ACE 2013 10B Flashcards Preview

Anesthesiology > ACE 2013 10B > Flashcards

Flashcards in ACE 2013 10B Deck (88)
Loading flashcards...
1

How do NSAIDs affect the kidneys?

They inhibit production of prostaglandins which cause afferent arterial vasodilation which can cause acute renal failure

2

Which is a side effect seen with NSAIDs: obstructive uropathy, elevated BP, renal vasodilation, hypokalemia

Elevated BP - thought to be secondary to Na retention and volume expansion

3

What is the treatment for neurogenic diabetes insipidus?

Infusion of isotonic fluids (use hypotonic fluids if plasma osmolarity reaches 290 mOsm/L or higher) + desmopressin (DDAVP)

4

What is the treatment for nephrogenic diabetes insipidus?

Infusion of isotonic or hypotonic solutions + chlorpropamide or clofibrate (potentiate effects of arginine vasopressin on renal tubules)

5

What is the treatment for nephrogenic diabetes insipidus?

Infusion of isotonic or hypotonic solutions + chlorpropamide or clofibrate (potentiate effects of arginine vasopressin on renal tubules)

6

Which of the following increases risk of postop apnea in a ex-32 weeker: post-conceptual age 60 weeks, intraop caffeine, anemia, hx of necrotizing enterocolitis

Anemia

7

What is the Modified Aldrete Scoring System and what does it consist of?

PACU discharge criteria
Consists of Respiration, oximetry, BP, level of consciousness, and activity

8

What is the Post-Anesthetic Discharge Scoring System and what does it consist of?

PACU discharge criteria
Consists of pain, bleeding, nausea, CV changes, activity

9

What is the Post-Anesthetic Discharge Scoring System and what does it consist of?

PACU discharge criteria
Consists of pain, bleeding, nausea, CV changes, activity

10

Which of the following is an absolute contraindication for ECT: pregnancy, AICD, pheochromocytoma, neuroleptic malignant syndrome

Pheochromocytoma

11

Which of the following is an absolute contraindication for ECT: pregnancy, AICD, pheochromocytoma, neuroleptic malignant syndrome

Pheochromocytoma

12

What level are the cardiac accelerator fibers located?

Sympathetic fibers from T1-T4

13

Why might you see bradycardia following spinal anesthesia to T10?

Reverse Bainbridge reflex: normally, increased venous return causes increased HR (via SNS and inhibition of vagal outflow); this is the opposite where decreased venous return (from spinal) causes bradycardia

14

Why might you see bradycardia following spinal anesthesia to T10?

Reverse Bainbridge reflex: normally, increased venous return causes increased HR (via SNS and inhibition of vagal outflow); this is the opposite where decreased venous return (from spinal) causes bradycardia

15

Name some medications that are given intraoperatively that should be avoided in patients with Parkinson Disease

Promezathine, droperidol, metoclopramide (any medication that decreases the effects of dopamine)

16

How long after cosmetic liposuction via the tumescent technique do you expect peak serum levels of lidocaine?

12-14 hours after injection

17

How long after cosmetic liposuction via the tumescent technique do you expect peak serum levels of lidocaine?

12-14 hours after injection

18

What do you worry about in a neonate with generalized cyanosis and a concave abdomen?

Congenital diaphragmatic hernia

19

What congenital abnormalities are most commonly associated with congenital diaphragmatic hernias?

CVS (50%): ASD/VSD, ToF, Coarctation
GI (40%): malrotation
CNS (20%): spina bifida, hydrocephalus, microcephaly

20

What side effects do you worry about in patients taking cyclosporine?

Acute kidney injury

21

What side effects do you worry about in patients taking bleomycin?

Pulmonary fibrosis

22

What side effects do you worry about in patients taking bleomycin?

Pulmonary fibrosis

23

What are the classic characteristics of obesity hypoventilation syndrome?

1. Obesity (BMI >30)
2. Daytime awake hypercapnia and hypoxia
3. Sleep-disordered breathing without another known cause

24

What are the classic characteristics of obesity hypoventilation syndrome?

1. Obesity (BMI >30)
2. Daytime awake hypercapnia and hypoxia
3. Sleep-disordered breathing without another known cause

25

What medications are capable of producing burst suppression?

Volatile anesthetic gases (~2 MAC), etomidate, propofol, and barbiturates

26

Which is least likely to cause airway obstruction 1 hour after total thyroidectomy: neck hematoma, recurrent laryngeal nerve injury, tracheomalacia, hypercalcemia

Hypercalcemia (total thyroidectomies lead to hypocalcemia from parathyroid removal)

27

Which is least likely to cause airway obstruction 1 hour after total thyroidectomy: neck hematoma, recurrent laryngeal nerve injury, tracheomalacia, hypercalcemia

Hypercalcemia (total thyroidectomies lead to hypocalcemia from parathyroid removal)

28

What do you worry about in chronic methamphetamine users?

1. Depletion of neurotransmitters (NE and epi) - hypotension
2. Cardiomyopathy (40% of patients)

29

PEEP of 10 cm H2O will decrease which of the following: FRC, airway resistance, dead space, arterial oxygen sat

Airway resistance (from increase in lung volume)

30

What does the addition of sodium bicarbonate to lidocaine do?

Decreases pain on subcutaneous infiltration; although there are more non-ionized forms from the decreased pH, studies have not shown decreases in onset time or block intensity