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Anesthesia > True Learn > Flashcards

True Learn Flashcards

1
Q

bOhr effect

A

bOhr Oxygen Offloading ( hgb decreased affinity for Oxygen when pH is low and Co2 in high at tissues)

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2
Q

nitrous oxide tank values

A

750 psig 1500 L

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3
Q

oxygen tank values

A

2200 psig. 660L

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4
Q

phosgene effects

A

gas used in WW2, colorless odorless, immidiately damages lung epithelium

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5
Q

Drugs that don’t cross placenta (He is going nowhere soon)

A

Heparin, Insulin, Glycopyrolate, non-depolarizing, succ

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6
Q

Risk factors for post dural puncture headache

A

women, < age 40, vaginal delivery, multiple attempts, cutting needle

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7
Q

action of nitrous oxide

A

increases cGMP levels in cells –> smooth muscle relaxation

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8
Q

St. Johns Wart _____P450

A

induces 3A4 and 2C9 , decreases levels of cyclosporine and warfarin

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9
Q

action of Ginkgo herbal supplement

A

inhibits platelets

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10
Q

hexamethonium

A

blocks neuronal ganglion nicotinic receptors–blocks both sympathetic and parasympathetic transmission at ganglia

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11
Q

febrile post transfusion reactions

A

caused by pyrogenic cytokines released by donor leukocytes

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12
Q

TRALI cause

A

antibodies from donor blood attack HLA of recipient–> non cardiogenic pulmonary edema

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13
Q

carboprost

A

prostaglandin, used for uterine atony, contraindication: asthma…carbOprOst –> brOnchOspasm

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14
Q

methylergometrine

A

ergot, used for uterine atony, can cause HTN

metHYIERgometrine causes bp to go HYIER

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15
Q

drugs that can cause exacerbations of porphyria

A

barbituates, sulfonamides, ethyl alcohol, ergots, etomidate

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16
Q

respiratory centers in brainstem

A

DIVE—> dorsal medulla =inspiration, ventral medulla = expiration

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17
Q

changes to arterial wave form as you move peripherally

A

widening of pulse pressure, softening of dicrotic notch, MAP stays the same

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18
Q

propofol infusion syndrome

A

lactic acidosis, cardiac failure, renal failure, rhabdomyolysis, hyperkalemia, hypertriglyceridemia, hepatomegaly, and pancreatitis.

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19
Q

plasma osm equation

A

Posm = (2 * [Na]) + ([glucose] / 18) + ([BUN] / 2.8)

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20
Q

lambert-eaton syndrome

A

inhibits P-type calcium channels inhibiting release of Ach from nerve terminal

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21
Q

botulism toxin effect

A

inhibits SNARE proteins inhibiting binding of vesicles containing Ach at nerve terminal

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22
Q

drugs that inhibit hypoxic pulmonary vasoconstriction

A

Other vasodilating drugs such as nitroglycerin, nitroprusside, ACE-inhibitors, angiotensin receptor blockers, and calcium channel blockers. Volatile gases > 1.5 MAC

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23
Q

drugs that cause direct cerebral dilation

A

Calcium channel blockers, nitroglycerin, hydralazine, nitroprusside, and adenosine

24
Q

Mechanism of ketamine

A

NMDA antagonist (glutamate receptor) which leads to indirect agonism of GABA

25
Q

SVR equation (dynes)

A

SVR = 80 * (MAP - RAP) / CO

26
Q

carotid sinus vs carotid body receptors

A

CbC- carotid body: chemo receptors

carotid sinus- baroreceptors (sinus infection=pressure)

27
Q

anesthesia dolorosa

A

complication of neurolytic blocks for the treatment of trigeminal neuralgia, pain in area that lacks sensation, no effective treatment

28
Q

morphine metabolites

A

morphine-3-glucoronide (causes seizures in renal failure)

morphine-6- glucoronide: active metabolite (provides analgesia and can prolong effects in renal failure)

29
Q

hydromorphone metabolites

A

hydromorphone-3-glucoronide: causes seizures in renal failure, no analgesia (morphine metabolite 3-G also causes seizures)

30
Q

carotid body innervated by _____

A

CN IX …CbC (chemoreceptor)

31
Q

aortic chemo receptors innervated by _____

A

CN X

32
Q

codeine metabolized by ____ to morphine

A

cyp 2D6

33
Q

benefits of leukoreduction of blood products

A

decreased CMV transmission, decreased febrile reactions

34
Q

indication for irradiated blood products

A

BMT recipients

35
Q

nerve to block for upper extremity tourniquet pain

A

intercostobrachial

36
Q

factors found in cryoprecipitate

A

vWF, fibrinogen, fibronectin, factor VIII and XIII

37
Q

actions of metcloperamide on stomach

A

increases LES tone, increases gastric emptying

38
Q

effects of hypocalcemia on EKG

A

prolonged QT, narrow QRS, flattened T waves

39
Q

reynolds number (for predicting turbulent flow).

A

velocity x density x diameter // viscosity R> 4,000 likely turbulent flow. VISCOSITY ON BOTTOM

40
Q

Hering-Brewer reflex

A

stretch of receptors in lungs prevents over inflation by triggering expiration

41
Q

2nd messenger for NO

A

cGMP (increases levels)

42
Q

order of sensitivity to local anesthetics

A

small myelinated > large myelinated > small unmyelinated

43
Q

effect of lower temp on pO2 and pCO2

A

more soluble in cooled blood = lower pO2, and pCO2m and higher pH

44
Q

time constant =

A

capacity of circuit / FGF

45
Q

dabigataran

A

direct thrombin inhibitor, reversed by iduracuzimab

46
Q

andexanet alpha

A

reversal for DOACs eliquis and Xarelto (im the alpha)

47
Q

stop ticagrelor _____ days before surgery
clopidigrel?
prasugrel?

A

ticagrelor: 5-7 days
clopidigrel: 7 days
prasugrel: 7-10 days

48
Q

dabigatran mechanism

A

direct thrombin inhibitor, does not require monitoring

49
Q

argatraban

A

direct thrombin inhibitor, run as infusion in patients who can’t have heparin, monitored with PTT, hepatically cleared

50
Q

fondaparinux

A

indirect Xa inhibitor that works via ATIII, daily injection, long acting, used in people who can’t have lovenox

51
Q

VACTERL malformations

A

vertabra, anal, cardiac, TE fistula, renal, limb

52
Q

time interval during which vasospasm is MOST likely to develop after a subarachnoid hemorrhage?

A

2- 14 days

53
Q

what determines potency of local anesthetics

A 
lipid solubility  (enhances diffusion)  
bupivicaine> lidocaine > mepivicaine
54
Q

what determines speed of onset of local anesthetics

A

pKa
lower pKa = higher number of non-ionized molecules = penetrate lipid membrane faster. Can increase speed of onset by adding bicarbonate

55
Q

what determines duration of local anesthetics?

A

protein binding. higher protein binding = longer duration. Adding epinephrine can prolong block

Anesthesia (5 decks)

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