Daily Fun - Boards Review 2

Front 1

After transplantation, Cyclosporine causes this sort of organ damage 25-38% of the time

Back 1

nephrotoxicity

Front 2

Which is safer at equipotent doses: prilocaine or lidocaine

Back 2

prilocaine

Front 3

TEG. MA value decreased. Indicates what? Treatment?

Back 3

Measures strength of fully formed clot. Platelets.

Front 4

TEG. R value decreased. Indicates what? Treatment?

Back 4

R value = Reaction time. Prolonged = coag factor abnormalities, factor deficiencies, or heparin. give FFP.

Front 5

TEG. Alpha angle decreased. Indicates what? Treatment?

Back 5

rate of clot formation

Front 6

TEG. K value decreased. Indicates what? Treatment?

Back 6

K = Koagulation time. Decreased = speed of clot formation and strengthening. Prolonged: give Kryo.

Front 7

TEG. Teardrop formation. Indicates what? Treatment?

Back 7

Early fibrinolysis. Give antifibrinolytic (eg TXA).

Front 8

Order of TEG values

Back 8

R, K, alpha angle, MA.

Front 9

toxic dose of bupivacaine?

Back 9

2.5 mg/kg or 3 m/kg with epi

Front 10

toxic dose of ropivacaine?

Back 10

3 mg/kg

Front 11

axillary nerve block targets which three nerves? What does it miss?

Back 11

median (medial forearm sensation), radial (dorsal hand sensation), ulnar (palmar hand). Misses musculocutaneous (lateral forearm

Front 12

lumbar plexus block spares what nerve?

Back 12

It gets the femoral (hip flexion, extension of the lower leg at the knee), lateral femoral cutaneous, and obturator (adduction), sciatic (L4-S3 - LPB gets L1-L4 and part of T12), so foot and ankle movements are preserved.

Front 13

Incidence of ptx with supraclav block?

Back 13

up to 6.1%

Front 14

Incidence of ptx with infraclav block?

Back 14

0.2-0.7%

Front 15

Pain Dermatomes and Pain regions for labor stage one?

Back 15

T10-L1. Paracervical, Hypogastric plexus

Front 16

Pain Dermatomes and Pain regions for labor stage two?

Back 16

S2-S4. Pudendal nerve.

Front 17

ST segment depression is an indicator of what sort of myocardial ischemia?

Back 17

subendocardial

Front 18

ST segment elevation is an indicator of what sort of myocardial ischemia?

Back 18

Transmural

Front 19

Treatments for autonomic dysreflexia during surgery?

Back 19

Stop the surgical stimulus is possible. Pharm therapy: avoid beta blockade. Start with vasodilators such as nitroglycerine and nitroprusside. Other potential options: iv ganglion blockers, hydralazine, alpha adrenergic receptor blockers, calcium channel blockers, magnesium.

Front 20

Side effects of Prostaglandin E1?

Back 20

apnea, hypotension, fever

Front 21

Rule of nines for BSA burn calculations

Back 21

9 percent: each arm, head. 18 percent: leg, torso front, torso back.

Front 22

Progression of EKG signs for hyperkalemia

Back 22

peaked T waves, then lengethed PR interval (6.5-7.5), THEN prolonged QRS, THEN bradycardia, sine wave, vtach, progressing to asystole

Front 23

What EKG features to hyperkalemia and hypermagnesemia have in common?

Back 23

Prolonged PR interval, widened QRS complex

Front 24

Calcium abnormalites and ST intervals: relationship?

Back 24

Inverse relationship: HypOcalcemia causes prolonged ST interval, hypERcauses shortened ST interval (interval between ventric depol and repol).

Front 25

Describe blood supply to the liver

Back 25

75 percent portal vein, 25 percent hepatic artery

Front 26

metformin mechanism?

Back 26

inhibits gluconeogenesis by liver

Front 27

What regions of the heart does the PDA (posterior descending artery) supply?

Back 27

Posterior one-third of interventricular septum. Inferior wall and posterior base of LV. Posterior wall of RV. 70 percent have a PDA off the RCA, sometimes it's off the CX. Also known as posterior interventricular arter (PIV).

Front 28

Which coag factor is reduced in chronic liver disease that is NOT reduced in DIC?

Back 28

VIII

Front 29

Formula for Strong Ion Difference. How do changes in SID correlate to changes in pH?

Back 29

Strong cations (Na, K, Ca, Mg) minus Strong anions (Cl, lactate). Increased SID correlates with increased pH. Decreased SID, decreased pH.

Front 30

Which evoked potential is minimally affected by volatile anesthetic?

Back 30

Auditory Evoked Potentials

Front 31

Electrocautery is responsible for what percentage of OR fires?

Back 31

90

Front 32

TEF: most likely associated anomoly?

Back 32

congenital heart (15 to 35 percent)

Front 33

prolactinoma: why on carbergoline or bromocriptine?

Back 33

dopamine agonists, negative feedback neurotransmitter for prolactin

Front 34

p02 umbilical artery and vein?

Back 34

20 and 30

Front 35

Normal urine Na?

Back 35

20

Front 36

Normal serum osm?

Back 36

285-295

Front 37

Winter's Formula for expected amount of respiratory compensation

Back 37

PCO2 = 1.5 * bicarb +8 plus or minus 2

Front 38

chemotherapeutic agents that cause cardiotoxicity

Back 38

doxirubicin

Front 39

chemotherapeutic agents that cause pulmonary toxicity

Back 39

bleomycin

Front 40

chemotherapeutic agents that cause nephrotoxicity

Back 40

cisplatin, carboplatin, tacrolimus, cyclosporine

Front 41

chemotherapeutic agents that cause peripheral neuropathy

Back 41

vincristine

Front 42

sodium nitroprusside toxicity triad?

Back 42

elevated mixed venous oxygen, SNP tachyphlaxis, and metabolic acidosis

Front 43

wide complex QRS is defined as greater than how many seconds?

Back 43

0.09

Front 44

effects of sodium bicarb on calcium and potassium

Back 44

hypOcalcemia (temporarily binds Ca2+), hypOkalemia (alkalosis drives potassium into cells)

Front 45

lead most sensitive for detection of MI?

Back 45

V (75 percent, 90 if you add V4 and V5, 80 if you add II which is tood for rhythm detection)

Front 46

hypoalbuminemia, like with burn patients: give less of this common drug

Back 46

midazolam. Hypoalb increases the free fraction of benzos, which are highly albumin bound. Fentanyl to a lesser extent.

Front 47

complete bilateral recurrent laryngeal nerve injury: effect?

Back 47

aphonia, aspiration risk. Cords in paramedian position (both abduction and adduction affected).

Front 48

refractory (to phenyl, ephed) hypOtn on induction caused by ACE-I: drug of choice?

Back 48

Norepi over vaso

Front 49

Which nerve runs alongside the brachial artery in the upper arm and AC fossa?

Back 49

MEDIAN!

Front 50

Minimum pressure differences for UE and LE tourniquets?

Back 50

50 above BP for upper, 100 above BP for lower

Front 51

acetazolamide: what does it do to sodium, bicarb, chloride, and potassium?

Back 51

Acetazolamide is a carbonic anhydrase inhibitor that will increase minute ventilation. it wastes sodium and bicarb in the proximal tubule, which leads to a hyperchloremic metabolic acidosis. Hypokalemia ensues thanks to sodium potassium exchange. It also wastes phosphate!

Front 52

which one crosses the placenta: atropine or glyco?

Back 52

Atropine (tertiary) - glyco is quaternary

Front 53

Tamponade CVP tracing

Back 53

exaggerated X-descent (atrial relaXation), attenuated y descent

Front 54

Constrictive pericarditis CVP tracing

Back 54

exaggerated x and y descent (change in compliance)

Front 55

Hydroxyethyl starch affects coagulation by which mechanism?

Back 55

Decreased Factor VII

Front 56

Normal urine specific gravity?

Back 56

1.000 to 1.030