Flashcards in True Learn #1 Deck (64)
What medications can cause acute dystonic reactions and what is the treatment?
Metoclopramide and prochlorperazine (DA antagonism) or antipsychotics
Tx: diphenhydramine or benztropine or benzos
How much does cerebral blood flow change with every one Celsius decrease in temperature?
How much does cerebral blood flow change with every 1 mmHg change in PaCO2?
Increase in PaCO2 by 1 mmHg = 3% increase in CBF (linear increase until ~80 mmHg)
At what PaO2 value does cerebral blood flow drastically increase?
What percentage of receptors are blocked when you have 1 twitch? 2 twitches? 3? 4?
1: >90% blocked
2: 80-90% blocked
3: 70-80% blocked
4: 65-70% blocked
What is the gold standard used for assessing neuromuscular blockade?
Train of four ratio
What train of four ratio correlates to a sustained head lift for 5 seconds?
T4:T1 height ratio of 0.75
What are some common side effects of sodium bicarbonate?
1. Increased EtCO2
4. Cerebral vasodilation, increased ICP
5. Transient hypocalcemia
What patients need to have perioperative corticosteroid supplementation?
Those who are taking > 10 mg/day prednisone or previously taking >10 mg/day whose last dose was
What are hormonal side effects noted with chronic opioid therapy?
Decreased testosterone/estrogen/cortisol/LH/FSH, increased prolactin
What is the purpose of a vasoconstrictor prior to attempts at nasal intubations?
1. Minimize mucosal bleeding
2. Increases diameter of the nasal passages
What does the glossopharyngeal nerve innervate?
Sensory to posterior 1/3 of tongue, vallecula, anterior surface of epiglottis, and posterior and lateral walls of the pharynx
What does the superior laryngeal nerve innervate?
Sensory from the lower pharynx to the upper part of the larynx (including glottis surface of epiglottis and the aryepiglottic folds)
What does the recurrent laryngeal nerve innervate?
Sensory to the mucosa below vocal cords
What nerve does the superior laryngeal nerve branch from? The recurrent laryngeal?
Both come from the vagus nerve (CN X)
What does blinding study participants eliminate?
Participant bias (Hawthorne effect: groups being studied act differently than they normally would)
What are some complications of brachial artery catheterization?
3. Median nerve injury
What is the typical PaO2 value of an O2 sat of 50%?
Which drug is metabolized by RBC esterases: esmolol, atenolol, metoprolol, labetalol, propranolol?
Name some cardioselective (beta-1) blockers
BEAM: bisoprolol, esmolol, atenolol, metoprolol
Which drug is renally cleared: esmolol, atenolol, metoprolol, labetalol, propranolol?
What is the formula for static respiratory system compliance?
Cs = Vt / (Ppl - PEEP)
Vt: tidal volume
Ppl: plateau pressure
What is the pathophysiology of negative-pressure pulmonary edema?
1. Pulmonary capillary fluid entrainment into the airways from negative intrathoracic pressure
2. Reduced hydrostatic pressure of the pulmonary interstitium
3. Increased trans-capillary pressure gradiant
What is the pathophysiology of tetanus?
Block release of GABA causing generalized muscle spasms
How long must the suction bulb remain collapsed to pass a negative pressure leak test?
10 seconds or longer
What does the negative pressure test tell us?
The integrity of the low pressure circuit (flow control valves to common gas outlet) + differentiate between leaks in the machine and leaks in the breathing system
A patient with a 40% total body surface area burn 1 week ago with hypoalbuminemia will have lower dose requirements of which med: fentanyl, midazolam, rocuronium, insulin
Midazolam: highly albumin bound so hypoalbuminemia -> more free fraction of benzos
Note: due to increased extrajunctional Ach receptors, they develop resistance to non-depolarizing NMBs
What is the formula for specificity? Sensitivity?
Spec: TN / (TN + FP)
Sens: TP / (TP + FN)
(Horizontal is patient with or without disease, vertical is test results)
Do barbiturates or inhaled anesthetic gases uncouple cerebral blood flow and CMRO2?
Barbiturates do not (will decrease CBF and CMRO2)
Inhaled anesthetics > 1 MAC will increase CBF and decrease CMRO2 (uncouples)