H. Influenza
85
Which of the following is NOT TRUE regarding Pyloric Stenosis? - Hypokalemia - Hyponatremia - Metabolic alkalosis - Hyperchloremia
Hypochloremia
86
Where do benzodiazapines work in the brain?
At the Reticular Activating System (RAS)
87
Which local anesthetic is least likely to cross placenta?
Chloroprocaine
88
How does smoking cessation 2 days prior to surgery help?
Decreases carboxyhemoglobin
89
Where does aldosterone work?
Distal tubules and collecting duct
90
What decreases cerebral perfusion pressure (MAP-ICP)?
DECREASED MAP | INCREASED ICP

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