Review 2 Flashcards
(18 cards)
The arithmetic average of the range of doses that produce a given response is?
a) Standard Deviation
b) Mode
c) Median
d) Mean
d)Mean
An analgesic effect similar to the epidural administration of 10 mg of morphine could be achieved by which dose of intrathecal morphine?
a) 0.1 mg
b) 1 mg
c) 5 mg
d) 10 mg
b) 1 mg
The site of action of spinally administered opiates is the substantia gelatinosa of the spinal cord. Epidural administration is complicated by factors related to the dural dose absorption in fat, and systemic uptake: therefore the quantity of intrathecally administered opioid required to achieve effective analgesia is much smaller. The ratio of intrathecal morphine is 10:1. Morphine is typically given in doses of 3 to 10 mg in the lumbar epidural space. Intrathecal morphine dosage is 0.2 to 1.0 mg and time for epidural administration is 30 to 60 minutes with a peak effect of 90 to 120 minutes.
It is suggested that patients stop smoking _____ weeks prior to surgery?
8-12 weeks
The overall clinical manifestations of carcinoid syndrome include all of the following except:
a) Cutaneous flushing of the head and neck
b) Diarrhea
c) Hypotension
d) Diffuse locally mediated bronchodilation
d) Diffuse locally mediated bronchodilation
The overall clinical manifestations of carcinoid syndrome include cutaneous flushing of the head, neck, and upper thorax (most common); bronchoconstriction, hypotension, diarrhea, and carcinoid heart disease, hypertension may also be seen, serotonin increased the chronotropic and inotropic activity of the heart and when coupled with vasoconstriction will lead to hypertension.
Albuterol:
a) Is long acting
b) Bradycardia is a dose limiting side effect
c) Is used for acute symptoms of asthma
d) Has both alpha and beta effects
c) Is used for acute symptoms of asthma
Short-acting, inhaled b2-adrenergic agonists and anticholinergics are potent bronchodilators that are used to treat acute symptoms for all stages of severity. Albuterol is the prototype short acting b2-agonist that produces rapid (in minutes) and dose dependent bronchodilation. Its total dose during severe bronchospasm is limited by side effects — essentially tachycardia.
What is the range for a decrease in blood pressure or blood volume provokes ADH release?
a) 25-30%
b) 5-10%
c) 10-15%
d) 50-60%
b) 5-10%
This percentage change provokes ADH release and causes an increase in plasma osmolarity
SVR =?
a) MAP x CVP/CO x 80
b) CVP x LVEDP/CO x 80
c) MAP x ICP/CVP x 80
d) 80 x SVR/MAP-CVP
SVR = MAP x CVP/CO x 80
Chronic bronchitis:
a) Occurs in a short time frame
b) Is characterized by presence of cough and sputum production
c) causes loss of elastic recoil of lungs
d) Is a restrictive lung disease
b) Is characterized by presence of cough and sputum production
COPD consists of two entities - emphysema and chronic bronchitis. Emphysema
Where in the kidney does ADH preserve water?
Collecting ducts
ADH is the body’s principle preserver of water balance. It acts on renal collecting ducts to increase the absorption of solute free water from kidney tubules, therby conserving water in the body and supporting normal body fluid osmolality. Without ADH, the collecting ducts are impermeable to water reabsorption: in this setting, water loss in the urine is excessive and serious dehydration is provoked.
What enzyme is responsible for influencing the renal regulation of acid base balance?
a) Pseudocholinesterase
b) Carbonic anhydrase
c) Acetylcholinesterase
d) Nonspecific tissue esterases
b) Carbonic anhydrase
The kidneys, along with the body’s fluid buffers and respiratory system, play a major role in regulating acid-base balance. The collecting ducts secrete hydrogen into tubular fluid.. Secretory process begins with CO2 in the epithelial cells, under the influence of carbonic anhydrase - CO2 combines with water to form carbonic acid.
Myxedema coma represents a severe form of hypothyroidism and is characterized by all of the following except:
a) Hyponatremia
b) Hypertension
c) Hypothermia
d) Hypoventilation
b) Hypertension
Myxedema coma represents a severe form of hypothyroidism characterized by stupor or coma, hypoventilation, hypothermia, hypotension, and hyponatremia. This is a medical emergency and high mortality rate (25 to 50%)
Which of the following structures in the antecubital fossa is the most medial?
a) Musculocutaneous nerve
b) Radial nerve
c) Tendon of biceps
d) Brachial artery
e) Median nerve
e) Median nerve
The median nerve is the most medial structure in the antecubital fossa. To block this nerve, first the brachial artery is palpated at the level of the intercondylar line between the medial and lateral epicondyles, and then a needle is inserted just medial to the artery and directed perpendicular to the skin.
If a pulmonary artery rupture is suspected during placement of a PA catheter, what intervention is most appropriate?
a) Prayer
b) Prompt placement of an endotracheal tube
c) Forward pressure on the catheter
d) Prompt placement of a double-lumen tracheal tube
d) Prompt placement of a double-lumen tracheal tube
M&M Ch 6 pg 135 - Even trace hemoptysis should not be ignored, as it may herald pulmonary artery rupture. If this is suspected, prompt placement of a double lumen tube may maintain adequate oxygenation by the unaffected lung.
The liver is the site of synthesis of all clotting factors with the exception of what?
a) Factor V
b) Christmas Factor
c) Factor IX
d) Von Wilebrand Factor
d) Von Wilebrand Factor
Von Wilebrand is an endothelial product
What two factors indicate that a COPD patient is at increased risk for post op ventilator support?
FEV1/FVC < 50% of predicted and/or
PaCO2 >50 mm Hg
The two posterior curvatures (concave anteriorly) of the spine are the :
Cervical and lumbar
A median-plane longitudinal view of the vertebral column reveals four curvatures in the normal adult. The thoracic and sacral curvatures have posterior curvatures (concave anteriorly), whereas the cervical and lumbar regions have anterior curvatures (concave posteriorly)
The discrete receptors found in the endocardium are located at the junctions of the vena cava with the right atrium and the pulmonary veins with the left atrium. They affect ______.
a) Myofibrillar relaxation
b) Heart rate but not contractility
c) Contractility only
d) Stroke volume and contractility
b) Heart rate but not contractility
These receptors activate myelinated vagal afferent fibers that project to the nucleus tractus solitaries and increase sympathetic nerve activity to the SA node but not to the ventricles, thereby increasing heart rate but not contractility.
The plasma normally contains of Thyroxine (T4):
5 to 12 mcg/dL
