Shared Flashcard Set

Details

Boards
Anesthesia
38
Medical
Professional
09/28/2013

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Cards

Term
What are Clopidogrel and Ticlodipine? How do they work?
Definition
Anti-platelets. Inhibit platelet aggregation by blocking adenosine diphosphate receptors.
Term
What are Abciximab and Eptifibatide? How do they work?
Definition
Inhibit platelet adhesion, activation, and aggregation by antagozing platelet glycoprotein IIb/IIIa receptors.
Term
What are the VPs of Des, N2O, Sevo, Enflurane, Iso, Halothane?
Definition
Des 669
N20 ---
Sevo 157
Enflurane 172
Isoflurane 238
Halothane 242
Term
How do you intubate for TEF?
Definition
Go right main stem, then pull back til breath sounds are heard on left. Then rotate bevel to face anterior. Keep precordial stethoscope over left side and if breath sounds are lost you've slipped back right mainstem. TEF pt's have chance of subglottic stenosis (so need smaller ETT).
Term
Cerebral palsy pts..
Definition
CP pts do NOT have an exaggerated hyperkalemic response to succinylcholine, nor are they more susceptible to malignant hyperthermia. Severe gastric reflux though!
Term
Drugs that cause Lupus symptoms..
Definition
Hydralazine, Phenytoin, Isoniazid.
Term
How do you emergently reverse warfarin?
Definition
FFP and Vitamin K
Term
Carcinoid tumor resection. Name 4 drugs to avoid... Why?
Definition
Avoid Sux, Thiopental, Atracurium, Morphine or any drug that releases HISTAMINE.
Term
Trendelenburg patient... why doesn't CBF increase?
Definition
Offset by venous and CSF pressure, actually results in net decrease in arterial blood flow to brain.
Term
Infrared gas monitors.
Definition
Infrared gas monitors are small and portable, they have a quick response time, a short warm-up time, and do not need to be connected to a scavenger because the analyzed gases can be returned to the circuit.
Term
Cushing's disease. Cortisol? Potassium? glucose? NDMR? Why steroid injection pre-op?
Definition
Patients with Cushing's disease have increased serum cortisol levels resulting in hypokalemia, hyperglycemia, and skeletal muscle relaxation which may require a decreased non-depolarizing muscle relaxant dose. Because bilateral adrenalectomy results in rapidly falling cortisol levels, steroid replacement therapy should be initiated prior to or during surgery.
Term
Thoracic aortic aneurysm repair. Where do you put a-line?
Definition
Right radial as clamp might be placed between left common carotid and left subclavian blocking everything downstream.
Term
What NDMR undergoes NO metabolism at all.
Definition
Rocuronium. Excreted by liver, and a little by kidneys.
Term
How is atracurium metabolized?
Definition
plasma esterases.
Term
What percent of cardiac output goes to brain? How many ml/min?
Definition
15-20%. 750 ml/min.
Term
Superior to inferior order of INTERCOSTAL neurovascular bundle...
Definition
bone, vein, artery, nerve
Term
What is normal intraocular pressure? Higher in morning or night?
Definition
10-20 mmHg, >22 mmHg is ocular HTN. Intraocular pressure is higher in the morning.
Term
Normal phos level? What happens is hypophosphatemia?
Definition
2.7 - 4.5 mg/dL. Hypophos (~1.8) may lead to parasthesias, myopathy, delirium, seizures, coma.
Term
What is primary goal of mgmt of pulmonic stenosis?
Definition
Avoid increases in myocardial o2 demand. Avoid tachycardia, avoid increases in contractility.
Term
Explain PCWP, CO, and SVR in a pt with hypovolemic shock.
Definition
Low PCWP
Low CO
High SVR
Term
Platelets release _________ which causes vasoconstriction
Definition
Thromboxane A2
Term
Platelets are derived from ____karyocytes in the ____ ______
Definition
MEGAkaryocytes in the BONE MARROW.
Term
Platelets release _______ which activates other nearby platelets.
Definition
Adenosine diphosphate
Term
Speeds of intrinsic vs extrinsic clottings paths? Activating factor?
Definition
Extrinsic FAST. 15 seconds. Tissue Factor (III)

Intrinsix SLOW. 1-6 minutes. factor XII.
Term
How does hypocalcemia affect clotting?
Definition
Impaired clotting. Calcium required at nearly every step of extrinsic and intrinsic paths.
Term
Max dose of Lido? W/ and W/o epi. Calc for 70 kg pt.
Definition
Max dose w/o epi: 4.5 mg/kg
Max dose w/ epi: 7 mg/kg

4900 mg/kg with epi
Term
Ropivicaine and bupivicaine max dose with and without epi.
Definition
Basically 3 mg/kg with or without.
Term
Max dose etidocaine with and without epi.
Definition
4mg/kg

6mg/kg with epi.
Term
Cocaine dose with/without epi
Definition
1/5 mg/kg DO NOT USE EPI.
Term
How long do you have to wait to use N2O if pt had opthalm surgery and gas bubble in eye?
Definition
10 days
Term
How long should herbals be stopped before elective surgery?
Definition
7-14 days. Longer the better.
Term
70 kg pt has been NPO for 10 hours. How do you replete?
Definition
110ml/hr NPO loss so 1100 cc lost in 10 hours.

Replete 2:1:1

Give 550 cc first hour, 275 each of next 2 hours.
Term
How does hypercarbia/hypercapnea affect local anesthetics CNS toxicity? How does protein binding affect it?
Definition
Hypercarbia increases risk of CNS toxicity. Less protein bound drug will increase effect of drug also.
Term
What bones are you lifting when you do a jaw thrust?
Definition
Hyoid and mandible.
Term
What is the maximum size ETT that can pass through a size 3 LMA.
Definition
6.0 ?
Term
What does cimetidine inhibit? Name some drugs inhibited..
Definition
Cimetidine inhibits P450!! All amide anesthetics, Labetalol, phenytoin, etc.
Term
If your pt cannot adduct their thumb what nerve is injured?
Definition
ulnar
Term
Oculocardiac reflex bradycardia during strabismus surgery is exacerbated by ______carbia.
Definition
Hypercarbia = worse bradycardia

"Slow breathing = slow HR"
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