RPM

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Author:
ssbhat
ID:
248146
Filename:
RPM
Updated:
2013-11-23 19:11:11
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Anesthesia
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Anesthesia
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  1. Infection rate is highest with cannulation of what vein?
    Femoral
  2. What commonly used straight laryngoscope blade is meant to be inserted below the epiglottis?
    Miller (flat)
  3. What is the intrathecal space also referred to?
    subarachnoid
  4. What puncture is one of the most common complications of internal jugular catheter insertion?
    carotid
  5. Hemothorax rate is highest with cannulation of what vein?
    subclavian
  6. What can make mask ventilation more difficult?
    • history of snoring
    • age>55
    • missing teeth
    • BMI>36
    • beard
  7. What fibers are found at levels T1-T4 and can be blocked by neuraxial anesthesia at these levels?
    cardioacelerator
  8. What commonly used automatic BP monitoring technique is used in the operating room?
    oscillometry
  9. What upper extremity block has a side effect of also blocking the ipsilateral phrenic nerve 100% of the time?
    interscalene
  10. What commonly used muscle relaxant is contraindicated in patients with spinal cord injuries (not acute injuries)?
    Succinylcholine
  11. What device helps to measure urine output?
    urometer
  12. What term refers to the density of a local anesthetic as compared to cerebral spinal fluid?
    baricity
  13. What term refers to the continual measurement of carbon dioxide
    capnography
  14. What artery provides blood supply to the anterior lower 2/3rds of the spinal cord?
    adamkiewicz (largest anterior segmental medullary artery)
  15. What test, which is no longer commonly used, is performed prior to insertion of a radial arterial line?
    allens
  16. When a patient has ____ stenosis, the goal of anesthetic management is to maintain a normal systemic vascular resistance and sinus rhythm.
    Aortic
  17. The neuromuscular blocker, cisatracurium, is metabolized by what degradation/elimination?
    Hoffman.
  18. What general blood product is often given for SEVERE coagulopathy and Factor VIII deficiency?
    cryoprecipitate
  19. An overdose of this would cause bradycardia, excessive salivation, bronchospasm, vomiting, miosis, and muscle weakness.
    acetylcholineesterase
  20. When a person becomes hypoxic during one-lung ventilation, it is important to first apply CPAP to the non-ventilated lung. If there is no improvement, then the anesthesiologist should apply what to the ventilated lung?
    PEEP
  21. What is a rare postop complication associated with long surgeries, prone positioning, anemia, increased applied pressure or edema, hypotension, spine surgeries, and/or cardiopulmonary bypass.
    blindness
  22. An abnormal sensation, such as burning, prickling, tickling, or tingling.
    paresthesia
  23. The body is what percent water, by height?
    sixty
  24. The left main coronary first branches into what?
    Left anterior descending and circumflex.
  25. Which opioid has a slower peak onset than fentanyl, is the least lipid soluble opioid and is thus the most likely agent to accumulate in the presence of renal failure?
    morphine
  26. Fluid replacement for large, open surgeries can be as high as how many ml/kg/hour?
    10ml/kg/hr
  27. Heat lost by what is the #1 cause of heat loss in the OR?
    convection
  28. Stacking or auto-PEEP of mechanical breaths can occur when what phase of respiration is relatively too short?
    expiratory
  29. How does pulse pressure change in aortic stenosis?
    Decreases
  30. Which narcotic has tachycardia as a side effect?
    meperidine
  31. Stabbed in chest presenting with hypotension, equal breath sounds, and jugular venous distention.
    Pericardial tamponade
  32. Securing a definitive airway should be considered for an injured patient with a GCS score of less than or equal to what?
    8
  33. Right ventricular myocardial infarction usually occurs with which left-sided MI?
    Inferior wall
  34. What are some complications of acupuncture?
    • Fainting
    • Pneumothorax
    • Needle breakage
  35. What is the most important therapeutic modality for a patient with complex regional pain syndrome?
    Physical therapy
  36. What are some emergency pain conditions?
    • Myocardial infarction
    • Intracranial bleed
    • Pneumothorax
    • Ischemic extremities
    • Acute abdomen(infection, obstruction, ischemia)
    • Trauma
  37. Low back pain emergencies?
    • Aortic dissection
    • Abdominal aortic aneurysm
    • Metastasis esp. spinal
    • Spinal cord compression syndromes, abscess, hematoma and central disc herniations, cauda equina syndrome
  38. PCA drugs?
    • Morphine
    • Hydromorphine
    • Fentanyl
    • (not meperidine b/c of SE)
  39. What are the benefits and disadvantages to COX2 inhibitors?
    Benefits: platelet function, GI effects, dosing convenience

    Disadvantages: increased cardiac risk, cost, no parenteral form
  40. Ketorolac
    • 30mg = 10mg MSO4
    • 60% renal excretion, 40% glucoronide conjugation
    • Inhibits platelet aggregation
    • Renal toxicity - hypovolemia, CHF, cirrhosis
  41. Site of action of opioid receptors?
    mesencephalic periaqueductal grey in the brain and substantia gelatinosa in the spine
  42. Cancer bone pain therapy?
    • Steroids
    • Radiotherapy & radiopharmaceuticals
    • Bisphosphonates
    • Calcitonin
    • Chemotherapy
  43. Which induction agent causes an increase in ICP,cerebral metabolic rate, and cerebral oxygen consumption?
    ketamine
  44. Which induction agent is contraindicated in patients with porphyria?
    Thiopental
  45. What are the side effects of succinylcholine?
    bradycardia, fasciculations, hyperkalemia

    NOT HTN
  46. Which neuromuscular blocker has a side effect of tachycardia?
    pancuronium
  47. Which neuromuscular blocker is metabolized by pseudocholinesterase?
    succinylcholine
  48. What effect does addition of epinephrine have on local anesthetic block?
    It prolongs duration of local anesthetic block.
  49. What are signs of local anesthetic toxicity?
    Tinnitus, seizures, cardiac arrest
  50. Commonly monitored ECG leads?
    II: detects arrhythmias - maximal amplitude of the P-wave of all leads helps identify rhythm, detects inferior wall MI

    V: detects anterior and lateral wall MI
  51. MAP
    MAP = DP + 1/3(SP-DP)

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