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TruLearn Exam Flashcards > UBP 4 > Flashcards

UBP 4 Flashcards

(52 cards)

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1
Q

What opiod related effects can Naloxone reduce or reverse? (6)

A

Opioid induced nausea, pruritus, urinary retention, rigidity, constipation, and biliary spasm.

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2
Q

What can acute withdrawal precipitated by Naloxone cause? (3)

A

Sympathetic activation, pulmonary edema, and acute pain crisis.

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3
Q

Which nerve root is associated with the triceps reflex?

A

C7 nerve root.

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4
Q

What is the effect of a single bolus administration of methohexital and thiopental compared to propofol?

A

Allows for a similar wake up time.

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5
Q

What side effect can Pancuronium administration cause?

A

Tachycardia.

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6
Q

What is not a described presentation for TRALI?

A

Leukocytosis.

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7
Q

What can occur in TRALI and is thought to be related to neutrophil sequestration?

A

Neutropenia.

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8
Q

What is the proposed mechanism of TRALI?

A

A two-hit mechanism:
Iinitial insult then activating stimulus (e.g., transfusion)

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9
Q

What deficiency often causes resistance to heparin?

A

Antithrombin III deficiency.

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10
Q

What does antithrombin III bind and inactivate?

A

Thrombin, factors X, XI, XII, and XIII.

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11
Q

What is the current treatment of choice for heparin resistance?

A

Antithrombin concentrates or recombinant AT.

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12
Q

What can be utilized for heparin resistance if AT concentrates are unavailable?

A

FFP (Fresh Frozen Plasma).

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13
Q

What is the primary mechanism for termination of norepinephrine?

A

Active reuptake (uptake 1) back into the presynaptic nerve terminal.

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14
Q

What drug can block the reuptake of norepinephrine?

A

Cocaine.

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15
Q

What could nitrite drugs for cyanide toxicity be detrimental in the presence of?

A

High methemoglobin levels.

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16
Q

What can be used to determine the methemoglobin level?

A

Co-oximetry.

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17
Q

What metabolic derangement can lead to tetany by decreasing ionized calcium levels?

A

Significant alkalosis (pH > 7.6).

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18
Q

What electrolyte imbalane does alkalosis cause?

A

Hypokalemia.

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19
Q

What metabolic conversion does codeine undergo?

A

Conversion to morphine by O-demethylation at CYP2D6.

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20
Q

What is the typical Neostigmine dose for achieving a TOF ratio of 0.9?

A

0.03 to 0.07 mg/kg.

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21
Q

What lab abnormalities can occur with corticosteroids? (4)

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A

Hyperglycemia, hypokalemia, leukocytosis, and metabolic alkalosis.

22
Q

Approximately how much CSF is present in the CNS at any given time for adults?

23
Q

What formula is used to determine appropriate carbon dioxide compensation?

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A

Winter formula (Expected PaCO2 = 1.5 x [bicarbonate] + 8).

24
Q

How long should heparin administration be delayed after epidural placement?

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A

At least 1 hour.

25
How do Dextrans interfere with blood cross-matching?
Coat red blood cell membranes.
26
Inhalational induction with a Right to left shunt is most pronouced for which agents?
insoluble agents
27
What is the correct order of evoked potential sensitivity to anesthetic agents?
VEP > MEP > SSEP > BAEP. | Most sensitive to least sensitive
28
Which NMBD causes greater neuromuscular blockade at the laryngeal adductors than the adductor pollicis?
Succinylcholine.
29
Aprepitant can reduce the efficacy of this commonly prescriped medication?
Hormonal contraception. | Reduces efficacy for 28 days
30
What effect do benzodiazepines have on EEG?
Cause EEG slowing but do not cause EEG burst suppression.
31
What mnemonic helps remember medications that can be administered through an endotracheal tube?
NAVEL (Naloxone, Atropine, Vasopressin, Epinephrine, Lidocaine).
32
When is blood pressure usually maintained until during hemorrhage?
Class 3 hemorrhage (loss of 30 percent of blood volume).
33
What is the 100-year global warming potential order?
Desflurane > isoflurane > nitrous oxide > sevoflurane > carbon dioxide.
34
What is Idarucizumab used for?
To reverse dabigatran.
35
What has been shown to be effective as an antianginal agent?
Metoprolol.
36
What variables impact oxygen delivery to tissues?
CO, Hgb, and SaO2. | O2 Content (mL/dL) = (1.34 X Hgb X SaO2) + (0.003 X PaO2)
37
What is the formula for O2 Content (mL/dL)?
O2 Content (mL/dL) = (1.34 X Hgb X SaO2) + (0.003 X PaO2).
38
What are the two most prominent risk factors for PION?
Surgery duration (> 6.5 hours) and blood loss (average 44.7% of estimated blood volume).
39
What is a risk factor for central retinal artery occlusion (CRAO)?
Pressure on the eye.
40
What does MHAUS recommend regarding calcium channel blockers and dantrolene?
Avoiding their combination due to worsening hyperkalemia and risk of cardiac arrest.
41
What preservative is found in 10 mL vials of cisatracurium?
Benzyl alcohol.
42
What serious adverse events has benzyl alcohol been associated with?
Serious adverse events and death in neonates. | It is not approved for patients < 1 month of age.
43
What is Laudanosine a metabolite of?
Cisatracurium and atracurium.
44
What should the maximum cuff inflation pressure be?
Less than 25 cmH2O.
45
What properties of benzodiazepines are mediated by the alpha-1 subunit of the GABA-A receptor?
Sedative, amnestic, and anticonvulsant properties.
46
What properties of benzodiazepines are mediated by the alpha-2 subunit of the GABA-A receptor?
Anxiolysis and muscle relaxation.
47
What do vasodilators inhibit that should be avoided in OLV? | E.g nitroglycerin, nitroprusside
HPV (Hypoxic Pulmonary Vasoconstriction).
48
What agent inhibits HPV besides vasodilators?
Nitrous oxide.
49
What can occur in patients with opioid dependence after receiving Naloxone?
Opioid withdrawal symptoms.
50
How can opioid induced hyperalgesia (OIH) be treated?
Multimodal pain therapy to reduce opioid exposure.
51
Explain the what happens during the initial insult in TRALI?
neutrophil attraction and sequestration in the pulmonary vasculature.
52
Explain what happens during the 2nd exposure (aka activating stimulus) in TRALI?
Activating stimulus (e.g., transfusion) causes activation of the neutrophils -> endothelial damage -> extravasation of fluid into the alveoli

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